Heights University Hospital

All Charges

Charge

Type

Setting

Price

DRAIN FINGER ABSC:SIMPLE

Facility

$1,800.90

Service Code	HCPCS 26010
Hospital Charge Code	1600000446
Hospital Revenue Code	360
Min. Negotiated Rate	$234.12
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$540.27
Rate for Payer: Aetna Medicare Advantage	$540.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$459.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$459.23
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	$459.23
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.12
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.13
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

DRAIN FINGER ABSC:SIMPLE

Facility

$1,800.90

Service Code	HCPCS 26010
Hospital Charge Code	1600000446
Hospital Revenue Code	360
Min. Negotiated Rate	$270.13
Max. Negotiated Rate	$270.13
Rate for Payer: Qualcare PPO/HMO/WC	$270.13

DRAIN FLAT 7mm 3/4 PERF

Facility

$231.10

Hospital Charge Code	270655684
Hospital Revenue Code	271
Min. Negotiated Rate	$30.04
Max. Negotiated Rate	$115.55
Rate for Payer: Aetna Commercial	$69.33
Rate for Payer: Aetna Medicare Advantage	$69.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.93
Rate for Payer: Cigna Commercial	$115.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.04
Rate for Payer: Oxford Commercial	$115.55
Rate for Payer: Qualcare PPO/HMO/WC	$34.66
Rate for Payer: UnitedHealthcare Commercial	$115.55

DRAIN FLAT 7mm 3/4 PERF

Facility

$231.10

Hospital Charge Code	270655684
Hospital Revenue Code	271
Min. Negotiated Rate	$34.66
Max. Negotiated Rate	$34.66
Rate for Payer: Qualcare PPO/HMO/WC	$34.66

DRAIN FLAT JACKSON PRATT 10MM

Facility

$30.69

Hospital Charge Code	270645145
Hospital Revenue Code	270
Min. Negotiated Rate	$3.99
Max. Negotiated Rate	$15.35
Rate for Payer: Aetna Commercial	$9.21
Rate for Payer: Aetna Medicare Advantage	$9.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.83
Rate for Payer: Cigna Commercial	$15.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.99
Rate for Payer: Oxford Commercial	$15.35
Rate for Payer: Qualcare PPO/HMO/WC	$4.60
Rate for Payer: UnitedHealthcare Commercial	$15.35

DRAIN FLAT JACKSON PRATT 10MM

Facility

$30.69

Hospital Charge Code	270645145
Hospital Revenue Code	270
Min. Negotiated Rate	$4.60
Max. Negotiated Rate	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.60

DRAIN FLAT PERFOR 06200071360

Facility

$46.95

Hospital Charge Code	270635478
Hospital Revenue Code	272
Min. Negotiated Rate	$6.10
Max. Negotiated Rate	$23.48
Rate for Payer: Aetna Commercial	$14.09
Rate for Payer: Aetna Medicare Advantage	$14.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.97
Rate for Payer: Cigna Commercial	$23.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.10
Rate for Payer: Oxford Commercial	$23.48
Rate for Payer: Qualcare PPO/HMO/WC	$7.04
Rate for Payer: UnitedHealthcare Commercial	$23.48

DRAIN FLAT PERFOR 06200071360

Facility

$46.95

Hospital Charge Code	270635478
Hospital Revenue Code	272
Min. Negotiated Rate	$7.04
Max. Negotiated Rate	$7.04
Rate for Payer: Qualcare PPO/HMO/WC	$7.04

DRAIN FULLY PERFORATED 10MM

Facility

$725.00

Hospital Charge Code	270654982
Hospital Revenue Code	272
Min. Negotiated Rate	$94.25
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.25
Rate for Payer: Oxford Commercial	$362.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Commercial	$362.50

DRAIN FULLY PERFORATED 10MM

Facility

$725.00

Hospital Charge Code	270654982
Hospital Revenue Code	272
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$108.75
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

DRAIN HEMOVAC W/NDL 400ML

Facility

$200.85

Hospital Charge Code	270060975
Hospital Revenue Code	272
Min. Negotiated Rate	$26.11
Max. Negotiated Rate	$100.42
Rate for Payer: Aetna Commercial	$60.26
Rate for Payer: Aetna Medicare Advantage	$60.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.22
Rate for Payer: Cigna Commercial	$100.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.11
Rate for Payer: Oxford Commercial	$100.42
Rate for Payer: Qualcare PPO/HMO/WC	$30.13
Rate for Payer: UnitedHealthcare Commercial	$100.42

DRAIN HEMOVAC W/NDL 400ML

Facility

$200.85

Hospital Charge Code	270060975
Hospital Revenue Code	272
Min. Negotiated Rate	$30.13
Max. Negotiated Rate	$30.13
Rate for Payer: Qualcare PPO/HMO/WC	$30.13

DRAIN HEYER SCHUTE FLT SUCT***

Facility

$25.00

Hospital Charge Code	8002446
Hospital Revenue Code	279
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

