Heights University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE JOURNEY 300MM STR

Facility

$700.00

Hospital Charge Code	270644823
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$210.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

GUIDEWIRE JOURNEY 300MM STR

Facility

$700.00

Hospital Charge Code	270644823
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

GUIDEWIRE JRNY STR 300cm 39128

Facility

$600.00

Hospital Charge Code	270644823C
Hospital Revenue Code	272
Min. Negotiated Rate	$78.00
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) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.00
Rate for Payer: Oxford Commercial	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Commercial	$300.00

GUIDEWIRE JRNY STR 300cm 39128

Facility

$600.00

Hospital Charge Code	270644823C
Hospital Revenue Code	272
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

GUIDEWIRE JTIP .14 182CM

Facility

$415.00

Service Code	HCPCS C1769
Hospital Charge Code	270696459
Hospital Revenue Code	278
Min. Negotiated Rate	$62.25
Max. Negotiated Rate	$100.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.43
Rate for Payer: Qualcare PPO/HMO/WC	$62.25

GUIDEWIRE JTIP .14 182CM

Facility

$415.00

Service Code	HCPCS C1769
Hospital Charge Code	270696459
Hospital Revenue Code	278
Min. Negotiated Rate	$62.25
Max. Negotiated Rate	$207.50
Rate for Payer: Aetna Commercial	$124.50
Rate for Payer: Aetna Medicare Advantage	$124.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.83
Rate for Payer: Cigna Commercial	$207.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.43
Rate for Payer: Qualcare PPO/HMO/WC	$62.25

GUIDEWIRE J TIP 3MMX7CM

Facility

$154.00

Hospital Charge Code	270331517
Hospital Revenue Code	278
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$37.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.27
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

GUIDEWIRE J TIP 3MMX7CM

Facility

$154.00

Hospital Charge Code	270331517
Hospital Revenue Code	278
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$77.00
Rate for Payer: Aetna Commercial	$46.20
Rate for Payer: Aetna Medicare Advantage	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.27
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.27
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

GUIDEWIRE K-WIRE 1.35mm DIA

Facility

$205.00

Service Code	HCPCS C1769
Hospital Charge Code	270678268
Hospital Revenue Code	278
Min. Negotiated Rate	$30.75
Max. Negotiated Rate	$49.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.61
Rate for Payer: Qualcare PPO/HMO/WC	$30.75

GUIDEWIRE K-WIRE 1.35mm DIA

Facility

$205.00

Service Code	HCPCS C1769
Hospital Charge Code	270678268
Hospital Revenue Code	278
Min. Negotiated Rate	$30.75
Max. Negotiated Rate	$102.50
Rate for Payer: Aetna Commercial	$61.50
Rate for Payer: Aetna Medicare Advantage	$61.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.27
Rate for Payer: Cigna Commercial	$102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.61
Rate for Payer: Qualcare PPO/HMO/WC	$30.75

GUIDEWIRE LAG SCREW 27914

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270635349
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

GUIDEWIRE LAG SCREW 27914

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270635349
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

GUIDEWIRE LAG SCREW 3.2x460mm

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270635350
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 LAG SCREW 3.2x460mm

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270635350
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 LG 3.2MM

Facility

$200.00

Service Code	HCPCS C1769
Hospital Charge Code	270698445
Hospital Revenue Code	278
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$60.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

GUIDEWIRE LG 3.2MM

Facility

$200.00

Service Code	HCPCS C1769
Hospital Charge Code	270698445
Hospital Revenue Code	278
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

GUIDE WIRE LONG 2.8X450MM

Facility

$369.00

Hospital Charge Code	270670832
Hospital Revenue Code	278
Min. Negotiated Rate	$55.35
Max. Negotiated Rate	$184.50
Rate for Payer: Aetna Commercial	$110.70
Rate for Payer: Aetna Medicare Advantage	$110.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.09
Rate for Payer: Cigna Commercial	$184.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.30
Rate for Payer: Qualcare PPO/HMO/WC	$55.35

GUIDE WIRE LONG 2.8X450MM

Facility

$369.00

Hospital Charge Code	270670832
Hospital Revenue Code	278
Min. Negotiated Rate	$55.35
Max. Negotiated Rate	$89.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.30
Rate for Payer: Qualcare PPO/HMO/WC	$55.35

GUIDEWIRE LT ST 35 150c 502560

Facility

$347.25

Hospital Charge Code	270624691
Hospital Revenue Code	272
Min. Negotiated Rate	$52.09
Max. Negotiated Rate	$52.09
Rate for Payer: Qualcare PPO/HMO/WC	$52.09

GUIDEWIRE LT ST 35 150c 502560

Facility

$347.25

Hospital Charge Code	270624691
Hospital Revenue Code	272
Min. Negotiated Rate	$45.14
Max. Negotiated Rate	$173.62
Rate for Payer: Aetna Commercial	$104.17
Rate for Payer: Aetna Medicare Advantage	$104.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.55
Rate for Payer: Cigna Commercial	$173.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.14
Rate for Payer: Oxford Commercial	$173.62
Rate for Payer: Qualcare PPO/HMO/WC	$52.09
Rate for Payer: UnitedHealthcare Commercial	$173.62

GUIDEWIRE LUGE 182cm 1213001

Facility

$2,500.00

Service Code	HCPCS C1769
Hospital Charge Code	270631645
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

GUIDEWIRE LUGE 182cm 1213001

Facility

$2,500.00

Service Code	HCPCS C1769
Hospital Charge Code	270631645
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

GUIDEWIRE LUGE 300cm 1210001

Facility

$595.25

Hospital Charge Code	270631646
Hospital Revenue Code	278
Min. Negotiated Rate	$89.29
Max. Negotiated Rate	$144.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.05
Rate for Payer: Qualcare PPO/HMO/WC	$89.29

GUIDEWIRE LUGE 300cm 1210001

Facility

$595.25

Hospital Charge Code	270631646
Hospital Revenue Code	278
Min. Negotiated Rate	$89.29
Max. Negotiated Rate	$297.62
Rate for Payer: Aetna Commercial	$178.57
Rate for Payer: Aetna Medicare Advantage	$178.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.79
Rate for Payer: Cigna Commercial	$297.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.05
Rate for Payer: Qualcare PPO/HMO/WC	$89.29

GUIDEWIRE LUNRQIUST 035 278839

Facility

$236.90

Hospital Charge Code	270632729
Hospital Revenue Code	278
Min. Negotiated Rate	$35.53
Max. Negotiated Rate	$57.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.33
Rate for Payer: Qualcare PPO/HMO/WC	$35.53

Know your out-of-pocket cost for care.

All Charges