Heights University Hospital

All Charges

Charge

Type

Setting

Price

GASTRODUODENOSTOMY WO VAGOTOMY

Facility

$112,126.91

Service Code	HCPCS 43850
Hospital Charge Code	1600186
Hospital Revenue Code	361
Min. Negotiated Rate	$16,819.04
Max. Negotiated Rate	$16,819.04
Rate for Payer: Qualcare PPO/HMO/WC	$16,819.04

GASTRODUODENOSTOMY W VAGOTOMY

Facility

$112,126.91

Service Code	HCPCS 43855
Hospital Charge Code	1600187
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$56,063.46
Rate for Payer: Aetna Commercial	$33,638.07
Rate for Payer: Aetna Medicare Advantage	$33,638.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,592.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,592.36
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	$28,592.36
Rate for Payer: Cigna Commercial	$56,063.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,576.50
Rate for Payer: Qualcare PPO/HMO/WC	$16,819.04

GASTRODUODENOSTOMY W VAGOTOMY

Facility

$112,126.91

Service Code	HCPCS 43855
Hospital Charge Code	1600187
Hospital Revenue Code	361
Min. Negotiated Rate	$16,819.04
Max. Negotiated Rate	$16,819.04
Rate for Payer: Qualcare PPO/HMO/WC	$16,819.04

GASTROGRAFIN 120 ML ORAL

Facility

$534.86

Service Code	NDC 270044540
Hospital Charge Code	606390130
Hospital Revenue Code	250
Min. Negotiated Rate	$80.23
Max. Negotiated Rate	$80.23
Rate for Payer: Qualcare PPO/HMO/WC	$80.23

GASTROGRAFIN 120 ML ORAL

Facility

$534.86

Service Code	NDC 270044540
Hospital Charge Code	606390130
Hospital Revenue Code	250
Min. Negotiated Rate	$69.53
Max. Negotiated Rate	$267.43
Rate for Payer: Aetna Commercial	$160.46
Rate for Payer: Aetna Medicare Advantage	$160.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.39
Rate for Payer: Cigna Commercial	$267.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.53
Rate for Payer: Oxford Commercial	$267.43
Rate for Payer: Qualcare PPO/HMO/WC	$80.23
Rate for Payer: UnitedHealthcare Commercial	$267.43

GASTROINTESTINAL HEMORRHAGE WITH CC

Facility

$40,287.75

Service Code	MSDRG 378
Min. Negotiated Rate	$10,701.97
Max. Negotiated Rate	$40,287.75
Rate for Payer: Aetna Commercial	$33,069.09
Rate for Payer: Aetna Medicare Advantage	$10,701.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,015.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,015.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,429.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,015.66
Rate for Payer: Cigna Commercial	$21,105.64
Rate for Payer: Cigna Medicare Advantage	$13,429.25
Rate for Payer: Clover Medicare Advantage	$12,757.79
Rate for Payer: EmblemHealth Commercial	$40,287.75
Rate for Payer: Humana Medicare Advantage	$13,832.13
Rate for Payer: Oxford Commercial	$13,190.42
Rate for Payer: UnitedHealthcare Commercial	$14,972.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,429.25
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14,235.00
Rate for Payer: Wellcare Medicare Advantage	$13,429.25

GASTROINTESTINAL HEMORRHAGE WITH MCC

Facility

$64,881.27

Service Code	MSDRG 377
Min. Negotiated Rate	$19,948.20
Max. Negotiated Rate	$64,881.27
Rate for Payer: Aetna Commercial	$61,639.94
Rate for Payer: Aetna Medicare Advantage	$19,948.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,344.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,344.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,627.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49,344.93
Rate for Payer: Cigna Commercial	$39,340.39
Rate for Payer: Cigna Medicare Advantage	$21,627.09
Rate for Payer: Clover Medicare Advantage	$20,545.74
Rate for Payer: EmblemHealth Commercial	$64,881.27
Rate for Payer: Humana Medicare Advantage	$22,275.90
Rate for Payer: Oxford Commercial	$24,586.60
Rate for Payer: UnitedHealthcare Commercial	$27,908.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,627.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22,924.72
Rate for Payer: Wellcare Medicare Advantage	$21,627.09

GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC

Facility

$30,120.06

Service Code	MSDRG 379
Min. Negotiated Rate	$6,879.29
Max. Negotiated Rate	$30,120.06
Rate for Payer: Aetna Commercial	$21,257.01
Rate for Payer: Aetna Medicare Advantage	$6,879.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,367.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,367.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10,040.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,367.21
Rate for Payer: Cigna Commercial	$13,566.84
Rate for Payer: Cigna Medicare Advantage	$10,040.02
Rate for Payer: Clover Medicare Advantage	$9,538.02
Rate for Payer: EmblemHealth Commercial	$30,120.06
Rate for Payer: Humana Medicare Advantage	$10,341.22
Rate for Payer: Oxford Commercial	$8,478.88
Rate for Payer: UnitedHealthcare Commercial	$9,624.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$10,040.02
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10,642.42
Rate for Payer: Wellcare Medicare Advantage	$10,040.02

GASTROINTESTINAL OBSTRUCTION WITH CC

Facility

$34,746.75

Service Code	MSDRG 389
Min. Negotiated Rate	$8,618.76
Max. Negotiated Rate	$34,746.75
Rate for Payer: Aetna Commercial	$26,631.97
Rate for Payer: Aetna Medicare Advantage	$8,618.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,053.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,053.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,582.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,053.60
Rate for Payer: Cigna Commercial	$16,997.29
Rate for Payer: Cigna Medicare Advantage	$11,582.25
Rate for Payer: Clover Medicare Advantage	$11,003.14
Rate for Payer: EmblemHealth Commercial	$34,746.75
Rate for Payer: Humana Medicare Advantage	$11,929.72
Rate for Payer: Oxford Commercial	$10,622.81
Rate for Payer: UnitedHealthcare Commercial	$12,057.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,582.25
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12,277.18
Rate for Payer: Wellcare Medicare Advantage	$11,582.25

GASTROINTESTINAL OBSTRUCTION WITH MCC

Facility

$54,687.42

Service Code	MSDRG 388
Min. Negotiated Rate	$16,115.70
Max. Negotiated Rate	$54,687.42
Rate for Payer: Aetna Commercial	$49,797.51
Rate for Payer: Aetna Medicare Advantage	$16,115.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39,972.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39,972.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,229.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39,972.15
Rate for Payer: Cigna Commercial	$31,782.21
Rate for Payer: Cigna Medicare Advantage	$18,229.14
Rate for Payer: Clover Medicare Advantage	$17,317.68
Rate for Payer: EmblemHealth Commercial	$54,687.42
Rate for Payer: Humana Medicare Advantage	$18,776.01
Rate for Payer: Oxford Commercial	$19,862.96
Rate for Payer: UnitedHealthcare Commercial	$22,546.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,229.14
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19,322.89
Rate for Payer: Wellcare Medicare Advantage	$18,229.14

GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC

Facility

$27,612.21

Service Code	MSDRG 390
Min. Negotiated Rate	$5,936.45
Max. Negotiated Rate	$27,612.21
Rate for Payer: Aetna Commercial	$18,343.63
Rate for Payer: Aetna Medicare Advantage	$5,936.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,437.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,437.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,204.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,437.52
Rate for Payer: Cigna Commercial	$11,707.42
Rate for Payer: Cigna Medicare Advantage	$9,204.07
Rate for Payer: Clover Medicare Advantage	$8,743.87
Rate for Payer: EmblemHealth Commercial	$27,612.21
Rate for Payer: Humana Medicare Advantage	$9,480.19
Rate for Payer: Oxford Commercial	$7,316.80
Rate for Payer: UnitedHealthcare Commercial	$8,305.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,204.07
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9,756.31
Rate for Payer: Wellcare Medicare Advantage	$9,204.07

GASTROINTESTINAL PANEL

Facility

$545.40

Hospital Charge Code	397073354
Hospital Revenue Code	306
Min. Negotiated Rate	$81.81
Max. Negotiated Rate	$81.81
Rate for Payer: Qualcare PPO/HMO/WC	$81.81

GASTROINTESTINAL PANEL

Facility

$545.40

Hospital Charge Code	397073354
Hospital Revenue Code	306
Min. Negotiated Rate	$70.90
Max. Negotiated Rate	$272.70
Rate for Payer: Aetna Commercial	$163.62
Rate for Payer: Aetna Medicare Advantage	$163.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.08
Rate for Payer: Cigna Commercial	$272.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.81
Rate for Payer: UnitedHealthcare Commercial	$114.00

