Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER AVUL NAIL PL EACH ADD PLATE

Facility

$256.25

Service Code	HCPCS 11732
Hospital Charge Code	5700511
Hospital Revenue Code	450
Min. Negotiated Rate	$38.44
Max. Negotiated Rate	$38.44
Rate for Payer: Qualcare PPO/HMO/WC	$38.44

ER AVUL NAIL PL EACH ADD PLATE

Facility

$256.25

Service Code	HCPCS 11732
Hospital Charge Code	5700511
Hospital Revenue Code	450
Min. Negotiated Rate	$16.14
Max. Negotiated Rate	$76.88
Rate for Payer: Aetna Commercial	$76.88
Rate for Payer: Aetna Medicare Advantage	$76.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.34
Rate for Payer: Cigna Commercial	$16.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.31
Rate for Payer: Qualcare PPO/HMO/WC	$38.44

ER AVULSION NAIL PLATE SINGLE

Facility

$518.75

Service Code	HCPCS 11730
Hospital Charge Code	5700510
Hospital Revenue Code	450
Min. Negotiated Rate	$62.18
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$155.62
Rate for Payer: Aetna Medicare Advantage	$155.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.28
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.44
Rate for Payer: Qualcare PPO/HMO/WC	$77.81

ER AVULSION NAIL PLATE SINGLE

Facility

$518.75

Service Code	HCPCS 11730
Hospital Charge Code	5700510
Hospital Revenue Code	450
Min. Negotiated Rate	$77.81
Max. Negotiated Rate	$77.81
Rate for Payer: Qualcare PPO/HMO/WC	$77.81

ERAXIS 50MG VIAL

Facility

$497.00

Hospital Charge Code	60635586
Hospital Revenue Code	636
Min. Negotiated Rate	$74.55
Max. Negotiated Rate	$248.50
Rate for Payer: Aetna Commercial	$149.10
Rate for Payer: Aetna Medicare Advantage	$149.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.73
Rate for Payer: Cigna Commercial	$248.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.27
Rate for Payer: Qualcare PPO/HMO/WC	$74.55

ERAXIS 50MG VIAL

Facility

$497.00

Hospital Charge Code	60635586
Hospital Revenue Code	636
Min. Negotiated Rate	$74.55
Max. Negotiated Rate	$120.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.27
Rate for Payer: Qualcare PPO/HMO/WC	$74.55

ER BE DRUG SCREENING GLOBAL

Facility

$312.50

Service Code	HCPCS 99283
Hospital Charge Code	5700082DRG
Hospital Revenue Code	450
Min. Negotiated Rate	$46.88
Max. Negotiated Rate	$46.88
Rate for Payer: Qualcare PPO/HMO/WC	$46.88

ER BE DRUG SCREENING GLOBAL

Facility

$312.50

Service Code	HCPCS 99283
Hospital Charge Code	5700082DRG
Hospital Revenue Code	450
Min. Negotiated Rate	$46.88
Max. Negotiated Rate	$1,718.00
Rate for Payer: Aetna Commercial	$93.75
Rate for Payer: Aetna Medicare Advantage	$93.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$505.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.69
Rate for Payer: Cigna Commercial	$650.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$869.00
Rate for Payer: Oxford Commercial	$1,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.88
Rate for Payer: UnitedHealthcare Commercial	$1,718.00
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

ER BE PES SCREENING GLOBAL

Facility

$475.00

Service Code	HCPCS 99283
Hospital Charge Code	5700082PES
Hospital Revenue Code	450
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

ER BE PES SCREENING GLOBAL

Facility

$475.00

Service Code	HCPCS 99283
Hospital Charge Code	5700082PES
Hospital Revenue Code	450
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$1,718.00
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$505.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$650.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$869.00
Rate for Payer: Oxford Commercial	$1,513.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Commercial	$1,718.00
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

ERBE PROBE

Facility

$391.00

Hospital Charge Code	270325607
Hospital Revenue Code	272
Min. Negotiated Rate	$58.65
Max. Negotiated Rate	$58.65
Rate for Payer: Qualcare PPO/HMO/WC	$58.65

ERBE PROBE

Facility

$391.00

Hospital Charge Code	270325607
Hospital Revenue Code	272
Min. Negotiated Rate	$50.83
Max. Negotiated Rate	$195.50
Rate for Payer: Aetna Commercial	$117.30
Rate for Payer: Aetna Medicare Advantage	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.70
Rate for Payer: Cigna Commercial	$195.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.83
Rate for Payer: Oxford Commercial	$195.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.65
Rate for Payer: UnitedHealthcare Commercial	$195.50

ER BLADDER IRRIGATION

Facility

$638.75

Service Code	HCPCS 51700
Hospital Charge Code	5700654
Hospital Revenue Code	450
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$594.98
Rate for Payer: Aetna Commercial	$191.62
Rate for Payer: Aetna Medicare Advantage	$191.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$162.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$162.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$162.88
Rate for Payer: Cigna Commercial	$594.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.04
Rate for Payer: Qualcare PPO/HMO/WC	$95.81

