Heights University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE BMW 190cm

Facility

$375.00

Hospital Charge Code	270642952
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
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) NJ Health	$75.00
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	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDEWIRE BMW 300cm

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270642953
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

GUIDEWIRE BMW 300cm

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270642953
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
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) NJ Health	$75.00
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	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDEWIREBMWJSH.014INX190CM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270666647S
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

GUIDEWIREBMWJSH.014INX190CM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270666647S
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
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) NJ Health	$75.00
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	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDEWIRE BMW STRAIGHT 300CM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270666650S
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
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) NJ Health	$75.00
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	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDEWIRE BMW STRAIGHT 300CM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270666650S
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

GUIDEWIRE BMW UNIV II 190CM

Facility

$375.00

Hospital Charge Code	270645901C
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

GUIDEWIRE BMW UNIV II 190CM

Facility

$375.00

Hospital Charge Code	270645901C
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
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) NJ Health	$75.00
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	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDEWIRE BMW UNIV II190CM

Facility

$3,750.00

Service Code	HCPCS C1769
Hospital Charge Code	270645901
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,125.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

GUIDEWIRE BMW UNIV II190CM

Facility

$3,750.00

Service Code	HCPCS C1769
Hospital Charge Code	270645901
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

GUIDEWIRE BMW UNIV II 300cm

Facility

$475.00

Hospital Charge Code	270642951C
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

GUIDEWIRE BMW UNIV II 300cm

Facility

$475.00

Hospital Charge Code	270642951C
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

GUIDEWIRE BMW UNIV II 300CM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270645900
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

GUIDEWIRE BMW UNIV II 300CM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270645900
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
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) NJ Health	$75.00
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	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDEWIRE BMW UNIV IIcm

Facility

$450.00

Hospital Charge Code	270642950C
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$135.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

GUIDEWIRE BMW UNIV IIcm

Facility

$450.00

Hospital Charge Code	270642950C
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

GUIDEWIRE BMW UNIV JII 300CM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270642951
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
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) NJ Health	$75.00
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	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDEWIRE BMW UNIV JII 300CM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270642951
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

GUIDEWIRE B/U MEIER JTIP 185cm

Facility

$159.65

Service Code	HCPCS C1769
Hospital Charge Code	270629981
Hospital Revenue Code	278
Min. Negotiated Rate	$23.95
Max. Negotiated Rate	$79.83
Rate for Payer: Aetna Commercial	$47.90
Rate for Payer: Aetna Medicare Advantage	$47.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.71
Rate for Payer: Cigna Commercial	$79.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.64
Rate for Payer: Qualcare PPO/HMO/WC	$23.95

GUIDEWIRE B/U MEIER JTIP 185cm

Facility

$159.65

Service Code	HCPCS C1769
Hospital Charge Code	270629981
Hospital Revenue Code	278
Min. Negotiated Rate	$23.95
Max. Negotiated Rate	$38.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.64
Rate for Payer: Qualcare PPO/HMO/WC	$23.95

GUIDEWIRE B/U MEIER JTIP 300cm

Facility

$159.65

Service Code	HCPCS C1769
Hospital Charge Code	270631344
Hospital Revenue Code	278
Min. Negotiated Rate	$23.95
Max. Negotiated Rate	$79.83
Rate for Payer: Aetna Commercial	$47.90
Rate for Payer: Aetna Medicare Advantage	$47.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.71
Rate for Payer: Cigna Commercial	$79.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.64
Rate for Payer: Qualcare PPO/HMO/WC	$23.95

GUIDEWIRE B/U MEIER JTIP 300cm

Facility

$159.65

Service Code	HCPCS C1769
Hospital Charge Code	270631344
Hospital Revenue Code	278
Min. Negotiated Rate	$23.95
Max. Negotiated Rate	$38.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.64
Rate for Payer: Qualcare PPO/HMO/WC	$23.95

GUIDEWIRE CHICE PT 300C ST TIP

Facility

$430.00

Service Code	HCPCS C1769
Hospital Charge Code	270653634
Hospital Revenue Code	278
Min. Negotiated Rate	$64.50
Max. Negotiated Rate	$215.00
Rate for Payer: Aetna Commercial	$129.00
Rate for Payer: Aetna Medicare Advantage	$129.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.65
Rate for Payer: Cigna Commercial	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.06
Rate for Payer: Qualcare PPO/HMO/WC	$64.50

GUIDEWIRE CHICE PT 300C ST TIP

Facility

$430.00

Service Code	HCPCS C1769
Hospital Charge Code	270653634
Hospital Revenue Code	278
Min. Negotiated Rate	$64.50
Max. Negotiated Rate	$104.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.06
Rate for Payer: Qualcare PPO/HMO/WC	$64.50

Know your out-of-pocket cost for care.

All Charges