Heights University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE MT .035 180 46525

Facility

$220.00

Hospital Charge Code	270624725C
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$53.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

GUIDEWIRE MT .035 180 46525

Facility

$220.00

Hospital Charge Code	270624725C
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$66.00
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

GUIDEWIRE MT 325 550-301

Facility

$1,835.25

Hospital Charge Code	270626582
Hospital Revenue Code	278
Min. Negotiated Rate	$275.29
Max. Negotiated Rate	$444.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$367.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$444.13
Rate for Payer: Qualcare PPO/HMO/WC	$275.29

GUIDEWIRE MT 325 550-301

Facility

$1,835.25

Hospital Charge Code	270626582
Hospital Revenue Code	278
Min. Negotiated Rate	$275.29
Max. Negotiated Rate	$917.62
Rate for Payer: Aetna Commercial	$550.58
Rate for Payer: Aetna Medicare Advantage	$550.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$467.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$467.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$367.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$467.99
Rate for Payer: Cigna Commercial	$917.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$444.13
Rate for Payer: Qualcare PPO/HMO/WC	$275.29

GUIDE WIRE MULTI HOLE

Facility

$5,310.45

Service Code	HCPCS C1769
Hospital Charge Code	270691508
Hospital Revenue Code	278
Min. Negotiated Rate	$796.57
Max. Negotiated Rate	$2,655.22
Rate for Payer: Aetna Commercial	$1,593.13
Rate for Payer: Aetna Medicare Advantage	$1,593.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,354.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,354.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,062.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,354.16
Rate for Payer: Cigna Commercial	$2,655.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,285.13
Rate for Payer: Qualcare PPO/HMO/WC	$796.57

GUIDE WIRE MULTI HOLE

Facility

$5,310.45

Service Code	HCPCS C1769
Hospital Charge Code	270691508
Hospital Revenue Code	278
Min. Negotiated Rate	$796.57
Max. Negotiated Rate	$1,285.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,062.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,285.13
Rate for Payer: Qualcare PPO/HMO/WC	$796.57

GUIDEWIRE NAVIPRO .018 STR

Facility

$517.65

Hospital Charge Code	270677500
Hospital Revenue Code	278
Min. Negotiated Rate	$77.65
Max. Negotiated Rate	$258.82
Rate for Payer: Aetna Commercial	$155.29
Rate for Payer: Aetna Medicare Advantage	$155.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.00
Rate for Payer: Cigna Commercial	$258.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.27
Rate for Payer: Qualcare PPO/HMO/WC	$77.65

GUIDEWIRE NAVIPRO .018 STR

Facility

$517.65

Hospital Charge Code	270677500
Hospital Revenue Code	278
Min. Negotiated Rate	$77.65
Max. Negotiated Rate	$125.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.27
Rate for Payer: Qualcare PPO/HMO/WC	$77.65

GUIDEWIRE NEWTON J .035 150cm

Facility

$56.58

Service Code	HCPCS C1769
Hospital Charge Code	270626619
Hospital Revenue Code	278
Min. Negotiated Rate	$8.49
Max. Negotiated Rate	$28.29
Rate for Payer: Aetna Commercial	$16.97
Rate for Payer: Aetna Medicare Advantage	$16.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.43
Rate for Payer: Cigna Commercial	$28.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$8.49

GUIDEWIRE NEWTON J .035 150cm

Facility

$65.36

Service Code	HCPCS C1769
Hospital Charge Code	270643672
Hospital Revenue Code	278
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$15.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.82
Rate for Payer: Qualcare PPO/HMO/WC	$9.80

GUIDEWIRE NEWTON J .035 150cm

Facility

$65.36

Service Code	HCPCS C1769
Hospital Charge Code	270643672
Hospital Revenue Code	278
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$32.68
Rate for Payer: Aetna Commercial	$19.61
Rate for Payer: Aetna Medicare Advantage	$19.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.67
Rate for Payer: Cigna Commercial	$32.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.82
Rate for Payer: Qualcare PPO/HMO/WC	$9.80

