Heights University Hospital

All Charges

Charge

Type

Setting

Price

CFH FP CERUMEN REMOVAL

Facility

$167.24

Service Code	HCPCS 69210
Hospital Charge Code	83652269
Hospital Revenue Code	761
Min. Negotiated Rate	$21.74
Max. Negotiated Rate	$197.37
Rate for Payer: Aetna Better Health Medicaid	$193.50
Rate for Payer: Aetna Commercial	$50.17
Rate for Payer: Aetna Medicare Advantage	$50.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.65
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.74
Rate for Payer: Oxford Commercial	$83.62
Rate for Payer: Qualcare PPO/HMO/WC	$25.09
Rate for Payer: UnitedHealthcare Commercial	$83.62
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37

CFH FP CERUMEN REMOVAL

Facility

$167.24

Service Code	HCPCS 69210
Hospital Charge Code	83652269
Hospital Revenue Code	761
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$25.09
Rate for Payer: Qualcare PPO/HMO/WC	$25.09

CFH FP CHEM CAUT.GRAN TISSUE

Facility

$612.00

Service Code	HCPCS 17250
Hospital Charge Code	83652087
Hospital Revenue Code	761
Min. Negotiated Rate	$50.15
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$183.60
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.56
Rate for Payer: Oxford Commercial	$306.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$306.00

CFH FP CHEM CAUT.GRAN TISSUE

Facility

$612.00

Service Code	HCPCS 17250
Hospital Charge Code	83652087
Hospital Revenue Code	761
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

CFH FP DEBRID SKIN 10% BODY

Facility

$297.00

Service Code	HCPCS 11000
Hospital Charge Code	83652013
Hospital Revenue Code	761
Min. Negotiated Rate	$44.55
Max. Negotiated Rate	$44.55
Rate for Payer: Qualcare PPO/HMO/WC	$44.55

CFH FP DEBRID SKIN 10% BODY

Facility

$297.00

Service Code	HCPCS 11000
Hospital Charge Code	83652013
Hospital Revenue Code	761
Min. Negotiated Rate	$32.18
Max. Negotiated Rate	$1,639.38
Rate for Payer: Aetna Better Health Medicaid	$1,607.24
Rate for Payer: Aetna Commercial	$89.10
Rate for Payer: Aetna Medicare Advantage	$89.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.73
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.61
Rate for Payer: Oxford Commercial	$148.50
Rate for Payer: Qualcare PPO/HMO/WC	$44.55
Rate for Payer: UnitedHealthcare Commercial	$148.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,639.38

CFH FP DRESS/DEBRID LARGE

Facility

$612.00

Service Code	HCPCS 16030
Hospital Charge Code	83652079
Hospital Revenue Code	361
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

CFH FP DRESS/DEBRID LARGE

Facility

$612.00

Service Code	HCPCS 16030
Hospital Charge Code	83652079
Hospital Revenue Code	361
Min. Negotiated Rate	$79.56
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$183.60
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
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	$156.06
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.56
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

CFH FP DRESSING/DEBRID MEDIUM

Facility

$612.00

Service Code	HCPCS 16020
Hospital Charge Code	83652077
Hospital Revenue Code	361
Min. Negotiated Rate	$79.56
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$183.60
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
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	$156.06
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.56
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

CFH FP DRESSING/DEBRID MEDIUM

Facility

$612.00

Service Code	HCPCS 16020
Hospital Charge Code	83652077
Hospital Revenue Code	361
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

CFH FP EKG 12 LEADS

Facility

$658.00

Service Code	HCPCS 93005
Hospital Charge Code	83652369
Hospital Revenue Code	730
Min. Negotiated Rate	$98.70
Max. Negotiated Rate	$98.70
Rate for Payer: Qualcare PPO/HMO/WC	$98.70

CFH FP EKG 12 LEADS

Facility

$658.00

Service Code	HCPCS 93005
Hospital Charge Code	83652369
Hospital Revenue Code	730
Min. Negotiated Rate	$70.15
Max. Negotiated Rate	$603.00
Rate for Payer: Aetna Commercial	$197.40
Rate for Payer: Aetna Medicare Advantage	$197.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.79
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.54
Rate for Payer: Oxford Commercial	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.70
Rate for Payer: UnitedHealthcare Commercial	$603.00

CFH FP EKG-INTER&REPORT ONLY

Facility

$49.00

Service Code	HCPCS 93010
Hospital Charge Code	83652371
Hospital Revenue Code	730
Min. Negotiated Rate	$6.33
Max. Negotiated Rate	$603.00
Rate for Payer: Aetna Commercial	$14.70
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.49
Rate for Payer: Cigna Commercial	$9.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.37
Rate for Payer: Oxford Commercial	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.35
Rate for Payer: UnitedHealthcare Commercial	$603.00

CFH FP EKG-INTER&REPORT ONLY

Facility

$49.00

Service Code	HCPCS 93010
Hospital Charge Code	83652371
Hospital Revenue Code	730
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$7.35
Rate for Payer: Qualcare PPO/HMO/WC	$7.35

