Heights University Hospital

All Charges

Charge

Type

Setting

Price

WIRE K ZIM .032 .045 .062*****

Facility

$15.00

Hospital Charge Code	1601558
Hospital Revenue Code	278
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$3.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.63
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

WIRE K ZIM DBLED 1/32 3/64****

Facility

$16.00

Hospital Charge Code	1602192
Hospital Revenue Code	278
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$3.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.87
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

WIRE K ZIM DBLED 1/32 3/64****

Facility

$16.00

Hospital Charge Code	1602192
Hospital Revenue Code	278
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$8.00
Rate for Payer: Aetna Commercial	$4.80
Rate for Payer: Aetna Medicare Advantage	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.08
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.87
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

WIRE LAUREATE HYDROPHILIC .03

Facility

$160.00

Hospital Charge Code	270664782
Hospital Revenue Code	270
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$80.00
Rate for Payer: Aetna Commercial	$48.00
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.80
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$80.00

WIRE LAUREATE HYDROPHILIC .03

Facility

$160.00

Hospital Charge Code	270664782
Hospital Revenue Code	270
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

WIRE LAUREATE HYDROPHILIC .03

Facility

$165.00

Hospital Charge Code	270664781
Hospital Revenue Code	270
Min. Negotiated Rate	$24.75
Max. Negotiated Rate	$24.75
Rate for Payer: Qualcare PPO/HMO/WC	$24.75

WIRE LAUREATE HYDROPHILIC .03

Facility

$165.00

Hospital Charge Code	270664781
Hospital Revenue Code	270
Min. Negotiated Rate	$21.45
Max. Negotiated Rate	$82.50
Rate for Payer: Aetna Commercial	$49.50
Rate for Payer: Aetna Medicare Advantage	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.08
Rate for Payer: Cigna Commercial	$82.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.45
Rate for Payer: Oxford Commercial	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$24.75
Rate for Payer: UnitedHealthcare Commercial	$82.50

WIRE LEAD ECG BLACK

Facility

$37.65

Hospital Charge Code	270061460
Hospital Revenue Code	272
Min. Negotiated Rate	$4.89
Max. Negotiated Rate	$18.82
Rate for Payer: Aetna Commercial	$11.29
Rate for Payer: Aetna Medicare Advantage	$11.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.60
Rate for Payer: Cigna Commercial	$18.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.89
Rate for Payer: Oxford Commercial	$18.82
Rate for Payer: Qualcare PPO/HMO/WC	$5.65
Rate for Payer: UnitedHealthcare Commercial	$18.82

WIRE LEAD ECG BLACK

Facility

$37.65

Hospital Charge Code	270061460
Hospital Revenue Code	272
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$5.65
Rate for Payer: Qualcare PPO/HMO/WC	$5.65

WIRE LEAD ECG RED

Facility

$37.65

Hospital Charge Code	270061455
Hospital Revenue Code	279
Min. Negotiated Rate	$4.89
Max. Negotiated Rate	$18.82
Rate for Payer: Aetna Commercial	$11.29
Rate for Payer: Aetna Medicare Advantage	$11.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.60
Rate for Payer: Cigna Commercial	$18.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.89
Rate for Payer: Oxford Commercial	$18.82
Rate for Payer: Qualcare PPO/HMO/WC	$5.65
Rate for Payer: UnitedHealthcare Commercial	$18.82

WIRE LEAD ECG RED

Facility

$37.65

Hospital Charge Code	270061455
Hospital Revenue Code	279
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$5.65
Rate for Payer: Qualcare PPO/HMO/WC	$5.65

WIRE LEAD ECG WHITE

Facility

$37.65

Hospital Charge Code	270061475
Hospital Revenue Code	279
Min. Negotiated Rate	$4.89
Max. Negotiated Rate	$18.82
Rate for Payer: Aetna Commercial	$11.29
Rate for Payer: Aetna Medicare Advantage	$11.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.60
Rate for Payer: Cigna Commercial	$18.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.89
Rate for Payer: Oxford Commercial	$18.82
Rate for Payer: Qualcare PPO/HMO/WC	$5.65
Rate for Payer: UnitedHealthcare Commercial	$18.82

WIRE LEAD ECG WHITE

Facility

$37.65

Hospital Charge Code	270061475
Hospital Revenue Code	279
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$5.65
Rate for Payer: Qualcare PPO/HMO/WC	$5.65

