Heights University Hospital

All Charges

Charge

Type

Setting

Price

COLONOSCOPY W/FB REMOVAL

Facility

$13,705.00

Service Code	HCPCS 45379
Hospital Charge Code	16000588
Hospital Revenue Code	360
Min. Negotiated Rate	$2,055.75
Max. Negotiated Rate	$2,055.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,055.75

COLONOSCOPY W/FB REMOVAL

Facility

$13,705.00

Service Code	HCPCS 45379
Hospital Charge Code	16000588
Hospital Revenue Code	360
Min. Negotiated Rate	$1,781.65
Max. Negotiated Rate	$4,111.50
Rate for Payer: Aetna Commercial	$4,111.50
Rate for Payer: Aetna Medicare Advantage	$4,111.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,494.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,494.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,494.78
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,781.65
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,055.75
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

COLONOSCOPY W/IRC***

Facility

$351.00

Hospital Charge Code	2300036
Hospital Revenue Code	759
Min. Negotiated Rate	$52.65
Max. Negotiated Rate	$52.65
Rate for Payer: Qualcare PPO/HMO/WC	$52.65

COLONOSCOPY W/IRC***

Facility

$351.00

Hospital Charge Code	2300036
Hospital Revenue Code	759
Min. Negotiated Rate	$45.63
Max. Negotiated Rate	$175.50
Rate for Payer: Aetna Commercial	$105.30
Rate for Payer: Aetna Medicare Advantage	$105.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.50
Rate for Payer: Cigna Commercial	$175.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.63
Rate for Payer: Qualcare PPO/HMO/WC	$52.65

COLONOSCOPY W/POLYPECTOMY***

Facility

$816.00

Hospital Charge Code	2300044
Hospital Revenue Code	759
Min. Negotiated Rate	$122.40
Max. Negotiated Rate	$122.40
Rate for Payer: Qualcare PPO/HMO/WC	$122.40

COLONOSCOPY W/POLYPECTOMY***

Facility

$816.00

Hospital Charge Code	2300044
Hospital Revenue Code	759
Min. Negotiated Rate	$106.08
Max. Negotiated Rate	$408.00
Rate for Payer: Aetna Commercial	$244.80
Rate for Payer: Aetna Medicare Advantage	$244.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.08
Rate for Payer: Cigna Commercial	$408.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.08
Rate for Payer: Qualcare PPO/HMO/WC	$122.40

COLONOSCP W/DECMPR SGMD VOLV**

Facility

$383.00

Hospital Charge Code	2300077
Hospital Revenue Code	759
Min. Negotiated Rate	$49.79
Max. Negotiated Rate	$191.50
Rate for Payer: Aetna Commercial	$114.90
Rate for Payer: Aetna Medicare Advantage	$114.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.67
Rate for Payer: Cigna Commercial	$191.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.79
Rate for Payer: Qualcare PPO/HMO/WC	$57.45

COLONOSCP W/DECMPR SGMD VOLV**

Facility

$383.00

Hospital Charge Code	2300077
Hospital Revenue Code	759
Min. Negotiated Rate	$57.45
Max. Negotiated Rate	$57.45
Rate for Payer: Qualcare PPO/HMO/WC	$57.45

COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK

Facility

$2,575.00

Service Code	CPT G0105
Hospital Revenue Code	750
Min. Negotiated Rate	$2,214.60
Max. Negotiated Rate	$2,575.00
Rate for Payer: Cigna Commercial	$2,214.60
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

COLORECTAL CA SCRN,COLONOSCOPY

Facility

$2,500.00

Service Code	HCPCS G0121
Hospital Charge Code	2300088
Hospital Revenue Code	750
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

COLORECTAL CA SCRN,COLONOSCOPY

Facility

$2,500.00

Service Code	HCPCS G0121
Hospital Charge Code	2300088
Hospital Revenue Code	750
Min. Negotiated Rate	$325.00
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$2,214.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

COLOR PRINTER PAPER

Facility

$843.80

Hospital Charge Code	270656369
Hospital Revenue Code	271
Min. Negotiated Rate	$126.57
Max. Negotiated Rate	$126.57
Rate for Payer: Qualcare PPO/HMO/WC	$126.57

