Heights University Hospital

All Charges

Charge

Type

Setting

Price

GUIDE WIRE STRAIGHT TIP O35X

Facility

$84.00

Hospital Charge Code	270331516
Hospital Revenue Code	278
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$25.20
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.33
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

GUIDE WIRE STRAIGHT TIP O35X

Facility

$84.00

Hospital Charge Code	270331516
Hospital Revenue Code	278
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$20.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.33
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

GUIDEWIRE STR TIP .035 180cm

Facility

$219.58

Service Code	HCPCS C1769
Hospital Charge Code	270651264
Hospital Revenue Code	278
Min. Negotiated Rate	$32.94
Max. Negotiated Rate	$53.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.14
Rate for Payer: Qualcare PPO/HMO/WC	$32.94

GUIDEWIRE STR TIP .035 180cm

Facility

$219.58

Service Code	HCPCS C1769
Hospital Charge Code	270651264
Hospital Revenue Code	278
Min. Negotiated Rate	$32.94
Max. Negotiated Rate	$109.79
Rate for Payer: Aetna Commercial	$65.87
Rate for Payer: Aetna Medicare Advantage	$65.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.99
Rate for Payer: Cigna Commercial	$109.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.14
Rate for Payer: Qualcare PPO/HMO/WC	$32.94

GUIDEWIRE SUPER STIFF .035/500

Facility

$557.09

Service Code	HCPCS C1769
Hospital Charge Code	270644082
Hospital Revenue Code	278
Min. Negotiated Rate	$83.56
Max. Negotiated Rate	$278.55
Rate for Payer: Aetna Commercial	$167.13
Rate for Payer: Aetna Medicare Advantage	$167.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.06
Rate for Payer: Cigna Commercial	$278.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.82
Rate for Payer: Qualcare PPO/HMO/WC	$83.56

GUIDEWIRE SUPER STIFF .035/500

Facility

$557.09

Service Code	HCPCS C1769
Hospital Charge Code	270644082
Hospital Revenue Code	278
Min. Negotiated Rate	$83.56
Max. Negotiated Rate	$134.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.82
Rate for Payer: Qualcare PPO/HMO/WC	$83.56

GUIDEWIRE SV5 .018 503558

Facility

$498.45

Hospital Charge Code	270624011
Hospital Revenue Code	278
Min. Negotiated Rate	$74.77
Max. Negotiated Rate	$120.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.62
Rate for Payer: Qualcare PPO/HMO/WC	$74.77

GUIDEWIRE SV5 .018 503558

Facility

$498.45

Hospital Charge Code	270624011
Hospital Revenue Code	278
Min. Negotiated Rate	$74.77
Max. Negotiated Rate	$249.22
Rate for Payer: Aetna Commercial	$149.53
Rate for Payer: Aetna Medicare Advantage	$149.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.10
Rate for Payer: Cigna Commercial	$249.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.62
Rate for Payer: Qualcare PPO/HMO/WC	$74.77

GUIDEWIRE SV OMNI FLUSH 4FR

Facility

$105.00

Hospital Charge Code	270654575
Hospital Revenue Code	278
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$31.50
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.41
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

GUIDEWIRE SV OMNI FLUSH 4FR

Facility

$105.00

Hospital Charge Code	270654575
Hospital Revenue Code	278
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$25.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.41
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

GUIDEWIRE SYNCHNO .014IN X200

Facility

$3,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516S
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

GUIDEWIRE SYNCHNO .014IN X200

Facility

$2,850.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516
Hospital Revenue Code	278
Min. Negotiated Rate	$427.50
Max. Negotiated Rate	$1,425.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$855.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$726.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$726.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$726.75
Rate for Payer: Cigna Commercial	$1,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.70
Rate for Payer: Qualcare PPO/HMO/WC	$427.50

GUIDEWIRE SYNCHNO .014IN X200

Facility

$2,850.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516
Hospital Revenue Code	278
Min. Negotiated Rate	$427.50
Max. Negotiated Rate	$689.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$689.70
Rate for Payer: Qualcare PPO/HMO/WC	$427.50

GUIDEWIRE SYNCHNO .014IN X200

Facility

$3,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516N
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

GUIDEWIRE SYNCHNO .014IN X200

Facility

$3,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516N
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

GUIDEWIRE SYNCHNO .014IN X200

Facility

$3,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270682516S
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

GUIDEWIRE SYNCHRO .014 200CM

Facility

$3,158.75

Service Code	HCPCS C1769
Hospital Charge Code	270693901S
Hospital Revenue Code	272
Min. Negotiated Rate	$473.81
Max. Negotiated Rate	$473.81
Rate for Payer: Qualcare PPO/HMO/WC	$473.81

GUIDEWIRE SYNCHRO .014 200CM

Facility

$3,158.75

Service Code	HCPCS C1769
Hospital Charge Code	270693901S
Hospital Revenue Code	272
Min. Negotiated Rate	$410.64
Max. Negotiated Rate	$1,579.38
Rate for Payer: Aetna Commercial	$947.62
Rate for Payer: Aetna Medicare Advantage	$947.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$805.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$805.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$805.48
Rate for Payer: Cigna Commercial	$1,579.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$410.64
Rate for Payer: Oxford Commercial	$1,579.38
Rate for Payer: Qualcare PPO/HMO/WC	$473.81
Rate for Payer: UnitedHealthcare Commercial	$1,579.38

GUIDEWIRE SYNCHRO10 .01IN200CM

Facility

$3,058.00

Service Code	HCPCS C1769
Hospital Charge Code	270699939S
Hospital Revenue Code	278
Min. Negotiated Rate	$458.70
Max. Negotiated Rate	$1,529.00
Rate for Payer: Aetna Commercial	$917.40
Rate for Payer: Aetna Medicare Advantage	$917.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$779.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$779.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$611.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$779.79
Rate for Payer: Cigna Commercial	$1,529.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.04
Rate for Payer: Qualcare PPO/HMO/WC	$458.70

GUIDEWIRE SYNCHRO10 .01IN200CM

Facility

$3,058.00

Service Code	HCPCS C1769
Hospital Charge Code	270699939S
Hospital Revenue Code	278
Min. Negotiated Rate	$458.70
Max. Negotiated Rate	$740.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$611.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.04
Rate for Payer: Qualcare PPO/HMO/WC	$458.70

GUIDEWIRE SYNCHRO 200CM

Facility

$3,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270685069S
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

GUIDEWIRE SYNCHRO 200CM

Facility

$3,000.00

Service Code	HCPCS C1789
Hospital Charge Code	270685069
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

GUIDEWIRE SYNCHRO 200CM

Facility

$3,000.00

Service Code	HCPCS C1789
Hospital Charge Code	270685069
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

GUIDEWIRE SYNCHRO 200CM

Facility

$3,000.00

Service Code	HCPCS C1769
Hospital Charge Code	270685069S
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

GUIDEWIRE SYNCHRO 300CM

Facility

$3,750.00

Service Code	HCPCS C1769
Hospital Charge Code	270685070S
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

Know your out-of-pocket cost for care.

All Charges