Heights University Hospital

All Charges

Charge

Type

Setting

Price

CFH SHAVE BIOPSY DERMAL LESION

Facility

$69.00

Service Code	HCPCS 11300
Hospital Charge Code	83652035
Hospital Revenue Code	510
Min. Negotiated Rate	$8.97
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$20.70
Rate for Payer: Aetna Medicare Advantage	$20.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.59
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.97
Rate for Payer: Qualcare PPO/HMO/WC	$10.35

CFH SHAVE BIOPSY DERMAL LESION

Facility

$69.00

Service Code	HCPCS 11300
Hospital Charge Code	83652035
Hospital Revenue Code	510
Min. Negotiated Rate	$10.35
Max. Negotiated Rate	$10.35
Rate for Payer: Qualcare PPO/HMO/WC	$10.35

CFH STREP SCREEN

Facility

$115.00

Service Code	HCPCS 86403
Hospital Charge Code	83652283
Hospital Revenue Code	302
Min. Negotiated Rate	$5.77
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.39
Rate for Payer: Aetna Medicare Advantage	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.28
Rate for Payer: Cigna Commercial	$11.54
Rate for Payer: Cigna Medicare Advantage	$5.77
Rate for Payer: Clover Medicare Advantage	$10.96
Rate for Payer: EmblemHealth Commercial	$34.62
Rate for Payer: Humana Medicare Advantage	$11.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.95
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.54
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.23
Rate for Payer: Wellcare Medicare Advantage	$11.54

CFH STREP SCREEN

Facility

$115.00

Service Code	HCPCS 86403
Hospital Charge Code	83652283
Hospital Revenue Code	302
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

CFH TRIGGER POINT INJECTION

Facility

$174.75

Service Code	HCPCS 20552
Hospital Charge Code	83652091
Hospital Revenue Code	761
Min. Negotiated Rate	$26.21
Max. Negotiated Rate	$26.21
Rate for Payer: Qualcare PPO/HMO/WC	$26.21

CFH TRIGGER POINT INJECTION

Facility

$174.75

Service Code	HCPCS 20552
Hospital Charge Code	83652091
Hospital Revenue Code	761
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$730.97
Rate for Payer: Aetna Commercial	$52.42
Rate for Payer: Aetna Medicare Advantage	$52.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.56
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.72
Rate for Payer: Oxford Commercial	$87.38
Rate for Payer: Qualcare PPO/HMO/WC	$26.21
Rate for Payer: UnitedHealthcare Commercial	$87.38

CFH WC CERV/VAG BX-SINGLE-MULT

Facility

$290.00

Service Code	HCPCS 57500
Hospital Charge Code	83652145
Hospital Revenue Code	361
Min. Negotiated Rate	$37.70
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$87.00
Rate for Payer: Aetna Medicare Advantage	$87.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.95
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	$73.95
Rate for Payer: Cigna Commercial	$2,193.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.70
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.50
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

CFH WC CERV/VAG BX-SINGLE-MULT

Facility

$290.00

Service Code	HCPCS 57500
Hospital Charge Code	83652145
Hospital Revenue Code	361
Min. Negotiated Rate	$43.50
Max. Negotiated Rate	$43.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.50

CFH WC COLPOSCOPY OF CERVIX

Facility

$669.00

Service Code	HCPCS 57452
Hospital Charge Code	83652137
Hospital Revenue Code	361
Min. Negotiated Rate	$86.97
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$200.70
Rate for Payer: Aetna Medicare Advantage	$200.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.59
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	$170.59
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.97
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.35
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

CFH WC COLPOSCOPY OF CERVIX

Facility

$669.00

Service Code	HCPCS 57452
Hospital Charge Code	83652137
Hospital Revenue Code	361
Min. Negotiated Rate	$100.35
Max. Negotiated Rate	$100.35
Rate for Payer: Qualcare PPO/HMO/WC	$100.35

CFH WC COLPOSCOPY WITH BIOPSY

Facility

$863.00

Service Code	HCPCS 57454
Hospital Charge Code	83652139
Hospital Revenue Code	361
Min. Negotiated Rate	$129.45
Max. Negotiated Rate	$129.45
Rate for Payer: Qualcare PPO/HMO/WC	$129.45

CFH WC COLPOSCOPY WITH BIOPSY

Facility

$863.00

Service Code	HCPCS 57454
Hospital Charge Code	83652139
Hospital Revenue Code	361
Min. Negotiated Rate	$112.19
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$258.90
Rate for Payer: Aetna Medicare Advantage	$258.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$220.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$220.06
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	$220.06
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.19
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$129.45
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

CFH WC EST.PT E&M MINIMAL

Facility

$311.00

Service Code	HCPCS 99211
Hospital Charge Code	83652403
Hospital Revenue Code	514
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$93.30
Rate for Payer: Aetna Commercial	$93.30
Rate for Payer: Aetna Medicare Advantage	$93.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.31
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.43
Rate for Payer: Qualcare PPO/HMO/WC	$46.65