ER BLADDER IRRIGATION

Facility

$638.75

Service Code	HCPCS 51700
Hospital Charge Code	5700654
Hospital Revenue Code	450
Min. Negotiated Rate	$95.81
Max. Negotiated Rate	$95.81
Rate for Payer: Qualcare PPO/HMO/WC	$95.81

ER-BLOOD: OCCULT STOOL

Facility

$38.00

Service Code	HCPCS 82270
Hospital Charge Code	5790225
Hospital Revenue Code	301
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.19
Rate for Payer: Aetna Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.05
Rate for Payer: Cigna Commercial	$4.38
Rate for Payer: Cigna Medicare Advantage	$2.19
Rate for Payer: Clover Medicare Advantage	$4.16
Rate for Payer: EmblemHealth Commercial	$13.14
Rate for Payer: Humana Medicare Advantage	$4.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.94
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.38
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.64
Rate for Payer: Wellcare Medicare Advantage	$4.38

ER-BLOOD: OCCULT STOOL

Facility

$38.00

Service Code	HCPCS 82270
Hospital Charge Code	5790225
Hospital Revenue Code	301
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

ER BRIEF - I

Facility

$5,786.44

Service Code	HCPCS 99281
Hospital Charge Code	5700075
Hospital Revenue Code	450
Min. Negotiated Rate	$867.97
Max. Negotiated Rate	$867.97
Rate for Payer: Qualcare PPO/HMO/WC	$867.97

ER BRIEF - I

Facility

$5,786.44

Service Code	HCPCS 99281
Hospital Charge Code	5700075
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$1,735.93
Rate for Payer: Aetna Commercial	$1,735.93
Rate for Payer: Aetna Medicare Advantage	$1,735.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,475.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,475.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,475.54
Rate for Payer: Cigna Commercial	$200.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$321.00
Rate for Payer: Oxford Commercial	$673.00
Rate for Payer: Qualcare PPO/HMO/WC	$867.97
Rate for Payer: UnitedHealthcare Commercial	$763.00
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

ER BRIEF - PP I

Facility

$598.75

Service Code	HCPCS 9928125
Hospital Charge Code	5700208
Hospital Revenue Code	450
Min. Negotiated Rate	$77.84
Max. Negotiated Rate	$763.00
Rate for Payer: Aetna Commercial	$179.62
Rate for Payer: Aetna Medicare Advantage	$179.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$152.68
Rate for Payer: Cigna Commercial	$299.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.84
Rate for Payer: Oxford Commercial	$673.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.81
Rate for Payer: UnitedHealthcare Commercial	$763.00
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

ER BRIEF - PP I

Facility

$598.75

Service Code	HCPCS 9928125
Hospital Charge Code	5700208
Hospital Revenue Code	450
Min. Negotiated Rate	$89.81
Max. Negotiated Rate	$89.81
Rate for Payer: Qualcare PPO/HMO/WC	$89.81

ER BURN 1 DEGREE INITIAL TREAT

Facility

$252.50

Service Code	HCPCS 16000
Hospital Charge Code	5700541
Hospital Revenue Code	450
Min. Negotiated Rate	$37.88
Max. Negotiated Rate	$37.88
Rate for Payer: Qualcare PPO/HMO/WC	$37.88

ER BURN 1 DEGREE INITIAL TREAT

Facility

$252.50

Service Code	HCPCS 16000
Hospital Charge Code	5700541
Hospital Revenue Code	450
Min. Negotiated Rate	$32.83
Max. Negotiated Rate	$554.01
Rate for Payer: Aetna Better Health Medicaid	$543.15
Rate for Payer: Aetna Commercial	$75.75
Rate for Payer: Aetna Medicare Advantage	$75.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.39
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.83
Rate for Payer: Qualcare PPO/HMO/WC	$37.88
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$554.01

ER BURN DSG/DEBRID LRG W/O ANE

Facility

$847.50

Service Code	HCPCS 16030
Hospital Charge Code	5700543
Hospital Revenue Code	450
Min. Negotiated Rate	$127.12
Max. Negotiated Rate	$127.12
Rate for Payer: Qualcare PPO/HMO/WC	$127.12

ER BURN DSG/DEBRID LRG W/O ANE

Facility

$847.50

Service Code	HCPCS 16030
Hospital Charge Code	5700543
Hospital Revenue Code	450
Min. Negotiated Rate	$110.17
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$254.25
Rate for Payer: Aetna Medicare Advantage	$254.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.11
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.17
Rate for Payer: Qualcare PPO/HMO/WC	$127.12

ER BURN DSG/DEBRID MED W/O ANE

Facility

$847.50

Service Code	HCPCS 16025
Hospital Charge Code	5700542
Hospital Revenue Code	450
Min. Negotiated Rate	$127.12
Max. Negotiated Rate	$127.12
Rate for Payer: Qualcare PPO/HMO/WC	$127.12

Know your out-of-pocket cost for care.

All Charges