Heights University Hospital

All Charges

Charge

Type

Setting

Price

ENDO CATCH *******

Facility

$494.00

Hospital Charge Code	1603521
Hospital Revenue Code	272
Min. Negotiated Rate	$64.22
Max. Negotiated Rate	$247.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$148.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.97
Rate for Payer: Cigna Commercial	$247.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.22
Rate for Payer: Oxford Commercial	$247.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.10
Rate for Payer: UnitedHealthcare Commercial	$247.00

ENDO CATCH *******

Facility

$494.00

Hospital Charge Code	1603521
Hospital Revenue Code	272
Min. Negotiated Rate	$74.10
Max. Negotiated Rate	$74.10
Rate for Payer: Qualcare PPO/HMO/WC	$74.10

ENDO CATCH GOLD POUCH 10MM

Facility

$2,028.10

Hospital Charge Code	270600099
Hospital Revenue Code	272
Min. Negotiated Rate	$304.21
Max. Negotiated Rate	$304.21
Rate for Payer: Qualcare PPO/HMO/WC	$304.21

ENDO CATCH GOLD POUCH 10MM

Facility

$2,028.10

Hospital Charge Code	270600099
Hospital Revenue Code	272
Min. Negotiated Rate	$263.65
Max. Negotiated Rate	$1,014.05
Rate for Payer: Aetna Commercial	$608.43
Rate for Payer: Aetna Medicare Advantage	$608.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$517.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$517.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$517.17
Rate for Payer: Cigna Commercial	$1,014.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$263.65
Rate for Payer: Oxford Commercial	$1,014.05
Rate for Payer: Qualcare PPO/HMO/WC	$304.21
Rate for Payer: UnitedHealthcare Commercial	$1,014.05

ENDO CATCH II ********

Facility

$464.00

Hospital Charge Code	1606599
Hospital Revenue Code	278
Min. Negotiated Rate	$69.60
Max. Negotiated Rate	$112.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.29
Rate for Payer: Qualcare PPO/HMO/WC	$69.60

ENDO CATCH II ********

Facility

$464.00

Hospital Charge Code	1606599
Hospital Revenue Code	278
Min. Negotiated Rate	$69.60
Max. Negotiated Rate	$232.00
Rate for Payer: Aetna Commercial	$139.20
Rate for Payer: Aetna Medicare Advantage	$139.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.32
Rate for Payer: Cigna Commercial	$232.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.29
Rate for Payer: Qualcare PPO/HMO/WC	$69.60

ENDO CATCH SPECIMEN POUCH 10mm

Facility

$316.20

Hospital Charge Code	270657207
Hospital Revenue Code	272
Min. Negotiated Rate	$41.11
Max. Negotiated Rate	$158.10
Rate for Payer: Aetna Commercial	$94.86
Rate for Payer: Aetna Medicare Advantage	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.63
Rate for Payer: Cigna Commercial	$158.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.11
Rate for Payer: Oxford Commercial	$158.10
Rate for Payer: Qualcare PPO/HMO/WC	$47.43
Rate for Payer: UnitedHealthcare Commercial	$158.10

ENDO CATCH SPECIMEN POUCH 10mm

Facility

$316.20

Hospital Charge Code	270657207
Hospital Revenue Code	272
Min. Negotiated Rate	$47.43
Max. Negotiated Rate	$47.43
Rate for Payer: Qualcare PPO/HMO/WC	$47.43

ENDO CATH II 15MM POUCH SPECIM

Facility

$1,800.97

Hospital Charge Code	270622365
Hospital Revenue Code	272
Min. Negotiated Rate	$270.15
Max. Negotiated Rate	$270.15
Rate for Payer: Qualcare PPO/HMO/WC	$270.15

ENDO CATH II 15MM POUCH SPECIM

Facility

$1,800.97

Hospital Charge Code	270622365
Hospital Revenue Code	272
Min. Negotiated Rate	$234.13
Max. Negotiated Rate	$900.49
Rate for Payer: Aetna Commercial	$540.29
Rate for Payer: Aetna Medicare Advantage	$540.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$459.25
Rate for Payer: Cigna Commercial	$900.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.13
Rate for Payer: Oxford Commercial	$900.49
Rate for Payer: Qualcare PPO/HMO/WC	$270.15
Rate for Payer: UnitedHealthcare Commercial	$900.49

ENDOCERV CURETTAGE W/SCOPE

Facility

$1,573.30

Service Code	HCPCS 57456
Hospital Charge Code	412357456
Hospital Revenue Code	361
Min. Negotiated Rate	$236.00
Max. Negotiated Rate	$236.00
Rate for Payer: Qualcare PPO/HMO/WC	$236.00

ENDOCERV CURETTAGE W/SCOPE

Facility

$1,573.30

Service Code	HCPCS 57456
Hospital Charge Code	412357456
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

ENDO CHANNEL TUBING

Facility

$32.50

Hospital Charge Code	270658747
Hospital Revenue Code	270
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$4.88
Rate for Payer: Qualcare PPO/HMO/WC	$4.88