CFH WC EST.PT E&M MINIMAL

Facility

$311.00

Service Code	HCPCS 99211
Hospital Charge Code	83652403
Hospital Revenue Code	514
Min. Negotiated Rate	$46.65
Max. Negotiated Rate	$46.65
Rate for Payer: Qualcare PPO/HMO/WC	$46.65

CFH WC FETAL NON STRESS TEST

Facility

$1,898.40

Service Code	HCPCS 59025
Hospital Charge Code	83652197
Hospital Revenue Code	761
Min. Negotiated Rate	$284.76
Max. Negotiated Rate	$284.76
Rate for Payer: Qualcare PPO/HMO/WC	$284.76

CFH WC FETAL NON STRESS TEST

Facility

$1,898.40

Service Code	HCPCS 59025
Hospital Charge Code	83652197
Hospital Revenue Code	761
Min. Negotiated Rate	$246.79
Max. Negotiated Rate	$949.20
Rate for Payer: Aetna Commercial	$569.52
Rate for Payer: Aetna Medicare Advantage	$569.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$484.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$484.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$484.09
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.79
Rate for Payer: Oxford Commercial	$949.20
Rate for Payer: Qualcare PPO/HMO/WC	$284.76
Rate for Payer: UnitedHealthcare Commercial	$949.20

CFH WC HEMOCULT-BLOOD OCULT-

Facility

$23.00

Service Code	HCPCS 82270
Hospital Charge Code	83652277
Hospital Revenue Code	301
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

CFH WC HEMOCULT-BLOOD OCULT-

Facility

$23.00

Service Code	HCPCS 82270
Hospital Charge Code	83652277
Hospital Revenue Code	301
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.19
Rate for Payer: Aetna Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.05
Rate for Payer: Cigna Commercial	$4.38
Rate for Payer: Cigna Medicare Advantage	$2.19
Rate for Payer: Clover Medicare Advantage	$4.16
Rate for Payer: EmblemHealth Commercial	$13.14
Rate for Payer: Humana Medicare Advantage	$4.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.38
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.64
Rate for Payer: Wellcare Medicare Advantage	$4.38

CFH WC I&D BARTHOLINS ABSCESS

Facility

$942.15

Service Code	HCPCS 56420
Hospital Charge Code	83652121
Hospital Revenue Code	761
Min. Negotiated Rate	$141.32
Max. Negotiated Rate	$141.32
Rate for Payer: Qualcare PPO/HMO/WC	$141.32

CFH WC I&D BARTHOLINS ABSCESS

Facility

$942.15

Service Code	HCPCS 56420
Hospital Charge Code	83652121
Hospital Revenue Code	761
Min. Negotiated Rate	$122.48
Max. Negotiated Rate	$481.45
Rate for Payer: Aetna Commercial	$282.64
Rate for Payer: Aetna Medicare Advantage	$282.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.25
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.48
Rate for Payer: Oxford Commercial	$471.07
Rate for Payer: Qualcare PPO/HMO/WC	$141.32
Rate for Payer: UnitedHealthcare Commercial	$471.07

CFH WC IUD INSERTION

Facility

$376.00

Service Code	HCPCS 58300
Hospital Charge Code	83652163
Hospital Revenue Code	761
Min. Negotiated Rate	$48.88
Max. Negotiated Rate	$188.00
Rate for Payer: Aetna Commercial	$112.80
Rate for Payer: Aetna Medicare Advantage	$112.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.88
Rate for Payer: Cigna Commercial	$188.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.88
Rate for Payer: Oxford Commercial	$188.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.40
Rate for Payer: UnitedHealthcare Commercial	$188.00

CFH WC IUD INSERTION

Facility

$376.00

Service Code	HCPCS 58300
Hospital Charge Code	83652163
Hospital Revenue Code	761
Min. Negotiated Rate	$56.40
Max. Negotiated Rate	$56.40
Rate for Payer: Qualcare PPO/HMO/WC	$56.40

CFH WC IUD REMOVAL

Facility

$669.00

Service Code	HCPCS 58301
Hospital Charge Code	83652165
Hospital Revenue Code	761
Min. Negotiated Rate	$100.35
Max. Negotiated Rate	$100.35
Rate for Payer: Qualcare PPO/HMO/WC	$100.35

CFH WC IUD REMOVAL

Facility

$669.00

Service Code	HCPCS 58301
Hospital Charge Code	83652165
Hospital Revenue Code	761
Min. Negotiated Rate	$86.97
Max. Negotiated Rate	$725.69
Rate for Payer: Aetna Commercial	$200.70
Rate for Payer: Aetna Medicare Advantage	$200.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.59
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.97
Rate for Payer: Oxford Commercial	$334.50
Rate for Payer: Qualcare PPO/HMO/WC	$100.35
Rate for Payer: UnitedHealthcare Commercial	$334.50

CFH WC NP OV E&M COMPLEX

Facility

$1,003.00

Service Code	HCPCS 99205
Hospital Charge Code	83652401
Hospital Revenue Code	514
Min. Negotiated Rate	$150.45
Max. Negotiated Rate	$150.45
Rate for Payer: Qualcare PPO/HMO/WC	$150.45

Know your out-of-pocket cost for care.

All Charges