Heights University Hospital

All Charges

Charge

Type

Setting

Price

GUIDE WIRES 1.2MMX70MM

Facility

$265.00

Hospital Charge Code	270657351
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 WIRES 1.2MMX70MM

Facility

$265.00

Hospital Charge Code	270657351
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 SCIMD 300 GW 1210001

Facility

$430.00

Service Code	HCPCS C1769
Hospital Charge Code	270629662
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

GUIDEWIRE SCIMD 300 GW 1210001

Facility

$430.00

Service Code	HCPCS C1769
Hospital Charge Code	270629662
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 SCIMED 12130-01

Facility

$1,920.00

Hospital Charge Code	270629661
Hospital Revenue Code	278
Min. Negotiated Rate	$288.00
Max. Negotiated Rate	$464.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$384.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.64
Rate for Payer: Qualcare PPO/HMO/WC	$288.00

GUIDEWIRE SCIMED 12130-01

Facility

$1,920.00

Hospital Charge Code	270629661
Hospital Revenue Code	278
Min. Negotiated Rate	$288.00
Max. Negotiated Rate	$960.00
Rate for Payer: Aetna Commercial	$576.00
Rate for Payer: Aetna Medicare Advantage	$576.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$489.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$489.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$384.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$489.60
Rate for Payer: Cigna Commercial	$960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.64
Rate for Payer: Qualcare PPO/HMO/WC	$288.00

GUIDEWIRE SDK SHARP 8670002

Facility

$291.25

Hospital Charge Code	270629194
Hospital Revenue Code	278
Min. Negotiated Rate	$43.69
Max. Negotiated Rate	$70.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.48
Rate for Payer: Qualcare PPO/HMO/WC	$43.69

GUIDEWIRE SDK SHARP 8670002

Facility

$291.25

Hospital Charge Code	270629194
Hospital Revenue Code	278
Min. Negotiated Rate	$43.69
Max. Negotiated Rate	$145.62
Rate for Payer: Aetna Commercial	$87.38
Rate for Payer: Aetna Medicare Advantage	$87.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.27
Rate for Payer: Cigna Commercial	$145.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.48
Rate for Payer: Qualcare PPO/HMO/WC	$43.69

GUIDEWIRE SENSOR .035 SENSOR

Facility

$374.66

Service Code	HCPCS C1769
Hospital Charge Code	270685946
Hospital Revenue Code	278
Min. Negotiated Rate	$56.20
Max. Negotiated Rate	$90.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.67
Rate for Payer: Qualcare PPO/HMO/WC	$56.20

GUIDEWIRE SENSOR .035 SENSOR

Facility

$374.66

Service Code	HCPCS C1769
Hospital Charge Code	270685946
Hospital Revenue Code	278
Min. Negotiated Rate	$56.20
Max. Negotiated Rate	$187.33
Rate for Payer: Aetna Commercial	$112.40
Rate for Payer: Aetna Medicare Advantage	$112.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.54
Rate for Payer: Cigna Commercial	$187.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.67
Rate for Payer: Qualcare PPO/HMO/WC	$56.20

GUIDE WIRE SHILEY SUB CANNV***

Facility

$64.00

Hospital Charge Code	8002487
Hospital Revenue Code	279
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$19.20
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.32
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$32.00

GUIDE WIRE SHILEY SUB CANNV***

Facility

$64.00

Hospital Charge Code	8002487
Hospital Revenue Code	279
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

GUIDEWIRE SHINOBI 300c 547114X

Facility

$432.20

Hospital Charge Code	270632478
Hospital Revenue Code	272
Min. Negotiated Rate	$56.19
Max. Negotiated Rate	$216.10
Rate for Payer: Aetna Commercial	$129.66
Rate for Payer: Aetna Medicare Advantage	$129.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.21
Rate for Payer: Cigna Commercial	$216.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.19
Rate for Payer: Oxford Commercial	$216.10
Rate for Payer: Qualcare PPO/HMO/WC	$64.83
Rate for Payer: UnitedHealthcare Commercial	$216.10

GUIDEWIRE SHINOBI 300c 547114X

Facility

$432.20

Hospital Charge Code	270632478
Hospital Revenue Code	272
Min. Negotiated Rate	$64.83
Max. Negotiated Rate	$64.83
Rate for Payer: Qualcare PPO/HMO/WC	$64.83

GUIDEWIRE SINGLE SHARP THREADE

Facility

$1,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270695152
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

GUIDEWIRE SINGLE SHARP THREADE

Facility

$1,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270695152
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

GUIDEWIRE SMALL 2.0MM

Facility

$100.00

Service Code	HCPCS C1769
Hospital Charge Code	270698454
Hospital Revenue Code	278
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$30.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

GUIDEWIRE SMALL 2.0MM

Facility

$100.00

Service Code	HCPCS C1769
Hospital Charge Code	270698454
Hospital Revenue Code	278
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$24.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

GUIDE WIRE SMOOTH TIPPED

Facility

$1,475.00

Hospital Charge Code	270674284
Hospital Revenue Code	272
Min. Negotiated Rate	$191.75
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.75
Rate for Payer: Oxford Commercial	$737.50
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$737.50

GUIDE WIRE SMOOTH TIPPED

Facility

$1,475.00

Hospital Charge Code	270674284
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

GUIDE WIRE SMOOTH TIPPED

Facility

$876.65

Service Code	HCPCS C1769
Hospital Charge Code	270661240
Hospital Revenue Code	278
Min. Negotiated Rate	$131.50
Max. Negotiated Rate	$212.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.15
Rate for Payer: Qualcare PPO/HMO/WC	$131.50

GUIDE WIRE SMOOTH TIPPED

Facility

$876.65

Service Code	HCPCS C1769
Hospital Charge Code	270661240
Hospital Revenue Code	278
Min. Negotiated Rate	$131.50
Max. Negotiated Rate	$438.32
Rate for Payer: Aetna Commercial	$263.00
Rate for Payer: Aetna Medicare Advantage	$263.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.55
Rate for Payer: Cigna Commercial	$438.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.15
Rate for Payer: Qualcare PPO/HMO/WC	$131.50

GUIDEWIRE SOLO FLEX NI .035 15

Facility

$212.00

Service Code	HCPCS C1769
Hospital Charge Code	270682482
Hospital Revenue Code	278
Min. Negotiated Rate	$31.80
Max. Negotiated Rate	$106.00
Rate for Payer: Aetna Commercial	$63.60
Rate for Payer: Aetna Medicare Advantage	$63.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.06
Rate for Payer: Cigna Commercial	$106.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.30
Rate for Payer: Qualcare PPO/HMO/WC	$31.80

GUIDEWIRE SOLO FLEX NI .035 15

Facility

$212.00

Service Code	HCPCS C1769
Hospital Charge Code	270682482
Hospital Revenue Code	278
Min. Negotiated Rate	$31.80
Max. Negotiated Rate	$51.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.30
Rate for Payer: Qualcare PPO/HMO/WC	$31.80

GUIDEWIRE SOLO FLEX NI .038 15

Facility

$212.00

Service Code	HCPCS C1769
Hospital Charge Code	270682483
Hospital Revenue Code	278
Min. Negotiated Rate	$31.80
Max. Negotiated Rate	$106.00
Rate for Payer: Aetna Commercial	$63.60
Rate for Payer: Aetna Medicare Advantage	$63.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.06
Rate for Payer: Cigna Commercial	$106.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.30
Rate for Payer: Qualcare PPO/HMO/WC	$31.80

Know your out-of-pocket cost for care.

All Charges