COLOR PRINTER PAPER

Facility

$843.80

Hospital Charge Code	270656369
Hospital Revenue Code	271
Min. Negotiated Rate	$109.69
Max. Negotiated Rate	$421.90
Rate for Payer: Aetna Commercial	$253.14
Rate for Payer: Aetna Medicare Advantage	$253.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$215.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$215.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$215.17
Rate for Payer: Cigna Commercial	$421.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.69
Rate for Payer: Oxford Commercial	$421.90
Rate for Payer: Qualcare PPO/HMO/WC	$126.57
Rate for Payer: UnitedHealthcare Commercial	$421.90

COLOSTOMY

Facility

$134,093.30

Service Code	HCPCS 44320
Hospital Charge Code	16000976
Hospital Revenue Code	360
Min. Negotiated Rate	$1,224.73
Max. Negotiated Rate	$40,227.99
Rate for Payer: Aetna Commercial	$40,227.99
Rate for Payer: Aetna Medicare Advantage	$40,227.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34,193.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34,193.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34,193.79
Rate for Payer: Cigna Commercial	$1,224.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17,432.13
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$20,113.99
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

COLOSTOMY

Facility

$134,093.30

Service Code	HCPCS 44320
Hospital Charge Code	16000976
Hospital Revenue Code	360
Min. Negotiated Rate	$20,113.99
Max. Negotiated Rate	$20,113.99
Rate for Payer: Qualcare PPO/HMO/WC	$20,113.99

COLOSTOMY/ILEOSTMY SYS 020931*

Facility

$43.00

Hospital Charge Code	1605872
Hospital Revenue Code	272
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

COLOSTOMY/ILEOSTMY SYS 020931*

Facility

$43.00

Hospital Charge Code	1605872
Hospital Revenue Code	272
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$21.50

COLOSTOMY/ILEOSTMY SYS 020932*

Facility

$43.00

Hospital Charge Code	1605880
Hospital Revenue Code	272
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

COLOSTOMY/ILEOSTMY SYS 020932*

Facility

$43.00

Hospital Charge Code	1605880
Hospital Revenue Code	272
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$21.50

COLOSTOMY IRRIGATION

Facility

$110.00

Hospital Charge Code	8001331
Hospital Revenue Code	279
Min. Negotiated Rate	$14.30
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) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$55.00

COLOSTOMY IRRIGATION

Facility

$110.00

Hospital Charge Code	8001331
Hospital Revenue Code	279
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

COLP CERVIX W BX & CURETT

Facility

$3,375.20

Service Code	HCPCS 57454
Hospital Charge Code	160000232
Hospital Revenue Code	360
Min. Negotiated Rate	$506.28
Max. Negotiated Rate	$506.28
Rate for Payer: Qualcare PPO/HMO/WC	$506.28

COLP CERVIX W BX & CURETT

Facility

$3,375.20

Service Code	HCPCS 57454
Hospital Charge Code	160000232
Hospital Revenue Code	360
Min. Negotiated Rate	$438.78
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$1,012.56
Rate for Payer: Aetna Medicare Advantage	$1,012.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.68
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$438.78
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$506.28
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

COLPOPEXY INTRAPERITONEAL

Facility

$42,389.30

Service Code	HCPCS 57283
Hospital Charge Code	1600000762
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,659.09
Rate for Payer: Aetna Commercial	$12,716.79
Rate for Payer: Aetna Medicare Advantage	$12,716.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,809.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,809.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,809.27
Rate for Payer: Cigna Commercial	$17,659.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,510.61
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,358.40
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

COLPOPEXY INTRAPERITONEAL

Facility

$42,389.30

Service Code	HCPCS 57283
Hospital Charge Code	1600000762
Hospital Revenue Code	360
Min. Negotiated Rate	$6,358.40
Max. Negotiated Rate	$6,358.40
Rate for Payer: Qualcare PPO/HMO/WC	$6,358.40

Know your out-of-pocket cost for care.

All Charges