Heights University Hospital

All Charges

Charge

Type

Setting

Price

ERIBULIN MESYLATE 0.5MG/ML INJ

Facility

$7,863.12

Service Code	HCPCS J9179
Hospital Charge Code	60630227
Hospital Revenue Code	636
Min. Negotiated Rate	$1,179.47
Max. Negotiated Rate	$1,902.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,902.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,179.47

ER I&D ABSCESS COMPLCATED/MULT

Facility

$796.20

Service Code	HCPCS 10061
Hospital Charge Code	5700502
Hospital Revenue Code	450
Min. Negotiated Rate	$103.51
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$238.86
Rate for Payer: Aetna Medicare Advantage	$238.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.03
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.51
Rate for Payer: Qualcare PPO/HMO/WC	$119.43

ER I&D ABSCESS COMPLCATED/MULT

Facility

$796.20

Service Code	HCPCS 10061
Hospital Charge Code	5700502
Hospital Revenue Code	450
Min. Negotiated Rate	$119.43
Max. Negotiated Rate	$119.43
Rate for Payer: Qualcare PPO/HMO/WC	$119.43

ER I&D ABS PERITONSILLAR

Facility

$796.25

Service Code	HCPCS 42700
Hospital Charge Code	5700648
Hospital Revenue Code	450
Min. Negotiated Rate	$119.44
Max. Negotiated Rate	$119.44
Rate for Payer: Qualcare PPO/HMO/WC	$119.44

ER I&D ABS PERITONSILLAR

Facility

$796.25

Service Code	HCPCS 42700
Hospital Charge Code	5700648
Hospital Revenue Code	450
Min. Negotiated Rate	$55.04
Max. Negotiated Rate	$564.04
Rate for Payer: Aetna Commercial	$238.88
Rate for Payer: Aetna Medicare Advantage	$238.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.04
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.51
Rate for Payer: Qualcare PPO/HMO/WC	$119.44

ER I&D BARTHOLIN'S GLAND

Facility

$942.15

Service Code	HCPCS 56420
Hospital Charge Code	5700800
Hospital Revenue Code	450
Min. Negotiated Rate	$122.48
Max. Negotiated Rate	$481.45
Rate for Payer: Aetna Commercial	$282.64
Rate for Payer: Aetna Medicare Advantage	$282.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.25
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.48
Rate for Payer: Qualcare PPO/HMO/WC	$141.32

ER I&D BARTHOLIN'S GLAND

Facility

$942.15

Service Code	HCPCS 56420
Hospital Charge Code	5700800
Hospital Revenue Code	450
Min. Negotiated Rate	$141.32
Max. Negotiated Rate	$141.32
Rate for Payer: Qualcare PPO/HMO/WC	$141.32

ER I&D DENTAL ABSCESS

Facility

$447.50

Service Code	HCPCS 41800
Hospital Charge Code	5700647
Hospital Revenue Code	450
Min. Negotiated Rate	$67.12
Max. Negotiated Rate	$67.12
Rate for Payer: Qualcare PPO/HMO/WC	$67.12

ER I&D DENTAL ABSCESS

Facility

$447.50

Service Code	HCPCS 41800
Hospital Charge Code	5700647
Hospital Revenue Code	450
Min. Negotiated Rate	$28.98
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$134.25
Rate for Payer: Aetna Medicare Advantage	$134.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.11
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	$114.11
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.17
Rate for Payer: Qualcare PPO/HMO/WC	$67.12

ER I&D EAR ABSCESS SIMPL

Facility

$796.20

Service Code	HCPCS 69000
Hospital Charge Code	5700807
Hospital Revenue Code	450
Min. Negotiated Rate	$35.49
Max. Negotiated Rate	$1,686.34
Rate for Payer: Aetna Commercial	$238.86
Rate for Payer: Aetna Medicare Advantage	$238.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.03
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.51
Rate for Payer: Qualcare PPO/HMO/WC	$119.43

ER I&D EAR ABSCESS SIMPL

Facility

$796.20

Service Code	HCPCS 69000
Hospital Charge Code	5700807
Hospital Revenue Code	450
Min. Negotiated Rate	$119.43
Max. Negotiated Rate	$119.43
Rate for Payer: Qualcare PPO/HMO/WC	$119.43

