Heights University Hospital

All Charges

Charge

Type

Setting

Price

DRAIN OUTER EAR CANAL LESION

Facility

$3,005.56

Service Code	HCPCS 69020
Hospital Charge Code	16001045
Hospital Revenue Code	360
Min. Negotiated Rate	$390.72
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$901.67
Rate for Payer: Aetna Medicare Advantage	$901.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$766.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$766.42
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	$766.42
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.72
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.83
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

DRAIN OVARY ABSCES PERCUT

Facility

$3,390.00

Service Code	HCPCS 58822
Hospital Charge Code	2690215
Hospital Revenue Code	361
Min. Negotiated Rate	$440.70
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$1,017.00
Rate for Payer: Aetna Medicare Advantage	$1,017.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.45
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	$864.45
Rate for Payer: Cigna Commercial	$690.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$440.70
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$508.50
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

DRAIN OVARY ABSCES PERCUT

Facility

$3,390.00

Service Code	HCPCS 58822
Hospital Charge Code	7411637
Hospital Revenue Code	361
Min. Negotiated Rate	$508.50
Max. Negotiated Rate	$508.50
Rate for Payer: Qualcare PPO/HMO/WC	$508.50

DRAIN OVARY ABSCES PERCUT

Facility

$3,390.00

Service Code	HCPCS 58822
Hospital Charge Code	7411637
Hospital Revenue Code	361
Min. Negotiated Rate	$440.70
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$1,017.00
Rate for Payer: Aetna Medicare Advantage	$1,017.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.45
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	$864.45
Rate for Payer: Cigna Commercial	$690.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$440.70
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$508.50
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

DRAIN OVARY ABSCES PERCUT

Facility

$3,390.00

Service Code	HCPCS 58822
Hospital Charge Code	2690215
Hospital Revenue Code	361
Min. Negotiated Rate	$508.50
Max. Negotiated Rate	$508.50
Rate for Payer: Qualcare PPO/HMO/WC	$508.50

DRAIN PENROSE 1/2x12

Facility

$3.85

Hospital Charge Code	270649921
Hospital Revenue Code	278
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.16
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.93
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

DRAIN PENROSE 1/2x12

Facility

$3.85

Hospital Charge Code	270649921
Hospital Revenue Code	278
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.93
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

DRAIN PENROSE 1/4 STERILE

Facility

$2.20

Hospital Charge Code	27061545
Hospital Revenue Code	270
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$1.10
Rate for Payer: Aetna Commercial	$0.66
Rate for Payer: Aetna Medicare Advantage	$0.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.56
Rate for Payer: Cigna Commercial	$1.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.29
Rate for Payer: Oxford Commercial	$1.10
Rate for Payer: Qualcare PPO/HMO/WC	$0.33
Rate for Payer: UnitedHealthcare Commercial	$1.10

DRAIN PENROSE 1/4 STERILE

Facility

$2.20

Hospital Charge Code	27061545
Hospital Revenue Code	270
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.33
Rate for Payer: Qualcare PPO/HMO/WC	$0.33

DRAIN PENROSE 5/8 STER

Facility

$11.25

Hospital Charge Code	270061431
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

DRAIN PENROSE 5/8 STER

Facility

$11.25

Hospital Charge Code	270061431
Hospital Revenue Code	272
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$3.38
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$5.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$5.62

DRAIN PENROSE 5/8 STER *****

Facility

$3.00

Hospital Charge Code	8001240
Hospital Revenue Code	279
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

DRAIN PENROSE 5/8 STER *****

Facility

$3.00

Hospital Charge Code	8001240
Hospital Revenue Code	279
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

DRAIN PENROSE STER 1/4

Facility

$7.25

Hospital Charge Code	270061545
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.17
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.94
Rate for Payer: Oxford Commercial	$3.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$3.62

DRAIN PENROSE STER 1/4

Facility

$7.25

Hospital Charge Code	270061545
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

