Heights University Hospital

All Charges

Charge

Type

Setting

Price

ENDO LEVEL 1 VISIT

Facility

$224.00

Service Code	HCPCS 99211
Hospital Charge Code	2300920
Hospital Revenue Code	510
Min. Negotiated Rate	$33.60
Max. Negotiated Rate	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$33.60

ENDO L HOOK LAP 13/.5 STRL

Facility

$1,650.00

Hospital Charge Code	270657331
Hospital Revenue Code	272
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$825.00
Rate for Payer: Aetna Commercial	$495.00
Rate for Payer: Aetna Medicare Advantage	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.75
Rate for Payer: Cigna Commercial	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.50
Rate for Payer: Oxford Commercial	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.50
Rate for Payer: UnitedHealthcare Commercial	$825.00

ENDO L HOOK LAP 13/.5 STRL

Facility

$1,650.00

Hospital Charge Code	270657331
Hospital Revenue Code	272
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$247.50

ENDOLINEAR 60MM RELOADS

Facility

$433.00

Hospital Charge Code	270337851
Hospital Revenue Code	272
Min. Negotiated Rate	$64.95
Max. Negotiated Rate	$64.95
Rate for Payer: Qualcare PPO/HMO/WC	$64.95

ENDOLINEAR 60MM RELOADS

Facility

$433.00

Hospital Charge Code	270337851
Hospital Revenue Code	272
Min. Negotiated Rate	$56.29
Max. Negotiated Rate	$216.50
Rate for Payer: Aetna Commercial	$129.90
Rate for Payer: Aetna Medicare Advantage	$129.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.42
Rate for Payer: Cigna Commercial	$216.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.29
Rate for Payer: Oxford Commercial	$216.50
Rate for Payer: Qualcare PPO/HMO/WC	$64.95
Rate for Payer: UnitedHealthcare Commercial	$216.50

ENDOLINEAR STAPLER 60 MM

Facility

$811.00

Hospital Charge Code	270337850
Hospital Revenue Code	272
Min. Negotiated Rate	$121.65
Max. Negotiated Rate	$121.65
Rate for Payer: Qualcare PPO/HMO/WC	$121.65

ENDOLINEAR STAPLER 60 MM

Facility

$811.00

Hospital Charge Code	270337850
Hospital Revenue Code	272
Min. Negotiated Rate	$105.43
Max. Negotiated Rate	$405.50
Rate for Payer: Aetna Commercial	$243.30
Rate for Payer: Aetna Medicare Advantage	$243.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.81
Rate for Payer: Cigna Commercial	$405.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.43
Rate for Payer: Oxford Commercial	$405.50
Rate for Payer: Qualcare PPO/HMO/WC	$121.65
Rate for Payer: UnitedHealthcare Commercial	$405.50

ENDO LINEAR STAPLER X-L 45MM

Facility

$493.00

Hospital Charge Code	270338709
Hospital Revenue Code	272
Min. Negotiated Rate	$73.95
Max. Negotiated Rate	$73.95
Rate for Payer: Qualcare PPO/HMO/WC	$73.95

ENDO LINEAR STAPLER X-L 45MM

Facility

$493.00

Hospital Charge Code	270338709
Hospital Revenue Code	272
Min. Negotiated Rate	$64.09
Max. Negotiated Rate	$246.50
Rate for Payer: Aetna Commercial	$147.90
Rate for Payer: Aetna Medicare Advantage	$147.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.72
Rate for Payer: Cigna Commercial	$246.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.09
Rate for Payer: Oxford Commercial	$246.50
Rate for Payer: Qualcare PPO/HMO/WC	$73.95
Rate for Payer: UnitedHealthcare Commercial	$246.50

ENDOLOGIX ENSNARE

Facility

$2,325.00

Service Code	HCPCS C1773
Hospital Charge Code	270665547
Hospital Revenue Code	272
Min. Negotiated Rate	$348.75
Max. Negotiated Rate	$348.75
Rate for Payer: Qualcare PPO/HMO/WC	$348.75

ENDOLOGIX ENSNARE

Facility

$2,325.00

Service Code	HCPCS C1773
Hospital Charge Code	270665547
Hospital Revenue Code	272
Min. Negotiated Rate	$302.25
Max. Negotiated Rate	$1,162.50
Rate for Payer: Aetna Commercial	$697.50
Rate for Payer: Aetna Medicare Advantage	$697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.88
Rate for Payer: Cigna Commercial	$1,162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.25
Rate for Payer: Oxford Commercial	$1,162.50
Rate for Payer: Qualcare PPO/HMO/WC	$348.75
Rate for Payer: UnitedHealthcare Commercial	$1,162.50

