Heights University Hospital

All Charges

Charge

Type

Setting

Price

GUIDWR BMW UNV II 190c1009664J

Facility

$3,750.00

Service Code	HCPCS C1769
Hospital Charge Code	270642950
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

GUIDWR BMW UNV II 190c1009664J

Facility

$3,750.00

Service Code	HCPCS C1769
Hospital Charge Code	270642950
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,125.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

GUIDZEBRA UROLOGICAL

Facility

$453.77

Hospital Charge Code	270653658
Hospital Revenue Code	271
Min. Negotiated Rate	$58.99
Max. Negotiated Rate	$226.88
Rate for Payer: Aetna Commercial	$136.13
Rate for Payer: Aetna Medicare Advantage	$136.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.71
Rate for Payer: Cigna Commercial	$226.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.99
Rate for Payer: Oxford Commercial	$226.88
Rate for Payer: Qualcare PPO/HMO/WC	$68.07
Rate for Payer: UnitedHealthcare Commercial	$226.88

GUIDZEBRA UROLOGICAL

Facility

$453.77

Hospital Charge Code	270653658
Hospital Revenue Code	271
Min. Negotiated Rate	$68.07
Max. Negotiated Rate	$68.07
Rate for Payer: Qualcare PPO/HMO/WC	$68.07

GUI WIR .09Mx100m .03K100.09S

Facility

$37.50

Hospital Charge Code	270639854
Hospital Revenue Code	272
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$18.75
Rate for Payer: Aetna Commercial	$11.25
Rate for Payer: Aetna Medicare Advantage	$11.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.56
Rate for Payer: Cigna Commercial	$18.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.88
Rate for Payer: Oxford Commercial	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$5.62
Rate for Payer: UnitedHealthcare Commercial	$18.75

GUI WIR .09Mx100m .03K100.09S

Facility

$37.50

Hospital Charge Code	270639854
Hospital Revenue Code	272
Min. Negotiated Rate	$5.62
Max. Negotiated Rate	$5.62
Rate for Payer: Qualcare PPO/HMO/WC	$5.62

GUI WIR 1.1Mx100m .045K10011S

Facility

$37.50

Hospital Charge Code	270639855
Hospital Revenue Code	272
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$18.75
Rate for Payer: Aetna Commercial	$11.25
Rate for Payer: Aetna Medicare Advantage	$11.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.56
Rate for Payer: Cigna Commercial	$18.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.88
Rate for Payer: Oxford Commercial	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$5.62
Rate for Payer: UnitedHealthcare Commercial	$18.75

GUI WIR 1.1Mx100m .045K10011S

Facility

$37.50

Hospital Charge Code	270639855
Hospital Revenue Code	272
Min. Negotiated Rate	$5.62
Max. Negotiated Rate	$5.62
Rate for Payer: Qualcare PPO/HMO/WC	$5.62

GUI/WIRE AMPLATZ STIFF.035/180

Facility

$202.74

Hospital Charge Code	2709000697
Hospital Revenue Code	272
Min. Negotiated Rate	$30.41
Max. Negotiated Rate	$30.41
Rate for Payer: Qualcare PPO/HMO/WC	$30.41

GUI/WIRE AMPLATZ STIFF.035/180

Facility

$202.74

Hospital Charge Code	2709000697
Hospital Revenue Code	272
Min. Negotiated Rate	$26.36
Max. Negotiated Rate	$101.37
Rate for Payer: Aetna Commercial	$60.82
Rate for Payer: Aetna Medicare Advantage	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.70
Rate for Payer: Cigna Commercial	$101.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.36
Rate for Payer: Oxford Commercial	$101.37
Rate for Payer: Qualcare PPO/HMO/WC	$30.41
Rate for Payer: UnitedHealthcare Commercial	$101.37

GUN INFLATION ALLIANCE II

Facility

$778.95

Hospital Charge Code	270658166
Hospital Revenue Code	278
Min. Negotiated Rate	$116.84
Max. Negotiated Rate	$188.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.51
Rate for Payer: Qualcare PPO/HMO/WC	$116.84

