Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER-EVAC SUBUNG HEMATO-BIL

Facility

$214.00

Hospital Charge Code	5790270
Hospital Revenue Code	450
Min. Negotiated Rate	$27.82
Max. Negotiated Rate	$107.00
Rate for Payer: Aetna Commercial	$64.20
Rate for Payer: Aetna Medicare Advantage	$64.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.57
Rate for Payer: Cigna Commercial	$107.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.82
Rate for Payer: Qualcare PPO/HMO/WC	$32.10

ER EVACUATION SUBNGUAL HEMATOM

Facility

$273.34

Service Code	HCPCS 11740
Hospital Charge Code	5700512
Hospital Revenue Code	450
Min. Negotiated Rate	$18.66
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Better Health Medicaid	$193.50
Rate for Payer: Aetna Commercial	$82.00
Rate for Payer: Aetna Medicare Advantage	$82.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.70
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.53
Rate for Payer: Qualcare PPO/HMO/WC	$41.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37

ER EVACUATION SUBNGUAL HEMATOM

Facility

$273.34

Service Code	HCPCS 11740
Hospital Charge Code	5700512
Hospital Revenue Code	450
Min. Negotiated Rate	$41.00
Max. Negotiated Rate	$41.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.00

ER EVALUATEPT USE OF INHALER

Facility

$182.75

Service Code	HCPCS 94664
Hospital Charge Code	5700656
Hospital Revenue Code	410
Min. Negotiated Rate	$23.76
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$54.83
Rate for Payer: Aetna Medicare Advantage	$54.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.60
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.76
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.41
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

ER EVALUATEPT USE OF INHALER

Facility

$182.75

Service Code	HCPCS 94664
Hospital Charge Code	5700656
Hospital Revenue Code	410
Min. Negotiated Rate	$27.41
Max. Negotiated Rate	$27.41
Rate for Payer: Qualcare PPO/HMO/WC	$27.41

ER-EXC H-F-NK-SP B9 0.5<

Facility

$2,457.00

Service Code	HCPCS 11420
Hospital Charge Code	5790005
Hospital Revenue Code	450
Min. Negotiated Rate	$368.55
Max. Negotiated Rate	$368.55
Rate for Payer: Qualcare PPO/HMO/WC	$368.55

ER-EXC H-F-NK-SP B9 0.5<

Facility

$2,457.00

Service Code	HCPCS 11420
Hospital Charge Code	5790005
Hospital Revenue Code	450
Min. Negotiated Rate	$79.21
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$737.10
Rate for Payer: Aetna Medicare Advantage	$737.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$626.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$626.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$626.53
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.41
Rate for Payer: Qualcare PPO/HMO/WC	$368.55

ER-EXCISIN BENGN LSION-BI

Facility

$1,304.00

Service Code	HCPCS 11402
Hospital Charge Code	5790260
Hospital Revenue Code	450
Min. Negotiated Rate	$195.60
Max. Negotiated Rate	$195.60
Rate for Payer: Qualcare PPO/HMO/WC	$195.60

ER-EXCISIN BENGN LSION-BI

Facility

$1,304.00

Service Code	HCPCS 11402
Hospital Charge Code	5790260
Hospital Revenue Code	450
Min. Negotiated Rate	$65.09
Max. Negotiated Rate	$1,686.34
Rate for Payer: Aetna Commercial	$391.20
Rate for Payer: Aetna Medicare Advantage	$391.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$332.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$332.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$332.52
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.52
Rate for Payer: Qualcare PPO/HMO/WC	$195.60

ER-EXCISION NAIL FOLD-BIL

Facility

$512.00

Service Code	HCPCS 11765
Hospital Charge Code	5790280
Hospital Revenue Code	450
Min. Negotiated Rate	$39.85
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$153.60
Rate for Payer: Aetna Medicare Advantage	$153.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.56
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.56
Rate for Payer: Qualcare PPO/HMO/WC	$76.80

ER-EXCISION NAIL FOLD-BIL

Facility

$512.00

Service Code	HCPCS 11765
Hospital Charge Code	5790280
Hospital Revenue Code	450
Min. Negotiated Rate	$76.80
Max. Negotiated Rate	$76.80
Rate for Payer: Qualcare PPO/HMO/WC	$76.80

ER EXCISION NAIL PARTIAL COMP

Facility

$1,375.00

Service Code	HCPCS 11750
Hospital Charge Code	5700513
Hospital Revenue Code	450
Min. Negotiated Rate	$141.00
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$412.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.75
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

ER EXCISION NAIL PARTIAL COMP

Facility

$1,375.00

Service Code	HCPCS 11750
Hospital Charge Code	5700513
Hospital Revenue Code	450
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$206.25
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

