Heights University Hospital

All Charges

Charge

Type

Setting

Price

WIRE ZIM K 1 1.6MM 47-186-76

Facility

$447.25

Service Code	HCPCS C1769
Hospital Charge Code	270610638
Hospital Revenue Code	278
Min. Negotiated Rate	$67.09
Max. Negotiated Rate	$108.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.23
Rate for Payer: Qualcare PPO/HMO/WC	$67.09

WIRE ZIM K 1.1MM 186-27-16

Facility

$24.85

Service Code	HCPCS C1769
Hospital Charge Code	270610289
Hospital Revenue Code	278
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.01
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

WIRE ZIM K 1.1MM 186-27-16

Facility

$24.85

Service Code	HCPCS C1769
Hospital Charge Code	270610289
Hospital Revenue Code	278
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$7.46
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.01
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

WIRE ZIM K 1.25 152 186-27-12

Facility

$22.45

Hospital Charge Code	270610157
Hospital Revenue Code	278
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$5.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.43
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

WIRE ZIM K 1.25 152 186-27-12

Facility

$22.45

Hospital Charge Code	270610157
Hospital Revenue Code	278
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$6.74
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.43
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

WIRE ZIM K 7 76 186-04-53

Facility

$22.45

Hospital Charge Code	270610154
Hospital Revenue Code	278
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$6.74
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.43
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

WIRE ZIM K 7 76 186-04-53

Facility

$22.45

Hospital Charge Code	270610154
Hospital Revenue Code	278
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$5.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.43
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

WIRE ZIM K DBL .028 186-04-15

Facility

$47.25

Hospital Charge Code	270601982
Hospital Revenue Code	272
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Qualcare PPO/HMO/WC	$7.09

WIRE ZIM K DBL .028 186-04-15

Facility

$47.25

Hospital Charge Code	270601982
Hospital Revenue Code	272
Min. Negotiated Rate	$6.14
Max. Negotiated Rate	$23.62
Rate for Payer: Aetna Commercial	$14.18
Rate for Payer: Aetna Medicare Advantage	$14.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.05
Rate for Payer: Cigna Commercial	$23.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.14
Rate for Payer: Oxford Commercial	$23.62
Rate for Payer: Qualcare PPO/HMO/WC	$7.09
Rate for Payer: UnitedHealthcare Commercial	$23.62

WIRE ZIM K DBL .035 186-01-79

Facility

$43.25

Hospital Charge Code	270601981
Hospital Revenue Code	272
Min. Negotiated Rate	$5.62
Max. Negotiated Rate	$21.62
Rate for Payer: Aetna Commercial	$12.97
Rate for Payer: Aetna Medicare Advantage	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.62
Rate for Payer: Oxford Commercial	$21.62
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$21.62

WIRE ZIM K DBL .035 186-01-79

Facility

$43.25

Hospital Charge Code	270601981
Hospital Revenue Code	272
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

WIRE ZIM K DBL .045 186-02-79

Facility

$46.45

Hospital Charge Code	270606052
Hospital Revenue Code	272
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$6.97
Rate for Payer: Qualcare PPO/HMO/WC	$6.97

WIRE ZIM K DBL .045 186-02-79

Facility

$46.45

Hospital Charge Code	270606052
Hospital Revenue Code	272
Min. Negotiated Rate	$6.04
Max. Negotiated Rate	$23.23
Rate for Payer: Aetna Commercial	$13.94
Rate for Payer: Aetna Medicare Advantage	$13.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.84
Rate for Payer: Cigna Commercial	$23.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.04
Rate for Payer: Oxford Commercial	$23.23
Rate for Payer: Qualcare PPO/HMO/WC	$6.97
Rate for Payer: UnitedHealthcare Commercial	$23.23

WIRE ZIM K DBL .062 186-03-79

Facility

$43.25

Hospital Charge Code	270601918
Hospital Revenue Code	278
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$10.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.47
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

WIRE ZIM K DBL .062 186-03-79

Facility

$43.25

Hospital Charge Code	270601918
Hospital Revenue Code	278
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$21.62
Rate for Payer: Aetna Commercial	$12.97
Rate for Payer: Aetna Medicare Advantage	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.47
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

WIRE ZIM K PT 2.5 1142-01-25

Facility

$72.52

Service Code	HCPCS C1769
Hospital Charge Code	270617347
Hospital Revenue Code	278
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$36.26
Rate for Payer: Aetna Commercial	$21.76
Rate for Payer: Aetna Medicare Advantage	$21.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.49
Rate for Payer: Cigna Commercial	$36.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.55
Rate for Payer: Qualcare PPO/HMO/WC	$10.88

WIRE ZIM K PT 2.5 1142-01-25

Facility

$72.52

Service Code	HCPCS C1769
Hospital Charge Code	270617347
Hospital Revenue Code	278
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$17.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.55
Rate for Payer: Qualcare PPO/HMO/WC	$10.88

WIRE ZIM K STYLE 1 .7MM

Facility

$372.00

Hospital Charge Code	270610634
Hospital Revenue Code	278
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$186.00
Rate for Payer: Aetna Commercial	$111.60
Rate for Payer: Aetna Medicare Advantage	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.86
Rate for Payer: Cigna Commercial	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.02
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

WIRE ZIM K STYLE 1 .7MM

Facility

$372.00

Hospital Charge Code	270610634
Hospital Revenue Code	278
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$90.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.02
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

WIRE ZIM K THRD .062 262-08-04

Facility

$63.13

Service Code	HCPCS C1769
Hospital Charge Code	270601916
Hospital Revenue Code	278
Min. Negotiated Rate	$9.47
Max. Negotiated Rate	$31.57
Rate for Payer: Aetna Commercial	$18.94
Rate for Payer: Aetna Medicare Advantage	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.10
Rate for Payer: Cigna Commercial	$31.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.28
Rate for Payer: Qualcare PPO/HMO/WC	$9.47

WIRE ZIM K THRD .062 262-08-04

Facility

$63.13

Service Code	HCPCS C1769
Hospital Charge Code	270601916
Hospital Revenue Code	278
Min. Negotiated Rate	$9.47
Max. Negotiated Rate	$15.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.28
Rate for Payer: Qualcare PPO/HMO/WC	$9.47

WIRE ZIM K THRD 1.7MM 11420117

Facility

$85.65

Hospital Charge Code	270613427
Hospital Revenue Code	272
Min. Negotiated Rate	$11.13
Max. Negotiated Rate	$42.83
Rate for Payer: Aetna Commercial	$25.70
Rate for Payer: Aetna Medicare Advantage	$25.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.84
Rate for Payer: Cigna Commercial	$42.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.13
Rate for Payer: Oxford Commercial	$42.83
Rate for Payer: Qualcare PPO/HMO/WC	$12.85
Rate for Payer: UnitedHealthcare Commercial	$42.83

WIRE ZIM K THRD 1.7MM 11420117

Facility

$85.65

Hospital Charge Code	270613427
Hospital Revenue Code	272
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$12.85
Rate for Payer: Qualcare PPO/HMO/WC	$12.85

WIRE ZIM SPOOL .97 4.9 191-38

Facility

$110.00

Service Code	HCPCS C1769
Hospital Charge Code	270619387
Hospital Revenue Code	278
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$33.00
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

WIRE ZIM SPOOL .97 4.9 191-38

Facility

$110.00

Service Code	HCPCS C1769
Hospital Charge Code	270619387
Hospital Revenue Code	278
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$26.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

Know your out-of-pocket cost for care.

All Charges