Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

ER I&D SOFT TISSUE ABSC SUPERF

Facility

$450.00

Hospital Charge Code	5700544
Hospital Revenue Code	450
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$225.00
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) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

ER I&D SOFT TISSUE ABSC SUPERF

Facility

$450.00

Hospital Charge Code	5700544
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 SUPERFIC INTRAORAL ABSC

Facility

$1,873.45

Service Code	HCPCS 41005
Hospital Charge Code	5700792
Hospital Revenue Code	450
Min. Negotiated Rate	$281.02
Max. Negotiated Rate	$281.02
Rate for Payer: Qualcare PPO/HMO/WC	$281.02

ER I&D SUPERFIC INTRAORAL ABSC

Facility

$1,873.45

Service Code	HCPCS 41005
Hospital Charge Code	5700792
Hospital Revenue Code	450
Min. Negotiated Rate	$58.44
Max. Negotiated Rate	$564.04
Rate for Payer: Aetna Commercial	$562.03
Rate for Payer: Aetna Medicare Advantage	$562.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$477.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$477.73
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	$477.73
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.55
Rate for Payer: Qualcare PPO/HMO/WC	$281.02

ER I&D THIGH OR KNEE

Facility

$10,614.65

Service Code	HCPCS 27301
Hospital Charge Code	5700758
Hospital Revenue Code	450
Min. Negotiated Rate	$433.72
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	$433.72
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 THIGH OR KNEE

Facility

$10,614.65

Service Code	HCPCS 27301
Hospital Charge Code	5700758
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 VESTIB OF MOUTH COMP

Facility

$4,167.70

Service Code	HCPCS 40801
Hospital Charge Code	5700789
Hospital Revenue Code	450
Min. Negotiated Rate	$64.01
Max. Negotiated Rate	$1,284.36
Rate for Payer: Aetna Commercial	$1,250.31
Rate for Payer: Aetna Medicare Advantage	$1,250.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,062.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,062.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,062.76
Rate for Payer: Cigna Commercial	$1,284.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$541.80
Rate for Payer: Qualcare PPO/HMO/WC	$625.15

ER I&D VESTIB OF MOUTH COMP

Facility

$4,167.70

Service Code	HCPCS 40801
Hospital Charge Code	5700789
Hospital Revenue Code	450
Min. Negotiated Rate	$625.15
Max. Negotiated Rate	$625.15
Rate for Payer: Qualcare PPO/HMO/WC	$625.15

ER I&D VESTIB OF MOUTH SIM

Facility

$796.20

Service Code	HCPCS 40800
Hospital Charge Code	5700788
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 VESTIB OF MOUTH SIM

Facility

$796.20

Service Code	HCPCS 40800
Hospital Charge Code	5700788
Hospital Revenue Code	450
Min. Negotiated Rate	$25.05
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	$25.05
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-IMMOBILIZATIN TOES-BIL

Facility

$351.00

Service Code	HCPCS 2955050
Hospital Charge Code	5790770
Hospital Revenue Code	450
Min. Negotiated Rate	$52.65
Max. Negotiated Rate	$52.65
Rate for Payer: Qualcare PPO/HMO/WC	$52.65

ER-IMMOBILIZATIN TOES-BIL

Facility

$351.00

Service Code	HCPCS 2955050
Hospital Charge Code	5790770
Hospital Revenue Code	450
Min. Negotiated Rate	$45.63
Max. Negotiated Rate	$175.50
Rate for Payer: Aetna Commercial	$105.30
Rate for Payer: Aetna Medicare Advantage	$105.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.50
Rate for Payer: Cigna Commercial	$175.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.63
Rate for Payer: Qualcare PPO/HMO/WC	$52.65

ER IMMUNIZATION ADMIN DT

Facility

$12.50

Service Code	HCPCS 90702
Hospital Charge Code	5700380
Hospital Revenue Code	636
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$3.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