ENDOLOOP COATED VICRYL 0 18

Facility

$682.90

Hospital Charge Code	270638747
Hospital Revenue Code	272
Min. Negotiated Rate	$102.44
Max. Negotiated Rate	$102.44
Rate for Payer: Qualcare PPO/HMO/WC	$102.44

ENDOLOOP COATED VICRYL 0 18

Facility

$682.90

Hospital Charge Code	270638747
Hospital Revenue Code	272
Min. Negotiated Rate	$88.78
Max. Negotiated Rate	$341.45
Rate for Payer: Aetna Commercial	$204.87
Rate for Payer: Aetna Medicare Advantage	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.14
Rate for Payer: Cigna Commercial	$341.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.78
Rate for Payer: Oxford Commercial	$341.45
Rate for Payer: Qualcare PPO/HMO/WC	$102.44
Rate for Payer: UnitedHealthcare Commercial	$341.45

ENDO LOOP VICRYL

Facility

$181.00

Hospital Charge Code	270335196
Hospital Revenue Code	272
Min. Negotiated Rate	$27.15
Max. Negotiated Rate	$27.15
Rate for Payer: Qualcare PPO/HMO/WC	$27.15

ENDO LOOP VICRYL

Facility

$181.00

Hospital Charge Code	270335196
Hospital Revenue Code	272
Min. Negotiated Rate	$23.53
Max. Negotiated Rate	$90.50
Rate for Payer: Aetna Commercial	$54.30
Rate for Payer: Aetna Medicare Advantage	$54.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.16
Rate for Payer: Cigna Commercial	$90.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.53
Rate for Payer: Oxford Commercial	$90.50
Rate for Payer: Qualcare PPO/HMO/WC	$27.15
Rate for Payer: UnitedHealthcare Commercial	$90.50

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	2011579
Hospital Revenue Code	361
Min. Negotiated Rate	$134.86
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$927.05
Rate for Payer: Aetna Medicare Advantage	$927.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$788.00
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	$788.00
Rate for Payer: Cigna Commercial	$134.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.72
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$463.53
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	2011579
Hospital Revenue Code	361
Min. Negotiated Rate	$463.53
Max. Negotiated Rate	$463.53
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	2600231
Hospital Revenue Code	361
Min. Negotiated Rate	$134.86
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$927.05
Rate for Payer: Aetna Medicare Advantage	$927.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$788.00
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	$788.00
Rate for Payer: Cigna Commercial	$134.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.72
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$463.53
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	2600231
Hospital Revenue Code	361
Min. Negotiated Rate	$463.53
Max. Negotiated Rate	$463.53
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	7411614
Hospital Revenue Code	361
Min. Negotiated Rate	$463.53
Max. Negotiated Rate	$463.53
Rate for Payer: Qualcare PPO/HMO/WC	$463.53

ENDOLUMINAL BX URTR RNL PLVS

Facility

$3,090.18

Service Code	HCPCS 50606
Hospital Charge Code	7411614
Hospital Revenue Code	361
Min. Negotiated Rate	$134.86
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$927.05
Rate for Payer: Aetna Medicare Advantage	$927.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$788.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$788.00
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	$788.00
Rate for Payer: Cigna Commercial	$134.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.72
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$463.53
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

ENDO MARK

Facility

$155.56

Hospital Charge Code	270667919
Hospital Revenue Code	272
Min. Negotiated Rate	$23.33
Max. Negotiated Rate	$23.33
Rate for Payer: Qualcare PPO/HMO/WC	$23.33

ENDO MARK

Facility

$155.56

Hospital Charge Code	270667919
Hospital Revenue Code	272
Min. Negotiated Rate	$20.22
Max. Negotiated Rate	$77.78
Rate for Payer: Aetna Commercial	$46.67
Rate for Payer: Aetna Medicare Advantage	$46.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.67
Rate for Payer: Cigna Commercial	$77.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.22
Rate for Payer: Oxford Commercial	$77.78
Rate for Payer: Qualcare PPO/HMO/WC	$23.33
Rate for Payer: UnitedHealthcare Commercial	$77.78

ENDOMETAL BX WO CERVICL DILATN

Facility

$2,249.90

Service Code	HCPCS 58100
Hospital Charge Code	16000759
Hospital Revenue Code	360
Min. Negotiated Rate	$337.49
Max. Negotiated Rate	$337.49
Rate for Payer: Qualcare PPO/HMO/WC	$337.49

ENDOMETAL BX WO CERVICL DILATN

Facility

$2,249.90

Service Code	HCPCS 58100
Hospital Charge Code	16000759
Hospital Revenue Code	360
Min. Negotiated Rate	$292.49
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$674.97
Rate for Payer: Aetna Medicare Advantage	$674.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.72
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	$573.72
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.49
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.49
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

Know your out-of-pocket cost for care.

All Charges