Heights University Hospital

All Charges

Charge

Type

Setting

Price

CLN OV EP DETAILED

Facility

$828.80

Service Code	HCPCS 99214
Hospital Charge Code	75190225
Hospital Revenue Code	510
Min. Negotiated Rate	$91.37
Max. Negotiated Rate	$248.64
Rate for Payer: Aetna Commercial	$248.64
Rate for Payer: Aetna Medicare Advantage	$248.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.34
Rate for Payer: Cigna Commercial	$91.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.74
Rate for Payer: Qualcare PPO/HMO/WC	$124.32

CLN OV EP DETAILED

Facility

$828.80

Service Code	HCPCS 99214
Hospital Charge Code	75190225
Hospital Revenue Code	510
Min. Negotiated Rate	$124.32
Max. Negotiated Rate	$124.32
Rate for Payer: Qualcare PPO/HMO/WC	$124.32

CLN OV EP PROBLEM FOCUSED

Facility

$446.00

Service Code	HCPCS 99212
Hospital Charge Code	75190210
Hospital Revenue Code	510
Min. Negotiated Rate	$33.58
Max. Negotiated Rate	$133.80
Rate for Payer: Aetna Commercial	$133.80
Rate for Payer: Aetna Medicare Advantage	$133.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.73
Rate for Payer: Cigna Commercial	$33.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.98
Rate for Payer: Qualcare PPO/HMO/WC	$66.90

CLN OV EP PROBLEM FOCUSED

Facility

$446.00

Service Code	HCPCS 99212
Hospital Charge Code	75190210
Hospital Revenue Code	510
Min. Negotiated Rate	$66.90
Max. Negotiated Rate	$66.90
Rate for Payer: Qualcare PPO/HMO/WC	$66.90

CLN REM SKIN TAGS < 15CM

Facility

$372.00

Service Code	HCPCS 11200
Hospital Charge Code	75190035
Hospital Revenue Code	761
Min. Negotiated Rate	$34.16
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$111.60
Rate for Payer: Aetna Medicare Advantage	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.86
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.36
Rate for Payer: Oxford Commercial	$186.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$186.00

CLN REM SKIN TAGS < 15CM

Facility

$372.00

Service Code	HCPCS 11200
Hospital Charge Code	75190035
Hospital Revenue Code	761
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

CLNSCPY FLX W REM LESN BY SNA

Facility

$8,878.50

Service Code	HCPCS 45385
Hospital Charge Code	16000274
Hospital Revenue Code	360
Min. Negotiated Rate	$1,154.20
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$2,663.55
Rate for Payer: Aetna Medicare Advantage	$2,663.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,264.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,264.02
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	$2,264.02
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,154.20
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.78
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CLNSCPY FLX W REM LESN BY SNA

Facility

$8,878.50

Service Code	HCPCS 45385
Hospital Charge Code	16000274
Hospital Revenue Code	360
Min. Negotiated Rate	$1,331.78
Max. Negotiated Rate	$1,331.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.78

CLNSPY W/HEMORROIDS LIGATION**

Facility

$861.00

Hospital Charge Code	2300069
Hospital Revenue Code	361
Min. Negotiated Rate	$111.93
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$258.30
Rate for Payer: Aetna Medicare Advantage	$258.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.56
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	$219.56
Rate for Payer: Cigna Commercial	$430.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.93
Rate for Payer: Qualcare PPO/HMO/WC	$129.15

CLNSPY W/HEMORROIDS LIGATION**

Facility

$861.00

Hospital Charge Code	2300069
Hospital Revenue Code	361
Min. Negotiated Rate	$129.15
Max. Negotiated Rate	$129.15
Rate for Payer: Qualcare PPO/HMO/WC	$129.15

CLN SURG OV NP COMPLEX

Facility

$1,048.92

Service Code	HCPCS 99205
Hospital Charge Code	75190195
Hospital Revenue Code	510
Min. Negotiated Rate	$136.36
Max. Negotiated Rate	$314.68
Rate for Payer: Aetna Commercial	$314.68
Rate for Payer: Aetna Medicare Advantage	$314.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.47
Rate for Payer: Cigna Commercial	$173.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.36
Rate for Payer: Qualcare PPO/HMO/WC	$157.34

CLN SURG OV NP COMPLEX

Facility

$1,048.92

Service Code	HCPCS 99205
Hospital Charge Code	75190195
Hospital Revenue Code	510
Min. Negotiated Rate	$157.34
Max. Negotiated Rate	$157.34
Rate for Payer: Qualcare PPO/HMO/WC	$157.34

CLN SURG OV NP COMPREHENSIVE

Facility

$1,068.20

Service Code	HCPCS 99204
Hospital Charge Code	75190190
Hospital Revenue Code	510
Min. Negotiated Rate	$160.23
Max. Negotiated Rate	$160.23
Rate for Payer: Qualcare PPO/HMO/WC	$160.23

CLN SURG OV NP COMPREHENSIVE

Facility

$1,068.20

Service Code	HCPCS 99204
Hospital Charge Code	75190190
Hospital Revenue Code	510
Min. Negotiated Rate	$126.45
Max. Negotiated Rate	$320.46
Rate for Payer: Aetna Commercial	$320.46
Rate for Payer: Aetna Medicare Advantage	$320.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.39
Rate for Payer: Cigna Commercial	$126.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.87
Rate for Payer: Qualcare PPO/HMO/WC	$160.23