CFH FP EXC. DIAM. 0.6-1.0 CM

Facility

$105.94

Service Code	HCPCS 11401
Hospital Charge Code	83652039
Hospital Revenue Code	761
Min. Negotiated Rate	$13.77
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$31.78
Rate for Payer: Aetna Medicare Advantage	$31.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.01
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.77
Rate for Payer: Oxford Commercial	$52.97
Rate for Payer: Qualcare PPO/HMO/WC	$15.89
Rate for Payer: UnitedHealthcare Commercial	$52.97
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

CFH FP EXC. DIAM. 0.6-1.0 CM

Facility

$105.94

Service Code	HCPCS 11401
Hospital Charge Code	83652039
Hospital Revenue Code	761
Min. Negotiated Rate	$15.89
Max. Negotiated Rate	$15.89
Rate for Payer: Qualcare PPO/HMO/WC	$15.89

CFH FP EXC DIAM 1.1-2.0 CM

Facility

$540.62

Service Code	HCPCS 11402
Hospital Charge Code	83652041
Hospital Revenue Code	761
Min. Negotiated Rate	$81.09
Max. Negotiated Rate	$81.09
Rate for Payer: Qualcare PPO/HMO/WC	$81.09

CFH FP EXC DIAM 1.1-2.0 CM

Facility

$540.62

Service Code	HCPCS 11402
Hospital Charge Code	83652041
Hospital Revenue Code	761
Min. Negotiated Rate	$65.09
Max. Negotiated Rate	$1,686.34
Rate for Payer: Aetna Commercial	$162.19
Rate for Payer: Aetna Medicare Advantage	$162.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.86
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.28
Rate for Payer: Oxford Commercial	$270.31
Rate for Payer: Qualcare PPO/HMO/WC	$81.09
Rate for Payer: UnitedHealthcare Commercial	$270.31

CFH FP EXC.DIAM 2.1-3.0 CM

Facility

$619.61

Service Code	HCPCS 11403
Hospital Charge Code	83652043
Hospital Revenue Code	761
Min. Negotiated Rate	$80.55
Max. Negotiated Rate	$1,686.34
Rate for Payer: Aetna Commercial	$185.88
Rate for Payer: Aetna Medicare Advantage	$185.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.00
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.55
Rate for Payer: Oxford Commercial	$309.81
Rate for Payer: Qualcare PPO/HMO/WC	$92.94
Rate for Payer: UnitedHealthcare Commercial	$309.81

CFH FP EXC.DIAM 2.1-3.0 CM

Facility

$619.61

Service Code	HCPCS 11403
Hospital Charge Code	83652043
Hospital Revenue Code	761
Min. Negotiated Rate	$92.94
Max. Negotiated Rate	$92.94
Rate for Payer: Qualcare PPO/HMO/WC	$92.94

CFH FP EXC. DIAM. OVER 4.0

Facility

$440.80

Service Code	HCPCS 11406
Hospital Charge Code	83652045
Hospital Revenue Code	761
Min. Negotiated Rate	$57.30
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$132.24
Rate for Payer: Aetna Medicare Advantage	$132.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.40
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.30
Rate for Payer: Oxford Commercial	$220.40
Rate for Payer: Qualcare PPO/HMO/WC	$66.12
Rate for Payer: UnitedHealthcare Commercial	$220.40

CFH FP EXC. DIAM. OVER 4.0

Facility

$440.80

Service Code	HCPCS 11406
Hospital Charge Code	83652045
Hospital Revenue Code	761
Min. Negotiated Rate	$66.12
Max. Negotiated Rate	$66.12
Rate for Payer: Qualcare PPO/HMO/WC	$66.12

CFH FP EXC.PILONIDAL CYST

Facility

$1,490.00

Service Code	HCPCS 11770
Hospital Charge Code	83652059
Hospital Revenue Code	761
Min. Negotiated Rate	$173.65
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$447.00
Rate for Payer: Aetna Medicare Advantage	$447.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$379.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$379.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$379.95
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.70
Rate for Payer: Oxford Commercial	$745.00
Rate for Payer: Qualcare PPO/HMO/WC	$223.50
Rate for Payer: UnitedHealthcare Commercial	$745.00

CFH FP EXC.PILONIDAL CYST

Facility

$1,490.00

Service Code	HCPCS 11770
Hospital Charge Code	83652059
Hospital Revenue Code	761
Min. Negotiated Rate	$223.50
Max. Negotiated Rate	$223.50
Rate for Payer: Qualcare PPO/HMO/WC	$223.50

CFH FP FB REMOVAL,EAR

Facility

$299.00

Service Code	HCPCS 69200
Hospital Charge Code	83652267
Hospital Revenue Code	510
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$44.85
Rate for Payer: Qualcare PPO/HMO/WC	$44.85

Know your out-of-pocket cost for care.

All Charges