ER IMMUNIZATION ADMIN DT

Facility

$12.50

Service Code	HCPCS 90702
Hospital Charge Code	5700380
Hospital Revenue Code	636
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$6.25
Rate for Payer: Aetna Commercial	$3.75
Rate for Payer: Aetna Medicare Advantage	$3.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.19
Rate for Payer: Cigna Commercial	$6.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

ER IMPACTED CERUMEN REMOVAL

Facility

$201.25

Service Code	HCPCS 69210
Hospital Charge Code	5700677
Hospital Revenue Code	450
Min. Negotiated Rate	$26.16
Max. Negotiated Rate	$197.37
Rate for Payer: Aetna Better Health Medicaid	$193.50
Rate for Payer: Aetna Commercial	$60.38
Rate for Payer: Aetna Medicare Advantage	$60.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.32
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.16
Rate for Payer: Qualcare PPO/HMO/WC	$30.19
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37

ER IMPACTED CERUMEN REMOVAL

Facility

$201.25

Service Code	HCPCS 69210
Hospital Charge Code	5700677
Hospital Revenue Code	450
Min. Negotiated Rate	$30.19
Max. Negotiated Rate	$30.19
Rate for Payer: Qualcare PPO/HMO/WC	$30.19

ER-INDERMIL PER SQ CM

Facility

$280.00

Hospital Charge Code	5792180
Hospital Revenue Code	250
Min. Negotiated Rate	$36.40
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$84.00
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.40
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Commercial	$140.00

ER-INDERMIL PER SQ CM

Facility

$280.00

Hospital Charge Code	5792180
Hospital Revenue Code	250
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

ER INJ,EPIDURAL OB BLD OR CLOT

Facility

$2,982.70

Service Code	HCPCS 62273
Hospital Charge Code	5700446
Hospital Revenue Code	450
Min. Negotiated Rate	$447.40
Max. Negotiated Rate	$447.40
Rate for Payer: Qualcare PPO/HMO/WC	$447.40

ER INJ,EPIDURAL OB BLD OR CLOT

Facility

$2,982.70

Service Code	HCPCS 62273
Hospital Charge Code	5700446
Hospital Revenue Code	450
Min. Negotiated Rate	$387.75
Max. Negotiated Rate	$1,680.99
Rate for Payer: Aetna Commercial	$894.81
Rate for Payer: Aetna Medicare Advantage	$894.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$760.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$760.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$760.59
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.75
Rate for Payer: Qualcare PPO/HMO/WC	$447.40

ER INJ TEND SHEATH LIGAMENT

Facility

$740.00

Service Code	HCPCS 20550
Hospital Charge Code	5700547
Hospital Revenue Code	450
Min. Negotiated Rate	$36.70
Max. Negotiated Rate	$730.97
Rate for Payer: Aetna Commercial	$222.00
Rate for Payer: Aetna Medicare Advantage	$222.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.70
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.20
Rate for Payer: Qualcare PPO/HMO/WC	$111.00

ER INJ TEND SHEATH LIGAMENT

Facility

$740.00

Service Code	HCPCS 20550
Hospital Charge Code	5700547
Hospital Revenue Code	450
Min. Negotiated Rate	$111.00
Max. Negotiated Rate	$111.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.00

ER INSERT CHEST TUBE

Facility

$2,422.65

Service Code	HCPCS 32551
Hospital Charge Code	5700628
Hospital Revenue Code	450
Min. Negotiated Rate	$363.40
Max. Negotiated Rate	$363.40
Rate for Payer: Qualcare PPO/HMO/WC	$363.40

ER INSERT CHEST TUBE

Facility

$2,422.65

Service Code	HCPCS 32551
Hospital Charge Code	5700628
Hospital Revenue Code	450
Min. Negotiated Rate	$314.94
Max. Negotiated Rate	$3,748.67
Rate for Payer: Aetna Better Health Medicaid	$2,426.75
Rate for Payer: Aetna Commercial	$726.79
Rate for Payer: Aetna Medicare Advantage	$726.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$617.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$617.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$617.78
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.94
Rate for Payer: Qualcare PPO/HMO/WC	$363.40
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$2,475.28

Know your out-of-pocket cost for care.

All Charges