Heights University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE ROSEN .035 260cm

Facility

$81.80

Service Code	HCPCS C1769
Hospital Charge Code	270624343S
Hospital Revenue Code	278
Min. Negotiated Rate	$12.27
Max. Negotiated Rate	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.80
Rate for Payer: Qualcare PPO/HMO/WC	$12.27

GUIDEWIRE ROSEN .035 260cm J

Facility

$86.13

Service Code	HCPCS C1769
Hospital Charge Code	270623263
Hospital Revenue Code	278
Min. Negotiated Rate	$12.92
Max. Negotiated Rate	$43.06
Rate for Payer: Aetna Commercial	$25.84
Rate for Payer: Aetna Medicare Advantage	$25.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.96
Rate for Payer: Cigna Commercial	$43.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.92

GUIDEWIRE ROSEN .035 260cm J

Facility

$86.13

Service Code	HCPCS C1769
Hospital Charge Code	270623263
Hospital Revenue Code	278
Min. Negotiated Rate	$12.92
Max. Negotiated Rate	$20.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.92

GUIDEWIRE ROSEN THSCF 35-145-1

Facility

$56.80

Hospital Charge Code	270658311S
Hospital Revenue Code	272
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$8.52
Rate for Payer: Qualcare PPO/HMO/WC	$8.52

GUIDEWIRE ROSEN THSCF 35-145-1

Facility

$56.80

Hospital Charge Code	270658311S
Hospital Revenue Code	272
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$28.40
Rate for Payer: Aetna Commercial	$17.04
Rate for Payer: Aetna Medicare Advantage	$17.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.48
Rate for Payer: Cigna Commercial	$28.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.38
Rate for Payer: Oxford Commercial	$28.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.52
Rate for Payer: UnitedHealthcare Commercial	$28.40

GUIDEWIRE ROSEN THSCF 35-145-1

Facility

$56.80

Hospital Charge Code	270658311
Hospital Revenue Code	272
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$8.52
Rate for Payer: Qualcare PPO/HMO/WC	$8.52

GUIDEWIRE ROSEN THSCF 35-145-1

Facility

$56.80

Hospital Charge Code	270658311
Hospital Revenue Code	272
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$28.40
Rate for Payer: Aetna Commercial	$17.04
Rate for Payer: Aetna Medicare Advantage	$17.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.48
Rate for Payer: Cigna Commercial	$28.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.38
Rate for Payer: Oxford Commercial	$28.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.52
Rate for Payer: UnitedHealthcare Commercial	$28.40

GUIDEWIRE ROSEN THSCF 35-145-1

Facility

$70.00

Hospital Charge Code	270658311N
Hospital Revenue Code	272
Min. Negotiated Rate	$9.10
Max. Negotiated Rate	$35.00
Rate for Payer: Aetna Commercial	$21.00
Rate for Payer: Aetna Medicare Advantage	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.85
Rate for Payer: Cigna Commercial	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.10
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.50
Rate for Payer: UnitedHealthcare Commercial	$35.00

GUIDEWIRE ROSEN THSCF 35-145-1

Facility

$70.00

Hospital Charge Code	270658311N
Hospital Revenue Code	272
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.50

GUIDEWIRE ROSEN THSCF-35-180-1

Facility

$56.80

Hospital Charge Code	2706000672
Hospital Revenue Code	272
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$28.40
Rate for Payer: Aetna Commercial	$17.04
Rate for Payer: Aetna Medicare Advantage	$17.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.48
Rate for Payer: Cigna Commercial	$28.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.38
Rate for Payer: Oxford Commercial	$28.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.52
Rate for Payer: UnitedHealthcare Commercial	$28.40

GUIDEWIRE ROSEN THSCF-35-180-1

Facility

$56.80

Hospital Charge Code	2706000672
Hospital Revenue Code	272
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$8.52
Rate for Payer: Qualcare PPO/HMO/WC	$8.52

GUIDEWIRE ROSEN THSCF35260***

Facility

$50.00

Hospital Charge Code	270623529
Hospital Revenue Code	272
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$15.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$25.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$25.00

