Heights University Hospital

All Charges

Charge

Type

Setting

Price

ENDOMETRIAL ABLATION KIT

Facility

$18,300.00

Hospital Charge Code	270657261
Hospital Revenue Code	278
Min. Negotiated Rate	$2,745.00
Max. Negotiated Rate	$9,150.00
Rate for Payer: Aetna Commercial	$5,490.00
Rate for Payer: Aetna Medicare Advantage	$5,490.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,666.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,666.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,660.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,666.50
Rate for Payer: Cigna Commercial	$9,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,428.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,745.00

ENDOMETRIAL ABLATION KIT

Facility

$18,300.00

Hospital Charge Code	270657261
Hospital Revenue Code	278
Min. Negotiated Rate	$2,745.00
Max. Negotiated Rate	$4,428.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,428.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,745.00

ENDOMETRIAL CRYOABLATION

Facility

$29,715.20

Service Code	HCPCS 58356
Hospital Charge Code	1600000874
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$11,912.81
Rate for Payer: Aetna Commercial	$8,914.56
Rate for Payer: Aetna Medicare Advantage	$8,914.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,577.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,577.38
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	$7,577.38
Rate for Payer: Cigna Commercial	$11,912.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,862.98
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,457.28
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

ENDOMETRIAL CRYOABLATION

Facility

$29,715.20

Service Code	HCPCS 58356
Hospital Charge Code	1600000874
Hospital Revenue Code	360
Min. Negotiated Rate	$4,457.28
Max. Negotiated Rate	$4,457.28
Rate for Payer: Qualcare PPO/HMO/WC	$4,457.28

ENDOMETRIAL SAMPLING BX

Facility

$786.65

Service Code	HCPCS 58110
Hospital Charge Code	412358110
Hospital Revenue Code	761
Min. Negotiated Rate	$25.62
Max. Negotiated Rate	$393.32
Rate for Payer: Aetna Commercial	$236.00
Rate for Payer: Aetna Medicare Advantage	$236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.60
Rate for Payer: Cigna Commercial	$38.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.26
Rate for Payer: Oxford Commercial	$393.32
Rate for Payer: Qualcare PPO/HMO/WC	$118.00
Rate for Payer: UnitedHealthcare Commercial	$393.32

ENDOMETRIAL SAMPLING BX

Facility

$786.65

Service Code	HCPCS 58110
Hospital Charge Code	412358110
Hospital Revenue Code	761
Min. Negotiated Rate	$118.00
Max. Negotiated Rate	$118.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.00

ENDO MINI SHEARS 5MM SINGLE

Facility

$412.75

Hospital Charge Code	270697813
Hospital Revenue Code	272
Min. Negotiated Rate	$61.91
Max. Negotiated Rate	$61.91
Rate for Payer: Qualcare PPO/HMO/WC	$61.91

ENDO MINI SHEARS 5MM SINGLE

Facility

$412.75

Hospital Charge Code	270697813
Hospital Revenue Code	272
Min. Negotiated Rate	$53.66
Max. Negotiated Rate	$206.38
Rate for Payer: Aetna Commercial	$123.83
Rate for Payer: Aetna Medicare Advantage	$123.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.25
Rate for Payer: Cigna Commercial	$206.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.66
Rate for Payer: Oxford Commercial	$206.38
Rate for Payer: Qualcare PPO/HMO/WC	$61.91
Rate for Payer: UnitedHealthcare Commercial	$206.38

ENDO MULTIFIRE HERNIA 4MM*****

Facility

$245.00

Hospital Charge Code	1605948
Hospital Revenue Code	272
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$36.75
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

ENDO MULTIFIRE HERNIA 4MM*****

Facility

$245.00

Hospital Charge Code	1605948
Hospital Revenue Code	272
Min. Negotiated Rate	$31.85
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$73.50
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.85
Rate for Payer: Oxford Commercial	$122.50
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Commercial	$122.50

ENDOMYOCARDIAL BX*****

Facility

$1,031.00

Service Code	HCPCS 93505
Hospital Charge Code	5100060
Hospital Revenue Code	481
Min. Negotiated Rate	$154.65
Max. Negotiated Rate	$154.65
Rate for Payer: Qualcare PPO/HMO/WC	$154.65