ER-I&D EAR ABSC HEMA-LT

Facility

$530.00

Hospital Charge Code	5792150
Hospital Revenue Code	450
Min. Negotiated Rate	$68.90
Max. Negotiated Rate	$265.00
Rate for Payer: Aetna Commercial	$159.00
Rate for Payer: Aetna Medicare Advantage	$159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.15
Rate for Payer: Cigna Commercial	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.90
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

ER-I&D EAR ABSC HEMA-LT

Facility

$530.00

Hospital Charge Code	5792150
Hospital Revenue Code	450
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$79.50
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

ER-I&D EAR ABSC HEMATO-RT

Facility

$530.00

Hospital Charge Code	5792155
Hospital Revenue Code	450
Min. Negotiated Rate	$68.90
Max. Negotiated Rate	$265.00
Rate for Payer: Aetna Commercial	$159.00
Rate for Payer: Aetna Medicare Advantage	$159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.15
Rate for Payer: Cigna Commercial	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.90
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

ER-I&D EAR ABSC HEMATO-RT

Facility

$530.00

Hospital Charge Code	5792155
Hospital Revenue Code	450
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$79.50
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

ER I&D FINGER ABSCESS COMPLX

Facility

$6,903.75

Service Code	HCPCS 26011
Hospital Charge Code	5700749
Hospital Revenue Code	450
Min. Negotiated Rate	$1,035.56
Max. Negotiated Rate	$1,035.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.56

ER I&D FINGER ABSCESS COMPLX

Facility

$6,903.75

Service Code	HCPCS 26011
Hospital Charge Code	5700749
Hospital Revenue Code	450
Min. Negotiated Rate	$100.59
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,071.12
Rate for Payer: Aetna Medicare Advantage	$2,071.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,760.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,760.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,760.46
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$897.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.56

ER I&D FINGER ABSCESS SIMPLE

Facility

$450.00

Service Code	HCPCS 26010
Hospital Charge Code	5700574
Hospital Revenue Code	450
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

ER I&D FINGER ABSCESS SIMPLE

Facility

$450.00

Service Code	HCPCS 26010
Hospital Charge Code	5700574
Hospital Revenue Code	450
Min. Negotiated Rate	$43.47
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$135.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
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	$114.75
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

ER I&D HAND BURSA

Facility

$10,614.65

Service Code	HCPCS 23931
Hospital Charge Code	5700737
Hospital Revenue Code	450
Min. Negotiated Rate	$1,592.20
Max. Negotiated Rate	$1,592.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,592.20

ER I&D HAND BURSA

Facility

$10,614.65

Service Code	HCPCS 23931
Hospital Charge Code	5700737
Hospital Revenue Code	450
Min. Negotiated Rate	$27.14
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$3,184.39
Rate for Payer: Aetna Medicare Advantage	$3,184.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,706.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,706.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,706.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,379.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,592.20

ER I&D HAND DEEP ABSC HEMATOMA

Facility

$10,614.65

Service Code	HCPCS 23930
Hospital Charge Code	5700736
Hospital Revenue Code	450
Min. Negotiated Rate	$1,592.20
Max. Negotiated Rate	$1,592.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,592.20

ER I&D HAND DEEP ABSC HEMATOMA

Facility

$10,614.65

Service Code	HCPCS 23930
Hospital Charge Code	5700736
Hospital Revenue Code	450
Min. Negotiated Rate	$231.41
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$3,184.39
Rate for Payer: Aetna Medicare Advantage	$3,184.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,706.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,706.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$231.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,706.74
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,379.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,592.20

ER I&D HEMATOMA/SEROMA/FLD COL

Facility

$3,553.75

Service Code	HCPCS 10140
Hospital Charge Code	5700506
Hospital Revenue Code	450
Min. Negotiated Rate	$43.47
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$1,066.12
Rate for Payer: Aetna Medicare Advantage	$1,066.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$906.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$906.21
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	$906.21
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$461.99
Rate for Payer: Qualcare PPO/HMO/WC	$533.06

ER I&D HEMATOMA/SEROMA/FLD COL

Facility

$3,553.75

Service Code	HCPCS 10140
Hospital Charge Code	5700506
Hospital Revenue Code	450
Min. Negotiated Rate	$533.06
Max. Negotiated Rate	$533.06
Rate for Payer: Qualcare PPO/HMO/WC	$533.06

Know your out-of-pocket cost for care.

All Charges