GUIDEWIRE ROSEN THSCF35260***

Facility

$50.00

Hospital Charge Code	270623529
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

GUIDEWIRE ROSEN THSCF-35-260-1

Facility

$81.80

Hospital Charge Code	2706000673
Hospital Revenue Code	272
Min. Negotiated Rate	$12.27
Max. Negotiated Rate	$12.27
Rate for Payer: Qualcare PPO/HMO/WC	$12.27

GUIDEWIRE ROSEN THSCF-35-260-1

Facility

$81.80

Hospital Charge Code	2706000673
Hospital Revenue Code	272
Min. Negotiated Rate	$10.63
Max. Negotiated Rate	$40.90
Rate for Payer: Aetna Commercial	$24.54
Rate for Payer: Aetna Medicare Advantage	$24.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.86
Rate for Payer: Cigna Commercial	$40.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.63
Rate for Payer: Oxford Commercial	$40.90
Rate for Payer: Qualcare PPO/HMO/WC	$12.27
Rate for Payer: UnitedHealthcare Commercial	$40.90

GUIDEWIRE RUNTHR NS 180 251011

Facility

$530.00

Service Code	HCPCS C1769
Hospital Charge Code	270642945C
Hospital Revenue Code	278
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$265.00
Rate for Payer: Aetna Commercial	$159.00
Rate for Payer: Aetna Medicare Advantage	$159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.15
Rate for Payer: Cigna Commercial	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.26
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

GUIDEWIRE RUNTHR NS 180 251011

Facility

$530.00

Service Code	HCPCS C1769
Hospital Charge Code	270642945C
Hospital Revenue Code	278
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.26
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

GUIDEWIRE RUNTHROUGH NS .014

Facility

$420.00

Hospital Charge Code	270642946
Hospital Revenue Code	278
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$101.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

GUIDEWIRE RUNTHROUGH NS .014

Facility

$420.00

Hospital Charge Code	270642946
Hospital Revenue Code	278
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$210.00
Rate for Payer: Aetna Commercial	$126.00
Rate for Payer: Aetna Medicare Advantage	$126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.10
Rate for Payer: Cigna Commercial	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

GUIDEWIRE RUNTHROUGH NS 150cm

Facility

$687.50

Hospital Charge Code	270642947
Hospital Revenue Code	278
Min. Negotiated Rate	$103.12
Max. Negotiated Rate	$166.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.38
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

GUIDEWIRE RUNTHROUGH NS 150cm

Facility

$687.50

Hospital Charge Code	270642947
Hospital Revenue Code	278
Min. Negotiated Rate	$103.12
Max. Negotiated Rate	$343.75
Rate for Payer: Aetna Commercial	$206.25
Rate for Payer: Aetna Medicare Advantage	$206.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.31
Rate for Payer: Cigna Commercial	$343.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.38
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

GUIDEWIRE RUNTHROUGH NS 300c

Facility

$530.00

Service Code	HCPCS C1769
Hospital Charge Code	270642946C
Hospital Revenue Code	278
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$265.00
Rate for Payer: Aetna Commercial	$159.00
Rate for Payer: Aetna Medicare Advantage	$159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.15
Rate for Payer: Cigna Commercial	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.26
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

GUIDEWIRE RUNTHROUGH NS 300c

Facility

$530.00

Service Code	HCPCS C1769
Hospital Charge Code	270642946C
Hospital Revenue Code	278
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.26
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

GUIDEWIRES

Facility

$1,680.00

Hospital Charge Code	270702849
Hospital Revenue Code	278
Min. Negotiated Rate	$252.00
Max. Negotiated Rate	$406.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.56
Rate for Payer: Qualcare PPO/HMO/WC	$252.00

GUIDEWIRES

Facility

$1,680.00

Hospital Charge Code	270702849
Hospital Revenue Code	278
Min. Negotiated Rate	$252.00
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Commercial	$504.00
Rate for Payer: Aetna Medicare Advantage	$504.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$428.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$428.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$428.40
Rate for Payer: Cigna Commercial	$840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.56
Rate for Payer: Qualcare PPO/HMO/WC	$252.00

Know your out-of-pocket cost for care.

All Charges