Heights University Hospital

All Charges

Charge

Type

Setting

Price

HYPROCURE DEVICE SZ7

Facility

$9,900.00

Hospital Charge Code	270675464
Hospital Revenue Code	278
Min. Negotiated Rate	$1,485.00
Max. Negotiated Rate	$4,950.00
Rate for Payer: Aetna Commercial	$2,970.00
Rate for Payer: Aetna Medicare Advantage	$2,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,524.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,524.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,524.50
Rate for Payer: Cigna Commercial	$4,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,395.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.00

HYPROCURE SIZE 10

Facility

$9,950.00

Service Code	HCPCS C1776
Hospital Charge Code	270679093
Hospital Revenue Code	278
Min. Negotiated Rate	$1,492.50
Max. Negotiated Rate	$4,975.00
Rate for Payer: Aetna Commercial	$2,985.00
Rate for Payer: Aetna Medicare Advantage	$2,985.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,537.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,537.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,537.25
Rate for Payer: Cigna Commercial	$4,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,407.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,492.50

HYPROCURE SIZE 10

Facility

$9,950.00

Service Code	HCPCS C1776
Hospital Charge Code	270679093
Hospital Revenue Code	278
Min. Negotiated Rate	$1,492.50
Max. Negotiated Rate	$2,407.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,407.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,492.50

HYSKON

Facility

$158.00

Hospital Charge Code	60634498
Hospital Revenue Code	250
Min. Negotiated Rate	$20.54
Max. Negotiated Rate	$79.00
Rate for Payer: Aetna Commercial	$47.40
Rate for Payer: Aetna Medicare Advantage	$47.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.29
Rate for Payer: Cigna Commercial	$79.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.54
Rate for Payer: Oxford Commercial	$79.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.70
Rate for Payer: UnitedHealthcare Commercial	$79.00

HYSKON

Facility

$158.00

Hospital Charge Code	60634498
Hospital Revenue Code	250
Min. Negotiated Rate	$23.70
Max. Negotiated Rate	$23.70
Rate for Payer: Qualcare PPO/HMO/WC	$23.70

HYSKON 32%/100ML

Facility

$158.00

Hospital Charge Code	60633143
Hospital Revenue Code	250
Min. Negotiated Rate	$23.70
Max. Negotiated Rate	$23.70
Rate for Payer: Qualcare PPO/HMO/WC	$23.70

HYSKON 32%/100ML

Facility

$158.00

Hospital Charge Code	60633143
Hospital Revenue Code	250
Min. Negotiated Rate	$20.54
Max. Negotiated Rate	$79.00
Rate for Payer: Aetna Commercial	$47.40
Rate for Payer: Aetna Medicare Advantage	$47.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.29
Rate for Payer: Cigna Commercial	$79.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.54
Rate for Payer: Oxford Commercial	$79.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.70
Rate for Payer: UnitedHealthcare Commercial	$79.00

HYSTERECTOMY KIT W/T-TUBE 200M

Facility

$136.00

Hospital Charge Code	270332079
Hospital Revenue Code	272
Min. Negotiated Rate	$17.68
Max. Negotiated Rate	$68.00
Rate for Payer: Aetna Commercial	$40.80
Rate for Payer: Aetna Medicare Advantage	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.68
Rate for Payer: Cigna Commercial	$68.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.68
Rate for Payer: Oxford Commercial	$68.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.40
Rate for Payer: UnitedHealthcare Commercial	$68.00

HYSTERECTOMY KIT W/T-TUBE 200M

Facility

$136.00

Hospital Charge Code	270332079
Hospital Revenue Code	272
Min. Negotiated Rate	$20.40
Max. Negotiated Rate	$20.40
Rate for Payer: Qualcare PPO/HMO/WC	$20.40

HYSTERECTOMY,TOTAL ABDOMINAL

Facility

$11,332.50

Service Code	HCPCS 58150
Hospital Charge Code	16001005
Hospital Revenue Code	360
Min. Negotiated Rate	$1,017.37
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$3,399.75
Rate for Payer: Aetna Medicare Advantage	$3,399.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,889.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,889.79
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	$2,889.79
Rate for Payer: Cigna Commercial	$1,017.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,473.22
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,699.88
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

HYSTERECTOMY,TOTAL ABDOMINAL

Facility

$11,332.50

Service Code	HCPCS 58150
Hospital Charge Code	16001005
Hospital Revenue Code	360
Min. Negotiated Rate	$1,699.88
Max. Negotiated Rate	$1,699.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,699.88

HYSTEROSALPINGOGRAM

Facility

$5,100.00

Service Code	HCPCS 74740
Hospital Charge Code	321074740
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HYSTEROSALPINGOGRAM

