Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

GLIDECATH NTAPER 4F 100c 32173

Facility

OP

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270623515S
Hospital Revenue Code	278
Min. Negotiated Rate	$7.19
Max. Negotiated Rate	$126.62
Rate for Payer: Aetna Commercial	$96.23
Rate for Payer: Aetna Medicare Advantage	$75.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.58
Rate for Payer: Cigna Commercial	$126.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: Qualcare PPO/HMO/WC	$37.99
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: Wellpoint Medicaid Managed Care	$7.19

GLIDECATH NTAPER 4F 100c 32173

Facility

OP

$273.65

Service Code	HCPCS C1887
Hospital Charge Code	270623515N
Hospital Revenue Code	278
Min. Negotiated Rate	$7.77
Max. Negotiated Rate	$136.82
Rate for Payer: Aetna Commercial	$103.99
Rate for Payer: Aetna Medicare Advantage	$82.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.78
Rate for Payer: Cigna Commercial	$136.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.22
Rate for Payer: Qualcare PPO/HMO/WC	$41.05
Rate for Payer: UnitedHealthcare Community & State	$8.65
Rate for Payer: Wellpoint Medicaid Managed Care	$7.77

GLIDECATH NTAPER 4F 100c 32173

Facility

IP

$253.25

Service Code	HCPCS C1887
Hospital Charge Code	270623515S
Hospital Revenue Code	278
Min. Negotiated Rate	$37.99
Max. Negotiated Rate	$61.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.29
Rate for Payer: Qualcare PPO/HMO/WC	$37.99

GLIDECATH NTAPER 4F 100c 32173

Facility

IP

$273.65

Service Code	HCPCS C1887
Hospital Charge Code	270623515N
Hospital Revenue Code	278
Min. Negotiated Rate	$41.05
Max. Negotiated Rate	$66.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.22
Rate for Payer: Qualcare PPO/HMO/WC	$41.05

GLIDECATH NTAPER 4F 100c 32173

Facility

IP

$1,775.00

Hospital Charge Code	270623515
Hospital Revenue Code	278
Min. Negotiated Rate	$266.25
Max. Negotiated Rate	$429.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.55
Rate for Payer: Qualcare PPO/HMO/WC	$266.25

GLIDECATH NTAPER 4F 100c 32173

Facility

OP

$1,775.00

Hospital Charge Code	270623515
Hospital Revenue Code	278
Min. Negotiated Rate	$50.41
Max. Negotiated Rate	$887.50
Rate for Payer: Aetna Commercial	$674.50
Rate for Payer: Aetna Medicare Advantage	$532.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.62
Rate for Payer: Cigna Commercial	$887.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$429.55
Rate for Payer: Qualcare PPO/HMO/WC	$266.25
Rate for Payer: UnitedHealthcare Community & State	$56.09
Rate for Payer: Wellpoint Medicaid Managed Care	$50.41

GLIDECATH SIM3 5FR 100CM

Facility

OP

$74.30

Service Code	HCPCS C1887
Hospital Charge Code	270681564S
Hospital Revenue Code	278
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$37.15
Rate for Payer: Aetna Commercial	$28.23
Rate for Payer: Aetna Medicare Advantage	$22.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.95
Rate for Payer: Cigna Commercial	$37.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.98
Rate for Payer: Qualcare PPO/HMO/WC	$11.14
Rate for Payer: UnitedHealthcare Community & State	$2.35
Rate for Payer: Wellpoint Medicaid Managed Care	$2.11

GLIDECATH SIM3 5FR 100CM

Facility

IP

$74.30

Service Code	HCPCS C1887
Hospital Charge Code	270681564S
Hospital Revenue Code	278
Min. Negotiated Rate	$11.14
Max. Negotiated Rate	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.98
Rate for Payer: Qualcare PPO/HMO/WC	$11.14

GLIDECATH STR 150CM 4FR D-BRD

Facility

IP

$1,080.00

Hospital Charge Code	270665134
Hospital Revenue Code	272
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$162.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.00

GLIDECATH STR 150CM 4FR D-BRD

Facility

OP

$1,080.00

Hospital Charge Code	270665134
Hospital Revenue Code	272
Min. Negotiated Rate	$30.67
Max. Negotiated Rate	$540.00
Rate for Payer: Aetna Commercial	$410.40
Rate for Payer: Aetna Medicare Advantage	$324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.40
Rate for Payer: Cigna Commercial	$540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$280.80
Rate for Payer: Oxford Commercial	$216.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.00
Rate for Payer: UnitedHealthcare Commercial	$216.00
Rate for Payer: UnitedHealthcare Community & State	$34.13
Rate for Payer: Wellpoint Medicaid Managed Care	$30.67

GLIDECATH STRAIGHT 4FR 65cm

Facility

IP

$357.50

Service Code	HCPCS C2629
Hospital Charge Code	270645472A
Hospital Revenue Code	278
Min. Negotiated Rate	$53.62
Max. Negotiated Rate	$86.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.52
Rate for Payer: Qualcare PPO/HMO/WC	$53.62

