Heights University Hospital

All Charges

Charge

Type

Setting

Price

GLIDEWIRE 035 260 STF GS3509

Facility

$1,800.00

Hospital Charge Code	270637622
Hospital Revenue Code	279
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$270.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

GLIDEWIRE .035 450CM SS ANGLED

Facility

$186.00

Hospital Charge Code	270654320
Hospital Revenue Code	270
Min. Negotiated Rate	$27.90
Max. Negotiated Rate	$27.90
Rate for Payer: Qualcare PPO/HMO/WC	$27.90

GLIDEWIRE .035 450CM SS ANGLED

Facility

$186.00

Hospital Charge Code	270654320
Hospital Revenue Code	270
Min. Negotiated Rate	$24.18
Max. Negotiated Rate	$93.00
Rate for Payer: Aetna Commercial	$55.80
Rate for Payer: Aetna Medicare Advantage	$55.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.43
Rate for Payer: Cigna Commercial	$93.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.18
Rate for Payer: Oxford Commercial	$93.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.90
Rate for Payer: UnitedHealthcare Commercial	$93.00

GLIDEWIRE .038 150CM STRAIGHT

Facility

$320.00

Service Code	HCPCS C1769
Hospital Charge Code	270658605
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$96.00
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

GLIDEWIRE .038 150CM STRAIGHT

Facility

$320.00

Service Code	HCPCS C1769
Hospital Charge Code	270658605
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

GLIDEWIRE .038 180 CM STN ANG

Facility

$224.25

Hospital Charge Code	270684296N
Hospital Revenue Code	272
Min. Negotiated Rate	$33.64
Max. Negotiated Rate	$33.64
Rate for Payer: Qualcare PPO/HMO/WC	$33.64

GLIDEWIRE .038 180 CM STN ANG

Facility

$224.25

Hospital Charge Code	270684296
Hospital Revenue Code	272
Min. Negotiated Rate	$33.64
Max. Negotiated Rate	$33.64
Rate for Payer: Qualcare PPO/HMO/WC	$33.64

GLIDEWIRE .038 180 CM STN ANG

Facility

$224.25

Hospital Charge Code	270684296N
Hospital Revenue Code	272
Min. Negotiated Rate	$29.15
Max. Negotiated Rate	$112.12
Rate for Payer: Aetna Commercial	$67.28
Rate for Payer: Aetna Medicare Advantage	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.18
Rate for Payer: Cigna Commercial	$112.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.15
Rate for Payer: Oxford Commercial	$112.12
Rate for Payer: Qualcare PPO/HMO/WC	$33.64
Rate for Payer: UnitedHealthcare Commercial	$112.12

GLIDEWIRE .038 180 CM STN ANG

Facility

$224.25

Hospital Charge Code	270684296
Hospital Revenue Code	272
Min. Negotiated Rate	$29.15
Max. Negotiated Rate	$112.12
Rate for Payer: Aetna Commercial	$67.28
Rate for Payer: Aetna Medicare Advantage	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.18
Rate for Payer: Cigna Commercial	$112.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.15
Rate for Payer: Oxford Commercial	$112.12
Rate for Payer: Qualcare PPO/HMO/WC	$33.64
Rate for Payer: UnitedHealthcare Commercial	$112.12

GLIDEWIRE .038X150CM BENTS STF

Facility

$270.00

Service Code	HCPCS C1769
Hospital Charge Code	270658529
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$65.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

GLIDEWIRE .038X150CM BENTS STF

Facility

$270.00

Service Code	HCPCS C1769
Hospital Charge Code	270658529
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$81.00
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

GLIDEWIRE .038X150CM DUAL FLEX

Facility

$374.66

Service Code	HCPCS C1769
Hospital Charge Code	270684750
Hospital Revenue Code	278
Min. Negotiated Rate	$56.20
Max. Negotiated Rate	$187.33
Rate for Payer: Aetna Commercial	$112.40
Rate for Payer: Aetna Medicare Advantage	$112.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.54
Rate for Payer: Cigna Commercial	$187.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.67
Rate for Payer: Qualcare PPO/HMO/WC	$56.20

