Heights University Hospital

All Charges

Charge

Type

Setting

Price

ENDOSCOPY 1-2 HRS WITH TWO BX

Facility

$5,625.00

Hospital Charge Code	2300072
Hospital Revenue Code	750
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$2,812.50
Rate for Payer: Aetna Commercial	$1,687.50
Rate for Payer: Aetna Medicare Advantage	$1,687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,434.38
Rate for Payer: Cigna Commercial	$2,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$731.25
Rate for Payer: Qualcare PPO/HMO/WC	$843.75

ENDOSCOPY < 1 HR W/ > FIVE BX

Facility

$9,375.00

Hospital Charge Code	2300066
Hospital Revenue Code	750
Min. Negotiated Rate	$1,406.25
Max. Negotiated Rate	$1,406.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,406.25

ENDOSCOPY < 1 HR W/ > FIVE BX

Facility

$9,375.00

Hospital Charge Code	2300066
Hospital Revenue Code	750
Min. Negotiated Rate	$1,218.75
Max. Negotiated Rate	$4,687.50
Rate for Payer: Aetna Commercial	$2,812.50
Rate for Payer: Aetna Medicare Advantage	$2,812.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,390.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,390.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,390.62
Rate for Payer: Cigna Commercial	$4,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,218.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,406.25

ENDOSCOPY < 1 HR WITH FIVE BX

Facility

$8,125.00

Hospital Charge Code	2300065
Hospital Revenue Code	750
Min. Negotiated Rate	$1,218.75
Max. Negotiated Rate	$1,218.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75

ENDOSCOPY < 1 HR WITH FIVE BX

Facility

$8,125.00

Hospital Charge Code	2300065
Hospital Revenue Code	750
Min. Negotiated Rate	$1,056.25
Max. Negotiated Rate	$4,062.50
Rate for Payer: Aetna Commercial	$2,437.50
Rate for Payer: Aetna Medicare Advantage	$2,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,071.88
Rate for Payer: Cigna Commercial	$4,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,056.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75

ENDOSCOPY < 1 HR WITH FOUR BX

Facility

$6,875.00

Hospital Charge Code	2300064
Hospital Revenue Code	750
Min. Negotiated Rate	$1,031.25
Max. Negotiated Rate	$1,031.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.25

ENDOSCOPY < 1 HR WITH FOUR BX

Facility

$6,875.00

Hospital Charge Code	2300064
Hospital Revenue Code	750
Min. Negotiated Rate	$893.75
Max. Negotiated Rate	$3,437.50
Rate for Payer: Aetna Commercial	$2,062.50
Rate for Payer: Aetna Medicare Advantage	$2,062.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,753.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,753.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,753.12
Rate for Payer: Cigna Commercial	$3,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$893.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,031.25

ENDOSCOPY < 1 HR WITH ONE BX

Facility

$3,125.00

Hospital Charge Code	2300061
Hospital Revenue Code	750
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$468.75
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

ENDOSCOPY < 1 HR WITH ONE BX

Facility

$3,125.00

Hospital Charge Code	2300061
Hospital Revenue Code	750
Min. Negotiated Rate	$406.25
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$937.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

ENDOSCOPY < 1 HR WITHOUT BX

Facility

$1,875.00

Hospital Charge Code	2300060
Hospital Revenue Code	750
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$281.25
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

ENDOSCOPY < 1 HR WITHOUT BX

Facility

$1,875.00

Hospital Charge Code	2300060
Hospital Revenue Code	750
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$562.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

ENDOSCOPY < 1 HR WITH THREE BX

Facility

$5,625.00

Hospital Charge Code	2300063
Hospital Revenue Code	750
Min. Negotiated Rate	$843.75
Max. Negotiated Rate	$843.75
Rate for Payer: Qualcare PPO/HMO/WC	$843.75

ENDOSCOPY < 1 HR WITH THREE BX

Facility

$5,625.00

Hospital Charge Code	2300063
Hospital Revenue Code	750
Min. Negotiated Rate	$731.25
Max. Negotiated Rate	$2,812.50
Rate for Payer: Aetna Commercial	$1,687.50
Rate for Payer: Aetna Medicare Advantage	$1,687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,434.38
Rate for Payer: Cigna Commercial	$2,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$731.25
Rate for Payer: Qualcare PPO/HMO/WC	$843.75

ENDOSCOPY < 1 HR WITH TWO BX

Facility

$4,375.00

Hospital Charge Code	2300062
Hospital Revenue Code	750
Min. Negotiated Rate	$568.75
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,312.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$568.75
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

ENDOSCOPY < 1 HR WITH TWO BX

Facility

$4,375.00

Hospital Charge Code	2300062
Hospital Revenue Code	750
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$656.25
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

ENDOSCOPY 1 PROCEDURE < 1 HR

Facility

$3,125.00

Hospital Charge Code	2300082
Hospital Revenue Code	750
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$468.75
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

ENDOSCOPY 1 PROCEDURE < 1 HR

Facility

$3,125.00

Hospital Charge Code	2300082
Hospital Revenue Code	750
Min. Negotiated Rate	$406.25
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$937.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$406.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

ENDOSCOPY 1 PROCEDURE >1 HR

Facility

$3,974.24

Hospital Charge Code	2300083
Hospital Revenue Code	750
Min. Negotiated Rate	$596.14
Max. Negotiated Rate	$596.14
Rate for Payer: Qualcare PPO/HMO/WC	$596.14

ENDOSCOPY 1 PROCEDURE >1 HR

Facility

$3,974.24

Hospital Charge Code	2300083
Hospital Revenue Code	750
Min. Negotiated Rate	$516.65
Max. Negotiated Rate	$1,987.12
Rate for Payer: Aetna Commercial	$1,192.27
Rate for Payer: Aetna Medicare Advantage	$1,192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.43
Rate for Payer: Cigna Commercial	$1,987.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$516.65
Rate for Payer: Qualcare PPO/HMO/WC	$596.14

ENDOSCOPY 2 PROCEDURES < 1 HR

Facility

$6,250.00

Hospital Charge Code	2300084
Hospital Revenue Code	750
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$937.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

ENDOSCOPY 2 PROCEDURES < 1 HR

Facility

$6,250.00

Hospital Charge Code	2300084
Hospital Revenue Code	750
Min. Negotiated Rate	$812.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$1,875.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$812.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

ENDOSCOPY 2 PROCEDURES > 1 HR

Facility

$7,948.47

Hospital Charge Code	2300085
Hospital Revenue Code	750
Min. Negotiated Rate	$1,033.30
Max. Negotiated Rate	$3,974.24
Rate for Payer: Aetna Commercial	$2,384.54
Rate for Payer: Aetna Medicare Advantage	$2,384.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,026.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,026.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,026.86
Rate for Payer: Cigna Commercial	$3,974.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,033.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.27

ENDOSCOPY 2 PROCEDURES > 1 HR

Facility

$7,948.47

Hospital Charge Code	2300085
Hospital Revenue Code	750
Min. Negotiated Rate	$1,192.27
Max. Negotiated Rate	$1,192.27
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.27

ENDOSCOPY 3 PROCEDURES < 1 HR

Facility

$7,500.00

Hospital Charge Code	2300086
Hospital Revenue Code	750
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

ENDOSCOPY 3 PROCEDURES < 1 HR

Facility

$7,500.00

Hospital Charge Code	2300086
Hospital Revenue Code	750
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,250.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$975.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

Know your out-of-pocket cost for care.

All Charges