Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER I&D INTRAORAL LINGUAL ABSC

Facility

$9,401.30

Service Code	HCPCS 41000
Hospital Charge Code	5700791
Hospital Revenue Code	450
Min. Negotiated Rate	$1,410.19
Max. Negotiated Rate	$1,410.19
Rate for Payer: Qualcare PPO/HMO/WC	$1,410.19

ER I&D INTRAORAL LINGUAL ABSC

Facility

$9,401.30

Service Code	HCPCS 41000
Hospital Charge Code	5700791
Hospital Revenue Code	450
Min. Negotiated Rate	$58.44
Max. Negotiated Rate	$2,820.39
Rate for Payer: Aetna Commercial	$2,820.39
Rate for Payer: Aetna Medicare Advantage	$2,820.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,397.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,397.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,397.33
Rate for Payer: Cigna Commercial	$1,284.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,222.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,410.19

ER I&D LEG OR ANK INFECT BURSA

Facility

$12,041.50

Service Code	HCPCS 27604
Hospital Charge Code	5700763
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 I&D LEG OR ANK INFECT BURSA

Facility

$12,041.50

Service Code	HCPCS 27604
Hospital Charge Code	5700763
Hospital Revenue Code	450
Min. Negotiated Rate	$33.40
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	$33.40
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 I&D LEG OR ANKLE DEEP ABSC

Facility

$10,614.65

Service Code	HCPCS 27603
Hospital Charge Code	5700762
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 LEG OR ANKLE DEEP ABSC

Facility

$10,614.65

Service Code	HCPCS 27603
Hospital Charge Code	5700762
Hospital Revenue Code	450
Min. Negotiated Rate	$349.43
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	$349.43
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 OF FOREIGN BODY REMOVEL

Facility

$1,061.25

Service Code	HCPCS 10120
Hospital Charge Code	5700480
Hospital Revenue Code	450
Min. Negotiated Rate	$159.19
Max. Negotiated Rate	$159.19
Rate for Payer: Qualcare PPO/HMO/WC	$159.19

ER I&D OF FOREIGN BODY REMOVEL

Facility

$1,061.25

Service Code	HCPCS 10120
Hospital Charge Code	5700480
Hospital Revenue Code	450
Min. Negotiated Rate	$91.25
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$318.38
Rate for Payer: Aetna Medicare Advantage	$318.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$270.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$270.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$270.62
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.96
Rate for Payer: Qualcare PPO/HMO/WC	$159.19
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

ER I & D OF VULVA/PERINEUM

Facility

$1,573.30

Service Code	HCPCS 56405
Hospital Charge Code	5701005
Hospital Revenue Code	450
Min. Negotiated Rate	$204.53
Max. Negotiated Rate	$725.69
Rate for Payer: Aetna Commercial	$471.99
Rate for Payer: Aetna Medicare Advantage	$471.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$401.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$401.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$401.19
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$204.53
Rate for Payer: Qualcare PPO/HMO/WC	$236.00

ER I & D OF VULVA/PERINEUM

Facility

$1,573.30

Service Code	HCPCS 56405
Hospital Charge Code	5701005
Hospital Revenue Code	450
Min. Negotiated Rate	$236.00
Max. Negotiated Rate	$236.00
Rate for Payer: Qualcare PPO/HMO/WC	$236.00

ER I&D PERIANAL ABSCESS

Facility

$7,719.95

Service Code	HCPCS 46050
Hospital Charge Code	5700794
Hospital Revenue Code	450
Min. Negotiated Rate	$1,157.99
Max. Negotiated Rate	$1,157.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,157.99

ER I&D PERIANAL ABSCESS

Facility

$7,719.95

Service Code	HCPCS 46050
Hospital Charge Code	5700794
Hospital Revenue Code	450
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$2,315.99
Rate for Payer: Aetna Commercial	$2,315.99
Rate for Payer: Aetna Medicare Advantage	$2,315.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,968.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,968.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,968.59
Rate for Payer: Cigna Commercial	$2,214.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,003.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,157.99