GUN INFLATION ALLIANCE II

Facility

$778.95

Hospital Charge Code	270658166
Hospital Revenue Code	278
Min. Negotiated Rate	$116.84
Max. Negotiated Rate	$389.48
Rate for Payer: Aetna Commercial	$233.69
Rate for Payer: Aetna Medicare Advantage	$233.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$155.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.63
Rate for Payer: Cigna Commercial	$389.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.51
Rate for Payer: Qualcare PPO/HMO/WC	$116.84

GUN MAXCORE 18G 16cm

Facility

$177.09

Hospital Charge Code	270624452
Hospital Revenue Code	272
Min. Negotiated Rate	$23.02
Max. Negotiated Rate	$88.55
Rate for Payer: Aetna Commercial	$53.13
Rate for Payer: Aetna Medicare Advantage	$53.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.16
Rate for Payer: Cigna Commercial	$88.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.02
Rate for Payer: Oxford Commercial	$88.55
Rate for Payer: Qualcare PPO/HMO/WC	$26.56
Rate for Payer: UnitedHealthcare Commercial	$88.55

GUN MAXCORE 18G 16cm

Facility

$177.09

Hospital Charge Code	270624452
Hospital Revenue Code	272
Min. Negotiated Rate	$26.56
Max. Negotiated Rate	$26.56
Rate for Payer: Qualcare PPO/HMO/WC	$26.56

Gun Max Core 18G x 10CM

Facility

$29.20

Hospital Charge Code	270655482
Hospital Revenue Code	272
Min. Negotiated Rate	$4.38
Max. Negotiated Rate	$4.38
Rate for Payer: Qualcare PPO/HMO/WC	$4.38

Gun Max Core 18G x 10CM

Facility

$29.20

Hospital Charge Code	270655482
Hospital Revenue Code	272
Min. Negotiated Rate	$3.80
Max. Negotiated Rate	$14.60
Rate for Payer: Aetna Commercial	$8.76
Rate for Payer: Aetna Medicare Advantage	$8.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.45
Rate for Payer: Cigna Commercial	$14.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.80
Rate for Payer: Oxford Commercial	$14.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.38
Rate for Payer: UnitedHealthcare Commercial	$14.60

GUN MAX CORE 18G X 10CM

Facility

$146.00

Hospital Charge Code	2709001228
Hospital Revenue Code	272
Min. Negotiated Rate	$18.98
Max. Negotiated Rate	$73.00
Rate for Payer: Aetna Commercial	$43.80
Rate for Payer: Aetna Medicare Advantage	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.23
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$73.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$73.00

GUN MAX CORE 18G X 10CM

Facility

$146.00

Hospital Charge Code	2709001228
Hospital Revenue Code	272
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

GUN MAX CORE 18G X 16CM 5/BX

Facility

$146.00

Hospital Charge Code	2706000702
Hospital Revenue Code	272
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

GUN MAX CORE 18G X 16CM 5/BX

Facility

$146.00

Hospital Charge Code	2706000702
Hospital Revenue Code	272
Min. Negotiated Rate	$18.98
Max. Negotiated Rate	$73.00
Rate for Payer: Aetna Commercial	$43.80
Rate for Payer: Aetna Medicare Advantage	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.23
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$73.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$73.00

GUN MAX CORE 18G X 16CM 5/BX

Facility

$146.00

Hospital Charge Code	2706000706
Hospital Revenue Code	272
Min. Negotiated Rate	$18.98
Max. Negotiated Rate	$73.00
Rate for Payer: Aetna Commercial	$43.80
Rate for Payer: Aetna Medicare Advantage	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.23
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$73.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$73.00

GUN MAX CORE 18G X 16CM 5/BX

Facility

$146.00

Hospital Charge Code	2706000706
Hospital Revenue Code	272
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

GUN MAX CORE 18G X 25CM

Facility

$146.00

Hospital Charge Code	2709003439
Hospital Revenue Code	272
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

GUN MAX CORE 18G X 25CM

Facility

$146.00

Hospital Charge Code	2709003439
Hospital Revenue Code	272
Min. Negotiated Rate	$18.98
Max. Negotiated Rate	$73.00
Rate for Payer: Aetna Commercial	$43.80
Rate for Payer: Aetna Medicare Advantage	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.23
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$73.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$73.00

GUN MAXCORE 18GX25cm MC1825

Facility

$260.00

Hospital Charge Code	270662000
Hospital Revenue Code	272
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00

Know your out-of-pocket cost for care.

All Charges