Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER-FB REMOVAL EAR-LT

Facility

$203.00

Hospital Charge Code	5792160
Hospital Revenue Code	450
Min. Negotiated Rate	$30.45
Max. Negotiated Rate	$30.45
Rate for Payer: Qualcare PPO/HMO/WC	$30.45

ER-FB REMOVAL - EAR-RT

Facility

$268.00

Hospital Charge Code	5792165
Hospital Revenue Code	450
Min. Negotiated Rate	$40.20
Max. Negotiated Rate	$40.20
Rate for Payer: Qualcare PPO/HMO/WC	$40.20

ER-FB REMOVAL - EAR-RT

Facility

$268.00

Hospital Charge Code	5792165
Hospital Revenue Code	450
Min. Negotiated Rate	$34.84
Max. Negotiated Rate	$134.00
Rate for Payer: Aetna Commercial	$80.40
Rate for Payer: Aetna Medicare Advantage	$80.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.34
Rate for Payer: Cigna Commercial	$134.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.84
Rate for Payer: Qualcare PPO/HMO/WC	$40.20

ER FB REMOVAL FOOT COMPX

Facility

$4,486.70

Service Code	HCPCS 28193
Hospital Charge Code	5700767
Hospital Revenue Code	450
Min. Negotiated Rate	$82.11
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$1,346.01
Rate for Payer: Aetna Medicare Advantage	$1,346.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,144.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,144.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,144.11
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$583.27
Rate for Payer: Qualcare PPO/HMO/WC	$673.00

ER FB REMOVAL FOOT COMPX

Facility

$4,486.70

Service Code	HCPCS 28193
Hospital Charge Code	5700767
Hospital Revenue Code	450
Min. Negotiated Rate	$673.00
Max. Negotiated Rate	$673.00
Rate for Payer: Qualcare PPO/HMO/WC	$673.00

ER FB REMOVAL FOOT DEEP

Facility

$9,570.65

Service Code	HCPCS 28192
Hospital Charge Code	5700766
Hospital Revenue Code	450
Min. Negotiated Rate	$82.11
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,871.20
Rate for Payer: Aetna Medicare Advantage	$2,871.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,440.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,440.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$82.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,440.52
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,244.18
Rate for Payer: Qualcare PPO/HMO/WC	$1,435.60

ER FB REMOVAL FOOT DEEP

Facility

$9,570.65

Service Code	HCPCS 28192
Hospital Charge Code	5700766
Hospital Revenue Code	450
Min. Negotiated Rate	$1,435.60
Max. Negotiated Rate	$1,435.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,435.60

ER FB REMOVAL HIP/PELVIS SQ

Facility

$4,486.70

Service Code	HCPCS 27086
Hospital Charge Code	5700752
Hospital Revenue Code	450
Min. Negotiated Rate	$673.00
Max. Negotiated Rate	$673.00
Rate for Payer: Qualcare PPO/HMO/WC	$673.00

ER FB REMOVAL HIP/PELVIS SQ

Facility

$4,486.70

Service Code	HCPCS 27086
Hospital Charge Code	5700752
Hospital Revenue Code	450
Min. Negotiated Rate	$37.57
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$1,346.01
Rate for Payer: Aetna Medicare Advantage	$1,346.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,144.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,144.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,144.11
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$583.27
Rate for Payer: Qualcare PPO/HMO/WC	$673.00

ER FB REMOVAL LARYNX W SCOPE

Facility

$2,413.20

Service Code	HCPCS 31577
Hospital Charge Code	5700775
Hospital Revenue Code	450
Min. Negotiated Rate	$165.60
Max. Negotiated Rate	$931.42
Rate for Payer: Aetna Commercial	$723.96
Rate for Payer: Aetna Medicare Advantage	$723.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$615.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$615.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$615.37
Rate for Payer: Cigna Commercial	$931.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.72
Rate for Payer: Qualcare PPO/HMO/WC	$361.98

ER FB REMOVAL LARYNX W SCOPE

Facility

$2,413.20

Service Code	HCPCS 31577
Hospital Charge Code	5700775
Hospital Revenue Code	450
Min. Negotiated Rate	$361.98
Max. Negotiated Rate	$361.98
Rate for Payer: Qualcare PPO/HMO/WC	$361.98

ER FB REMOVAL SHOULDER SQ

Facility

$4,486.70

Service Code	HCPCS 23330
Hospital Charge Code	5700730
Hospital Revenue Code	450
Min. Negotiated Rate	$43.47
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$1,346.01
Rate for Payer: Aetna Medicare Advantage	$1,346.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,144.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,144.11
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	$1,144.11
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$583.27
Rate for Payer: Qualcare PPO/HMO/WC	$673.00

ER FB REMOVAL SHOULDER SQ

Facility

$4,486.70

Service Code	HCPCS 23330
Hospital Charge Code	5700730
Hospital Revenue Code	450
Min. Negotiated Rate	$673.00
Max. Negotiated Rate	$673.00
Rate for Payer: Qualcare PPO/HMO/WC	$673.00

