Heights University Hospital

All Charges

Charge

Type

Setting

Price

GLIDESHEATH ACCESS KIT 5FR

Facility

$533.50

Hospital Charge Code	270644230C
Hospital Revenue Code	272
Min. Negotiated Rate	$69.36
Max. Negotiated Rate	$266.75
Rate for Payer: Aetna Commercial	$160.05
Rate for Payer: Aetna Medicare Advantage	$160.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.04
Rate for Payer: Cigna Commercial	$266.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.36
Rate for Payer: Oxford Commercial	$266.75
Rate for Payer: Qualcare PPO/HMO/WC	$80.03
Rate for Payer: UnitedHealthcare Commercial	$266.75

GLIDESHEATH ACCESS KIT 5FR

Facility

$300.00

Hospital Charge Code	270644320C
Hospital Revenue Code	272
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$150.00

GLIDESHEATH ACCESS KIT 5FR

Facility

$533.50

Hospital Charge Code	270644230C
Hospital Revenue Code	272
Min. Negotiated Rate	$80.03
Max. Negotiated Rate	$80.03
Rate for Payer: Qualcare PPO/HMO/WC	$80.03

GLIDESHEATH ACCESS KIT 5FR

Facility

$300.00

Hospital Charge Code	270644320C
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

GLIDESHEATH B KIT INTRODUCER

Facility

$46.10

Hospital Charge Code	270682540
Hospital Revenue Code	272
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$6.92
Rate for Payer: Qualcare PPO/HMO/WC	$6.92

GLIDESHEATH B KIT INTRODUCER

Facility

$46.10

Hospital Charge Code	270682540
Hospital Revenue Code	272
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$23.05
Rate for Payer: Aetna Commercial	$13.83
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.76
Rate for Payer: Cigna Commercial	$23.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.99
Rate for Payer: Oxford Commercial	$23.05
Rate for Payer: Qualcare PPO/HMO/WC	$6.92
Rate for Payer: UnitedHealthcare Commercial	$23.05

GLIDESHEATH NITINOL KIT .021

Facility

$74.12

Hospital Charge Code	270682541
Hospital Revenue Code	272
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$11.12
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

GLIDESHEATH NITINOL KIT .021

Facility

$74.12

Hospital Charge Code	270682541
Hospital Revenue Code	272
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$37.06
Rate for Payer: Aetna Commercial	$22.24
Rate for Payer: Aetna Medicare Advantage	$22.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.90
Rate for Payer: Cigna Commercial	$37.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.64
Rate for Payer: Oxford Commercial	$37.06
Rate for Payer: Qualcare PPO/HMO/WC	$11.12
Rate for Payer: UnitedHealthcare Commercial	$37.06

GLIDESHEATH RADL 6FR PINN 10cm

Facility

$247.50

Hospital Charge Code	270646471C
Hospital Revenue Code	272
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$37.12
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

GLIDESHEATH RADL 6FR PINN 10cm

Facility

$247.50

Hospital Charge Code	270646471C
Hospital Revenue Code	272
Min. Negotiated Rate	$32.17
Max. Negotiated Rate	$123.75
Rate for Payer: Aetna Commercial	$74.25
Rate for Payer: Aetna Medicare Advantage	$74.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.11
Rate for Payer: Cigna Commercial	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.17
Rate for Payer: Oxford Commercial	$123.75
Rate for Payer: Qualcare PPO/HMO/WC	$37.12
Rate for Payer: UnitedHealthcare Commercial	$123.75

GLIDESHEATH RADL 6 RMAFGG10HAT

Facility

$446.00

Hospital Charge Code	270643103C
Hospital Revenue Code	272
Min. Negotiated Rate	$66.90
Max. Negotiated Rate	$66.90
Rate for Payer: Qualcare PPO/HMO/WC	$66.90

GLIDESHEATH RADL 6 RMAFGG10HAT

Facility

$446.00

Hospital Charge Code	270643103C
Hospital Revenue Code	272
Min. Negotiated Rate	$57.98
Max. Negotiated Rate	$223.00
Rate for Payer: Aetna Commercial	$133.80
Rate for Payer: Aetna Medicare Advantage	$133.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.73
Rate for Payer: Cigna Commercial	$223.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.98
Rate for Payer: Oxford Commercial	$223.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.90
Rate for Payer: UnitedHealthcare Commercial	$223.00

