Heights University Hospital

All Charges

Charge

Type

Setting

Price

DEBRIDE NAIL 1-5

Facility

$328.10

Service Code	HCPCS 11720
Hospital Charge Code	412311720
Hospital Revenue Code	361
Min. Negotiated Rate	$49.22
Max. Negotiated Rate	$49.22
Rate for Payer: Qualcare PPO/HMO/WC	$49.22

DEBRIDE NAIL 6 OR MORE

Facility

$328.10

Service Code	HCPCS 11721
Hospital Charge Code	412311721
Hospital Revenue Code	361
Min. Negotiated Rate	$42.65
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$193.50
Rate for Payer: Aetna Commercial	$98.43
Rate for Payer: Aetna Medicare Advantage	$98.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.67
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	$83.67
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.65
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.22
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37
Rate for Payer: Wellpoint Medicaid Managed Care	$193.50

DEBRIDE NAIL 6 OR MORE

Facility

$328.10

Service Code	HCPCS 11721
Hospital Charge Code	412311721
Hospital Revenue Code	361
Min. Negotiated Rate	$49.22
Max. Negotiated Rate	$49.22
Rate for Payer: Qualcare PPO/HMO/WC	$49.22

DEBRIDE NAILS 6 OR MORE

Facility

$354.00

Service Code	HCPCS 11721
Hospital Charge Code	5792296
Hospital Revenue Code	450
Min. Negotiated Rate	$27.24
Max. Negotiated Rate	$197.37
Rate for Payer: Aetna Better Health Medicaid	$193.50
Rate for Payer: Aetna Commercial	$106.20
Rate for Payer: Aetna Medicare Advantage	$106.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.27
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.02
Rate for Payer: Qualcare PPO/HMO/WC	$53.10
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37

DEBRIDE NAILS 6 OR MORE

Facility

$354.00

Service Code	HCPCS 11721
Hospital Charge Code	5792296
Hospital Revenue Code	450
Min. Negotiated Rate	$53.10
Max. Negotiated Rate	$53.10
Rate for Payer: Qualcare PPO/HMO/WC	$53.10

DEBRIDE SKIN AT FX SITE

Facility

$4,221.55

Service Code	HCPCS 11010
Hospital Charge Code	5700411
Hospital Revenue Code	450
Min. Negotiated Rate	$289.08
Max. Negotiated Rate	$1,950.58
Rate for Payer: Aetna Better Health Medicaid	$1,912.33
Rate for Payer: Aetna Commercial	$1,266.46
Rate for Payer: Aetna Medicare Advantage	$1,266.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,076.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,076.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,076.50
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$548.80
Rate for Payer: Qualcare PPO/HMO/WC	$633.23
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,950.58

DEBRIDE SKIN AT FX SITE

Facility

$4,221.55

Service Code	HCPCS 11010
Hospital Charge Code	5700411
Hospital Revenue Code	450
Min. Negotiated Rate	$633.23
Max. Negotiated Rate	$633.23
Rate for Payer: Qualcare PPO/HMO/WC	$633.23

DEBRIDE SKIN AT FX SITE

Facility

$7,992.92

Service Code	HCPCS 11010
Hospital Charge Code	1600000807
Hospital Revenue Code	360
Min. Negotiated Rate	$1,039.08
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Better Health Medicaid	$1,912.33
Rate for Payer: Aetna Commercial	$2,397.88
Rate for Payer: Aetna Medicare Advantage	$2,397.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,038.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,038.19
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	$2,038.19
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,039.08
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,198.94
Rate for Payer: UnitedHealthcare Commercial	$2,575.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,950.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1,912.33

DEBRIDE SKIN AT FX SITE

Facility

$7,992.92

Service Code	HCPCS 11010
Hospital Charge Code	1600000807
Hospital Revenue Code	360
Min. Negotiated Rate	$1,198.94
Max. Negotiated Rate	$1,198.94
Rate for Payer: Qualcare PPO/HMO/WC	$1,198.94

DEBRIDE SKIN MUSC AT FX SITE

Facility

$3,609.90

Service Code	HCPCS 11011
Hospital Charge Code	16000491
Hospital Revenue Code	360
Min. Negotiated Rate	$469.29
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,082.97
Rate for Payer: Aetna Medicare Advantage	$1,082.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$920.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$920.52
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	$920.52
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$469.29
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$541.49
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

DEBRIDE SKIN MUSC AT FX SITE

Facility

$3,609.90

Service Code	HCPCS 11011
Hospital Charge Code	16000491
Hospital Revenue Code	360
Min. Negotiated Rate	$541.49
Max. Negotiated Rate	$541.49
Rate for Payer: Qualcare PPO/HMO/WC	$541.49