ER FB REMOVA TGH OR KNEE DEEP

Facility

$12,792.55

Service Code	HCPCS 27372
Hospital Charge Code	5700759
Hospital Revenue Code	450
Min. Negotiated Rate	$137.66
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$3,837.76
Rate for Payer: Aetna Medicare Advantage	$3,837.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,262.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,262.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,262.10
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,663.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,918.88

ER FB REMOVA TGH OR KNEE DEEP

Facility

$12,792.55

Service Code	HCPCS 27372
Hospital Charge Code	5700759
Hospital Revenue Code	450
Min. Negotiated Rate	$1,918.88
Max. Negotiated Rate	$1,918.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,918.88

ER FB REMOV HIP/PELVIS DEEP

Facility

$12,041.50

Service Code	HCPCS 27087
Hospital Charge Code	5700753
Hospital Revenue Code	450
Min. Negotiated Rate	$1,806.22
Max. Negotiated Rate	$1,806.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,806.22

ER FB REMOV HIP/PELVIS DEEP

Facility

$12,041.50

Service Code	HCPCS 27087
Hospital Charge Code	5700753
Hospital Revenue Code	450
Min. Negotiated Rate	$70.03
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$3,612.45
Rate for Payer: Aetna Medicare Advantage	$3,612.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,070.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,070.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,070.58
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,565.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,806.22

ER FB REMOV MOUTH EMBED SIM

Facility

$3,717.20

Service Code	HCPCS 40804
Hospital Charge Code	5700790
Hospital Revenue Code	450
Min. Negotiated Rate	$28.98
Max. Negotiated Rate	$2,159.89
Rate for Payer: Aetna Commercial	$1,115.16
Rate for Payer: Aetna Medicare Advantage	$1,115.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$947.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$947.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$947.89
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$483.24
Rate for Payer: Qualcare PPO/HMO/WC	$557.58

ER FB REMOV MOUTH EMBED SIM

Facility

$3,717.20

Service Code	HCPCS 40804
Hospital Charge Code	5700790
Hospital Revenue Code	450
Min. Negotiated Rate	$557.58
Max. Negotiated Rate	$557.58
Rate for Payer: Qualcare PPO/HMO/WC	$557.58

ER FB SQ TISSUE COMPLEX

Facility

$5,127.50

Service Code	HCPCS 10121
Hospital Charge Code	5700505
Hospital Revenue Code	450
Min. Negotiated Rate	$175.79
Max. Negotiated Rate	$4,474.27
Rate for Payer: Aetna Better Health Medicaid	$4,386.54
Rate for Payer: Aetna Commercial	$1,538.25
Rate for Payer: Aetna Medicare Advantage	$1,538.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,307.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,307.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,307.51
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$666.58
Rate for Payer: Qualcare PPO/HMO/WC	$769.12
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,474.27

ER FB SQ TISSUE COMPLEX

Facility

$5,127.50

Service Code	HCPCS 10121
Hospital Charge Code	5700505
Hospital Revenue Code	450
Min. Negotiated Rate	$769.12
Max. Negotiated Rate	$769.12
Rate for Payer: Qualcare PPO/HMO/WC	$769.12

ER-FELON/FINGR ABSCES-BIL

Facility

$3,801.00

Hospital Charge Code	5790475
Hospital Revenue Code	450
Min. Negotiated Rate	$570.15
Max. Negotiated Rate	$570.15
Rate for Payer: Qualcare PPO/HMO/WC	$570.15

ER-FELON/FINGR ABSCES-BIL

Facility

$3,801.00

Hospital Charge Code	5790475
Hospital Revenue Code	450
Min. Negotiated Rate	$494.13
Max. Negotiated Rate	$1,900.50
Rate for Payer: Aetna Commercial	$1,140.30
Rate for Payer: Aetna Medicare Advantage	$1,140.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$969.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$969.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$969.25
Rate for Payer: Cigna Commercial	$1,900.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$494.13
Rate for Payer: Qualcare PPO/HMO/WC	$570.15

ER-FEMALE GENITAL-OTHER

Facility

$963.00

Service Code	HCPCS 58999
Hospital Charge Code	5790205
Hospital Revenue Code	450
Min. Negotiated Rate	$144.45
Max. Negotiated Rate	$144.45
Rate for Payer: Qualcare PPO/HMO/WC	$144.45

ER-FEMALE GENITAL-OTHER

Facility

$963.00

Service Code	HCPCS 58999
Hospital Charge Code	5790205
Hospital Revenue Code	450
Min. Negotiated Rate	$125.19
Max. Negotiated Rate	$481.45
Rate for Payer: Aetna Commercial	$288.90
Rate for Payer: Aetna Medicare Advantage	$288.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.56
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.19
Rate for Payer: Qualcare PPO/HMO/WC	$144.45

Know your out-of-pocket cost for care.

All Charges