GLIDEWIRE .038X150CM DUAL FLEX

Facility

$374.66

Service Code	HCPCS C1769
Hospital Charge Code	270684750
Hospital Revenue Code	278
Min. Negotiated Rate	$56.20
Max. Negotiated Rate	$90.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.67
Rate for Payer: Qualcare PPO/HMO/WC	$56.20

GLIDEWIRE 150CM 18MM

Facility

$191.25

Hospital Charge Code	270664201
Hospital Revenue Code	270
Min. Negotiated Rate	$28.69
Max. Negotiated Rate	$28.69
Rate for Payer: Qualcare PPO/HMO/WC	$28.69

GLIDEWIRE 150CM 18MM

Facility

$191.25

Hospital Charge Code	270664201
Hospital Revenue Code	270
Min. Negotiated Rate	$24.86
Max. Negotiated Rate	$95.62
Rate for Payer: Aetna Commercial	$57.38
Rate for Payer: Aetna Medicare Advantage	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.77
Rate for Payer: Cigna Commercial	$95.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.86
Rate for Payer: Oxford Commercial	$95.62
Rate for Payer: Qualcare PPO/HMO/WC	$28.69
Rate for Payer: UnitedHealthcare Commercial	$95.62

GLIDEWIRE ADVAN ANG .014X180MM

Facility

$1,700.00

Hospital Charge Code	270701893
Hospital Revenue Code	279
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$255.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00

GLIDEWIRE ADVAN ANG .014X180MM

Facility

$1,700.00

Hospital Charge Code	270701893
Hospital Revenue Code	279
Min. Negotiated Rate	$221.00
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$510.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.00
Rate for Payer: Oxford Commercial	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Commercial	$850.00

GLIDEWIRE ADVAN ANG .035X180MM

Facility

$1,265.00

Hospital Charge Code	270701894
Hospital Revenue Code	279
Min. Negotiated Rate	$189.75
Max. Negotiated Rate	$189.75
Rate for Payer: Qualcare PPO/HMO/WC	$189.75

GLIDEWIRE ADVAN ANG .035X180MM

Facility

$1,265.00

Hospital Charge Code	270701894
Hospital Revenue Code	279
Min. Negotiated Rate	$164.45
Max. Negotiated Rate	$632.50
Rate for Payer: Aetna Commercial	$379.50
Rate for Payer: Aetna Medicare Advantage	$379.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.57
Rate for Payer: Cigna Commercial	$632.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.45
Rate for Payer: Oxford Commercial	$632.50
Rate for Payer: Qualcare PPO/HMO/WC	$189.75
Rate for Payer: UnitedHealthcare Commercial	$632.50

GLIDEWIRE ADVANTAGE ANGLED

Facility

$245.00

Service Code	HCPCS C1769
Hospital Charge Code	270658283N
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$73.50
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

GLIDEWIRE ADVANTAGE ANGLED

Facility

$1,150.00

Service Code	HCPCS C1769
Hospital Charge Code	270658283S
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$345.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

GLIDEWIRE ADVANTAGE ANGLED

Facility

$1,150.00

Service Code	HCPCS C1769
Hospital Charge Code	270658283S
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$278.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

GLIDEWIRE ADVANTAGE ANGLED

Facility

$245.00

Service Code	HCPCS C1769
Hospital Charge Code	270658283N
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$59.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.29
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

GLIDEWIRE ADVANT ANG .035X260

Facility

$1,407.50

Service Code	HCPCS C1769
Hospital Charge Code	270658283
Hospital Revenue Code	279
Min. Negotiated Rate	$182.97
Max. Negotiated Rate	$703.75
Rate for Payer: Aetna Commercial	$422.25
Rate for Payer: Aetna Medicare Advantage	$422.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.91
Rate for Payer: Cigna Commercial	$703.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.97
Rate for Payer: Oxford Commercial	$703.75
Rate for Payer: Qualcare PPO/HMO/WC	$211.12
Rate for Payer: UnitedHealthcare Commercial	$703.75

GLIDEWIRE ADVANT ANG .035X260

Facility

$1,407.50

Service Code	HCPCS C1769
Hospital Charge Code	270658283
Hospital Revenue Code	279
Min. Negotiated Rate	$211.12
Max. Negotiated Rate	$211.12
Rate for Payer: Qualcare PPO/HMO/WC	$211.12

Know your out-of-pocket cost for care.

All Charges