Heights University Hospital

All Charges

Charge

Type

Setting

Price

CLMP MULTI PIN LARGE

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699322
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

CLN CONSULTATION MINIMUM

Facility

$290.00

Service Code	HCPCS 99241
Hospital Charge Code	75190235
Hospital Revenue Code	510
Min. Negotiated Rate	$37.70
Max. Negotiated Rate	$145.00
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) PPO	$73.95
Rate for Payer: Cigna Commercial	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.70
Rate for Payer: Qualcare PPO/HMO/WC	$43.50

CLN CONSULTATION MINIMUM

Facility

$290.00

Service Code	HCPCS 99241
Hospital Charge Code	75190235
Hospital Revenue Code	510
Min. Negotiated Rate	$43.50
Max. Negotiated Rate	$43.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.50

CLN DEBRD SKN FULL THICKNESS

Facility

$545.00

Hospital Charge Code	75190015
Hospital Revenue Code	761
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$81.75
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

CLN DEBRD SKN FULL THICKNESS

Facility

$545.00

Hospital Charge Code	75190015
Hospital Revenue Code	761
Min. Negotiated Rate	$70.85
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$163.50
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.85
Rate for Payer: Oxford Commercial	$272.50
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Commercial	$272.50

CLN DEBRD SKN PRTL THICKNESS

Facility

$545.00

Service Code	HCPCS 11040
Hospital Charge Code	75190010
Hospital Revenue Code	761
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$81.75
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

CLN DEBRD SKN PRTL THICKNESS

Facility

$545.00

Service Code	HCPCS 11040
Hospital Charge Code	75190010
Hospital Revenue Code	761
Min. Negotiated Rate	$70.85
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$163.50
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.85
Rate for Payer: Oxford Commercial	$272.50
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Commercial	$272.50

CLN DEBRD SKN & SUBCUT TISSUE

Facility

$1,147.40

Service Code	HCPCS 11042
Hospital Charge Code	75190020
Hospital Revenue Code	761
Min. Negotiated Rate	$172.11
Max. Negotiated Rate	$172.11
Rate for Payer: Qualcare PPO/HMO/WC	$172.11

CLN DEBRD SKN & SUBCUT TISSUE

Facility

$1,147.40

Service Code	HCPCS 11042
Hospital Charge Code	75190020
Hospital Revenue Code	761
Min. Negotiated Rate	$44.88
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$344.22
Rate for Payer: Aetna Medicare Advantage	$344.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.59
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.16
Rate for Payer: Oxford Commercial	$573.70
Rate for Payer: Qualcare PPO/HMO/WC	$172.11
Rate for Payer: UnitedHealthcare Commercial	$573.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

CLN DX PAT-ABDOM COMP & CHEST

Facility

$788.00

Service Code	HCPCS 74022
Hospital Charge Code	75190290
Hospital Revenue Code	320
Min. Negotiated Rate	$118.20
Max. Negotiated Rate	$118.20
Rate for Payer: Qualcare PPO/HMO/WC	$118.20

CLN DX PAT-ABDOM COMP & CHEST

Facility

$788.00

Service Code	HCPCS 74022
Hospital Charge Code	75190290
Hospital Revenue Code	320
Min. Negotiated Rate	$51.42
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$236.40
Rate for Payer: Aetna Better Health Medicaid	$399.88
Rate for Payer: Aetna Medicare Advantage	$236.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.94
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.44
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.20
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

CLN DX PAT-ABDOMEN SINGLE

Facility

$278.00

Service Code	HCPCS 74000
Hospital Charge Code	75190285
Hospital Revenue Code	320
Min. Negotiated Rate	$36.14
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Better Health Medicaid	$242.34
Rate for Payer: Aetna Commercial	$83.40
Rate for Payer: Aetna Medicare Advantage	$83.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.89
Rate for Payer: Cigna Commercial	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.14
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.70
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$247.19

CLN DX PAT-ABDOMEN SINGLE

Facility

$278.00

Service Code	HCPCS 74000
Hospital Charge Code	75190285
Hospital Revenue Code	320
Min. Negotiated Rate	$41.70
Max. Negotiated Rate	$41.70
Rate for Payer: Qualcare PPO/HMO/WC	$41.70

CLN DX PAT-ANKLE AP/LA POS-LT

Facility

$251.00

Service Code	HCPCS 73600LT
Hospital Charge Code	75190540
Hospital Revenue Code	320
Min. Negotiated Rate	$32.63
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.30
Rate for Payer: Aetna Medicare Advantage	$75.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.00
Rate for Payer: Cigna Commercial	$125.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.63
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.65
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

CLN DX PAT-ANKLE AP/LA POS-LT

Facility

$251.00

Service Code	HCPCS 73600LT
Hospital Charge Code	75190540
Hospital Revenue Code	320
Min. Negotiated Rate	$37.65
Max. Negotiated Rate	$37.65
Rate for Payer: Qualcare PPO/HMO/WC	$37.65

CLN DX PAT-ANKLE AP&LAT 2-LT

Facility

$251.00

Service Code	HCPCS 73600LT
Hospital Charge Code	75190535
Hospital Revenue Code	320
Min. Negotiated Rate	$37.65
Max. Negotiated Rate	$37.65
Rate for Payer: Qualcare PPO/HMO/WC	$37.65

CLN DX PAT-ANKLE AP&LAT 2-LT

Facility

$251.00

Service Code	HCPCS 73600LT
Hospital Charge Code	75190535
Hospital Revenue Code	320
Min. Negotiated Rate	$32.63
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.30
Rate for Payer: Aetna Medicare Advantage	$75.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.00
Rate for Payer: Cigna Commercial	$125.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.63
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.65
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

CLN DX PAT-ANKLE AP&LAT 2-RT

Facility

$251.00

Service Code	HCPCS 73600RT
Hospital Charge Code	75190550
Hospital Revenue Code	320
Min. Negotiated Rate	$32.63
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.30
Rate for Payer: Aetna Medicare Advantage	$75.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.00
Rate for Payer: Cigna Commercial	$125.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.63
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.65
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

CLN DX PAT-ANKLE AP&LAT 2-RT

Facility

$251.00

Service Code	HCPCS 73600RT
Hospital Charge Code	75190550
Hospital Revenue Code	320
Min. Negotiated Rate	$37.65
Max. Negotiated Rate	$37.65
Rate for Payer: Qualcare PPO/HMO/WC	$37.65

CLN DX PAT-ANKLE AP&LAT-BIL

Facility

$250.00

Service Code	HCPCS 7360050
Hospital Charge Code	75190345
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

CLN DX PAT-ANKLE AP&LAT-BIL

Facility

$250.00

Service Code	HCPCS 7360050
Hospital Charge Code	75190345
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

CLN DX PAT-ANKLE APLAT POS-BI

Facility

$250.00

Service Code	HCPCS 7360050
Hospital Charge Code	75190350
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

CLN DX PAT-ANKLE APLAT POS-BI

Facility

$250.00

Service Code	HCPCS 7360050
Hospital Charge Code	75190350
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

CLN DX PAT-ANKLE APLAT POS-RT

Facility

$250.00

Service Code	HCPCS 73600RT
Hospital Charge Code	75190545
Hospital Revenue Code	320
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

CLN DX PAT-ANKLE APLAT POS-RT

Facility

$250.00

Service Code	HCPCS 73600RT
Hospital Charge Code	75190545
Hospital Revenue Code	320
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

Know your out-of-pocket cost for care.

All Charges