Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER-IP FINGER DISLOCAT-BIL

Facility

$612.00

Hospital Charge Code	5790540
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-IRRIGATION,BLADDER COMPLIC

Facility

$511.00

Service Code	HCPCS 51703
Hospital Charge Code	5770030
Hospital Revenue Code	450
Min. Negotiated Rate	$76.65
Max. Negotiated Rate	$76.65
Rate for Payer: Qualcare PPO/HMO/WC	$76.65

ER-IRRIGATION,BLADDER COMPLIC

Facility

$511.00

Service Code	HCPCS 51703
Hospital Charge Code	5770030
Hospital Revenue Code	450
Min. Negotiated Rate	$66.43
Max. Negotiated Rate	$459.87
Rate for Payer: Aetna Better Health Medicaid	$450.85
Rate for Payer: Aetna Commercial	$153.30
Rate for Payer: Aetna Medicare Advantage	$153.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.31
Rate for Payer: Cigna Commercial	$306.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.43
Rate for Payer: Qualcare PPO/HMO/WC	$76.65
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$459.87

ER IV NEEDLE PLACE INTRACATH

Facility

$621.65

Service Code	HCPCS 36000
Hospital Charge Code	5700630
Hospital Revenue Code	450
Min. Negotiated Rate	$93.25
Max. Negotiated Rate	$93.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.25

ER IV NEEDLE PLACE INTRACATH

Facility

$621.65

Service Code	HCPCS 36000
Hospital Charge Code	5700630
Hospital Revenue Code	450
Min. Negotiated Rate	$33.35
Max. Negotiated Rate	$310.82
Rate for Payer: Aetna Commercial	$186.50
Rate for Payer: Aetna Medicare Advantage	$186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.52
Rate for Payer: Cigna Commercial	$310.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.81
Rate for Payer: Qualcare PPO/HMO/WC	$93.25

ER IVPB PUMP SETUP PROCEDURE**

Facility

$59.00

Hospital Charge Code	8004103
Hospital Revenue Code	272
Min. Negotiated Rate	$8.85
Max. Negotiated Rate	$8.85
Rate for Payer: Qualcare PPO/HMO/WC	$8.85

ER IVPB PUMP SETUP PROCEDURE**

Facility

$59.00

Hospital Charge Code	8004103
Hospital Revenue Code	272
Min. Negotiated Rate	$7.67
Max. Negotiated Rate	$29.50
Rate for Payer: Aetna Commercial	$17.70
Rate for Payer: Aetna Medicare Advantage	$17.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.04
Rate for Payer: Cigna Commercial	$29.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.67
Rate for Payer: Oxford Commercial	$29.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.85
Rate for Payer: UnitedHealthcare Commercial	$29.50

ER IVPB SETUP PROCEDURE

Facility

$52.00

Hospital Charge Code	8004095
Hospital Revenue Code	272
Min. Negotiated Rate	$6.76
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$15.60
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.76
Rate for Payer: Oxford Commercial	$26.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$26.00

ER IVPB SETUP PROCEDURE

Facility

$52.00

Hospital Charge Code	8004095
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

ER IV REG SETUP PROCEDURE***

Facility

$57.00

Hospital Charge Code	8004087
Hospital Revenue Code	272
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$8.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.55

ER IV REG SETUP PROCEDURE***

Facility

$57.00

Hospital Charge Code	8004087
Hospital Revenue Code	272
Min. Negotiated Rate	$7.41
Max. Negotiated Rate	$28.50
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$17.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.54
Rate for Payer: Cigna Commercial	$28.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.41
Rate for Payer: Oxford Commercial	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.55
Rate for Payer: UnitedHealthcare Commercial	$28.50

ER JAW RESET DISLOCATION

Facility

$744.46

Service Code	HCPCS 21480
Hospital Charge Code	5700452
Hospital Revenue Code	450
Min. Negotiated Rate	$111.67
Max. Negotiated Rate	$111.67
Rate for Payer: Qualcare PPO/HMO/WC	$111.67

ER JAW RESET DISLOCATION

Facility

$744.46

Service Code	HCPCS 21480
Hospital Charge Code	5700452
Hospital Revenue Code	450
Min. Negotiated Rate	$43.47
Max. Negotiated Rate	$587.42
Rate for Payer: Aetna Commercial	$223.34
Rate for Payer: Aetna Medicare Advantage	$223.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.84
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	$189.84
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.78
Rate for Payer: Qualcare PPO/HMO/WC	$111.67

ER-KNEECAP DISL W/ANES-BI

Facility

$3,955.00

Hospital Charge Code	5790580
Hospital Revenue Code	450
Min. Negotiated Rate	$593.25
Max. Negotiated Rate	$593.25
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