ER EXCISION OF INGROWN TOENAIL

Facility

$468.75

Service Code	HCPCS 11765
Hospital Charge Code	5700514
Hospital Revenue Code	450
Min. Negotiated Rate	$70.31
Max. Negotiated Rate	$70.31
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

ER EXCISION OF INGROWN TOENAIL

Facility

$468.75

Service Code	HCPCS 11765
Hospital Charge Code	5700514
Hospital Revenue Code	450
Min. Negotiated Rate	$39.85
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$140.62
Rate for Payer: Aetna Medicare Advantage	$140.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.53
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.94
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

ER-EXC LES TONGU W/O CLOS

Facility

$5,019.00

Service Code	HCPCS 41110
Hospital Charge Code	5790130
Hospital Revenue Code	450
Min. Negotiated Rate	$25.05
Max. Negotiated Rate	$7,895.42
Rate for Payer: Aetna Commercial	$1,505.70
Rate for Payer: Aetna Medicare Advantage	$1,505.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,279.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,279.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,279.85
Rate for Payer: Cigna Commercial	$7,895.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$652.47
Rate for Payer: Qualcare PPO/HMO/WC	$752.85

ER-EXC LES TONGU W/O CLOS

Facility

$5,019.00

Service Code	HCPCS 41110
Hospital Charge Code	5790130
Hospital Revenue Code	450
Min. Negotiated Rate	$752.85
Max. Negotiated Rate	$752.85
Rate for Payer: Qualcare PPO/HMO/WC	$752.85

ER-EXPLORE ABDOMIN VESSEL

Facility

$5,000.00

Service Code	HCPCS 35840
Hospital Charge Code	5790095
Hospital Revenue Code	450
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

ER-EXPLORE ABDOMIN VESSEL

Facility

$5,000.00

Service Code	HCPCS 35840
Hospital Charge Code	5790095
Hospital Revenue Code	450
Min. Negotiated Rate	$309.52
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,500.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$309.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$1,222.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$650.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

ER-EXPLORE WND EXTRMTY-BI

Facility

$2,707.00

Hospital Charge Code	5790290
Hospital Revenue Code	450
Min. Negotiated Rate	$406.05
Max. Negotiated Rate	$406.05
Rate for Payer: Qualcare PPO/HMO/WC	$406.05

ER-EXPLORE WND EXTRMTY-BI

Facility

$2,707.00

Hospital Charge Code	5790290
Hospital Revenue Code	450
Min. Negotiated Rate	$351.91
Max. Negotiated Rate	$1,353.50
Rate for Payer: Aetna Commercial	$812.10
Rate for Payer: Aetna Medicare Advantage	$812.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$690.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$690.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$690.28
Rate for Payer: Cigna Commercial	$1,353.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.91
Rate for Payer: Qualcare PPO/HMO/WC	$406.05

ER-EXPLORE WOUND ABDOM

Facility

$6,137.00

Service Code	HCPCS 20102
Hospital Charge Code	5790055
Hospital Revenue Code	450
Min. Negotiated Rate	$920.55
Max. Negotiated Rate	$920.55
Rate for Payer: Qualcare PPO/HMO/WC	$920.55

ER-EXPLORE WOUND ABDOM

Facility

$6,137.00

Service Code	HCPCS 20102
Hospital Charge Code	5790055
Hospital Revenue Code	450
Min. Negotiated Rate	$125.83
Max. Negotiated Rate	$4,913.48
Rate for Payer: Aetna Commercial	$1,841.10
Rate for Payer: Aetna Medicare Advantage	$1,841.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,564.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,564.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,564.93
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$797.81
Rate for Payer: Qualcare PPO/HMO/WC	$920.55

ER EXTENDED - IV

Facility

$14,610.29

Service Code	HCPCS 99284
Hospital Charge Code	5700091
Hospital Revenue Code	450
Min. Negotiated Rate	$2,191.54
Max. Negotiated Rate	$2,191.54
Rate for Payer: Qualcare PPO/HMO/WC	$2,191.54

ER EXTENDED - IV

Facility

$14,610.29

Service Code	HCPCS 99284
Hospital Charge Code	5700091
Hospital Revenue Code	450
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$4,383.09
Rate for Payer: Aetna Commercial	$4,383.09
Rate for Payer: Aetna Medicare Advantage	$4,383.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,725.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,725.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$715.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,725.62
Rate for Payer: Cigna Commercial	$993.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,397.00
Rate for Payer: Oxford Commercial	$2,186.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,191.54
Rate for Payer: UnitedHealthcare Commercial	$2,481.00
Rate for Payer: Wellpoint Medicaid Managed Care	$450.00

Know your out-of-pocket cost for care.

All Charges