ENDOMYOCARDIAL BX*****

Facility

$1,031.00

Service Code	HCPCS 93505
Hospital Charge Code	5100060
Hospital Revenue Code	481
Min. Negotiated Rate	$134.03
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$309.30
Rate for Payer: Aetna Medicare Advantage	$309.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$262.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$262.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$262.90
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.03
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$154.65
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

ENDOMYSIAL AB

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900365
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

ENDOMYSIAL AB

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900365
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ENDOMYSIAL AB (IGA) SCREEN

Facility

$187.25

Service Code	HCPCS 83516
Hospital Charge Code	3006623
Hospital Revenue Code	302
Min. Negotiated Rate	$5.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.36
Rate for Payer: Aetna Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.25
Rate for Payer: Cigna Commercial	$11.53
Rate for Payer: Cigna Medicare Advantage	$5.76
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.09
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.22
Rate for Payer: Wellcare Medicare Advantage	$11.53

ENDOMYSIAL AB (IGA) SCREEN

Facility

$187.25

Service Code	HCPCS 83516
Hospital Charge Code	3006623
Hospital Revenue Code	302
Min. Negotiated Rate	$28.09
Max. Negotiated Rate	$28.09
Rate for Payer: Qualcare PPO/HMO/WC	$28.09

ENDOMYSIAL ANTIBODY

Facility

$333.00

Service Code	HCPCS 86255
Hospital Charge Code	38476261
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.29
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

ENDOMYSIAL ANTIBODY

Facility

$333.00

Service Code	HCPCS 86255
Hospital Charge Code	38476261
Hospital Revenue Code	302
Min. Negotiated Rate	$49.95
Max. Negotiated Rate	$49.95
Rate for Payer: Qualcare PPO/HMO/WC	$49.95

ENDOMYSIAL(IGG)ANTIBDYSCR&TITR

Facility

$120.00

Service Code	HCPCS 86231
Hospital Charge Code	401191985
Hospital Revenue Code	302
Min. Negotiated Rate	$6.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.17
Rate for Payer: Aetna Medicare Advantage	$12.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.30
Rate for Payer: Cigna Commercial	$12.09
Rate for Payer: Cigna Medicare Advantage	$6.04
Rate for Payer: Clover Medicare Advantage	$11.49
Rate for Payer: EmblemHealth Commercial	$36.27
Rate for Payer: Humana Medicare Advantage	$12.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.82
Rate for Payer: Wellcare Medicare Advantage	$12.09

ENDOMYSIAL(IGG)ANTIBDYSCR&TITR

Facility

$120.00

Service Code	HCPCS 86231
Hospital Charge Code	401191985
Hospital Revenue Code	302
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

ENDOPATH TROCAR 10/11MM

Facility

$612.00

Hospital Charge Code	270334711
Hospital Revenue Code	272
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ENDOPATH TROCAR 10/11MM

Facility

$612.00

Hospital Charge Code	270334711
Hospital Revenue Code	272
Min. Negotiated Rate	$79.56
Max. Negotiated Rate	$306.00
Rate for Payer: Aetna Commercial	$183.60
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.56
Rate for Payer: Oxford Commercial	$306.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$306.00

ENDOPRASTHESIS AORTIC 28X30

Facility

$13,950.00

Hospital Charge Code	270645165
Hospital Revenue Code	278
Min. Negotiated Rate	$2,092.50
Max. Negotiated Rate	$3,375.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,790.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,375.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,092.50

ENDOPRASTHESIS AORTIC 28X30

Facility

$13,950.00

Hospital Charge Code	270645165
Hospital Revenue Code	278
Min. Negotiated Rate	$2,092.50
Max. Negotiated Rate	$6,975.00
Rate for Payer: Aetna Commercial	$4,185.00
Rate for Payer: Aetna Medicare Advantage	$4,185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,557.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,557.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,790.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,557.25
Rate for Payer: Cigna Commercial	$6,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,375.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,092.50

ENDOPRO EXCLR 14x10 PXC141000

Facility

$17,955.00

Hospital Charge Code	270638318V
Hospital Revenue Code	278
Min. Negotiated Rate	$2,693.25
Max. Negotiated Rate	$4,345.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,591.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,345.11
Rate for Payer: Qualcare PPO/HMO/WC	$2,693.25

Know your out-of-pocket cost for care.

All Charges