Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 TROCAR 1.6 MM

Facility

$100.00

Service Code	HCPCS C1713
Hospital Charge Code	270689810
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 TROCAR 1.6 MM

Facility

$100.00

Service Code	HCPCS C1713
Hospital Charge Code	270689810
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

GUIDEWIRE TROCAR TIP 1.4X150MM

Facility

$2,095.00

Service Code	HCPCS C1713
Hospital Charge Code	270695506
Hospital Revenue Code	278
Min. Negotiated Rate	$314.25
Max. Negotiated Rate	$1,047.50
Rate for Payer: Aetna Commercial	$628.50
Rate for Payer: Aetna Medicare Advantage	$628.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$534.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$534.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$419.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$534.23
Rate for Payer: Cigna Commercial	$1,047.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$506.99
Rate for Payer: Qualcare PPO/HMO/WC	$314.25

GUIDEWIRE TROCAR TIP 1.4X150MM

Facility

$2,095.00

Service Code	HCPCS C1713
Hospital Charge Code	270695506
Hospital Revenue Code	278
Min. Negotiated Rate	$314.25
Max. Negotiated Rate	$506.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$419.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$506.99
Rate for Payer: Qualcare PPO/HMO/WC	$314.25

GUIDEWIRE TROCAR TIP 1.6X220MM

Facility

$2,285.25

Service Code	HCPCS C1713
Hospital Charge Code	270695505
Hospital Revenue Code	278
Min. Negotiated Rate	$342.79
Max. Negotiated Rate	$553.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$457.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$553.03
Rate for Payer: Qualcare PPO/HMO/WC	$342.79

GUIDEWIRE TROCAR TIP 1.6X220MM

Facility

$2,285.25

Service Code	HCPCS C1713
Hospital Charge Code	270695505
Hospital Revenue Code	278
Min. Negotiated Rate	$342.79
Max. Negotiated Rate	$1,142.62
Rate for Payer: Aetna Commercial	$685.58
Rate for Payer: Aetna Medicare Advantage	$685.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$582.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$582.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$457.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$582.74
Rate for Payer: Cigna Commercial	$1,142.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$553.03
Rate for Payer: Qualcare PPO/HMO/WC	$342.79

GUIDEWIRE TROCAR TIP THD 2.4X9

Facility

$150.00

Service Code	HCPCS C1713
Hospital Charge Code	270693889
Hospital Revenue Code	278
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

GUIDEWIRE TROCAR TIP THD 2.4X9

Facility

$150.00

Service Code	HCPCS C1713
Hospital Charge Code	270693889
Hospital Revenue Code	278
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

GUIDEWIRE TSCM-35-125-3

Facility

$107.00

Hospital Charge Code	270601492
Hospital Revenue Code	278
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$53.50
Rate for Payer: Aetna Commercial	$32.10
Rate for Payer: Aetna Medicare Advantage	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.29
Rate for Payer: Cigna Commercial	$53.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.89
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

GUIDEWIRE TSCM-35-125-3

Facility

$107.00

Hospital Charge Code	270601492
Hospital Revenue Code	278
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$25.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.89
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

GUIDEWIRE TSCM-38-125-3

Facility

$57.10

Hospital Charge Code	270606105
Hospital Revenue Code	272
Min. Negotiated Rate	$8.56
Max. Negotiated Rate	$8.56
Rate for Payer: Qualcare PPO/HMO/WC	$8.56

GUIDEWIRE TSCM-38-125-3

Facility

$57.10

Hospital Charge Code	270606105
Hospital Revenue Code	272
Min. Negotiated Rate	$7.42
Max. Negotiated Rate	$28.55
Rate for Payer: Aetna Commercial	$17.13
Rate for Payer: Aetna Medicare Advantage	$17.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.56
Rate for Payer: Cigna Commercial	$28.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.42
Rate for Payer: Oxford Commercial	$28.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.56
Rate for Payer: UnitedHealthcare Commercial	$28.55

GUIDEWIRE TWAY 190X0.018 49279

Facility

$505.25

Hospital Charge Code	270633630
Hospital Revenue Code	278
Min. Negotiated Rate	$75.79
Max. Negotiated Rate	$122.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.27
Rate for Payer: Qualcare PPO/HMO/WC	$75.79

