Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER ORBIT FX(NON-BLOWOUT)W/O MA

Facility

$4,167.70

Service Code	HCPCS 21400
Hospital Charge Code	5700726
Hospital Revenue Code	450
Min. Negotiated Rate	$81.60
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	$81.60
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 ORBIT FX(NON-BLOWOUT)W/O MA

Facility

$4,167.70

Service Code	HCPCS 21400
Hospital Charge Code	5700726
Hospital Revenue Code	450
Min. Negotiated Rate	$625.15
Max. Negotiated Rate	$625.15
Rate for Payer: Qualcare PPO/HMO/WC	$625.15

ER-OTHER VASCULAR

Facility

$3,948.00

Service Code	HCPCS 37799
Hospital Charge Code	5790120
Hospital Revenue Code	450
Min. Negotiated Rate	$592.20
Max. Negotiated Rate	$592.20
Rate for Payer: Qualcare PPO/HMO/WC	$592.20

ER-OTHER VASCULAR

Facility

$3,948.00

Service Code	HCPCS 37799
Hospital Charge Code	5790120
Hospital Revenue Code	450
Min. Negotiated Rate	$513.24
Max. Negotiated Rate	$1,493.86
Rate for Payer: Aetna Commercial	$1,184.40
Rate for Payer: Aetna Medicare Advantage	$1,184.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,006.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,006.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,006.74
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$513.24
Rate for Payer: Qualcare PPO/HMO/WC	$592.20

ER PACER TEMP INSERTION SINGLE

Facility

$13,567.40

Service Code	HCPCS 33210
Hospital Charge Code	5700414
Hospital Revenue Code	450
Min. Negotiated Rate	$196.65
Max. Negotiated Rate	$19,706.96
Rate for Payer: Aetna Commercial	$4,070.22
Rate for Payer: Aetna Medicare Advantage	$4,070.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,459.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,459.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,459.69
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,763.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.11

ER PACER TEMP INSERTION SINGLE

Facility

$13,567.40

Service Code	HCPCS 33210
Hospital Charge Code	5700414
Hospital Revenue Code	450
Min. Negotiated Rate	$2,035.11
Max. Negotiated Rate	$2,035.11
Rate for Payer: Qualcare PPO/HMO/WC	$2,035.11

ER PARACENTESIS W/O IMAGING

Facility

$2,422.65

Service Code	HCPCS 49082
Hospital Charge Code	5700652
Hospital Revenue Code	450
Min. Negotiated Rate	$82.80
Max. Negotiated Rate	$2,159.89
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) NJ Health	$82.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$617.78
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$314.94
Rate for Payer: Qualcare PPO/HMO/WC	$363.40

ER PARACENTESIS W/O IMAGING

Facility

$2,422.65

Service Code	HCPCS 49082
Hospital Charge Code	5700652
Hospital Revenue Code	450
Min. Negotiated Rate	$363.40
Max. Negotiated Rate	$363.40
Rate for Payer: Qualcare PPO/HMO/WC	$363.40

ER PARING SKIN LESION

Facility

$1,170.00

Service Code	HCPCS 11055
Hospital Charge Code	5700475
Hospital Revenue Code	450
Min. Negotiated Rate	$175.50
Max. Negotiated Rate	$175.50
Rate for Payer: Qualcare PPO/HMO/WC	$175.50

ER PARING SKIN LESION

Facility

$1,170.00

Service Code	HCPCS 11055
Hospital Charge Code	5700475
Hospital Revenue Code	450
Min. Negotiated Rate	$32.61
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$351.00
Rate for Payer: Aetna Medicare Advantage	$351.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$298.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$298.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$298.35
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.10
Rate for Payer: Qualcare PPO/HMO/WC	$175.50

ER-PATELA ANKL DISLOC-BIL

Facility

$612.00

Hospital Charge Code	5790575
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-PATELA ANKL DISLOC-BIL

