Heights University Hospital

All Charges

Charge

Type

Setting

Price

SIGMOIDOSCOPY AND BIOPSY

Facility

$3,330.02

Service Code	HCPCS 45331
Hospital Charge Code	16000403
Hospital Revenue Code	360
Min. Negotiated Rate	$499.50
Max. Negotiated Rate	$499.50
Rate for Payer: Qualcare PPO/HMO/WC	$499.50

SIGMOIDOSCOPY AND BIOPSY

Facility

$3,330.02

Service Code	HCPCS 45331
Hospital Charge Code	16000403
Hospital Revenue Code	360
Min. Negotiated Rate	$432.90
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$999.01
Rate for Payer: Aetna Medicare Advantage	$999.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$849.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$849.16
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	$849.16
Rate for Payer: Cigna Commercial	$2,214.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$432.90
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$499.50
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

SIGMOIDOSCOPY DX W/WO BRUSH/W

Facility

$5,319.00

Hospital Charge Code	1600000552
Hospital Revenue Code	360
Min. Negotiated Rate	$691.47
Max. Negotiated Rate	$2,659.50
Rate for Payer: Aetna Commercial	$1,595.70
Rate for Payer: Aetna Medicare Advantage	$1,595.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,356.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,356.35
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	$1,356.35
Rate for Payer: Cigna Commercial	$2,659.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$691.47
Rate for Payer: Qualcare PPO/HMO/WC	$797.85

SIGMOIDOSCOPY DX W/WO BRUSH/W

Facility

$5,319.00

Hospital Charge Code	1600000552
Hospital Revenue Code	360
Min. Negotiated Rate	$797.85
Max. Negotiated Rate	$797.85
Rate for Payer: Qualcare PPO/HMO/WC	$797.85

SIGMOIDOSCOPY FLEXIBLE***

Facility

$1,186.00

Service Code	HCPCS 45331
Hospital Charge Code	1001150
Hospital Revenue Code	759
Min. Negotiated Rate	$177.90
Max. Negotiated Rate	$177.90
Rate for Payer: Qualcare PPO/HMO/WC	$177.90

SIGMOIDOSCOPY FLEXIBLE***

Facility

$1,186.00

Service Code	HCPCS 45331
Hospital Charge Code	1001150
Hospital Revenue Code	759
Min. Negotiated Rate	$62.10
Max. Negotiated Rate	$2,214.60
Rate for Payer: Aetna Commercial	$355.80
Rate for Payer: Aetna Medicare Advantage	$355.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$302.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$302.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$302.43
Rate for Payer: Cigna Commercial	$2,214.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.18
Rate for Payer: Qualcare PPO/HMO/WC	$177.90

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

Facility

$2,575.00

Service Code	CPT 45330
Hospital Revenue Code	750
Min. Negotiated Rate	$54.62
Max. Negotiated Rate	$2,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.62
Rate for Payer: Cigna Commercial	$2,214.60
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

SIGMOIDOSCOPY FLEX W/BIOPSY***

Facility

$742.00

Hospital Charge Code	2300018
Hospital Revenue Code	759
Min. Negotiated Rate	$111.30
Max. Negotiated Rate	$111.30
Rate for Payer: Qualcare PPO/HMO/WC	$111.30

SIGMOIDOSCOPY FLEX W/BIOPSY***

Facility

$742.00

Hospital Charge Code	2300018
Hospital Revenue Code	759
Min. Negotiated Rate	$96.46
Max. Negotiated Rate	$371.00
Rate for Payer: Aetna Commercial	$222.60
Rate for Payer: Aetna Medicare Advantage	$222.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.21
Rate for Payer: Cigna Commercial	$371.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.46
Rate for Payer: Qualcare PPO/HMO/WC	$111.30

SIGMOIDOSCOPY W/DECOMP VOLV***

Facility

$742.00

Hospital Charge Code	2300019
Hospital Revenue Code	759
Min. Negotiated Rate	$96.46
Max. Negotiated Rate	$371.00
Rate for Payer: Aetna Commercial	$222.60
Rate for Payer: Aetna Medicare Advantage	$222.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.21
Rate for Payer: Cigna Commercial	$371.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.46
Rate for Payer: Qualcare PPO/HMO/WC	$111.30

SIGMOIDOSCOPY W/DECOMP VOLV***

Facility

$742.00

Hospital Charge Code	2300019
Hospital Revenue Code	759
Min. Negotiated Rate	$111.30
Max. Negotiated Rate	$111.30
Rate for Payer: Qualcare PPO/HMO/WC	$111.30

SIGMOIDOSCP W/REM LESN SNARE**

Facility

$742.00

Hospital Charge Code	2300020
Hospital Revenue Code	759
Min. Negotiated Rate	$111.30
Max. Negotiated Rate	$111.30
Rate for Payer: Qualcare PPO/HMO/WC	$111.30

SIGMOIDOSCP W/REM LESN SNARE**

Facility

$742.00

Hospital Charge Code	2300020
Hospital Revenue Code	759
Min. Negotiated Rate	$96.46
Max. Negotiated Rate	$371.00
Rate for Payer: Aetna Commercial	$222.60
Rate for Payer: Aetna Medicare Advantage	$222.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.21
Rate for Payer: Cigna Commercial	$371.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.46
Rate for Payer: Qualcare PPO/HMO/WC	$111.30