WIRELES EXTNL NEURO STIMULATOR

Facility

$6,500.00

Service Code	HCPCS C1767
Hospital Charge Code	270683933
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

WIRELES EXTNL NEURO STIMULATOR

Facility

$6,500.00

Service Code	HCPCS C1767
Hospital Charge Code	270683933
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$1,950.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

WIRE LUQUE CERCLAGE 1.2x30MM

Facility

$194.95

Hospital Charge Code	270601381
Hospital Revenue Code	272
Min. Negotiated Rate	$29.24
Max. Negotiated Rate	$29.24
Rate for Payer: Qualcare PPO/HMO/WC	$29.24

WIRE LUQUE CERCLAGE 1.2x30MM

Facility

$194.95

Hospital Charge Code	270601381
Hospital Revenue Code	272
Min. Negotiated Rate	$25.34
Max. Negotiated Rate	$97.47
Rate for Payer: Aetna Commercial	$58.48
Rate for Payer: Aetna Medicare Advantage	$58.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.71
Rate for Payer: Cigna Commercial	$97.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.34
Rate for Payer: Oxford Commercial	$97.47
Rate for Payer: Qualcare PPO/HMO/WC	$29.24
Rate for Payer: UnitedHealthcare Commercial	$97.47

WIRE LUQUE CERCLAGE .97x20MM

Facility

$194.95

Hospital Charge Code	270677271
Hospital Revenue Code	272
Min. Negotiated Rate	$25.34
Max. Negotiated Rate	$97.47
Rate for Payer: Aetna Commercial	$58.48
Rate for Payer: Aetna Medicare Advantage	$58.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.71
Rate for Payer: Cigna Commercial	$97.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.34
Rate for Payer: Oxford Commercial	$97.47
Rate for Payer: Qualcare PPO/HMO/WC	$29.24
Rate for Payer: UnitedHealthcare Commercial	$97.47

WIRE LUQUE CERCLAGE .97x20MM

Facility

$194.95

Hospital Charge Code	270677271
Hospital Revenue Code	272
Min. Negotiated Rate	$29.24
Max. Negotiated Rate	$29.24
Rate for Payer: Qualcare PPO/HMO/WC	$29.24

WIRE MCV GLIDE STR .025 5340

Facility

$3,214.45

Hospital Charge Code	270612717
Hospital Revenue Code	278
Min. Negotiated Rate	$482.17
Max. Negotiated Rate	$1,607.22
Rate for Payer: Aetna Commercial	$964.34
Rate for Payer: Aetna Medicare Advantage	$964.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$819.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$819.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$642.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$819.68
Rate for Payer: Cigna Commercial	$1,607.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$777.90
Rate for Payer: Qualcare PPO/HMO/WC	$482.17

WIRE MCV GLIDE STR .025 5340

Facility

$3,214.45

Hospital Charge Code	270612717
Hospital Revenue Code	278
Min. Negotiated Rate	$482.17
Max. Negotiated Rate	$777.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$642.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$777.90
Rate for Payer: Qualcare PPO/HMO/WC	$482.17

WIRE MCV GLIDE STR .035 5193

Facility

$1,225.65

Hospital Charge Code	270601172
Hospital Revenue Code	278
Min. Negotiated Rate	$183.85
Max. Negotiated Rate	$296.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$245.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.61
Rate for Payer: Qualcare PPO/HMO/WC	$183.85

WIRE MCV GLIDE STR .035 5193

Facility

$1,225.65

Hospital Charge Code	270601172
Hospital Revenue Code	278
Min. Negotiated Rate	$183.85
Max. Negotiated Rate	$612.83
Rate for Payer: Aetna Commercial	$367.69
Rate for Payer: Aetna Medicare Advantage	$367.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$312.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$312.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$245.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$312.54
Rate for Payer: Cigna Commercial	$612.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.61
Rate for Payer: Qualcare PPO/HMO/WC	$183.85

WIRE MCV GUIDE .025 610102

Facility

$75.00

Service Code	HCPCS C1769
Hospital Charge Code	270601263
Hospital Revenue Code	278
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

WIRE MCV GUIDE .025 610102

Facility

$75.00

Service Code	HCPCS C1769
Hospital Charge Code	270601263
Hospital Revenue Code	278
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

Know your out-of-pocket cost for care.

All Charges