Heights University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE 1.4MM MAXTORQUE 5IN

Facility

$125.00

Service Code	HCPCS C1769
Hospital Charge Code	270700604
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

GUIDEWIRE 1.4MM MAXTORQUE 5IN

Facility

$125.00

Service Code	HCPCS C1769
Hospital Charge Code	270700604
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: UnitedHealthcare Commercial	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

GUIDEWIRE 1.4X150MM

Facility

$1,183.00

Service Code	HCPCS C1769
Hospital Charge Code	270699453
Hospital Revenue Code	278
Min. Negotiated Rate	$177.45
Max. Negotiated Rate	$286.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$286.29
Rate for Payer: Qualcare PPO/HMO/WC	$177.45

GUIDEWIRE 1.4X150MM

Facility

$1,183.00

Service Code	HCPCS C1769
Hospital Charge Code	270699453
Hospital Revenue Code	278
Min. Negotiated Rate	$177.45
Max. Negotiated Rate	$591.50
Rate for Payer: Aetna Commercial	$354.90
Rate for Payer: Aetna Medicare Advantage	$354.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$301.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$301.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.67
Rate for Payer: Cigna Commercial	$591.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$286.29
Rate for Payer: Qualcare PPO/HMO/WC	$177.45

GUIDE WIRE 1.4X150MM STERILE

Facility

$570.75

Service Code	HCPCS C1769
Hospital Charge Code	270669238
Hospital Revenue Code	278
Min. Negotiated Rate	$85.61
Max. Negotiated Rate	$138.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.12
Rate for Payer: Qualcare PPO/HMO/WC	$85.61

GUIDE WIRE 1.4X150MM STERILE

Facility

$570.75

Service Code	HCPCS C1769
Hospital Charge Code	270669238
Hospital Revenue Code	278
Min. Negotiated Rate	$85.61
Max. Negotiated Rate	$285.38
Rate for Payer: Aetna Commercial	$171.22
Rate for Payer: Aetna Medicare Advantage	$171.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.54
Rate for Payer: Cigna Commercial	$285.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.12
Rate for Payer: Qualcare PPO/HMO/WC	$85.61

GUIDE WIRE 1.6

Facility

$157.50

Service Code	HCPCS C1769
Hospital Charge Code	270663860
Hospital Revenue Code	278
Min. Negotiated Rate	$23.62
Max. Negotiated Rate	$78.75
Rate for Payer: Aetna Commercial	$47.25
Rate for Payer: Aetna Medicare Advantage	$47.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.16
Rate for Payer: Cigna Commercial	$78.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.12
Rate for Payer: Qualcare PPO/HMO/WC	$23.62

GUIDE WIRE 1.6

Facility

$157.50

Service Code	HCPCS C1769
Hospital Charge Code	270663860
Hospital Revenue Code	278
Min. Negotiated Rate	$23.62
Max. Negotiated Rate	$38.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.12
Rate for Payer: Qualcare PPO/HMO/WC	$23.62

GUIDEWIRE 1.6MM

Facility

$85.00

Service Code	HCPCS C1769
Hospital Charge Code	270698444
Hospital Revenue Code	278
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$42.50
Rate for Payer: Aetna Commercial	$25.50
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.57
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

GUIDEWIRE 1.6MM

Facility

$85.00

Service Code	HCPCS C1769
Hospital Charge Code	270698444
Hospital Revenue Code	278
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.57
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

GUIDE WIRE 1.6MM SPADE 150MM

Facility

$121.50

Hospital Charge Code	270665886
Hospital Revenue Code	278
Min. Negotiated Rate	$18.23
Max. Negotiated Rate	$29.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$18.23

GUIDE WIRE 1.6MM SPADE 150MM

Facility

$121.50

Hospital Charge Code	270665886
Hospital Revenue Code	278
Min. Negotiated Rate	$18.23
Max. Negotiated Rate	$60.75
Rate for Payer: Aetna Commercial	$36.45
Rate for Payer: Aetna Medicare Advantage	$36.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.98
Rate for Payer: Cigna Commercial	$60.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$18.23

GUIDEWIRE 1.6x100mm

Facility

$100.00

Service Code	HCPCS C1769
Hospital Charge Code	270676445
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 1.6x100mm

Facility

$100.00

Service Code	HCPCS C1769
Hospital Charge Code	270676445
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

GUIDE WIRE 1.6X100MM

Facility

$81.25

Hospital Charge Code	270637829
Hospital Revenue Code	278
Min. Negotiated Rate	$12.19
Max. Negotiated Rate	$40.62
Rate for Payer: Aetna Commercial	$24.38
Rate for Payer: Aetna Medicare Advantage	$24.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.72
Rate for Payer: Cigna Commercial	$40.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.66
Rate for Payer: Qualcare PPO/HMO/WC	$12.19

GUIDE WIRE 1.6X100MM

Facility

$81.25

Hospital Charge Code	270637829
Hospital Revenue Code	278
Min. Negotiated Rate	$12.19
Max. Negotiated Rate	$19.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.66
Rate for Payer: Qualcare PPO/HMO/WC	$12.19

GUIDEWIRE 2.0X150MM

Facility

$75.00

Service Code	HCPCS C1769
Hospital Charge Code	270698541
Hospital Revenue Code	278
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

GUIDEWIRE 2.0X150MM

Facility

$75.00

Service Code	HCPCS C1769
Hospital Charge Code	270698541
Hospital Revenue Code	278
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

GUIDE WIRE 2.0x40MM

Facility

$144.45

Service Code	HCPCS C1769
Hospital Charge Code	270637808
Hospital Revenue Code	278
Min. Negotiated Rate	$21.67
Max. Negotiated Rate	$34.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.96
Rate for Payer: Qualcare PPO/HMO/WC	$21.67

GUIDE WIRE 2.0x40MM

Facility

$144.45

Service Code	HCPCS C1769
Hospital Charge Code	270637808
Hospital Revenue Code	278
Min. Negotiated Rate	$21.67
Max. Negotiated Rate	$72.22
Rate for Payer: Aetna Commercial	$43.34
Rate for Payer: Aetna Medicare Advantage	$43.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.83
Rate for Payer: Cigna Commercial	$72.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.96
Rate for Payer: Qualcare PPO/HMO/WC	$21.67

GUIDE WIRE 22.MM X 28IN

Facility

$600.00

Service Code	HCPCS C1769
Hospital Charge Code	270685087
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

GUIDE WIRE 22.MM X 28IN

Facility

$600.00

Service Code	HCPCS C1769
Hospital Charge Code	270685087
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$180.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

GUIDEWIRE 2.3X200MM

Facility

$75.00

Service Code	HCPCS C1769
Hospital Charge Code	270659330
Hospital Revenue Code	278
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

GUIDEWIRE 2.3X200MM

Facility

$75.00

Service Code	HCPCS C1769
Hospital Charge Code	270659330
Hospital Revenue Code	278
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

GUIDEWIRE 2 4X70 BUTIP 2255008

Facility

$460.00

Hospital Charge Code	270638046
Hospital Revenue Code	272
Min. Negotiated Rate	$59.80
Max. Negotiated Rate	$230.00
Rate for Payer: Aetna Commercial	$138.00
Rate for Payer: Aetna Medicare Advantage	$138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.30
Rate for Payer: Cigna Commercial	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.80
Rate for Payer: Oxford Commercial	$230.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.00
Rate for Payer: UnitedHealthcare Commercial	$230.00

Know your out-of-pocket cost for care.

All Charges