Heights University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE BENSTON 035 150cm

Facility

$76.29

Service Code	HCPCS C1769
Hospital Charge Code	270652348
Hospital Revenue Code	278
Min. Negotiated Rate	$11.44
Max. Negotiated Rate	$38.15
Rate for Payer: Aetna Commercial	$22.89
Rate for Payer: Aetna Medicare Advantage	$22.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.45
Rate for Payer: Cigna Commercial	$38.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.46
Rate for Payer: Qualcare PPO/HMO/WC	$11.44

GUIDEWIRE BENSTON 035 150cm

Facility

$76.29

Service Code	HCPCS C1769
Hospital Charge Code	270652348
Hospital Revenue Code	278
Min. Negotiated Rate	$11.44
Max. Negotiated Rate	$18.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.46
Rate for Payer: Qualcare PPO/HMO/WC	$11.44

GUIDEWIRE BENTSON 035 150cm

Facility

$69.92

Service Code	HCPCS C1769
Hospital Charge Code	270652346
Hospital Revenue Code	278
Min. Negotiated Rate	$10.49
Max. Negotiated Rate	$34.96
Rate for Payer: Aetna Commercial	$20.98
Rate for Payer: Aetna Medicare Advantage	$20.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.83
Rate for Payer: Cigna Commercial	$34.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.92
Rate for Payer: Qualcare PPO/HMO/WC	$10.49

GUIDEWIRE BENTSON 035 150cm

Facility

$69.92

Service Code	HCPCS C1769
Hospital Charge Code	270652346
Hospital Revenue Code	278
Min. Negotiated Rate	$10.49
Max. Negotiated Rate	$16.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.92
Rate for Payer: Qualcare PPO/HMO/WC	$10.49

GUIDEWIRE BENTSON 035 150CM

Facility

$76.29

Service Code	HCPCS C1769
Hospital Charge Code	270652348S
Hospital Revenue Code	278
Min. Negotiated Rate	$11.44
Max. Negotiated Rate	$38.15
Rate for Payer: Aetna Commercial	$22.89
Rate for Payer: Aetna Medicare Advantage	$22.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.45
Rate for Payer: Cigna Commercial	$38.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.46
Rate for Payer: Qualcare PPO/HMO/WC	$11.44

GUIDEWIRE BENTSON 035 150CM

Facility

$76.29

Service Code	HCPCS C1769
Hospital Charge Code	270652348S
Hospital Revenue Code	278
Min. Negotiated Rate	$11.44
Max. Negotiated Rate	$18.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.46
Rate for Payer: Qualcare PPO/HMO/WC	$11.44

GUIDEWIRE BENTSON .035 180cm

Facility

$77.24

Service Code	HCPCS C1769
Hospital Charge Code	270624072
Hospital Revenue Code	278
Min. Negotiated Rate	$11.59
Max. Negotiated Rate	$18.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.59

GUIDEWIRE BENTSON .035 180cm

Facility

$39.90

Service Code	HCPCS C1769
Hospital Charge Code	270624072N
Hospital Revenue Code	278
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$19.95
Rate for Payer: Aetna Commercial	$11.97
Rate for Payer: Aetna Medicare Advantage	$11.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.17
Rate for Payer: Cigna Commercial	$19.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.66
Rate for Payer: Qualcare PPO/HMO/WC	$5.99

GUIDEWIRE BENTSON .035 180cm

Facility

$77.24

Service Code	HCPCS C1769
Hospital Charge Code	270624072S
Hospital Revenue Code	278
Min. Negotiated Rate	$11.59
Max. Negotiated Rate	$38.62
Rate for Payer: Aetna Commercial	$23.17
Rate for Payer: Aetna Medicare Advantage	$23.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.70
Rate for Payer: Cigna Commercial	$38.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.59

GUIDEWIRE BENTSON .035 180cm

Facility

$39.90

Service Code	HCPCS C1769
Hospital Charge Code	270624072N
Hospital Revenue Code	278
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.66
Rate for Payer: Qualcare PPO/HMO/WC	$5.99

GUIDEWIRE BENTSON .035 180cm

Facility

$77.24

Service Code	HCPCS C1769
Hospital Charge Code	270624072
Hospital Revenue Code	278
Min. Negotiated Rate	$11.59
Max. Negotiated Rate	$38.62
Rate for Payer: Aetna Commercial	$23.17
Rate for Payer: Aetna Medicare Advantage	$23.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.70
Rate for Payer: Cigna Commercial	$38.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.59

