Heights University Hospital

All Charges

Charge

Type

Setting

Price

WIRE RNTHRG NS 3cm/22cm/180cm

Facility

$450.00

Hospital Charge Code	2709003599
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

WIRE RNTHRG NS 3cm/22cm/180cm

Facility

$450.00

Hospital Charge Code	2709003599
Hospital Revenue Code	272
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$135.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$225.00

WIRE RUNTHROUGH NS 3CM/22CM/18

Facility

$450.00

Service Code	HCPCS C1769
Hospital Charge Code	270642945N
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$135.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

WIRE RUNTHROUGH NS 3CM/22CM/18

Facility

$530.00

Service Code	HCPCS C1769
Hospital Charge Code	270642945S
Hospital Revenue Code	278
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$128.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.26
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

WIRE RUNTHROUGH NS 3CM/22CM/18

Facility

$450.00

Service Code	HCPCS C1769
Hospital Charge Code	270642945N
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.90
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

WIRE RUNTHROUGH NS 3CM/22CM/18

Facility

$530.00

Service Code	HCPCS C1769
Hospital Charge Code	270642945S
Hospital Revenue Code	278
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$265.00
Rate for Payer: Aetna Commercial	$159.00
Rate for Payer: Aetna Medicare Advantage	$159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.15
Rate for Payer: Cigna Commercial	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.26
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

WIRE RUNTHROUGH NS 3CM/22CM/18

Facility

$3,100.00

Service Code	HCPCS C1769
Hospital Charge Code	270642945
Hospital Revenue Code	278
Min. Negotiated Rate	$465.00
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$930.00
Rate for Payer: Aetna Medicare Advantage	$930.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$790.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$790.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$790.50
Rate for Payer: Cigna Commercial	$1,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.20
Rate for Payer: Qualcare PPO/HMO/WC	$465.00

WIRE RUNTHROUGH NS 3CM/22CM/18

Facility

$3,100.00

Service Code	HCPCS C1769
Hospital Charge Code	270642945
Hospital Revenue Code	278
Min. Negotiated Rate	$465.00
Max. Negotiated Rate	$750.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$620.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.20
Rate for Payer: Qualcare PPO/HMO/WC	$465.00

WIRE SAFE JC 018x45 TSCF181453

Facility

$84.25

Hospital Charge Code	270633613
Hospital Revenue Code	278
Min. Negotiated Rate	$12.64
Max. Negotiated Rate	$20.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.39
Rate for Payer: Qualcare PPO/HMO/WC	$12.64

WIRE SAFE JC 018x45 TSCF181453

Facility

$84.25

Hospital Charge Code	270633613
Hospital Revenue Code	278
Min. Negotiated Rate	$12.64
Max. Negotiated Rate	$42.12
Rate for Payer: Aetna Commercial	$25.27
Rate for Payer: Aetna Medicare Advantage	$25.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.48
Rate for Payer: Cigna Commercial	$42.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.39
Rate for Payer: Qualcare PPO/HMO/WC	$12.64

WIRE SMOOTH 2 MM

Facility

$660.00

Hospital Charge Code	270684458
Hospital Revenue Code	272
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$99.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

WIRE SMOOTH 2 MM

Facility

$660.00

Hospital Charge Code	270684458
Hospital Revenue Code	272
Min. Negotiated Rate	$85.80
Max. Negotiated Rate	$330.00
Rate for Payer: Aetna Commercial	$198.00
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.80
Rate for Payer: Oxford Commercial	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.00
Rate for Payer: UnitedHealthcare Commercial	$330.00

WIRE SPADE-POINT 1.8X400 29239

Facility

$788.70

Hospital Charge Code	270633841
Hospital Revenue Code	278
Min. Negotiated Rate	$118.31
Max. Negotiated Rate	$394.35
Rate for Payer: Aetna Commercial	$236.61
Rate for Payer: Aetna Medicare Advantage	$236.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.12
Rate for Payer: Cigna Commercial	$394.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.87
Rate for Payer: Qualcare PPO/HMO/WC	$118.31

WIRE SPADE-POINT 1.8X400 29239

Facility

$788.70

Hospital Charge Code	270633841
Hospital Revenue Code	278
Min. Negotiated Rate	$118.31
Max. Negotiated Rate	$190.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.87
Rate for Payer: Qualcare PPO/HMO/WC	$118.31

WIRE SPADE-POINT 2.0x400MM

Facility

$1,059.85

Hospital Charge Code	270638915
Hospital Revenue Code	278
Min. Negotiated Rate	$158.98
Max. Negotiated Rate	$529.92
Rate for Payer: Aetna Commercial	$317.95
Rate for Payer: Aetna Medicare Advantage	$317.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$270.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$270.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$270.26
Rate for Payer: Cigna Commercial	$529.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.48
Rate for Payer: Qualcare PPO/HMO/WC	$158.98

WIRE SPADE-POINT 2.0x400MM

Facility

$1,059.85

Hospital Charge Code	270638915
Hospital Revenue Code	278
Min. Negotiated Rate	$158.98
Max. Negotiated Rate	$256.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.48
Rate for Payer: Qualcare PPO/HMO/WC	$158.98

WIRE SPAD-PT 1.8mmX350mm 29238

Facility

$250.50

Hospital Charge Code	270633449
Hospital Revenue Code	278
Min. Negotiated Rate	$37.58
Max. Negotiated Rate	$60.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.62
Rate for Payer: Qualcare PPO/HMO/WC	$37.58

WIRE SPAD-PT 1.8mmX350mm 29238

Facility

$250.50

Hospital Charge Code	270633449
Hospital Revenue Code	278
Min. Negotiated Rate	$37.58
Max. Negotiated Rate	$125.25
Rate for Payer: Aetna Commercial	$75.15
Rate for Payer: Aetna Medicare Advantage	$75.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.88
Rate for Payer: Cigna Commercial	$125.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.62
Rate for Payer: Qualcare PPO/HMO/WC	$37.58

WIRE SP FLT FX SPD2-US-050-320

Facility

$6,975.00

Service Code	HCPCS C1884
Hospital Charge Code	270640584C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

WIRE SP FLT FX SPD2-US-050-320

Facility

$6,975.00

Service Code	HCPCS C1884
Hospital Charge Code	270640584C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,092.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

WIRE SPIDER FILTER FX 3.0x320

Facility

$6,000.00

Service Code	HCPCS C1884
Hospital Charge Code	270643589N
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

WIRE SPIDER FILTER FX 3.0x320

Facility

$6,000.00

Service Code	HCPCS C1884
Hospital Charge Code	270643589N
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

WIRE SPIDER FILTER FX 3.0x320

Facility

$6,000.00

Service Code	HCPCS C1884
Hospital Charge Code	270643589
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

WIRE SPIDER FILTER FX 3.0x320

Facility

$6,000.00

Service Code	HCPCS C1884
Hospital Charge Code	270643589
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

WIRE SPIDER FILTER FX 3.0x320

Facility

$6,000.00

Hospital Charge Code	270643589C
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

Know your out-of-pocket cost for care.

All Charges