Facility

$5,100.00

Service Code	HCPCS 74740
Hospital Charge Code	5701122
Hospital Revenue Code	320
Min. Negotiated Rate	$52.36
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
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	$1,300.50
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

HYSTEROSALPINGOGRAM

Facility

$5,100.00

Service Code	HCPCS 74740
Hospital Charge Code	5701122
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

HYSTEROSALPINGOGRAM

Facility

$5,100.00

Service Code	HCPCS 74740
Hospital Charge Code	321074740
Hospital Revenue Code	320
Min. Negotiated Rate	$52.36
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
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	$1,300.50
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

HYSTEROSCOPY DIAGNOSTIC_

Facility

$28,242.08

Service Code	HCPCS 58555
Hospital Charge Code	1600000252
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,472.62
Rate for Payer: Aetna Commercial	$8,472.62
Rate for Payer: Aetna Medicare Advantage	$8,472.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,201.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,201.73
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	$7,201.73
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,671.47
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,236.31
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

HYSTEROSCOPY DIAGNOSTIC_

Facility

$28,242.08

Service Code	HCPCS 58555
Hospital Charge Code	1600000252
Hospital Revenue Code	360
Min. Negotiated Rate	$4,236.31
Max. Negotiated Rate	$4,236.31
Rate for Payer: Qualcare PPO/HMO/WC	$4,236.31

HYSTEROSCOPY RESECT SEPTUM

Facility

$19,285.59

Service Code	HCPCS 58560
Hospital Charge Code	1600000461
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$11,912.81
Rate for Payer: Aetna Commercial	$5,785.68
Rate for Payer: Aetna Medicare Advantage	$5,785.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,917.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,917.83
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	$4,917.83
Rate for Payer: Cigna Commercial	$11,912.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,507.13
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,892.84
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

HYSTEROSCOPY RESECT SEPTUM

Facility

$19,285.59

Service Code	HCPCS 58560
Hospital Charge Code	1600000461
Hospital Revenue Code	360
Min. Negotiated Rate	$2,892.84
Max. Negotiated Rate	$2,892.84
Rate for Payer: Qualcare PPO/HMO/WC	$2,892.84

HYSTEROSCOPY,W ENDOMETAL ABLTN

Facility

$44,931.96

Service Code	HCPCS 58563
Hospital Charge Code	1600000318
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$13,479.59
Rate for Payer: Aetna Commercial	$13,479.59
Rate for Payer: Aetna Medicare Advantage	$13,479.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,457.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,457.65
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	$11,457.65
Rate for Payer: Cigna Commercial	$11,912.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,841.15
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,739.79
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

HYSTEROSCOPY,W ENDOMETAL ABLTN

Facility

$44,931.96

Service Code	HCPCS 58563
Hospital Charge Code	1600000318
Hospital Revenue Code	360
Min. Negotiated Rate	$6,739.79
Max. Negotiated Rate	$6,739.79
Rate for Payer: Qualcare PPO/HMO/WC	$6,739.79

HYSTEROSCOPY W REM IMPACTED FB

Facility

$20,944.30

Service Code	HCPCS 58562
Hospital Charge Code	1600000301
Hospital Revenue Code	360
Min. Negotiated Rate	$3,141.64
Max. Negotiated Rate	$3,141.64
Rate for Payer: Qualcare PPO/HMO/WC	$3,141.64

HYSTEROSCOPY W REM IMPACTED FB

Facility

$20,944.30

Service Code	HCPCS 58562
Hospital Charge Code	1600000301
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,708.87
Rate for Payer: Aetna Commercial	$6,283.29
Rate for Payer: Aetna Medicare Advantage	$6,283.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,340.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,340.80
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	$5,340.80
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,722.76
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,141.64
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

HYSTEROSCOPY,W REM LEIOMYOMAT

Facility

$35,886.86

Service Code	HCPCS 58561
Hospital Charge Code	16000651
Hospital Revenue Code	360
Min. Negotiated Rate	$5,383.03
Max. Negotiated Rate	$5,383.03
Rate for Payer: Qualcare PPO/HMO/WC	$5,383.03

HYSTEROSCOPY,W REM LEIOMYOMAT

Facility

$35,886.86

Service Code	HCPCS 58561
Hospital Charge Code	16000651
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$11,912.81
Rate for Payer: Aetna Commercial	$10,766.06
Rate for Payer: Aetna Medicare Advantage	$10,766.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,151.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,151.15
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	$9,151.15
Rate for Payer: Cigna Commercial	$11,912.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,665.29
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,383.03
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

Know your out-of-pocket cost for care.

All Charges