GUIDEWIRE TWAY 190X0.018 49279

Facility

$505.25

Hospital Charge Code	270633630
Hospital Revenue Code	278
Min. Negotiated Rate	$75.79
Max. Negotiated Rate	$252.62
Rate for Payer: Aetna Commercial	$151.57
Rate for Payer: Aetna Medicare Advantage	$151.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.84
Rate for Payer: Cigna Commercial	$252.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.27
Rate for Payer: Qualcare PPO/HMO/WC	$75.79

GUIDE WIRE UNTHD 2.0MM X150M

Facility

$611.05

Hospital Charge Code	270700898
Hospital Revenue Code	272
Min. Negotiated Rate	$79.44
Max. Negotiated Rate	$305.52
Rate for Payer: Aetna Commercial	$183.31
Rate for Payer: Aetna Medicare Advantage	$183.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.82
Rate for Payer: Cigna Commercial	$305.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.44
Rate for Payer: Oxford Commercial	$305.52
Rate for Payer: Qualcare PPO/HMO/WC	$91.66
Rate for Payer: UnitedHealthcare Commercial	$305.52

GUIDE WIRE UNTHD 2.0MM X150M

Facility

$611.05

Hospital Charge Code	270700898
Hospital Revenue Code	272
Min. Negotiated Rate	$91.66
Max. Negotiated Rate	$91.66
Rate for Payer: Qualcare PPO/HMO/WC	$91.66

GUIDE WIRE V-18 .018 200CM

Facility

$435.00

Service Code	HCPCS C1769
Hospital Charge Code	270653649
Hospital Revenue Code	278
Min. Negotiated Rate	$65.25
Max. Negotiated Rate	$217.50
Rate for Payer: Aetna Commercial	$130.50
Rate for Payer: Aetna Medicare Advantage	$130.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.92
Rate for Payer: Cigna Commercial	$217.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.27
Rate for Payer: Qualcare PPO/HMO/WC	$65.25

GUIDE WIRE V-18 .018 200CM

Facility

$435.00

Service Code	HCPCS C1769
Hospital Charge Code	270653649S
Hospital Revenue Code	278
Min. Negotiated Rate	$65.25
Max. Negotiated Rate	$105.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.27
Rate for Payer: Qualcare PPO/HMO/WC	$65.25

GUIDE WIRE V-18 .018 200CM

Facility

$435.00

Service Code	HCPCS C1769
Hospital Charge Code	270653649N
Hospital Revenue Code	278
Min. Negotiated Rate	$65.25
Max. Negotiated Rate	$105.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.27
Rate for Payer: Qualcare PPO/HMO/WC	$65.25

GUIDE WIRE V-18 .018 200CM

Facility

$435.00

Service Code	HCPCS C1769
Hospital Charge Code	270653649
Hospital Revenue Code	278
Min. Negotiated Rate	$65.25
Max. Negotiated Rate	$105.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.27
Rate for Payer: Qualcare PPO/HMO/WC	$65.25

GUIDE WIRE V-18 .018 200CM

Facility

$435.00

Service Code	HCPCS C1769
Hospital Charge Code	270653649N
Hospital Revenue Code	278
Min. Negotiated Rate	$65.25
Max. Negotiated Rate	$217.50
Rate for Payer: Aetna Commercial	$130.50
Rate for Payer: Aetna Medicare Advantage	$130.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.92
Rate for Payer: Cigna Commercial	$217.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.27
Rate for Payer: Qualcare PPO/HMO/WC	$65.25

GUIDE WIRE V-18 .018 200CM

Facility

$435.00

Service Code	HCPCS C1769
Hospital Charge Code	270653649S
Hospital Revenue Code	278
Min. Negotiated Rate	$65.25
Max. Negotiated Rate	$217.50
Rate for Payer: Aetna Commercial	$130.50
Rate for Payer: Aetna Medicare Advantage	$130.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.92
Rate for Payer: Cigna Commercial	$217.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.27
Rate for Payer: Qualcare PPO/HMO/WC	$65.25

GUIDEWIRE V-18 8x200cm

Facility

$375.00

Hospital Charge Code	270638880C
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 V-18 8x200cm

Facility

$17,975.00

Hospital Charge Code	270641201C
Hospital Revenue Code	278
Min. Negotiated Rate	$2,696.25
Max. Negotiated Rate	$4,349.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,349.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,696.25

Know your out-of-pocket cost for care.

All Charges