Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER DEBRIDE W/RMV FB W/OPEN FRA

Facility

$3,358.50

Service Code	HCPCS 11011
Hospital Charge Code	5700670
Hospital Revenue Code	450
Min. Negotiated Rate	$503.77
Max. Negotiated Rate	$503.77
Rate for Payer: Qualcare PPO/HMO/WC	$503.77

ER DEBRID FULL THICK SKIN

Facility

$843.05

Hospital Charge Code	5700704
Hospital Revenue Code	450
Min. Negotiated Rate	$126.46
Max. Negotiated Rate	$126.46
Rate for Payer: Qualcare PPO/HMO/WC	$126.46

ER DEBRID FULL THICK SKIN

Facility

$843.05

Hospital Charge Code	5700704
Hospital Revenue Code	450
Min. Negotiated Rate	$109.60
Max. Negotiated Rate	$421.52
Rate for Payer: Aetna Commercial	$252.91
Rate for Payer: Aetna Medicare Advantage	$252.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.98
Rate for Payer: Cigna Commercial	$421.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.60
Rate for Payer: Qualcare PPO/HMO/WC	$126.46

ER DEBRID GREATER THAN 20SQCM

Facility

$843.00

Service Code	HCPCS 97598
Hospital Charge Code	5700823
Hospital Revenue Code	450
Min. Negotiated Rate	$23.41
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$252.90
Rate for Payer: Aetna Medicare Advantage	$252.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.97
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	$214.97
Rate for Payer: Cigna Commercial	$23.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.59
Rate for Payer: Qualcare PPO/HMO/WC	$126.45

ER DEBRID GREATER THAN 20SQCM

Facility

$843.00

Service Code	HCPCS 97598
Hospital Charge Code	5700823
Hospital Revenue Code	450
Min. Negotiated Rate	$126.45
Max. Negotiated Rate	$126.45
Rate for Payer: Qualcare PPO/HMO/WC	$126.45

ER DEBRID LESS OR EQUAL 20SQCM

Facility

$990.50

Service Code	HCPCS 97597
Hospital Charge Code	5700822
Hospital Revenue Code	450
Min. Negotiated Rate	$128.76
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$297.15
Rate for Payer: Aetna Medicare Advantage	$297.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.58
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	$252.58
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.76
Rate for Payer: Qualcare PPO/HMO/WC	$148.57

ER DEBRID LESS OR EQUAL 20SQCM

Facility

$990.50

Service Code	HCPCS 97597
Hospital Charge Code	5700822
Hospital Revenue Code	450
Min. Negotiated Rate	$148.57
Max. Negotiated Rate	$148.57
Rate for Payer: Qualcare PPO/HMO/WC	$148.57

ER DEBRIDMENT SKIN SQ MUSCLE

Facility

$2,788.64

Service Code	HCPCS 11043
Hospital Charge Code	5700508
Hospital Revenue Code	450
Min. Negotiated Rate	$170.22
Max. Negotiated Rate	$1,760.02
Rate for Payer: Aetna Commercial	$836.59
Rate for Payer: Aetna Medicare Advantage	$836.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$711.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$711.10
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	$711.10
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$362.52
Rate for Payer: Qualcare PPO/HMO/WC	$418.30

ER DEBRIDMENT SKIN SQ MUSCLE

Facility

$2,788.64

Service Code	HCPCS 11043
Hospital Charge Code	5700508
Hospital Revenue Code	450
Min. Negotiated Rate	$418.30
Max. Negotiated Rate	$418.30
Rate for Payer: Qualcare PPO/HMO/WC	$418.30

ER DEBRID PARTIAL THICK SKIN

Facility

$843.05

Hospital Charge Code	5700703
Hospital Revenue Code	450
Min. Negotiated Rate	$109.60
Max. Negotiated Rate	$421.52
Rate for Payer: Aetna Commercial	$252.91
Rate for Payer: Aetna Medicare Advantage	$252.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.98
Rate for Payer: Cigna Commercial	$421.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.60
Rate for Payer: Qualcare PPO/HMO/WC	$126.46

ER DEBRID PARTIAL THICK SKIN

Facility

$843.05

Hospital Charge Code	5700703
Hospital Revenue Code	450
Min. Negotiated Rate	$126.46
Max. Negotiated Rate	$126.46
Rate for Payer: Qualcare PPO/HMO/WC	$126.46

ER DECLOT VASCULAR DEVICE

Facility

$1,113.85

Service Code	HCPCS 36593
Hospital Charge Code	5700640
Hospital Revenue Code	450
Min. Negotiated Rate	$20.95
Max. Negotiated Rate	$786.58
Rate for Payer: Aetna Commercial	$334.15
Rate for Payer: Aetna Medicare Advantage	$334.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$284.03
Rate for Payer: Cigna Commercial	$786.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.80
Rate for Payer: Qualcare PPO/HMO/WC	$167.08

ER DECLOT VASCULAR DEVICE

Facility

$1,113.85

Service Code	HCPCS 36593
Hospital Charge Code	5700640
Hospital Revenue Code	450
Min. Negotiated Rate	$167.08
Max. Negotiated Rate	$167.08
Rate for Payer: Qualcare PPO/HMO/WC	$167.08