ENDO CHANNEL TUBING

Facility

$32.50

Hospital Charge Code	270658747
Hospital Revenue Code	270
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$16.25
Rate for Payer: Aetna Commercial	$9.75
Rate for Payer: Aetna Medicare Advantage	$9.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.29
Rate for Payer: Cigna Commercial	$16.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.22
Rate for Payer: Oxford Commercial	$16.25
Rate for Payer: Qualcare PPO/HMO/WC	$4.88
Rate for Payer: UnitedHealthcare Commercial	$16.25

ENDO CLINCH *******

Facility

$519.00

Hospital Charge Code	1603547
Hospital Revenue Code	272
Min. Negotiated Rate	$67.47
Max. Negotiated Rate	$259.50
Rate for Payer: Aetna Commercial	$155.70
Rate for Payer: Aetna Medicare Advantage	$155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.34
Rate for Payer: Cigna Commercial	$259.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.47
Rate for Payer: Oxford Commercial	$259.50
Rate for Payer: Qualcare PPO/HMO/WC	$77.85
Rate for Payer: UnitedHealthcare Commercial	$259.50

ENDO CLINCH *******

Facility

$519.00

Hospital Charge Code	1603547
Hospital Revenue Code	272
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$77.85
Rate for Payer: Qualcare PPO/HMO/WC	$77.85

ENDO CLINCH 174305

Facility

$1,740.00

Hospital Charge Code	270600101
Hospital Revenue Code	272
Min. Negotiated Rate	$226.20
Max. Negotiated Rate	$870.00
Rate for Payer: Aetna Commercial	$522.00
Rate for Payer: Aetna Medicare Advantage	$522.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$443.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$443.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$443.70
Rate for Payer: Cigna Commercial	$870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.20
Rate for Payer: Oxford Commercial	$870.00
Rate for Payer: Qualcare PPO/HMO/WC	$261.00
Rate for Payer: UnitedHealthcare Commercial	$870.00

ENDO CLINCH 174305

Facility

$1,740.00

Hospital Charge Code	270600101
Hospital Revenue Code	272
Min. Negotiated Rate	$261.00
Max. Negotiated Rate	$261.00
Rate for Payer: Qualcare PPO/HMO/WC	$261.00

ENDOCLIP APPLIER 10MM

Facility

$211.00

Hospital Charge Code	270338726
Hospital Revenue Code	272
Min. Negotiated Rate	$27.43
Max. Negotiated Rate	$105.50
Rate for Payer: Aetna Commercial	$63.30
Rate for Payer: Aetna Medicare Advantage	$63.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.80
Rate for Payer: Cigna Commercial	$105.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.43
Rate for Payer: Oxford Commercial	$105.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.65
Rate for Payer: UnitedHealthcare Commercial	$105.50

ENDOCLIP APPLIER 10MM

Facility

$211.00

Hospital Charge Code	270338726
Hospital Revenue Code	272
Min. Negotiated Rate	$31.65
Max. Negotiated Rate	$31.65
Rate for Payer: Qualcare PPO/HMO/WC	$31.65

ENDOCLIP APPLIER 5MM

Facility

$279.00

Hospital Charge Code	270338725
Hospital Revenue Code	272
Min. Negotiated Rate	$36.27
Max. Negotiated Rate	$139.50
Rate for Payer: Aetna Commercial	$83.70
Rate for Payer: Aetna Medicare Advantage	$83.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.14
Rate for Payer: Cigna Commercial	$139.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.27
Rate for Payer: Oxford Commercial	$139.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.85
Rate for Payer: UnitedHealthcare Commercial	$139.50

ENDOCLIP APPLIER 5MM

Facility

$279.00

Hospital Charge Code	270338725
Hospital Revenue Code	272
Min. Negotiated Rate	$41.85
Max. Negotiated Rate	$41.85
Rate for Payer: Qualcare PPO/HMO/WC	$41.85

ENDO CLIP II #176657 *****

Facility

$781.00

Hospital Charge Code	1606102
Hospital Revenue Code	272
Min. Negotiated Rate	$101.53
Max. Negotiated Rate	$390.50
Rate for Payer: Aetna Commercial	$234.30
Rate for Payer: Aetna Medicare Advantage	$234.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$199.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$199.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$199.16
Rate for Payer: Cigna Commercial	$390.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.53
Rate for Payer: Oxford Commercial	$390.50
Rate for Payer: Qualcare PPO/HMO/WC	$117.15
Rate for Payer: UnitedHealthcare Commercial	$390.50

ENDO CLIP II #176657 *****

Facility

$781.00

Hospital Charge Code	1606102
Hospital Revenue Code	272
Min. Negotiated Rate	$117.15
Max. Negotiated Rate	$117.15
Rate for Payer: Qualcare PPO/HMO/WC	$117.15

ENDO CLIP LARGE *******

Facility

$696.00

Hospital Charge Code	1603505
Hospital Revenue Code	272
Min. Negotiated Rate	$90.48
Max. Negotiated Rate	$348.00
Rate for Payer: Aetna Commercial	$208.80
Rate for Payer: Aetna Medicare Advantage	$208.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.48
Rate for Payer: Cigna Commercial	$348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.48
Rate for Payer: Oxford Commercial	$348.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.40
Rate for Payer: UnitedHealthcare Commercial	$348.00

Know your out-of-pocket cost for care.

All Charges