GLIDESHEATH SLENDER 5F 80-1050

Facility

$325.00

Service Code	HCPCS C1894
Hospital Charge Code	270696640V
Hospital Revenue Code	278
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$78.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

GLIDESHEATH SLENDER 5F 80-1050

Facility

$325.00

Service Code	HCPCS C1894
Hospital Charge Code	270696640V
Hospital Revenue Code	278
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$97.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

GLIDE SHEATH SLENDER 5 FR

Facility

$240.00

Hospital Charge Code	270675359
Hospital Revenue Code	272
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$72.00
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$120.00

GLIDE SHEATH SLENDER 5 FR

Facility

$240.00

Hospital Charge Code	270675359
Hospital Revenue Code	272
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

GLIDE SHEATH SLENDER 6FR x 10c

Facility

$531.25

Hospital Charge Code	270665133
Hospital Revenue Code	270
Min. Negotiated Rate	$69.06
Max. Negotiated Rate	$265.62
Rate for Payer: Aetna Commercial	$159.38
Rate for Payer: Aetna Medicare Advantage	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.47
Rate for Payer: Cigna Commercial	$265.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.06
Rate for Payer: Oxford Commercial	$265.62
Rate for Payer: Qualcare PPO/HMO/WC	$79.69
Rate for Payer: UnitedHealthcare Commercial	$265.62

GLIDE SHEATH SLENDER 6FR x 10c

Facility

$531.25

Hospital Charge Code	270665133S
Hospital Revenue Code	270
Min. Negotiated Rate	$69.06
Max. Negotiated Rate	$265.62
Rate for Payer: Aetna Commercial	$159.38
Rate for Payer: Aetna Medicare Advantage	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.47
Rate for Payer: Cigna Commercial	$265.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.06
Rate for Payer: Oxford Commercial	$265.62
Rate for Payer: Qualcare PPO/HMO/WC	$79.69
Rate for Payer: UnitedHealthcare Commercial	$265.62

GLIDE SHEATH SLENDER 6FR x 10c

Facility

$375.00

Hospital Charge Code	270665133N
Hospital Revenue Code	270
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Oxford Commercial	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$187.50

GLIDE SHEATH SLENDER 6FR x 10c

Facility

$531.25

Hospital Charge Code	270665133S
Hospital Revenue Code	270
Min. Negotiated Rate	$79.69
Max. Negotiated Rate	$79.69
Rate for Payer: Qualcare PPO/HMO/WC	$79.69

GLIDE SHEATH SLENDER 6FR x 10c

Facility

$375.00

Hospital Charge Code	270665133N
Hospital Revenue Code	270
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GLIDE SHEATH SLENDER 6FR x 10c

Facility

$531.25

Hospital Charge Code	270665133
Hospital Revenue Code	270
Min. Negotiated Rate	$79.69
Max. Negotiated Rate	$79.69
Rate for Payer: Qualcare PPO/HMO/WC	$79.69

GLIDE SHEET IOL 34MM LG X 5MM

Facility

$6.62

Hospital Charge Code	270655024
Hospital Revenue Code	270
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$0.99
Rate for Payer: Qualcare PPO/HMO/WC	$0.99

GLIDE SHEET IOL 34MM LG X 5MM

Facility

$6.62

Hospital Charge Code	270655024
Hospital Revenue Code	270
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$3.31
Rate for Payer: Aetna Commercial	$1.99
Rate for Payer: Aetna Medicare Advantage	$1.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.69
Rate for Payer: Cigna Commercial	$3.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.86
Rate for Payer: Oxford Commercial	$3.31
Rate for Payer: Qualcare PPO/HMO/WC	$0.99
Rate for Payer: UnitedHealthcare Commercial	$3.31

Glidewire 0.035 180cm STIF ANG

Facility

$264.05

Service Code	HCPCS C1769
Hospital Charge Code	270638738N
Hospital Revenue Code	278
Min. Negotiated Rate	$39.61
Max. Negotiated Rate	$63.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.90
Rate for Payer: Qualcare PPO/HMO/WC	$39.61

Know your out-of-pocket cost for care.

All Charges