SIGN: AUTHERIZED PERSANNEL ONL

Facility

$57.15

Hospital Charge Code	270657150
Hospital Revenue Code	270
Min. Negotiated Rate	$7.43
Max. Negotiated Rate	$28.57
Rate for Payer: Aetna Commercial	$17.14
Rate for Payer: Aetna Medicare Advantage	$17.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.57
Rate for Payer: Cigna Commercial	$28.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.43
Rate for Payer: Oxford Commercial	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$8.57
Rate for Payer: UnitedHealthcare Commercial	$28.57

SIGN: AUTHERIZED PERSANNEL ONL

Facility

$57.15

Hospital Charge Code	270657150
Hospital Revenue Code	270
Min. Negotiated Rate	$8.57
Max. Negotiated Rate	$8.57
Rate for Payer: Qualcare PPO/HMO/WC	$8.57

SIGN: DANGER

Facility

$57.15

Hospital Charge Code	270657152
Hospital Revenue Code	270
Min. Negotiated Rate	$7.43
Max. Negotiated Rate	$28.57
Rate for Payer: Aetna Commercial	$17.14
Rate for Payer: Aetna Medicare Advantage	$17.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.57
Rate for Payer: Cigna Commercial	$28.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.43
Rate for Payer: Oxford Commercial	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$8.57
Rate for Payer: UnitedHealthcare Commercial	$28.57

SIGN: DANGER

Facility

$57.15

Hospital Charge Code	270657152
Hospital Revenue Code	270
Min. Negotiated Rate	$8.57
Max. Negotiated Rate	$8.57
Rate for Payer: Qualcare PPO/HMO/WC	$8.57

SIGN: HOT DANGER

Facility

$57.15

Hospital Charge Code	270657154
Hospital Revenue Code	270
Min. Negotiated Rate	$8.57
Max. Negotiated Rate	$8.57
Rate for Payer: Qualcare PPO/HMO/WC	$8.57

SIGN: HOT DANGER

Facility

$57.15

Hospital Charge Code	270657154
Hospital Revenue Code	270
Min. Negotiated Rate	$7.43
Max. Negotiated Rate	$28.57
Rate for Payer: Aetna Commercial	$17.14
Rate for Payer: Aetna Medicare Advantage	$17.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.57
Rate for Payer: Cigna Commercial	$28.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.43
Rate for Payer: Oxford Commercial	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$8.57
Rate for Payer: UnitedHealthcare Commercial	$28.57

Signia Linear Adapter

Facility

$10,180.30

Hospital Charge Code	270691833
Hospital Revenue Code	272
Min. Negotiated Rate	$1,323.44
Max. Negotiated Rate	$5,090.15
Rate for Payer: Aetna Commercial	$3,054.09
Rate for Payer: Aetna Medicare Advantage	$3,054.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,595.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,595.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,595.98
Rate for Payer: Cigna Commercial	$5,090.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,323.44
Rate for Payer: Oxford Commercial	$5,090.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,527.05
Rate for Payer: UnitedHealthcare Commercial	$5,090.15

Signia Linear Adapter

Facility

$10,180.30

Hospital Charge Code	270691833
Hospital Revenue Code	272
Min. Negotiated Rate	$1,527.05
Max. Negotiated Rate	$1,527.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,527.05

SIGNIA TRI STAPLE CURVE 30MM

Facility

$2,187.00

Hospital Charge Code	270698034
Hospital Revenue Code	272
Min. Negotiated Rate	$284.31
Max. Negotiated Rate	$1,093.50
Rate for Payer: Aetna Commercial	$656.10
Rate for Payer: Aetna Medicare Advantage	$656.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$557.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$557.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$557.68
Rate for Payer: Cigna Commercial	$1,093.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.31
Rate for Payer: Oxford Commercial	$1,093.50
Rate for Payer: Qualcare PPO/HMO/WC	$328.05
Rate for Payer: UnitedHealthcare Commercial	$1,093.50

SIGNIA TRI STAPLE CURVE 30MM

Facility

$2,187.00

Hospital Charge Code	270698034
Hospital Revenue Code	272
Min. Negotiated Rate	$328.05
Max. Negotiated Rate	$328.05
Rate for Payer: Qualcare PPO/HMO/WC	$328.05

SIGN: NOTICE

Facility

$57.15

Hospital Charge Code	270657156
Hospital Revenue Code	270
Min. Negotiated Rate	$8.57
Max. Negotiated Rate	$8.57
Rate for Payer: Qualcare PPO/HMO/WC	$8.57

SIGN: NOTICE

Facility

$57.15

Hospital Charge Code	270657156
Hospital Revenue Code	270
Min. Negotiated Rate	$7.43
Max. Negotiated Rate	$28.57
Rate for Payer: Aetna Commercial	$17.14
Rate for Payer: Aetna Medicare Advantage	$17.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.57
Rate for Payer: Cigna Commercial	$28.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.43
Rate for Payer: Oxford Commercial	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$8.57
Rate for Payer: UnitedHealthcare Commercial	$28.57

Know your out-of-pocket cost for care.

All Charges