Heights University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE 104

Facility

$361.25

Service Code	HCPCS C1713
Hospital Charge Code	270690802
Hospital Revenue Code	278
Min. Negotiated Rate	$54.19
Max. Negotiated Rate	$180.62
Rate for Payer: Aetna Commercial	$108.38
Rate for Payer: Aetna Medicare Advantage	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$72.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.12
Rate for Payer: Cigna Commercial	$180.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.42
Rate for Payer: Qualcare PPO/HMO/WC	$54.19

GUIDE WIRE 1.1 MM

Facility

$171.40

Hospital Charge Code	270925348
Hospital Revenue Code	278
Min. Negotiated Rate	$25.71
Max. Negotiated Rate	$85.70
Rate for Payer: Aetna Commercial	$51.42
Rate for Payer: Aetna Medicare Advantage	$51.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$85.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.48
Rate for Payer: Qualcare PPO/HMO/WC	$25.71

GUIDE WIRE 1.1 MM

Facility

$171.40

Hospital Charge Code	270925348
Hospital Revenue Code	278
Min. Negotiated Rate	$25.71
Max. Negotiated Rate	$41.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.48
Rate for Payer: Qualcare PPO/HMO/WC	$25.71

GUIDE WIRE 1.1MM

Facility

$170.00

Hospital Charge Code	270625348
Hospital Revenue Code	278
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$85.00
Rate for Payer: Aetna Commercial	$51.00
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.14
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

GUIDE WIRE 1.1MM

Facility

$170.00

Hospital Charge Code	270625348
Hospital Revenue Code	278
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$41.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.14
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

GUIDE WIRE 1.1MM 150MM THRD

Facility

$122.25

Hospital Charge Code	270622782
Hospital Revenue Code	278
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: Qualcare PPO/HMO/WC	$18.34

GUIDE WIRE 1.1MM 150MM THRD

Facility

$122.25

Hospital Charge Code	270622782
Hospital Revenue Code	278
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$61.12
Rate for Payer: Aetna Commercial	$36.67
Rate for Payer: Aetna Medicare Advantage	$36.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.17
Rate for Payer: Cigna Commercial	$61.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.58
Rate for Payer: Qualcare PPO/HMO/WC	$18.34

GUIDEWIRE 1.1MMX150MM TROCTIP

Facility

$343.75

Service Code	HCPCS C1713
Hospital Charge Code	270691913
Hospital Revenue Code	278
Min. Negotiated Rate	$51.56
Max. Negotiated Rate	$83.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.19
Rate for Payer: Qualcare PPO/HMO/WC	$51.56

GUIDEWIRE 1.1MMX150MM TROCTIP

Facility

$343.75

Service Code	HCPCS C1713
Hospital Charge Code	270691913
Hospital Revenue Code	278
Min. Negotiated Rate	$51.56
Max. Negotiated Rate	$171.88
Rate for Payer: Aetna Commercial	$103.12
Rate for Payer: Aetna Medicare Advantage	$103.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.66
Rate for Payer: Cigna Commercial	$171.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.19
Rate for Payer: Qualcare PPO/HMO/WC	$51.56

GUIDEWIRE 1.1 X 100

Facility

$189.00

Service Code	HCPCS C1769
Hospital Charge Code	270667243
Hospital Revenue Code	278
Min. Negotiated Rate	$28.35
Max. Negotiated Rate	$45.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.74
Rate for Payer: Qualcare PPO/HMO/WC	$28.35

GUIDEWIRE 1.1 X 100

Facility

$189.00

Service Code	HCPCS C1769
Hospital Charge Code	270667243
Hospital Revenue Code	278
Min. Negotiated Rate	$28.35
Max. Negotiated Rate	$94.50
Rate for Payer: Aetna Commercial	$56.70
Rate for Payer: Aetna Medicare Advantage	$56.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.20
Rate for Payer: Cigna Commercial	$94.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.74
Rate for Payer: Qualcare PPO/HMO/WC	$28.35

GUIDE WIRE 1.25M 150MM

Facility

$122.20

Service Code	HCPCS C1713
Hospital Charge Code	270642556
Hospital Revenue Code	278
Min. Negotiated Rate	$18.33
Max. Negotiated Rate	$61.10
Rate for Payer: Aetna Commercial	$36.66
Rate for Payer: Aetna Medicare Advantage	$36.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.16
Rate for Payer: Cigna Commercial	$61.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.57
Rate for Payer: Qualcare PPO/HMO/WC	$18.33

GUIDE WIRE 1.25M 150MM

Facility

$122.20

Service Code	HCPCS C1713
Hospital Charge Code	270642556
Hospital Revenue Code	278
Min. Negotiated Rate	$18.33
Max. Negotiated Rate	$29.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.57
Rate for Payer: Qualcare PPO/HMO/WC	$18.33

GUIDE WIRE 1.2MM

Facility

$121.75

Service Code	HCPCS C1769
Hospital Charge Code	270661039
Hospital Revenue Code	278
Min. Negotiated Rate	$18.26
Max. Negotiated Rate	$29.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.46
Rate for Payer: Qualcare PPO/HMO/WC	$18.26

GUIDE WIRE 1.2MM

Facility

$121.75

Service Code	HCPCS C1769
Hospital Charge Code	270661039
Hospital Revenue Code	278
Min. Negotiated Rate	$18.26
Max. Negotiated Rate	$60.88
Rate for Payer: Aetna Commercial	$36.52
Rate for Payer: Aetna Medicare Advantage	$36.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.05
Rate for Payer: Cigna Commercial	$60.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.46
Rate for Payer: Qualcare PPO/HMO/WC	$18.26

GUIDEWIRE 1.2MM

Facility

$115.00

Service Code	HCPCS C1769
Hospital Charge Code	270686223
Hospital Revenue Code	278
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$57.50
Rate for Payer: Aetna Commercial	$34.50
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.83
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

GUIDEWIRE 1.2MM

Facility

$150.00

Service Code	HCPCS C1769
Hospital Charge Code	270686758
Hospital Revenue Code	278
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

GUIDEWIRE 1.2MM

Facility

$115.00

Service Code	HCPCS C1769
Hospital Charge Code	270686223
Hospital Revenue Code	278
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$27.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.83
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

GUIDEWIRE 1.2MM

Facility

$150.00

Service Code	HCPCS C1769
Hospital Charge Code	270686758
Hospital Revenue Code	278
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

GUIDEWIRE 1.2x100mm

Facility

$110.00

Service Code	HCPCS C1769
Hospital Charge Code	270685400
Hospital Revenue Code	278
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$26.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

GUIDEWIRE 1.2x100mm

Facility

$110.00

Service Code	HCPCS C1769
Hospital Charge Code	270685400
Hospital Revenue Code	278
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$33.00
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

GUIDEWIRE 1.35MM

Facility

$100.00

Service Code	HCPCS C1769
Hospital Charge Code	270682618
Hospital Revenue Code	278
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$24.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

GUIDEWIRE 1.35MM

Facility

$100.00

Service Code	HCPCS C1769
Hospital Charge Code	270682618
Hospital Revenue Code	278
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$30.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

GUIDEWIRE 1.4MM

Facility

$65.00

Service Code	HCPCS C1769
Hospital Charge Code	270698539
Hospital Revenue Code	278
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$15.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.73
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

GUIDEWIRE 1.4MM

Facility

$65.00

Service Code	HCPCS C1769
Hospital Charge Code	270698539
Hospital Revenue Code	278
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$32.50
Rate for Payer: Aetna Commercial	$19.50
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.73
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

Know your out-of-pocket cost for care.

All Charges