Heights University Hospital

All Charges

Charge

Type

Setting

Price

COLPOPEXY LAPAROSCOPY

Facility

$44,535.70

Service Code	HCPCS 57425
Hospital Charge Code	1600000793
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$25,313.84
Rate for Payer: Aetna Commercial	$13,360.71
Rate for Payer: Aetna Medicare Advantage	$13,360.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,356.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,356.60
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	$11,356.60
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,789.64
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,680.35
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

COLPOPEXY LAPAROSCOPY

Facility

$44,535.70

Service Code	HCPCS 57425
Hospital Charge Code	1600000793
Hospital Revenue Code	360
Min. Negotiated Rate	$6,680.35
Max. Negotiated Rate	$6,680.35
Rate for Payer: Qualcare PPO/HMO/WC	$6,680.35

COLPORRHAPHY SUTR INJ VAG

Facility

$1,668.50

Hospital Charge Code	5792235
Hospital Revenue Code	450
Min. Negotiated Rate	$216.91
Max. Negotiated Rate	$834.25
Rate for Payer: Aetna Commercial	$500.55
Rate for Payer: Aetna Medicare Advantage	$500.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$425.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$425.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$425.47
Rate for Payer: Cigna Commercial	$834.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.91
Rate for Payer: Qualcare PPO/HMO/WC	$250.28

COLPORRHAPHY SUTR INJ VAG

Facility

$1,668.50

Hospital Charge Code	5792235
Hospital Revenue Code	450
Min. Negotiated Rate	$250.28
Max. Negotiated Rate	$250.28
Rate for Payer: Qualcare PPO/HMO/WC	$250.28

COLPOSCOPY

Facility

$669.00

Service Code	HCPCS 57452
Hospital Charge Code	87502580
Hospital Revenue Code	761
Min. Negotiated Rate	$100.35
Max. Negotiated Rate	$100.35
Rate for Payer: Qualcare PPO/HMO/WC	$100.35

COLPOSCOPY

Facility

$669.00

Service Code	HCPCS 57452
Hospital Charge Code	87502580
Hospital Revenue Code	761
Min. Negotiated Rate	$70.48
Max. Negotiated Rate	$481.45
Rate for Payer: Aetna Commercial	$200.70
Rate for Payer: Aetna Medicare Advantage	$200.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.59
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.97
Rate for Payer: Oxford Commercial	$334.50
Rate for Payer: Qualcare PPO/HMO/WC	$100.35
Rate for Payer: UnitedHealthcare Commercial	$334.50

COLPOSCOPY CERVIX

Facility

$613.00

Service Code	HCPCS 57452
Hospital Charge Code	87502180
Hospital Revenue Code	361
Min. Negotiated Rate	$79.69
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$183.90
Rate for Payer: Aetna Medicare Advantage	$183.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.31
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	$156.31
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.69
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.95
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

COLPOSCOPY CERVIX

Facility

$613.00

Service Code	HCPCS 57452
Hospital Charge Code	87502180
Hospital Revenue Code	361
Min. Negotiated Rate	$91.95
Max. Negotiated Rate	$91.95
Rate for Payer: Qualcare PPO/HMO/WC	$91.95

COLPOSCOPY CERVIX/VAG W/BX

Facility

$1,573.30

Service Code	HCPCS 57455
Hospital Charge Code	412357455
Hospital Revenue Code	361
Min. Negotiated Rate	$236.00
Max. Negotiated Rate	$236.00
Rate for Payer: Qualcare PPO/HMO/WC	$236.00

COLPOSCOPY CERVIX/VAG W/BX

Facility

$1,573.30

Service Code	HCPCS 57455
Hospital Charge Code	412357455
Hospital Revenue Code	361
Min. Negotiated Rate	$204.53
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$471.99
Rate for Payer: Aetna Medicare Advantage	$471.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$401.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$401.19
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	$401.19
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$204.53
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$236.00
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