GUIDEWIRE NEWTON J .035 150cm

Facility

$56.58

Service Code	HCPCS C1769
Hospital Charge Code	270626619
Hospital Revenue Code	278
Min. Negotiated Rate	$8.49
Max. Negotiated Rate	$13.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$8.49

GUIDEWIRE NEWTON ST 35X150

Facility

$45.00

Service Code	HCPCS C1769
Hospital Charge Code	270658324S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$13.50
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

GUIDEWIRE NEWTON ST 35X150

Facility

$47.50

Service Code	HCPCS C1769
Hospital Charge Code	270658324N
Hospital Revenue Code	278
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$11.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.49
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

GUIDEWIRE NEWTON ST 35X150

Facility

$45.00

Service Code	HCPCS C1769
Hospital Charge Code	270658324
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

GUIDEWIRE NEWTON ST 35X150

Facility

$45.00

Service Code	HCPCS C1769
Hospital Charge Code	270658324S
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$10.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

GUIDEWIRE NEWTON ST 35X150

Facility

$45.00

Service Code	HCPCS C1769
Hospital Charge Code	270658324
Hospital Revenue Code	278
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$13.50
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

GUIDEWIRE NEWTON ST 35X150

Facility

$47.50

Service Code	HCPCS C1769
Hospital Charge Code	270658324N
Hospital Revenue Code	278
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$23.75
Rate for Payer: Aetna Commercial	$14.25
Rate for Payer: Aetna Medicare Advantage	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.11
Rate for Payer: Cigna Commercial	$23.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.49
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

GUIDEWIRE NIT 18X60 MAK001N60

Facility

$164.75

Service Code	HCPCS C1769
Hospital Charge Code	270660310
Hospital Revenue Code	278
Min. Negotiated Rate	$24.71
Max. Negotiated Rate	$82.38
Rate for Payer: Aetna Commercial	$49.42
Rate for Payer: Aetna Medicare Advantage	$49.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.01
Rate for Payer: Cigna Commercial	$82.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.87
Rate for Payer: Qualcare PPO/HMO/WC	$24.71

GUIDEWIRE NIT 18X60 MAK001N60

Facility

$164.75

Service Code	HCPCS C1769
Hospital Charge Code	270660310
Hospital Revenue Code	278
Min. Negotiated Rate	$24.71
Max. Negotiated Rate	$39.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.87
Rate for Payer: Qualcare PPO/HMO/WC	$24.71

GUIDEWIRE NIT 18X60 MAK001N60

Facility

$171.50

Service Code	HCPCS C1769
Hospital Charge Code	270660310N
Hospital Revenue Code	278
Min. Negotiated Rate	$25.73
Max. Negotiated Rate	$85.75
Rate for Payer: Aetna Commercial	$51.45
Rate for Payer: Aetna Medicare Advantage	$51.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.73
Rate for Payer: Cigna Commercial	$85.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.73

GUIDEWIRE NIT 18X60 MAK001N60

Facility

$171.50

Service Code	HCPCS C1769
Hospital Charge Code	270660310N
Hospital Revenue Code	278
Min. Negotiated Rate	$25.73
Max. Negotiated Rate	$41.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.73

GUIDEWIRE NIT 18X60 MAK001N60

Facility

$164.75

Service Code	HCPCS C1769
Hospital Charge Code	270660310S
Hospital Revenue Code	278
Min. Negotiated Rate	$24.71
Max. Negotiated Rate	$39.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.87
Rate for Payer: Qualcare PPO/HMO/WC	$24.71

GUIDEWIRE NIT 18X60 MAK001N60

Facility

$164.75

Service Code	HCPCS C1769
Hospital Charge Code	270660310S
Hospital Revenue Code	278
Min. Negotiated Rate	$24.71
Max. Negotiated Rate	$82.38
Rate for Payer: Aetna Commercial	$49.42
Rate for Payer: Aetna Medicare Advantage	$49.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.01
Rate for Payer: Cigna Commercial	$82.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.87
Rate for Payer: Qualcare PPO/HMO/WC	$24.71

GUIDEWIRE NITINOL 1.4 MMX457

Facility

$500.00

Service Code	HCPCS C1769
Hospital Charge Code	270692234
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

Know your out-of-pocket cost for care.

All Charges