Heights University Hospital

All Charges

Charge

Type

Setting

Price

ESOPHAGOGASTROJEJUNOSCOPY***

Facility

$263.00

Hospital Charge Code	2300267
Hospital Revenue Code	759
Min. Negotiated Rate	$39.45
Max. Negotiated Rate	$39.45
Rate for Payer: Qualcare PPO/HMO/WC	$39.45

ESOPHAGOGASTROJEJUNOSCOPY***

Facility

$263.00

Hospital Charge Code	2300267
Hospital Revenue Code	759
Min. Negotiated Rate	$34.19
Max. Negotiated Rate	$131.50
Rate for Payer: Aetna Commercial	$78.90
Rate for Payer: Aetna Medicare Advantage	$78.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.06
Rate for Payer: Cigna Commercial	$131.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.19
Rate for Payer: Qualcare PPO/HMO/WC	$39.45

ESOPHAGOGASTROSCOPY***

Facility

$263.00

Hospital Charge Code	2300127
Hospital Revenue Code	759
Min. Negotiated Rate	$39.45
Max. Negotiated Rate	$39.45
Rate for Payer: Qualcare PPO/HMO/WC	$39.45

ESOPHAGOGASTROSCOPY***

Facility

$263.00

Hospital Charge Code	2300127
Hospital Revenue Code	759
Min. Negotiated Rate	$34.19
Max. Negotiated Rate	$131.50
Rate for Payer: Aetna Commercial	$78.90
Rate for Payer: Aetna Medicare Advantage	$78.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.06
Rate for Payer: Cigna Commercial	$131.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.19
Rate for Payer: Qualcare PPO/HMO/WC	$39.45

ESOPHAGOSCOPY***

Facility

$263.00

Hospital Charge Code	2300275
Hospital Revenue Code	759
Min. Negotiated Rate	$34.19
Max. Negotiated Rate	$131.50
Rate for Payer: Aetna Commercial	$78.90
Rate for Payer: Aetna Medicare Advantage	$78.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.06
Rate for Payer: Cigna Commercial	$131.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.19
Rate for Payer: Qualcare PPO/HMO/WC	$39.45

ESOPHAGOSCOPY***

Facility

$263.00

Hospital Charge Code	2300275
Hospital Revenue Code	759
Min. Negotiated Rate	$39.45
Max. Negotiated Rate	$39.45
Rate for Payer: Qualcare PPO/HMO/WC	$39.45

ESOPHAGOSCOPY FLEXIBLE BRUSH

Facility

$7,963.40

Service Code	HCPCS 43200
Hospital Charge Code	16000641
Hospital Revenue Code	360
Min. Negotiated Rate	$1,035.24
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$2,389.02
Rate for Payer: Aetna Medicare Advantage	$2,389.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,030.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,030.67
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	$2,030.67
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,035.24
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,194.51
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

ESOPHAGOSCOPY FLEXIBLE BRUSH

Facility

$7,963.40

Service Code	HCPCS 43200
Hospital Charge Code	16000641
Hospital Revenue Code	360
Min. Negotiated Rate	$1,194.51
Max. Negotiated Rate	$1,194.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,194.51

ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)

Facility

$3,687.00

Service Code	CPT 43200
Hospital Revenue Code	750
Min. Negotiated Rate	$97.75
Max. Negotiated Rate	$3,687.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.75
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

ESOPHAGOSCOPY W/BAND LIGAT****

Facility

$909.00

Hospital Charge Code	2300012
Hospital Revenue Code	759
Min. Negotiated Rate	$118.17
Max. Negotiated Rate	$454.50
Rate for Payer: Aetna Commercial	$272.70
Rate for Payer: Aetna Medicare Advantage	$272.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.79
Rate for Payer: Cigna Commercial	$454.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.17
Rate for Payer: Qualcare PPO/HMO/WC	$136.35

ESOPHAGOSCOPY W/BAND LIGAT****

Facility

$909.00

Hospital Charge Code	2300012
Hospital Revenue Code	759
Min. Negotiated Rate	$136.35
Max. Negotiated Rate	$136.35
Rate for Payer: Qualcare PPO/HMO/WC	$136.35

ESOPHAGOSCOPY W/BIOPSY****

Facility

$909.00

Hospital Charge Code	2300013
Hospital Revenue Code	759
Min. Negotiated Rate	$136.35
Max. Negotiated Rate	$136.35
Rate for Payer: Qualcare PPO/HMO/WC	$136.35