COLPOSCOPY W BIOPSY

Facility

$1,480.00

Service Code	HCPCS 57455
Hospital Charge Code	87502590
Hospital Revenue Code	761
Min. Negotiated Rate	$97.75
Max. Negotiated Rate	$740.00
Rate for Payer: Aetna Commercial	$444.00
Rate for Payer: Aetna Medicare Advantage	$444.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$377.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$377.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$377.40
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.40
Rate for Payer: Oxford Commercial	$740.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.00
Rate for Payer: UnitedHealthcare Commercial	$740.00

COLPOSCOPY W BIOPSY

Facility

$1,480.00

Service Code	HCPCS 57455
Hospital Charge Code	87502590
Hospital Revenue Code	761
Min. Negotiated Rate	$222.00
Max. Negotiated Rate	$222.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.00

COLUMN

Facility

$4,750.00

Hospital Charge Code	270657733
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

COLUMN

Facility

$4,750.00

Hospital Charge Code	270657733
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

COLUMN ASCARITE DESICAT 21506

Facility

$119.25

Hospital Charge Code	270600656
Hospital Revenue Code	270
Min. Negotiated Rate	$15.50
Max. Negotiated Rate	$59.62
Rate for Payer: Aetna Commercial	$35.77
Rate for Payer: Aetna Medicare Advantage	$35.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.41
Rate for Payer: Cigna Commercial	$59.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.50
Rate for Payer: Oxford Commercial	$59.62
Rate for Payer: Qualcare PPO/HMO/WC	$17.89
Rate for Payer: UnitedHealthcare Commercial	$59.62

COLUMN ASCARITE DESICAT 21506

Facility

$119.25

Hospital Charge Code	270600656
Hospital Revenue Code	270
Min. Negotiated Rate	$17.89
Max. Negotiated Rate	$17.89
Rate for Payer: Qualcare PPO/HMO/WC	$17.89

COLUMN HYDROUS DESICAT 21501

Facility

$65.65

Hospital Charge Code	270600655
Hospital Revenue Code	272
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

COLUMN HYDROUS DESICAT 21501

Facility

$65.65

Hospital Charge Code	270600655
Hospital Revenue Code	272
Min. Negotiated Rate	$8.53
Max. Negotiated Rate	$32.83
Rate for Payer: Aetna Commercial	$19.70
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.53
Rate for Payer: Oxford Commercial	$32.83
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$32.83

COLUMN HYDROUS DESICAT 21503

Facility

$64.00

Hospital Charge Code	270600654
Hospital Revenue Code	270
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$19.20
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.32
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$32.00

COLUMN HYDROUS DESICAT 21503

Facility

$64.00

Hospital Charge Code	270600654
Hospital Revenue Code	270
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

COLUMN MEDICAL LP 3.5

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270687075
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,242.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

COLUMN MEDICAL LP 3.5

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270687075
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

COLY-MYCIN

Facility

$1,855.90

Service Code	NDC 63481042105
Hospital Charge Code	606390221
Hospital Revenue Code	250
Min. Negotiated Rate	$278.38
Max. Negotiated Rate	$278.38
Rate for Payer: Qualcare PPO/HMO/WC	$278.38

COLY-MYCIN

Facility

$1,855.90

Service Code	NDC 63481042105
Hospital Charge Code	606390221
Hospital Revenue Code	250
Min. Negotiated Rate	$241.27
Max. Negotiated Rate	$927.95
Rate for Payer: Aetna Commercial	$556.77
Rate for Payer: Aetna Medicare Advantage	$556.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$473.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$473.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$473.25
Rate for Payer: Cigna Commercial	$927.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$241.27
Rate for Payer: Oxford Commercial	$927.95
Rate for Payer: Qualcare PPO/HMO/WC	$278.38
Rate for Payer: UnitedHealthcare Commercial	$927.95

COLY-MYCIN S OTIC/10ML

Facility

$101.00

Hospital Charge Code	60632728
Hospital Revenue Code	250
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$15.15
Rate for Payer: Qualcare PPO/HMO/WC	$15.15

Know your out-of-pocket cost for care.

All Charges