Heights University Hospital

All Charges

Charge

Type

Setting

Price

ZIPWIRE .035 150cm STRAIGHT

Facility

$165.00

Service Code	HCPCS C1769
Hospital Charge Code	270601266
Hospital Revenue Code	278
Min. Negotiated Rate	$24.75
Max. Negotiated Rate	$39.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.93
Rate for Payer: Qualcare PPO/HMO/WC	$24.75

ZIPWIRE .035 180cm STFF ANGL

Facility

$234.00

Service Code	HCPCS C1769
Hospital Charge Code	270623261
Hospital Revenue Code	278
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$56.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.63
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

ZIPWIRE .035 180cm STFF ANGL

Facility

$234.00

Service Code	HCPCS C1769
Hospital Charge Code	270623261
Hospital Revenue Code	278
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$117.00
Rate for Payer: Aetna Commercial	$70.20
Rate for Payer: Aetna Medicare Advantage	$70.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.67
Rate for Payer: Cigna Commercial	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.63
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

ZIPWIRE .035 260cm ANGLED

Facility

$219.58

Service Code	HCPCS C1769
Hospital Charge Code	270623295
Hospital Revenue Code	278
Min. Negotiated Rate	$32.94
Max. Negotiated Rate	$109.79
Rate for Payer: Aetna Commercial	$65.87
Rate for Payer: Aetna Medicare Advantage	$65.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.99
Rate for Payer: Cigna Commercial	$109.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.14
Rate for Payer: Qualcare PPO/HMO/WC	$32.94

ZIPWIRE .035 260cm ANGLED

Facility

$219.58

Service Code	HCPCS C1769
Hospital Charge Code	270623295
Hospital Revenue Code	278
Min. Negotiated Rate	$32.94
Max. Negotiated Rate	$53.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.14
Rate for Payer: Qualcare PPO/HMO/WC	$32.94

ZIPWIRE .035 260CM ANGLED

Facility

$242.64

Hospital Charge Code	270623295C
Hospital Revenue Code	278
Min. Negotiated Rate	$36.40
Max. Negotiated Rate	$58.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.72
Rate for Payer: Qualcare PPO/HMO/WC	$36.40

ZIPWIRE .035 260CM ANGLED

Facility

$242.64

Hospital Charge Code	270623295C
Hospital Revenue Code	278
Min. Negotiated Rate	$36.40
Max. Negotiated Rate	$121.32
Rate for Payer: Aetna Commercial	$72.79
Rate for Payer: Aetna Medicare Advantage	$72.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.87
Rate for Payer: Cigna Commercial	$121.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.72
Rate for Payer: Qualcare PPO/HMO/WC	$36.40

ZIPWIRE .035 260cm STIFF ANGLD

Facility

$271.44

Service Code	HCPCS C1769
Hospital Charge Code	270624371
Hospital Revenue Code	278
Min. Negotiated Rate	$40.72
Max. Negotiated Rate	$135.72
Rate for Payer: Aetna Commercial	$81.43
Rate for Payer: Aetna Medicare Advantage	$81.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.22
Rate for Payer: Cigna Commercial	$135.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.69
Rate for Payer: Qualcare PPO/HMO/WC	$40.72

ZIPWIRE .035 260cm STIFF ANGLD

Facility

$271.44

Service Code	HCPCS C1769
Hospital Charge Code	270624371
Hospital Revenue Code	278
Min. Negotiated Rate	$40.72
Max. Negotiated Rate	$65.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.69
Rate for Payer: Qualcare PPO/HMO/WC	$40.72

ZIPWIRE .038 150cm ANGLED

Facility

$165.00

Service Code	HCPCS C1769
Hospital Charge Code	270617878
Hospital Revenue Code	278
Min. Negotiated Rate	$24.75
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) NJ Health	$33.00
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	$39.93
Rate for Payer: Qualcare PPO/HMO/WC	$24.75

ZIPWIRE .038 150cm ANGLED

Facility

$165.00

Service Code	HCPCS C1769
Hospital Charge Code	270617878
Hospital Revenue Code	278
Min. Negotiated Rate	$24.75
Max. Negotiated Rate	$39.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.93
Rate for Payer: Qualcare PPO/HMO/WC	$24.75