ESOPHAGOSCOPY W/BIOPSY****

Facility

$909.00

Hospital Charge Code	2300013
Hospital Revenue Code	759
Min. Negotiated Rate	$118.17
Max. Negotiated Rate	$454.50
Rate for Payer: Aetna Commercial	$272.70
Rate for Payer: Aetna Medicare Advantage	$272.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$231.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$231.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$231.79
Rate for Payer: Cigna Commercial	$454.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.17
Rate for Payer: Qualcare PPO/HMO/WC	$136.35

ESOPHAGOSCOPY W/DILATION***

Facility

$962.00

Service Code	HCPCS 43450
Hospital Charge Code	2300184
Hospital Revenue Code	759
Min. Negotiated Rate	$47.56
Max. Negotiated Rate	$2,159.89
Rate for Payer: Aetna Commercial	$288.60
Rate for Payer: Aetna Medicare Advantage	$288.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.31
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.06
Rate for Payer: Qualcare PPO/HMO/WC	$144.30

ESOPHAGOSCOPY W/DILATION***

Facility

$962.00

Service Code	HCPCS 43450
Hospital Charge Code	2300184
Hospital Revenue Code	759
Min. Negotiated Rate	$144.30
Max. Negotiated Rate	$144.30
Rate for Payer: Qualcare PPO/HMO/WC	$144.30

ESOPHAGOSCOPY W/SAVRY DILATION

Facility

$406.80

Hospital Charge Code	2300606
Hospital Revenue Code	759
Min. Negotiated Rate	$52.88
Max. Negotiated Rate	$203.40
Rate for Payer: Aetna Commercial	$122.04
Rate for Payer: Aetna Medicare Advantage	$122.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.73
Rate for Payer: Cigna Commercial	$203.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.88
Rate for Payer: Qualcare PPO/HMO/WC	$61.02

ESOPHAGOSCOPY W/SAVRY DILATION

Facility

$406.80

Hospital Charge Code	2300606
Hospital Revenue Code	759
Min. Negotiated Rate	$61.02
Max. Negotiated Rate	$61.02
Rate for Payer: Qualcare PPO/HMO/WC	$61.02

ESOPHAGUS

Facility

$642.00

Service Code	HCPCS 74220
Hospital Charge Code	94061135
Hospital Revenue Code	320
Min. Negotiated Rate	$96.30
Max. Negotiated Rate	$96.30
Rate for Payer: Qualcare PPO/HMO/WC	$96.30

ESOPHAGUS

Facility

$642.00

Service Code	HCPCS 74220
Hospital Charge Code	94061135
Hospital Revenue Code	320
Min. Negotiated Rate	$52.36
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$192.60
Rate for Payer: Aetna Medicare Advantage	$192.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.71
Rate for Payer: Cigna Commercial	$417.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.46
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.30
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ESOPHAGUS SURGERY PROCEDURE

Facility

$3,487.18

Service Code	HCPCS 43499
Hospital Charge Code	16000966
Hospital Revenue Code	360
Min. Negotiated Rate	$523.08
Max. Negotiated Rate	$523.08
Rate for Payer: Qualcare PPO/HMO/WC	$523.08

ESOPHAGUS SURGERY PROCEDURE

Facility

$3,487.18

Service Code	HCPCS 43499
Hospital Charge Code	16000966
Hospital Revenue Code	360
Min. Negotiated Rate	$453.33
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$1,046.15
Rate for Payer: Aetna Medicare Advantage	$1,046.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$889.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$889.23
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	$889.23
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.33
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$523.08
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

ESSURE

Facility

$8,750.00

Hospital Charge Code	270658503
Hospital Revenue Code	270
Min. Negotiated Rate	$1,137.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$2,625.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,137.50
Rate for Payer: Oxford Commercial	$4,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50
Rate for Payer: UnitedHealthcare Commercial	$4,375.00

ESSURE

Facility

$8,750.00

Hospital Charge Code	270658503
Hospital Revenue Code	270
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$1,312.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

ESTABLISH ACCESS TO ARTERY

Facility

$46.15

Service Code	HCPCS 36100
Hospital Charge Code	5100082
Hospital Revenue Code	361
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$13.85
Rate for Payer: Aetna Medicare Advantage	$13.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.77
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	$11.77
Rate for Payer: Cigna Commercial	$143.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.92
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

ESTABLISH ACCESS TO ARTERY

Facility

$46.15

Service Code	HCPCS 36100
Hospital Charge Code	5100082
Hospital Revenue Code	361
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$6.92
Rate for Payer: Qualcare PPO/HMO/WC	$6.92

Know your out-of-pocket cost for care.

All Charges