ER-KNEECAP DISL W/ANES-BI

Facility

$3,955.00

Hospital Charge Code	5790580
Hospital Revenue Code	450
Min. Negotiated Rate	$514.15
Max. Negotiated Rate	$1,977.50
Rate for Payer: Aetna Commercial	$1,186.50
Rate for Payer: Aetna Medicare Advantage	$1,186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.52
Rate for Payer: Cigna Commercial	$1,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.15
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

ER-KNEECAP DISL W/ANES-RT

Facility

$3,955.00

Hospital Charge Code	5791595
Hospital Revenue Code	450
Min. Negotiated Rate	$514.15
Max. Negotiated Rate	$1,977.50
Rate for Payer: Aetna Commercial	$1,186.50
Rate for Payer: Aetna Medicare Advantage	$1,186.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,008.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,008.52
Rate for Payer: Cigna Commercial	$1,977.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.15
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

ER-KNEECAP DISL W/ANES-RT

Facility

$3,955.00

Hospital Charge Code	5791595
Hospital Revenue Code	450
Min. Negotiated Rate	$593.25
Max. Negotiated Rate	$593.25
Rate for Payer: Qualcare PPO/HMO/WC	$593.25

ER-LACER RPR MOUTH<=2.5CM

Facility

$546.00

Service Code	HCPCS 40830
Hospital Charge Code	5790125
Hospital Revenue Code	450
Min. Negotiated Rate	$28.98
Max. Negotiated Rate	$564.04
Rate for Payer: Aetna Commercial	$163.80
Rate for Payer: Aetna Medicare Advantage	$163.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.23
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	$139.23
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.98
Rate for Payer: Qualcare PPO/HMO/WC	$81.90

ER-LACER RPR MOUTH<=2.5CM

Facility

$546.00

Service Code	HCPCS 40830
Hospital Charge Code	5790125
Hospital Revenue Code	450
Min. Negotiated Rate	$81.90
Max. Negotiated Rate	$81.90
Rate for Payer: Qualcare PPO/HMO/WC	$81.90

ER LARYNGO DIRECT FOR ASPIRATI

Facility

$5,418.75

Service Code	HCPCS 31515
Hospital Charge Code	5700622
Hospital Revenue Code	450
Min. Negotiated Rate	$812.81
Max. Negotiated Rate	$812.81
Rate for Payer: Qualcare PPO/HMO/WC	$812.81

ER LARYNGO DIRECT FOR ASPIRATI

Facility

$5,418.75

Service Code	HCPCS 31515
Hospital Charge Code	5700622
Hospital Revenue Code	450
Min. Negotiated Rate	$105.22
Max. Negotiated Rate	$1,625.62
Rate for Payer: Aetna Better Health Medicaid	$1,283.80
Rate for Payer: Aetna Commercial	$1,625.62
Rate for Payer: Aetna Medicare Advantage	$1,625.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,381.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,381.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,381.78
Rate for Payer: Cigna Commercial	$931.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$704.44
Rate for Payer: Qualcare PPO/HMO/WC	$812.81
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,309.48

ER LARYNGO INDIRECT REMOVAL FB

Facility

$513.75

Service Code	HCPCS 31511
Hospital Charge Code	5700621
Hospital Revenue Code	450
Min. Negotiated Rate	$77.06
Max. Negotiated Rate	$77.06
Rate for Payer: Qualcare PPO/HMO/WC	$77.06

ER LARYNGO INDIRECT REMOVAL FB

Facility

$513.75

Service Code	HCPCS 31511
Hospital Charge Code	5700621
Hospital Revenue Code	450
Min. Negotiated Rate	$62.62
Max. Negotiated Rate	$475.34
Rate for Payer: Aetna Commercial	$154.12
Rate for Payer: Aetna Medicare Advantage	$154.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.01
Rate for Payer: Cigna Commercial	$475.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.79
Rate for Payer: Qualcare PPO/HMO/WC	$77.06

ER LARYNGOSCOPY DIAGNOSTC FLEX

Facility

$769.35

Service Code	HCPCS 31575
Hospital Charge Code	5700825
Hospital Revenue Code	450
Min. Negotiated Rate	$60.60
Max. Negotiated Rate	$528.97
Rate for Payer: Aetna Better Health Medicaid	$518.60
Rate for Payer: Aetna Commercial	$230.81
Rate for Payer: Aetna Medicare Advantage	$230.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.18
Rate for Payer: Cigna Commercial	$475.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.02
Rate for Payer: Qualcare PPO/HMO/WC	$115.40
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$528.97

ER LARYNGOSCOPY DIAGNOSTC FLEX

Facility

$769.35

Service Code	HCPCS 31575
Hospital Charge Code	5700825
Hospital Revenue Code	450
Min. Negotiated Rate	$115.40
Max. Negotiated Rate	$115.40
Rate for Payer: Qualcare PPO/HMO/WC	$115.40

Know your out-of-pocket cost for care.

All Charges