Heights University Hospital

All Charges

Charge

Type

Setting

Price

GUIDEWIRE THRD 2.0x230MM

Facility

$171.50

Hospital Charge Code	270605007
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 THRD 2.0x230MM

Facility

$171.50

Hospital Charge Code	270605007
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 THRD 2.8MMX220MM

Facility

$723.25

Service Code	HCPCS C1713
Hospital Charge Code	270697388
Hospital Revenue Code	278
Min. Negotiated Rate	$108.49
Max. Negotiated Rate	$175.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.03
Rate for Payer: Qualcare PPO/HMO/WC	$108.49

GUIDEWIRE THRD 2.8MMX220MM

Facility

$723.25

Service Code	HCPCS C1713
Hospital Charge Code	270697388
Hospital Revenue Code	278
Min. Negotiated Rate	$108.49
Max. Negotiated Rate	$361.62
Rate for Payer: Aetna Commercial	$216.97
Rate for Payer: Aetna Medicare Advantage	$216.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.43
Rate for Payer: Cigna Commercial	$361.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.03
Rate for Payer: Qualcare PPO/HMO/WC	$108.49

GUIDEWIRE THRD BOTH ENDS 1.6x1

Facility

$173.45

Service Code	HCPCS C1769
Hospital Charge Code	270682258
Hospital Revenue Code	278
Min. Negotiated Rate	$26.02
Max. Negotiated Rate	$41.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.97
Rate for Payer: Qualcare PPO/HMO/WC	$26.02

GUIDEWIRE THRD BOTH ENDS 1.6x1

Facility

$173.45

Service Code	HCPCS C1769
Hospital Charge Code	270682258
Hospital Revenue Code	278
Min. Negotiated Rate	$26.02
Max. Negotiated Rate	$86.72
Rate for Payer: Aetna Commercial	$52.03
Rate for Payer: Aetna Medicare Advantage	$52.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.23
Rate for Payer: Cigna Commercial	$86.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.97
Rate for Payer: Qualcare PPO/HMO/WC	$26.02

GUIDE WIRE THREADED 3.2x300MM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270656520
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDE WIRE THREADED 3.2x300MM

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270656520
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

GUIDEWIRE THRUWAY .014 130cm

Facility

$400.00

Hospital Charge Code	270634367
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

GUIDEWIRE THRUWAY .014 130cm

Facility

$400.00

Hospital Charge Code	270634367
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$120.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

GUIDEWIRE THRUWAY .014 190cm

Facility

$400.00

Hospital Charge Code	270634768
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$120.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

GUIDEWIRE THRUWAY .014 190cm

Facility

$400.00

Hospital Charge Code	270634768
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

GUIDEWIRE THRUWAY .014/190CM

Facility

$581.25

Hospital Charge Code	2709002345
Hospital Revenue Code	272
Min. Negotiated Rate	$87.19
Max. Negotiated Rate	$87.19
Rate for Payer: Qualcare PPO/HMO/WC	$87.19

GUIDEWIRE THRUWAY .014/190CM

Facility

$581.25

Hospital Charge Code	2709002345
Hospital Revenue Code	272
Min. Negotiated Rate	$75.56
Max. Negotiated Rate	$290.62
Rate for Payer: Aetna Commercial	$174.38
Rate for Payer: Aetna Medicare Advantage	$174.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.22
Rate for Payer: Cigna Commercial	$290.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.56
Rate for Payer: Oxford Commercial	$290.62
Rate for Payer: Qualcare PPO/HMO/WC	$87.19
Rate for Payer: UnitedHealthcare Commercial	$290.62

GUIDEWIRE THRUWAY .014 300cm

Facility

$625.00

Service Code	HCPCS C1769
Hospital Charge Code	270634769
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

GUIDEWIRE THRUWAY .014 300cm

Facility

$625.00

Service Code	HCPCS C1769
Hospital Charge Code	270634769
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$187.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

GUIDE WIRE THSF-35-480

Facility

$300.70

Hospital Charge Code	270639711
Hospital Revenue Code	272
Min. Negotiated Rate	$45.10
Max. Negotiated Rate	$45.10
Rate for Payer: Qualcare PPO/HMO/WC	$45.10

GUIDE WIRE THSF-35-480

Facility

$300.70

Hospital Charge Code	270639711
Hospital Revenue Code	272
Min. Negotiated Rate	$39.09
Max. Negotiated Rate	$150.35
Rate for Payer: Aetna Commercial	$90.21
Rate for Payer: Aetna Medicare Advantage	$90.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.68
Rate for Payer: Cigna Commercial	$150.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.09
Rate for Payer: Oxford Commercial	$150.35
Rate for Payer: Qualcare PPO/HMO/WC	$45.10
Rate for Payer: UnitedHealthcare Commercial	$150.35

GUIDEWIRE TORNUS 2.1FR

Facility

$3,975.00

Hospital Charge Code	270642954
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,192.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

GUIDEWIRE TORNUS 2.1FR

Facility

$3,975.00

Hospital Charge Code	270642954
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

GUIDEWIRE TORNUS 2.6FR

Facility

$3,975.00

Hospital Charge Code	270642955
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,192.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

GUIDEWIRE TORNUS 2.6FR

Facility

$3,975.00

Hospital Charge Code	270642955
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

GUIDE WIRE TROCAR .034

Facility

$110.00

Service Code	HCPCS C1769
Hospital Charge Code	270679769
Hospital Revenue Code	278
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$26.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

GUIDE WIRE TROCAR .034

Facility

$110.00

Service Code	HCPCS C1769
Hospital Charge Code	270679769
Hospital Revenue Code	278
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$33.00
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

GUIDEWIRE, TROCAR 1.1. MM

Facility

$100.00

Service Code	HCPCS C1713
Hospital Charge Code	270690416
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

Know your out-of-pocket cost for care.

All Charges