DRAIN PENROSE STERILE 1

Facility

$2.20

Hospital Charge Code	270649670
Hospital Revenue Code	270
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.33
Rate for Payer: Qualcare PPO/HMO/WC	$0.33

DRAIN PENROSE STERILE 1

Facility

$2.20

Hospital Charge Code	270649670
Hospital Revenue Code	270
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$1.10
Rate for Payer: Aetna Commercial	$0.66
Rate for Payer: Aetna Medicare Advantage	$0.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.56
Rate for Payer: Cigna Commercial	$1.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.29
Rate for Payer: Oxford Commercial	$1.10
Rate for Payer: Qualcare PPO/HMO/WC	$0.33
Rate for Payer: UnitedHealthcare Commercial	$1.10

DRAIN PENROSE STERILE 1/2

Facility

$2.20

Hospital Charge Code	270649671
Hospital Revenue Code	270
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.33
Rate for Payer: Qualcare PPO/HMO/WC	$0.33

DRAIN PENROSE STERILE 1/2

Facility

$2.20

Hospital Charge Code	270649671
Hospital Revenue Code	270
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$1.10
Rate for Payer: Aetna Commercial	$0.66
Rate for Payer: Aetna Medicare Advantage	$0.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.56
Rate for Payer: Cigna Commercial	$1.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.29
Rate for Payer: Oxford Commercial	$1.10
Rate for Payer: Qualcare PPO/HMO/WC	$0.33
Rate for Payer: UnitedHealthcare Commercial	$1.10

DRAIN PETONEAL ABSCESS/CYST,OP

Facility

$19,658.35

Service Code	HCPCS 49020
Hospital Charge Code	16000591
Hospital Revenue Code	360
Min. Negotiated Rate	$2,948.75
Max. Negotiated Rate	$2,948.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,948.75

DRAIN PETONEAL ABSCESS/CYST,OP

Facility

$19,658.35

Service Code	HCPCS 49020
Hospital Charge Code	16000591
Hospital Revenue Code	360
Min. Negotiated Rate	$1,622.37
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$5,897.51
Rate for Payer: Aetna Medicare Advantage	$5,897.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,012.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,012.88
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	$5,012.88
Rate for Payer: Cigna Commercial	$1,622.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,555.59
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,948.75
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

DRAIN PLEUREVAC SYS DOUBLE

Facility

$290.77

Service Code	HCPCS C1729
Hospital Charge Code	270652876
Hospital Revenue Code	278
Min. Negotiated Rate	$43.62
Max. Negotiated Rate	$70.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.37
Rate for Payer: Qualcare PPO/HMO/WC	$43.62

DRAIN PLEUREVAC SYS DOUBLE

Facility

$290.77

Service Code	HCPCS C1729
Hospital Charge Code	270652876
Hospital Revenue Code	278
Min. Negotiated Rate	$43.62
Max. Negotiated Rate	$145.38
Rate for Payer: Aetna Commercial	$87.23
Rate for Payer: Aetna Medicare Advantage	$87.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.15
Rate for Payer: Cigna Commercial	$145.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.37
Rate for Payer: Qualcare PPO/HMO/WC	$43.62

DRAIN RETROPETONEAL ABSCES,OPN

Facility

$12,226.80

Service Code	HCPCS 49060
Hospital Charge Code	16000487
Hospital Revenue Code	360
Min. Negotiated Rate	$1,118.67
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$3,668.04
Rate for Payer: Aetna Medicare Advantage	$3,668.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,117.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,117.83
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	$3,117.83
Rate for Payer: Cigna Commercial	$1,118.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,589.48
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,834.02
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

DRAIN RETROPETONEAL ABSCES,OPN

Facility

$12,226.80

Service Code	HCPCS 49060
Hospital Charge Code	16000487
Hospital Revenue Code	360
Min. Negotiated Rate	$1,834.02
Max. Negotiated Rate	$1,834.02
Rate for Payer: Qualcare PPO/HMO/WC	$1,834.02

Know your out-of-pocket cost for care.

All Charges