Heights University Hospital

All Charges

Charge

Type

Setting

Price

GUN MAXCORE 18GX25cm MC1825

Facility

$260.00

Hospital Charge Code	270662000
Hospital Revenue Code	272
Min. Negotiated Rate	$33.80
Max. Negotiated Rate	$130.00
Rate for Payer: Aetna Commercial	$78.00
Rate for Payer: Aetna Medicare Advantage	$78.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.30
Rate for Payer: Cigna Commercial	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.80
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00
Rate for Payer: UnitedHealthcare Commercial	$130.00

GUN MAXCORE 20G 10cm

Facility

$29.20

Hospital Charge Code	270626052
Hospital Revenue Code	272
Min. Negotiated Rate	$3.80
Max. Negotiated Rate	$14.60
Rate for Payer: UnitedHealthcare Commercial	$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

GUN MAXCORE 20G 10cm

Facility

$29.20

Hospital Charge Code	270626052
Hospital Revenue Code	272
Min. Negotiated Rate	$4.38
Max. Negotiated Rate	$4.38
Rate for Payer: Qualcare PPO/HMO/WC	$4.38

GUN MAXCORE 20G 16cm

Facility

$29.20

Hospital Charge Code	270624453
Hospital Revenue Code	272
Min. Negotiated Rate	$4.38
Max. Negotiated Rate	$4.38
Rate for Payer: Qualcare PPO/HMO/WC	$4.38

GUN MAXCORE 20G 16cm

Facility

$29.20

Hospital Charge Code	270624453
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 MAXCORE 20G 20cm

Facility

$176.90

Hospital Charge Code	270624454
Hospital Revenue Code	272
Min. Negotiated Rate	$23.00
Max. Negotiated Rate	$88.45
Rate for Payer: Aetna Commercial	$53.07
Rate for Payer: Aetna Medicare Advantage	$53.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.11
Rate for Payer: Cigna Commercial	$88.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.00
Rate for Payer: Oxford Commercial	$88.45
Rate for Payer: Qualcare PPO/HMO/WC	$26.54
Rate for Payer: UnitedHealthcare Commercial	$88.45

GUN MAXCORE 20G 20cm

Facility

$176.90

Hospital Charge Code	270624454
Hospital Revenue Code	272
Min. Negotiated Rate	$26.54
Max. Negotiated Rate	$26.54
Rate for Payer: Qualcare PPO/HMO/WC	$26.54

GUN MAX CORE 20G X 10CM

Facility

$146.00

Hospital Charge Code	2709000652
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 20G X 10CM

Facility

$146.00

Hospital Charge Code	2709000652
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 MONOPTY 18G 10cm

Facility

$220.00

Hospital Charge Code	270631205
Hospital Revenue Code	272
Min. Negotiated Rate	$28.60
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$66.00
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.60
Rate for Payer: Oxford Commercial	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Commercial	$110.00

GUN MONOPTY 18G 10cm

Facility

$220.00

Hospital Charge Code	270631205
Hospital Revenue Code	272
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

GUN MONOPTY 18G 20cm BIOPSY

Facility

$132.15

Hospital Charge Code	270627540
Hospital Revenue Code	272
Min. Negotiated Rate	$19.82
Max. Negotiated Rate	$19.82
Rate for Payer: Qualcare PPO/HMO/WC	$19.82

GUN MONOPTY 18G 20cm BIOPSY

Facility

$132.15

Hospital Charge Code	270627540
Hospital Revenue Code	272
Min. Negotiated Rate	$17.18
Max. Negotiated Rate	$66.08
Rate for Payer: Aetna Commercial	$39.65
Rate for Payer: Aetna Medicare Advantage	$39.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.70
Rate for Payer: Cigna Commercial	$66.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.18
Rate for Payer: Oxford Commercial	$66.08
Rate for Payer: Qualcare PPO/HMO/WC	$19.82
Rate for Payer: UnitedHealthcare Commercial	$66.08

GWIRE ANG ZIPWIRE 0.035X180CM

Facility

$211.61

Service Code	HCPCS C1769
Hospital Charge Code	270601268
Hospital Revenue Code	278
Min. Negotiated Rate	$31.74
Max. Negotiated Rate	$105.81
Rate for Payer: Aetna Commercial	$63.48
Rate for Payer: Aetna Medicare Advantage	$63.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.96
Rate for Payer: Cigna Commercial	$105.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.21
Rate for Payer: Qualcare PPO/HMO/WC	$31.74

GWIRE ANG ZIPWIRE 0.035X180CM

Facility

$211.61

Service Code	HCPCS C1769
Hospital Charge Code	270601268
Hospital Revenue Code	278
Min. Negotiated Rate	$31.74
Max. Negotiated Rate	$51.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.21
Rate for Payer: Qualcare PPO/HMO/WC	$31.74

GWIRE ATW FLOP 300C 595MEX014

Facility

$370.10

Hospital Charge Code	270636291
Hospital Revenue Code	278
Min. Negotiated Rate	$55.52
Max. Negotiated Rate	$89.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.56
Rate for Payer: Qualcare PPO/HMO/WC	$55.52

GWIRE ATW FLOP 300C 595MEX014

Facility

$370.10

Hospital Charge Code	270636291
Hospital Revenue Code	278
Min. Negotiated Rate	$55.52
Max. Negotiated Rate	$185.05
Rate for Payer: Aetna Commercial	$111.03
Rate for Payer: Aetna Medicare Advantage	$111.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.38
Rate for Payer: Cigna Commercial	$185.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.56
Rate for Payer: Qualcare PPO/HMO/WC	$55.52

GWIRE COUGAR XT 300 CGRXT300HJ

Facility

$725.00

Hospital Charge Code	270636548V
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

GWIRE COUGAR XT 300 CGRXT300HJ

Facility

$725.00

Hospital Charge Code	270636548V
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

GWIRE COUG XT190CM CGRXT190HJ

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270636547
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

GWIRE COUG XT190CM CGRXT190HJ

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270636547
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

GWIRE COUG XT190CM CGRXT190HJ

Facility

$719.25

Service Code	HCPCS C1769
Hospital Charge Code	270636547N
Hospital Revenue Code	278
Min. Negotiated Rate	$107.89
Max. Negotiated Rate	$174.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.06
Rate for Payer: Qualcare PPO/HMO/WC	$107.89

GWIRE COUG XT190CM CGRXT190HJ

Facility

$719.25

Service Code	HCPCS C1769
Hospital Charge Code	270636547N
Hospital Revenue Code	278
Min. Negotiated Rate	$107.89
Max. Negotiated Rate	$359.62
Rate for Payer: Aetna Commercial	$215.78
Rate for Payer: Aetna Medicare Advantage	$215.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$143.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.41
Rate for Payer: Cigna Commercial	$359.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.06
Rate for Payer: Qualcare PPO/HMO/WC	$107.89

GWIRE COUG XT300CM CGRXT300HJ

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270636548
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

GWIRE COUG XT300CM CGRXT300HJ

Facility

$375.00

Service Code	HCPCS C1769
Hospital Charge Code	270636548
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

Know your out-of-pocket cost for care.

All Charges