ER DELIVERY PLACENTA ONLY

Facility

$10,964.20

Service Code	HCPCS 59414
Hospital Charge Code	5700802
Hospital Revenue Code	450
Min. Negotiated Rate	$1,644.63
Max. Negotiated Rate	$1,644.63
Rate for Payer: Qualcare PPO/HMO/WC	$1,644.63

ER DELIVERY PLACENTA ONLY

Facility

$10,964.20

Service Code	HCPCS 59414
Hospital Charge Code	5700802
Hospital Revenue Code	450
Min. Negotiated Rate	$48.30
Max. Negotiated Rate	$7,708.87
Rate for Payer: Aetna Commercial	$3,289.26
Rate for Payer: Aetna Medicare Advantage	$3,289.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,795.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,795.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,795.87
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,425.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,644.63

ER-DESTRUCT B9 LESIN 1-14

Facility

$259.00

Service Code	HCPCS 17110
Hospital Charge Code	5790040
Hospital Revenue Code	450
Min. Negotiated Rate	$33.67
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$77.70
Rate for Payer: Aetna Medicare Advantage	$77.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.05
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.67
Rate for Payer: Qualcare PPO/HMO/WC	$38.85

ER-DESTRUCT B9 LESIN 1-14

Facility

$259.00

Service Code	HCPCS 17110
Hospital Charge Code	5790040
Hospital Revenue Code	450
Min. Negotiated Rate	$38.85
Max. Negotiated Rate	$38.85
Rate for Payer: Qualcare PPO/HMO/WC	$38.85

ER DIAG LARYNGOSCOPY INDIRECT

Facility

$437.95

Service Code	HCPCS 31505
Hospital Charge Code	5700774
Hospital Revenue Code	450
Min. Negotiated Rate	$18.40
Max. Negotiated Rate	$640.73
Rate for Payer: Aetna Better Health Medicaid	$628.17
Rate for Payer: Aetna Commercial	$131.38
Rate for Payer: Aetna Medicare Advantage	$131.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.68
Rate for Payer: Cigna Commercial	$475.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.93
Rate for Payer: Qualcare PPO/HMO/WC	$65.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$640.73

ER DIAG LARYNGOSCOPY INDIRECT

Facility

$437.95

Service Code	HCPCS 31505
Hospital Charge Code	5700774
Hospital Revenue Code	450
Min. Negotiated Rate	$65.69
Max. Negotiated Rate	$65.69
Rate for Payer: Qualcare PPO/HMO/WC	$65.69

ER DIAGNOSTIC ANOSCOPY

Facility

$366.05

Service Code	HCPCS 46600
Hospital Charge Code	5700795
Hospital Revenue Code	450
Min. Negotiated Rate	$54.91
Max. Negotiated Rate	$54.91
Rate for Payer: Qualcare PPO/HMO/WC	$54.91

ER DIAGNOSTIC ANOSCOPY

Facility

$366.05

Service Code	HCPCS 46600
Hospital Charge Code	5700795
Hospital Revenue Code	450
Min. Negotiated Rate	$18.40
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$109.81
Rate for Payer: Aetna Medicare Advantage	$109.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.34
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.59
Rate for Payer: Qualcare PPO/HMO/WC	$54.91

ER DIGITAL BLOCK

Facility

$2,035.90

Service Code	HCPCS 64450
Hospital Charge Code	5700805
Hospital Revenue Code	450
Min. Negotiated Rate	$43.47
Max. Negotiated Rate	$1,680.99
Rate for Payer: Aetna Commercial	$610.77
Rate for Payer: Aetna Medicare Advantage	$610.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$519.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$519.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$519.15
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$264.67
Rate for Payer: Qualcare PPO/HMO/WC	$305.38

ER DIGITAL BLOCK

Facility

$2,035.90

Service Code	HCPCS 64450
Hospital Charge Code	5700805
Hospital Revenue Code	450
Min. Negotiated Rate	$305.38
Max. Negotiated Rate	$305.38
Rate for Payer: Qualcare PPO/HMO/WC	$305.38

ER-DII URE STRIC MALE INI

Facility

$5,837.00

Service Code	HCPCS 53620
Hospital Charge Code	5790175
Hospital Revenue Code	450
Min. Negotiated Rate	$875.55
Max. Negotiated Rate	$875.55
Rate for Payer: Qualcare PPO/HMO/WC	$875.55

ER-DII URE STRIC MALE INI

Facility

$5,837.00

Service Code	HCPCS 53620
Hospital Charge Code	5790175
Hospital Revenue Code	450
Min. Negotiated Rate	$25.76
Max. Negotiated Rate	$1,751.10
Rate for Payer: Aetna Commercial	$1,751.10
Rate for Payer: Aetna Medicare Advantage	$1,751.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,488.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,488.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,488.43
Rate for Payer: Cigna Commercial	$1,660.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.81
Rate for Payer: Qualcare PPO/HMO/WC	$875.55

Know your out-of-pocket cost for care.

All Charges