CLN SURG OV NP DETAILED

Facility

$828.80

Service Code	HCPCS 99203
Hospital Charge Code	75190185
Hospital Revenue Code	510
Min. Negotiated Rate	$124.32
Max. Negotiated Rate	$124.32
Rate for Payer: Qualcare PPO/HMO/WC	$124.32

CLN SURG OV NP DETAILED

Facility

$828.80

Service Code	HCPCS 99203
Hospital Charge Code	75190185
Hospital Revenue Code	510
Min. Negotiated Rate	$77.24
Max. Negotiated Rate	$248.64
Rate for Payer: Aetna Commercial	$248.64
Rate for Payer: Aetna Medicare Advantage	$248.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$211.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$211.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$211.34
Rate for Payer: Cigna Commercial	$77.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.74
Rate for Payer: Qualcare PPO/HMO/WC	$124.32

CLOBETASOL 0.05% CREAM 30G

Facility

$1,718.28

Service Code	NDC 54569455000
Hospital Charge Code	60629135
Hospital Revenue Code	250
Min. Negotiated Rate	$223.38
Max. Negotiated Rate	$859.14
Rate for Payer: Aetna Commercial	$515.48
Rate for Payer: Aetna Medicare Advantage	$515.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$438.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$438.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$438.16
Rate for Payer: Cigna Commercial	$859.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.38
Rate for Payer: Oxford Commercial	$859.14
Rate for Payer: Qualcare PPO/HMO/WC	$257.74
Rate for Payer: UnitedHealthcare Commercial	$859.14

CLOBETASOL 0.05% CREAM 30G

Facility

$1,718.28

Service Code	NDC 54569455000
Hospital Charge Code	60629135
Hospital Revenue Code	250
Min. Negotiated Rate	$257.74
Max. Negotiated Rate	$257.74
Rate for Payer: Qualcare PPO/HMO/WC	$257.74

CLOBETASOL PROP 0.05% CR 15GM

Facility

$859.14

Service Code	NDC 51672125801
Hospital Charge Code	6023413
Hospital Revenue Code	250
Min. Negotiated Rate	$128.87
Max. Negotiated Rate	$128.87
Rate for Payer: Qualcare PPO/HMO/WC	$128.87

CLOBETASOL PROP 0.05% CR 15GM

Facility

$859.14

Service Code	NDC 51672125801
Hospital Charge Code	6023413
Hospital Revenue Code	250
Min. Negotiated Rate	$111.69
Max. Negotiated Rate	$429.57
Rate for Payer: Aetna Commercial	$257.74
Rate for Payer: Aetna Medicare Advantage	$257.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.08
Rate for Payer: Cigna Commercial	$429.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.69
Rate for Payer: Oxford Commercial	$429.57
Rate for Payer: Qualcare PPO/HMO/WC	$128.87
Rate for Payer: UnitedHealthcare Commercial	$429.57

CLOBETASOL PROP 0.05% GEL 30GM

Facility

$169.65

Hospital Charge Code	60629156
Hospital Revenue Code	250
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$84.83
Rate for Payer: Aetna Commercial	$50.90
Rate for Payer: Aetna Medicare Advantage	$50.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.26
Rate for Payer: Cigna Commercial	$84.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.05
Rate for Payer: Oxford Commercial	$84.83
Rate for Payer: Qualcare PPO/HMO/WC	$25.45
Rate for Payer: UnitedHealthcare Commercial	$84.83

CLOBETASOL PROP 0.05% GEL 30GM

Facility

$169.65

Hospital Charge Code	60629156
Hospital Revenue Code	250
Min. Negotiated Rate	$25.45
Max. Negotiated Rate	$25.45
Rate for Payer: Qualcare PPO/HMO/WC	$25.45

CLOBETASOL PROP CRM .05% 60GM

Facility

$3,075.03

Service Code	NDC 69238153206
Hospital Charge Code	606390496
Hospital Revenue Code	250
Min. Negotiated Rate	$399.75
Max. Negotiated Rate	$1,537.52
Rate for Payer: Aetna Commercial	$922.51
Rate for Payer: Aetna Medicare Advantage	$922.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$784.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$784.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$784.13
Rate for Payer: Cigna Commercial	$1,537.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$399.75
Rate for Payer: Oxford Commercial	$1,537.52
Rate for Payer: Qualcare PPO/HMO/WC	$461.25
Rate for Payer: UnitedHealthcare Commercial	$1,537.52

CLOBETASOL PROP CRM .05% 60GM

Facility

$3,075.03

Service Code	NDC 69238153206
Hospital Charge Code	606390496
Hospital Revenue Code	250
Min. Negotiated Rate	$461.25
Max. Negotiated Rate	$461.25
Rate for Payer: Qualcare PPO/HMO/WC	$461.25

CLOBETASOL PROPIONATE .05% 30G

Facility

$1,740.33

Service Code	NDC 50383026830
Hospital Charge Code	6008643
Hospital Revenue Code	250
Min. Negotiated Rate	$261.05
Max. Negotiated Rate	$261.05
Rate for Payer: Qualcare PPO/HMO/WC	$261.05

Know your out-of-pocket cost for care.

All Charges