ER-I&D PERINEAL ABSCESS

Facility

$1,573.30

Service Code	HCPCS 56405
Hospital Charge Code	5790195
Hospital Revenue Code	450
Min. Negotiated Rate	$236.00
Max. Negotiated Rate	$236.00
Rate for Payer: Qualcare PPO/HMO/WC	$236.00

ER-I&D PERINEAL ABSCESS

Facility

$1,573.30

Service Code	HCPCS 56405
Hospital Charge Code	5790195
Hospital Revenue Code	450
Min. Negotiated Rate	$204.53
Max. Negotiated Rate	$725.69
Rate for Payer: Aetna Commercial	$471.99
Rate for Payer: Aetna Medicare Advantage	$471.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$401.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$401.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$401.19
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$204.53
Rate for Payer: Qualcare PPO/HMO/WC	$236.00

ER I&D PERIRECTAL ABSCESS

Facility

$5,506.35

Service Code	HCPCS 46040
Hospital Charge Code	5700793
Hospital Revenue Code	450
Min. Negotiated Rate	$98.21
Max. Negotiated Rate	$2,849.67
Rate for Payer: Aetna Commercial	$1,651.90
Rate for Payer: Aetna Medicare Advantage	$1,651.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,404.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,404.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,404.12
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$715.83
Rate for Payer: Qualcare PPO/HMO/WC	$825.95

ER I&D PERIRECTAL ABSCESS

Facility

$5,506.35

Service Code	HCPCS 46040
Hospital Charge Code	5700793
Hospital Revenue Code	450
Min. Negotiated Rate	$825.95
Max. Negotiated Rate	$825.95
Rate for Payer: Qualcare PPO/HMO/WC	$825.95

ER I&D PILONDIAL CYST COMPLEX

Facility

$3,681.25

Service Code	HCPCS 10081
Hospital Charge Code	5700504
Hospital Revenue Code	450
Min. Negotiated Rate	$93.52
Max. Negotiated Rate	$1,686.34
Rate for Payer: Aetna Commercial	$1,104.38
Rate for Payer: Aetna Medicare Advantage	$1,104.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$938.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$938.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$938.72
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$478.56
Rate for Payer: Qualcare PPO/HMO/WC	$552.19

ER I&D PILONDIAL CYST COMPLEX

Facility

$3,681.25

Service Code	HCPCS 10081
Hospital Charge Code	5700504
Hospital Revenue Code	450
Min. Negotiated Rate	$552.19
Max. Negotiated Rate	$552.19
Rate for Payer: Qualcare PPO/HMO/WC	$552.19

ER I&D PILONIDAL CYST SIMPLE

Facility

$450.00

Service Code	HCPCS 10080
Hospital Charge Code	5700503
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 PILONIDAL CYST SIMPLE

Facility

$450.00

Service Code	HCPCS 10080
Hospital Charge Code	5700503
Hospital Revenue Code	450
Min. Negotiated Rate	$56.92
Max. Negotiated Rate	$1,686.34
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	$56.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

ER I&D POST-OP WOUND INFECTION

Facility

$10,614.65

Service Code	HCPCS 10180
Hospital Charge Code	5700700
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 POST-OP WOUND INFECTION

Facility

$10,614.65

Service Code	HCPCS 10180
Hospital Charge Code	5700700
Hospital Revenue Code	450
Min. Negotiated Rate	$158.25
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Better Health Medicaid	$622.61
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	$158.25
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
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$635.06

ER I&D PUNC ABSC HEMA BUL CYST

Facility

$450.00

Service Code	HCPCS 10160
Hospital Charge Code	5700507
Hospital Revenue Code	450
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
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	$83.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

ER I&D PUNC ABSC HEMA BUL CYST

Facility

$450.00

Service Code	HCPCS 10160
Hospital Charge Code	5700507
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 SHOULDER ABSCES

Facility

$10,614.65

Service Code	HCPCS 23030
Hospital Charge Code	5700729
Hospital Revenue Code	450
Min. Negotiated Rate	$285.59
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	$285.59
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

Know your out-of-pocket cost for care.

All Charges