ZIPWIRE ANGLED 0.018 150CM

Facility

$2,125.00

Hospital Charge Code	270669873
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$637.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

ZIPWIRE ANGLED 0.018 150CM

Facility

$2,125.00

Hospital Charge Code	270669873
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

ZIPWIRE STRAIGHT 260CM

Facility

$109.79

Hospital Charge Code	270672307
Hospital Revenue Code	278
Min. Negotiated Rate	$16.47
Max. Negotiated Rate	$26.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.57
Rate for Payer: Qualcare PPO/HMO/WC	$16.47

ZIPWIRE STRAIGHT 260CM

Facility

$109.79

Hospital Charge Code	270672307
Hospital Revenue Code	278
Min. Negotiated Rate	$16.47
Max. Negotiated Rate	$54.90
Rate for Payer: Aetna Commercial	$32.94
Rate for Payer: Aetna Medicare Advantage	$32.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.00
Rate for Payer: Cigna Commercial	$54.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.57
Rate for Payer: Qualcare PPO/HMO/WC	$16.47

ZITHROMAX 100MG/5ML 15ML

Facility

$172.00

Hospital Charge Code	60635236
Hospital Revenue Code	250
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

ZITHROMAX 100MG/5ML 15ML

Facility

$172.00

Hospital Charge Code	60635236
Hospital Revenue Code	250
Min. Negotiated Rate	$22.36
Max. Negotiated Rate	$86.00
Rate for Payer: Aetna Commercial	$51.60
Rate for Payer: Aetna Medicare Advantage	$51.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.36
Rate for Payer: Oxford Commercial	$86.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Commercial	$86.00

ZITHROMAX 200ML/5ML 30ML

Facility

$172.00

Hospital Charge Code	60635237
Hospital Revenue Code	250
Min. Negotiated Rate	$22.36
Max. Negotiated Rate	$86.00
Rate for Payer: Aetna Commercial	$51.60
Rate for Payer: Aetna Medicare Advantage	$51.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.36
Rate for Payer: Oxford Commercial	$86.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Commercial	$86.00

ZITHROMAX 200ML/5ML 30ML

Facility

$172.00

Hospital Charge Code	60635237
Hospital Revenue Code	250
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

ZITHROMAX 250MG

Facility

$27.00

Hospital Charge Code	60635114
Hospital Revenue Code	250
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

ZITHROMAX 250MG

Facility

$27.00

Hospital Charge Code	60635114
Hospital Revenue Code	250
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$8.10
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.51
Rate for Payer: Oxford Commercial	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$13.50

ZITHROMAX 500MG TAB

Facility

$104.19

Service Code	NDC 59762307002
Hospital Charge Code	60635615
Hospital Revenue Code	250
Min. Negotiated Rate	$15.63
Max. Negotiated Rate	$15.63
Rate for Payer: Qualcare PPO/HMO/WC	$15.63

ZITHROMAX 500MG TAB

Facility

$104.19

Service Code	NDC 59762307002
Hospital Charge Code	60635615
Hospital Revenue Code	250
Min. Negotiated Rate	$13.54
Max. Negotiated Rate	$52.09
Rate for Payer: Aetna Commercial	$31.26
Rate for Payer: Aetna Medicare Advantage	$31.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.57
Rate for Payer: Cigna Commercial	$52.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.54
Rate for Payer: Oxford Commercial	$52.09
Rate for Payer: Qualcare PPO/HMO/WC	$15.63
Rate for Payer: UnitedHealthcare Commercial	$52.09

ZITHROMAX CAPS/250MG

Facility

$61.00

Hospital Charge Code	60634743
Hospital Revenue Code	250
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$18.30
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.93
Rate for Payer: Oxford Commercial	$30.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$30.50

ZITHROMAX CAPS/250MG

Facility

$61.00

Hospital Charge Code	60634743
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

Know your out-of-pocket cost for care.

All Charges