GASTROINTESTINAL VASCULAR INSUFFICIENCY

Facility

$10,242.19

Service Code	APR-DRG 2462
Min. Negotiated Rate	$7,182.04
Max. Negotiated Rate	$10,242.19
Rate for Payer: Aetna Better Health Medicaid	$10,041.36
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,242.19
Rate for Payer: Wellpoint Medicaid Managed Care	$7,182.04

GASTROINTESTINAL VASCULAR INSUFFICIENCY

Facility

$21,957.46

Service Code	APR-DRG 2464
Min. Negotiated Rate	$20,779.34
Max. Negotiated Rate	$21,957.46
Rate for Payer: Aetna Better Health Medicaid	$20,779.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,194.93
Rate for Payer: Wellpoint Medicaid Managed Care	$21,957.46

GASTROINTESTINAL VASCULAR INSUFFICIENCY

Facility

$14,283.97

Service Code	APR-DRG 2463
Min. Negotiated Rate	$10,856.16
Max. Negotiated Rate	$14,283.97
Rate for Payer: Aetna Better Health Medicaid	$14,003.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,283.97
Rate for Payer: Wellpoint Medicaid Managed Care	$10,856.16

GASTROINTESTINAL VASCULAR INSUFFICIENCY

Facility

$8,163.64

Service Code	APR-DRG 2461
Min. Negotiated Rate	$5,980.31
Max. Negotiated Rate	$8,163.64
Rate for Payer: Aetna Better Health Medicaid	$8,003.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,163.64
Rate for Payer: Wellpoint Medicaid Managed Care	$5,980.31

GASTROSTOMY (PEG) TRAY 20FR

Facility

$724.00

Hospital Charge Code	270332481
Hospital Revenue Code	272
Min. Negotiated Rate	$108.60
Max. Negotiated Rate	$108.60
Rate for Payer: Qualcare PPO/HMO/WC	$108.60

GASTROSTOMY (PEG) TRAY 20FR

Facility

$724.00

Hospital Charge Code	270332481
Hospital Revenue Code	272
Min. Negotiated Rate	$94.12
Max. Negotiated Rate	$362.00
Rate for Payer: Aetna Commercial	$217.20
Rate for Payer: Aetna Medicare Advantage	$217.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.62
Rate for Payer: Cigna Commercial	$362.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.12
Rate for Payer: Oxford Commercial	$362.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.60
Rate for Payer: UnitedHealthcare Commercial	$362.00

GATA3

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	4016883421
Hospital Revenue Code	310
Min. Negotiated Rate	$162.34
Max. Negotiated Rate	$162.34
Rate for Payer: Qualcare PPO/HMO/WC	$162.34

GATA3

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	4016883421
Hospital Revenue Code	310
Min. Negotiated Rate	$62.80
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$324.69
Rate for Payer: Aetna Medicare Advantage	$324.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.99
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$62.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.34
Rate for Payer: UnitedHealthcare Commercial	$114.00

GATED HEART PLANNAR SINGLE

Facility

$2,275.12

Service Code	HCPCS 78472
Hospital Charge Code	74116005
Hospital Revenue Code	341
Min. Negotiated Rate	$341.27
Max. Negotiated Rate	$341.27
Rate for Payer: Qualcare PPO/HMO/WC	$341.27

GATED HEART PLANNAR SINGLE

Facility

$2,275.12

Service Code	HCPCS 78472
Hospital Charge Code	74117005
Hospital Revenue Code	341
Min. Negotiated Rate	$341.27
Max. Negotiated Rate	$341.27
Rate for Payer: Qualcare PPO/HMO/WC	$341.27

GATED HEART PLANNAR SINGLE

Facility

$2,275.12

Service Code	HCPCS 78472
Hospital Charge Code	74117005
Hospital Revenue Code	341
Min. Negotiated Rate	$187.00
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$682.54
Rate for Payer: Aetna Medicare Advantage	$682.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$580.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$580.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$580.16
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.77
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$341.27
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

GATED HEART PLANNAR SINGLE

Facility

$2,275.12

Service Code	HCPCS 78472
Hospital Charge Code	74116005
Hospital Revenue Code	341
Min. Negotiated Rate	$187.00
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$682.54
Rate for Payer: Aetna Medicare Advantage	$682.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$580.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$580.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$187.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$580.16
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.77
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$341.27
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

Know your out-of-pocket cost for care.

All Charges