Facility

$612.00

Hospital Charge Code	5790575
Hospital Revenue Code	450
Min. Negotiated Rate	$79.56
Max. Negotiated Rate	$306.00
Rate for Payer: Aetna Commercial	$183.60
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.56
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-PEAK FLOW

Facility

$190.00

Service Code	HCPCS 94200
Hospital Charge Code	5790245
Hospital Revenue Code	460
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.70
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.50
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

ER-PEAK FLOW

Facility

$190.00

Service Code	HCPCS 94200
Hospital Charge Code	5790245
Hospital Revenue Code	460
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

ER PERICARDIOCENTESIS INITIAL

Facility

$3,036.85

Service Code	HCPCS 33010
Hospital Charge Code	5700629
Hospital Revenue Code	450
Min. Negotiated Rate	$394.79
Max. Negotiated Rate	$1,518.42
Rate for Payer: Aetna Commercial	$911.05
Rate for Payer: Aetna Medicare Advantage	$911.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$774.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$774.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$774.40
Rate for Payer: Cigna Commercial	$1,518.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$394.79
Rate for Payer: Qualcare PPO/HMO/WC	$455.53

ER PERICARDIOCENTESIS INITIAL

Facility

$3,036.85

Service Code	HCPCS 33010
Hospital Charge Code	5700629
Hospital Revenue Code	450
Min. Negotiated Rate	$455.53
Max. Negotiated Rate	$455.53
Rate for Payer: Qualcare PPO/HMO/WC	$455.53

ER-PHALANX/PHALANGE FX-BI

Facility

$453.00

Hospital Charge Code	5790660
Hospital Revenue Code	450
Min. Negotiated Rate	$67.95
Max. Negotiated Rate	$67.95
Rate for Payer: Qualcare PPO/HMO/WC	$67.95

ER-PHALANX/PHALANGE FX-BI

Facility

$453.00

Hospital Charge Code	5790660
Hospital Revenue Code	450
Min. Negotiated Rate	$58.89
Max. Negotiated Rate	$226.50
Rate for Payer: Aetna Commercial	$135.90
Rate for Payer: Aetna Medicare Advantage	$135.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.52
Rate for Payer: Cigna Commercial	$226.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.89
Rate for Payer: Qualcare PPO/HMO/WC	$67.95

ER-PHALX DIS FIN FRAC-BIL

Facility

$612.00

Hospital Charge Code	5790525
Hospital Revenue Code	450
Min. Negotiated Rate	$79.56
Max. Negotiated Rate	$306.00
Rate for Payer: Aetna Commercial	$183.60
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.56
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-PHALX DIS FIN FRAC-BIL

Facility

$612.00

Hospital Charge Code	5790525
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-PHALX MID FIN FRAC-BIL

Facility

$612.00

Hospital Charge Code	5790515
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-PHALX MID FIN FRAC-BIL

Facility

$612.00

Hospital Charge Code	5790515
Hospital Revenue Code	450
Min. Negotiated Rate	$79.56
Max. Negotiated Rate	$306.00
Rate for Payer: Aetna Commercial	$183.60
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.56
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-PHALX TOE EA FRACT-BIL

Facility

$612.00

Hospital Charge Code	5790655
Hospital Revenue Code	450
Min. Negotiated Rate	$79.56
Max. Negotiated Rate	$306.00
Rate for Payer: Aetna Commercial	$183.60
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.56
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-PHALX TOE EA FRACT-BIL

Facility

$612.00

Hospital Charge Code	5790655
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER PRIMARY TENDON REPAIR

Facility

$3,290.85

Service Code	HCPCS 26433
Hospital Charge Code	5700234
Hospital Revenue Code	450
Min. Negotiated Rate	$493.63
Max. Negotiated Rate	$493.63
Rate for Payer: Qualcare PPO/HMO/WC	$493.63

Know your out-of-pocket cost for care.

All Charges