DEBRIDE SKIN & SQ TISSUE

Facility

$1,447.00

Service Code	HCPCS 11042
Hospital Charge Code	421011042
Hospital Revenue Code	761
Min. Negotiated Rate	$217.05
Max. Negotiated Rate	$217.05
Rate for Payer: Qualcare PPO/HMO/WC	$217.05

DEBRIDE SKIN & SQ TISSUE

Facility

$1,447.00

Service Code	HCPCS 11042
Hospital Charge Code	421011042
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	$434.10
Rate for Payer: Aetna Medicare Advantage	$434.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$368.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$368.99
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	$368.99
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.11
Rate for Payer: Oxford Commercial	$723.50
Rate for Payer: Qualcare PPO/HMO/WC	$217.05
Rate for Payer: UnitedHealthcare Commercial	$723.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

DEBRID SKIN FIRST 20SQ CM

Facility

$623.14

Service Code	HCPCS 97597
Hospital Charge Code	93950230
Hospital Revenue Code	510
Min. Negotiated Rate	$93.47
Max. Negotiated Rate	$93.47
Rate for Payer: Qualcare PPO/HMO/WC	$93.47

DEBRID SKIN FIRST 20SQ CM

Facility

$623.14

Service Code	HCPCS 97597
Hospital Charge Code	93950230
Hospital Revenue Code	510
Min. Negotiated Rate	$81.01
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$186.94
Rate for Payer: Aetna Medicare Advantage	$186.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$373.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.90
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.01
Rate for Payer: Qualcare PPO/HMO/WC	$93.47

DEBRID SKIN FIRST ADDITIONAL 2

Facility

$623.14

Service Code	HCPCS 97598
Hospital Charge Code	93950235
Hospital Revenue Code	510
Min. Negotiated Rate	$23.41
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$186.94
Rate for Payer: Aetna Medicare Advantage	$186.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.90
Rate for Payer: Cigna Commercial	$23.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.01
Rate for Payer: Qualcare PPO/HMO/WC	$93.47

DEBRID SKIN FIRST ADDITIONAL 2

Facility

$623.14

Service Code	HCPCS 97598
Hospital Charge Code	93950235
Hospital Revenue Code	510
Min. Negotiated Rate	$93.47
Max. Negotiated Rate	$93.47
Rate for Payer: Qualcare PPO/HMO/WC	$93.47

DEBRID SUBCUT TISSUE & MUSCLE

Facility

$1,147.40

Service Code	HCPCS 11043
Hospital Charge Code	93950220
Hospital Revenue Code	510
Min. Negotiated Rate	$149.16
Max. Negotiated Rate	$1,760.02
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	$170.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$292.59
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.16
Rate for Payer: Qualcare PPO/HMO/WC	$172.11

DEBRID SUBCUT TISSUE & MUSCLE

Facility

$1,147.40

Service Code	HCPCS 11043
Hospital Charge Code	93950220
Hospital Revenue Code	510
Min. Negotiated Rate	$172.11
Max. Negotiated Rate	$172.11
Rate for Payer: Qualcare PPO/HMO/WC	$172.11

DEBRID SUBCUT TISSUE, MUSCLE,

Facility

$3,473.00

Service Code	HCPCS 11044
Hospital Charge Code	93950225
Hospital Revenue Code	510
Min. Negotiated Rate	$520.95
Max. Negotiated Rate	$520.95
Rate for Payer: Qualcare PPO/HMO/WC	$520.95

DEBRID SUBCUT TISSUE, MUSCLE,

Facility

$3,473.00

Service Code	HCPCS 11044
Hospital Charge Code	93950225
Hospital Revenue Code	510
Min. Negotiated Rate	$234.39
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Better Health Medicaid	$386.54
Rate for Payer: Aetna Commercial	$1,041.90
Rate for Payer: Aetna Medicare Advantage	$1,041.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$885.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$885.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$234.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$885.62
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.49
Rate for Payer: Qualcare PPO/HMO/WC	$520.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$394.27

DEBRISAN/4GM

Facility

$17.00

Hospital Charge Code	60632780
Hospital Revenue Code	250
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

DEBRISAN/4GM

Facility

$17.00

Hospital Charge Code	60632780
Hospital Revenue Code	250
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$8.50
Rate for Payer: Aetna Commercial	$5.10
Rate for Payer: Aetna Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.33
Rate for Payer: Cigna Commercial	$8.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.21
Rate for Payer: Oxford Commercial	$8.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$8.50

DEBRISAN PASTE

Facility

$61.00

Hospital Charge Code	60635144
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

DEBRISAN PASTE

Facility

$61.00

Hospital Charge Code	60635144
Hospital Revenue Code	250
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$18.30
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.93
Rate for Payer: Oxford Commercial	$30.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$30.50

Know your out-of-pocket cost for care.

All Charges