DRAIN HEYER SCHUTE FLT SUCT***

Facility

$25.00

Hospital Charge Code	8002446
Hospital Revenue Code	279
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$7.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.25
Rate for Payer: Oxford Commercial	$12.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$12.50

DRAIN INCISION 24500000

Facility

$818.45

Hospital Charge Code	270611664
Hospital Revenue Code	272
Min. Negotiated Rate	$106.40
Max. Negotiated Rate	$409.23
Rate for Payer: Aetna Commercial	$245.53
Rate for Payer: Aetna Medicare Advantage	$245.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.70
Rate for Payer: Cigna Commercial	$409.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.40
Rate for Payer: Oxford Commercial	$409.23
Rate for Payer: Qualcare PPO/HMO/WC	$122.77
Rate for Payer: UnitedHealthcare Commercial	$409.23

DRAIN INCISION 24500000

Facility

$818.45

Hospital Charge Code	270611664
Hospital Revenue Code	272
Min. Negotiated Rate	$122.77
Max. Negotiated Rate	$122.77
Rate for Payer: Qualcare PPO/HMO/WC	$122.77

DRAIN/INJECT-FINGER/TOE

Facility

$613.00

Service Code	HCPCS 20600
Hospital Charge Code	94186001
Hospital Revenue Code	761
Min. Negotiated Rate	$34.58
Max. Negotiated Rate	$730.97
Rate for Payer: Aetna Commercial	$183.90
Rate for Payer: Aetna Medicare Advantage	$183.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.31
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.69
Rate for Payer: Oxford Commercial	$306.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.95
Rate for Payer: UnitedHealthcare Commercial	$306.50

DRAIN/INJECT-FINGER/TOE

Facility

$613.00

Service Code	HCPCS 20600
Hospital Charge Code	94186001
Hospital Revenue Code	761
Min. Negotiated Rate	$91.95
Max. Negotiated Rate	$91.95
Rate for Payer: Qualcare PPO/HMO/WC	$91.95

DRAIN/INJECT-SHLDR HIP KN

Facility

$613.00

Service Code	HCPCS 20610
Hospital Charge Code	94186015
Hospital Revenue Code	761
Min. Negotiated Rate	$45.06
Max. Negotiated Rate	$730.97
Rate for Payer: Aetna Commercial	$183.90
Rate for Payer: Aetna Medicare Advantage	$183.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.31
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.69
Rate for Payer: Oxford Commercial	$306.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.95
Rate for Payer: UnitedHealthcare Commercial	$306.50

DRAIN/INJECT-SHLDR HIP KN

Facility

$613.00

Service Code	HCPCS 20610
Hospital Charge Code	94186015
Hospital Revenue Code	761
Min. Negotiated Rate	$91.95
Max. Negotiated Rate	$91.95
Rate for Payer: Qualcare PPO/HMO/WC	$91.95

DRAIN/INJECT-WRST ELBW AN

Facility

$613.00

Service Code	HCPCS 20605
Hospital Charge Code	94186010
Hospital Revenue Code	761
Min. Negotiated Rate	$91.95
Max. Negotiated Rate	$91.95
Rate for Payer: Qualcare PPO/HMO/WC	$91.95

DRAIN/INJECT-WRST ELBW AN

Facility

$613.00

Service Code	HCPCS 20605
Hospital Charge Code	94186010
Hospital Revenue Code	761
Min. Negotiated Rate	$29.30
Max. Negotiated Rate	$730.97
Rate for Payer: Aetna Commercial	$183.90
Rate for Payer: Aetna Medicare Advantage	$183.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.31
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.69
Rate for Payer: Oxford Commercial	$306.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.95
Rate for Payer: UnitedHealthcare Commercial	$306.50

DRAIN/INJ INTER JOINT/BURSA W/

Facility

$2,930.12

Service Code	HCPCS 20606
Hospital Charge Code	1600000714
Hospital Revenue Code	360
Min. Negotiated Rate	$380.92
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$879.04
Rate for Payer: Aetna Medicare Advantage	$879.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$747.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$747.18
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	$747.18
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.92
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$439.52
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

DRAIN/INJ INTER JOINT/BURSA W/

Facility

$2,930.12

Service Code	HCPCS 20606
Hospital Charge Code	1600000714
Hospital Revenue Code	360
Min. Negotiated Rate	$439.52
Max. Negotiated Rate	$439.52
Rate for Payer: Qualcare PPO/HMO/WC	$439.52

DRAIN/INJ JOINT/BURSA

Facility

$1,630.99

Service Code	HCPCS 20605
Hospital Charge Code	1600000852
Hospital Revenue Code	360
Min. Negotiated Rate	$212.03
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$489.30
Rate for Payer: Aetna Medicare Advantage	$489.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$415.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$415.90
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	$415.90
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.03
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$244.65
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

Know your out-of-pocket cost for care.

All Charges