GUIDEWIRE BENTSON .035 180cm

Facility

$77.24

Service Code	HCPCS C1769
Hospital Charge Code	270624072S
Hospital Revenue Code	278
Min. Negotiated Rate	$11.59
Max. Negotiated Rate	$18.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.59

GUIDEWIRE BENTSON .035 260cm

Facility

$99.57

Service Code	HCPCS C1769
Hospital Charge Code	270630133
Hospital Revenue Code	278
Min. Negotiated Rate	$14.94
Max. Negotiated Rate	$24.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.94

GUIDEWIRE BENTSON .035 260cm

Facility

$99.57

Service Code	HCPCS C1769
Hospital Charge Code	270630133S
Hospital Revenue Code	278
Min. Negotiated Rate	$14.94
Max. Negotiated Rate	$49.78
Rate for Payer: Aetna Commercial	$29.87
Rate for Payer: Aetna Medicare Advantage	$29.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.39
Rate for Payer: Cigna Commercial	$49.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.94

GUIDEWIRE BENTSON .035 260cm

Facility

$51.30

Service Code	HCPCS C1769
Hospital Charge Code	270630133N
Hospital Revenue Code	278
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$12.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.41
Rate for Payer: Qualcare PPO/HMO/WC	$7.70

GUIDEWIRE BENTSON .035 260cm

Facility

$51.30

Service Code	HCPCS C1769
Hospital Charge Code	270630133N
Hospital Revenue Code	278
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$25.65
Rate for Payer: Aetna Commercial	$15.39
Rate for Payer: Aetna Medicare Advantage	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.08
Rate for Payer: Cigna Commercial	$25.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.41
Rate for Payer: Qualcare PPO/HMO/WC	$7.70

GUIDEWIRE BENTSON .035 260cm

Facility

$99.57

Service Code	HCPCS C1769
Hospital Charge Code	270630133S
Hospital Revenue Code	278
Min. Negotiated Rate	$14.94
Max. Negotiated Rate	$24.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.94

GUIDEWIRE BENTSON .035 260cm

Facility

$99.57

Service Code	HCPCS C1769
Hospital Charge Code	270630133
Hospital Revenue Code	278
Min. Negotiated Rate	$14.94
Max. Negotiated Rate	$49.78
Rate for Payer: Aetna Commercial	$29.87
Rate for Payer: Aetna Medicare Advantage	$29.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.39
Rate for Payer: Cigna Commercial	$49.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.94

GUIDEWIRE BENTSON 260cm

Facility

$492.50

Hospital Charge Code	270652350
Hospital Revenue Code	278
Min. Negotiated Rate	$73.88
Max. Negotiated Rate	$246.25
Rate for Payer: Aetna Commercial	$147.75
Rate for Payer: Aetna Medicare Advantage	$147.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.59
Rate for Payer: Cigna Commercial	$246.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.19
Rate for Payer: Qualcare PPO/HMO/WC	$73.88

GUIDEWIRE BENTSON 260cm

Facility

$492.50

Hospital Charge Code	270652350
Hospital Revenue Code	278
Min. Negotiated Rate	$73.88
Max. Negotiated Rate	$119.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.19
Rate for Payer: Qualcare PPO/HMO/WC	$73.88

GUIDE WIRE BLUNT

Facility

$265.00

Service Code	HCPCS C1769
Hospital Charge Code	270699143
Hospital Revenue Code	278
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$132.50
Rate for Payer: Aetna Commercial	$79.50
Rate for Payer: Aetna Medicare Advantage	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.58
Rate for Payer: Cigna Commercial	$132.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.13
Rate for Payer: Qualcare PPO/HMO/WC	$39.75

GUIDE WIRE BLUNT

Facility

$265.00

Service Code	HCPCS C1769
Hospital Charge Code	270699143
Hospital Revenue Code	278
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$64.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.13
Rate for Payer: Qualcare PPO/HMO/WC	$39.75

GUIDEWIRE BLUNT 21INCH

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270692304
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

GUIDEWIRE BLUNT 21INCH

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270692304
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$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) NJ Health	$25.00
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	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

GUIDEWIRE BMW 190cm

Facility

$375.00

Hospital Charge Code	270642952
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

Know your out-of-pocket cost for care.

All Charges