GLIDECATH STRAIGHT 4FR 65cm

Facility

IP

$357.50

Service Code	HCPCS C2629
Hospital Charge Code	270645472C
Hospital Revenue Code	278
Min. Negotiated Rate	$53.62
Max. Negotiated Rate	$86.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.52
Rate for Payer: Qualcare PPO/HMO/WC	$53.62

GLIDECATH STRAIGHT 4FR 65cm

Facility

OP

$357.50

Service Code	HCPCS C2629
Hospital Charge Code	270645472C
Hospital Revenue Code	278
Min. Negotiated Rate	$10.15
Max. Negotiated Rate	$178.75
Rate for Payer: Aetna Commercial	$135.85
Rate for Payer: Aetna Medicare Advantage	$107.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.16
Rate for Payer: Cigna Commercial	$178.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.52
Rate for Payer: Qualcare PPO/HMO/WC	$53.62
Rate for Payer: UnitedHealthcare Community & State	$11.30
Rate for Payer: Wellpoint Medicaid Managed Care	$10.15

GLIDECATH STRAIGHT 4FR 65cm

Facility

OP

$357.50

Service Code	HCPCS C2629
Hospital Charge Code	270645472A
Hospital Revenue Code	278
Min. Negotiated Rate	$10.15
Max. Negotiated Rate	$178.75
Rate for Payer: Aetna Commercial	$135.85
Rate for Payer: Aetna Medicare Advantage	$107.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.16
Rate for Payer: Cigna Commercial	$178.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.52
Rate for Payer: Qualcare PPO/HMO/WC	$53.62
Rate for Payer: UnitedHealthcare Community & State	$11.30
Rate for Payer: Wellpoint Medicaid Managed Care	$10.15

GLIDECATH TORCON NB SIM1 5F 10

Facility

IP

$74.30

Service Code	HCPCS C1887
Hospital Charge Code	270681566S
Hospital Revenue Code	278
Min. Negotiated Rate	$11.14
Max. Negotiated Rate	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.98
Rate for Payer: Qualcare PPO/HMO/WC	$11.14

GLIDECATH TORCON NB SIM1 5F 10

Facility

OP

$74.30

Service Code	HCPCS C1887
Hospital Charge Code	270681566S
Hospital Revenue Code	278
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$37.15
Rate for Payer: Aetna Commercial	$28.23
Rate for Payer: Aetna Medicare Advantage	$22.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.95
Rate for Payer: Cigna Commercial	$37.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.98
Rate for Payer: Qualcare PPO/HMO/WC	$11.14
Rate for Payer: UnitedHealthcare Community & State	$2.35
Rate for Payer: Wellpoint Medicaid Managed Care	$2.11

GLIDE POWERGLIDE 10 CM

Facility

OP

$570.00

Service Code	HCPCS C1887
Hospital Charge Code	270690135
Hospital Revenue Code	278
Min. Negotiated Rate	$16.19
Max. Negotiated Rate	$285.00
Rate for Payer: Aetna Commercial	$216.60
Rate for Payer: Aetna Medicare Advantage	$171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.35
Rate for Payer: Cigna Commercial	$285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.94
Rate for Payer: Qualcare PPO/HMO/WC	$85.50
Rate for Payer: UnitedHealthcare Community & State	$18.01
Rate for Payer: Wellpoint Medicaid Managed Care	$16.19

GLIDE POWERGLIDE 10 CM

Facility

IP

$570.00

Service Code	HCPCS C1887
Hospital Charge Code	270690135
Hospital Revenue Code	278
Min. Negotiated Rate	$85.50
Max. Negotiated Rate	$137.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.94
Rate for Payer: Qualcare PPO/HMO/WC	$85.50

GLIDERITE STYLET LARGE

Facility

IP

$50.00

Hospital Charge Code	270689167
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

GLIDERITE STYLET LARGE

Facility

OP

$50.00

Hospital Charge Code	270689167
Hospital Revenue Code	272
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.00
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$10.00
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

GLIDERITE SU STYLET

Facility

IP

$30.00

Hospital Charge Code	270689157
Hospital Revenue Code	272
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

GLIDERITE SU STYLET

Facility

OP

$30.00

Hospital Charge Code	270689157
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$15.00
Rate for Payer: Aetna Commercial	$11.40
Rate for Payer: Aetna Medicare Advantage	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.65
Rate for Payer: Cigna Commercial	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$6.00
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

GLIDESCOPE BFLEX 5.0

Facility

OP

$1,475.00

Hospital Charge Code	270689145
Hospital Revenue Code	272
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.50
Rate for Payer: Oxford Commercial	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$295.00
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

GLIDESCOPE BFLEX 5.0

Facility

IP

$1,475.00

Hospital Charge Code	270689145
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

GLIDESCOPE BFLEX 5.0 MM

Facility

OP

$1,700.00

Hospital Charge Code	270690090
Hospital Revenue Code	272
Min. Negotiated Rate	$48.28
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$646.00
Rate for Payer: Aetna Medicare Advantage	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$433.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$433.50
Rate for Payer: Cigna Commercial	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.00
Rate for Payer: Oxford Commercial	$340.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.00
Rate for Payer: UnitedHealthcare Commercial	$340.00
Rate for Payer: UnitedHealthcare Community & State	$53.72
Rate for Payer: Wellpoint Medicaid Managed Care	$48.28