Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER PRIMARY TENDON REPAIR

Facility

$3,290.85

Service Code	HCPCS 26433
Hospital Charge Code	5700234
Hospital Revenue Code	450
Min. Negotiated Rate	$144.03
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$987.25
Rate for Payer: Aetna Medicare Advantage	$987.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$839.17
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$427.81
Rate for Payer: Qualcare PPO/HMO/WC	$493.63

ER-PROCED SKIN/SUBCUT-OTH

Facility

$397.00

Service Code	HCPCS 17999
Hospital Charge Code	5790050
Hospital Revenue Code	450
Min. Negotiated Rate	$51.61
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$119.10
Rate for Payer: Aetna Medicare Advantage	$119.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.23
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.61
Rate for Payer: Qualcare PPO/HMO/WC	$59.55

ER-PROCED SKIN/SUBCUT-OTH

Facility

$397.00

Service Code	HCPCS 17999
Hospital Charge Code	5790050
Hospital Revenue Code	450
Min. Negotiated Rate	$59.55
Max. Negotiated Rate	$59.55
Rate for Payer: Qualcare PPO/HMO/WC	$59.55

ER PSYC DX EVAL W/MED SERVICES

Facility

$642.10

Service Code	HCPCS 90792
Hospital Charge Code	5792255
Hospital Revenue Code	900
Min. Negotiated Rate	$96.31
Max. Negotiated Rate	$96.31
Rate for Payer: Qualcare PPO/HMO/WC	$96.31

ER PSYC DX EVAL W/MED SERVICES

Facility

$642.10

Service Code	HCPCS 90792
Hospital Charge Code	5792255
Hospital Revenue Code	900
Min. Negotiated Rate	$83.47
Max. Negotiated Rate	$1,994.00
Rate for Payer: Aetna Commercial	$192.63
Rate for Payer: Aetna Medicare Advantage	$192.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$765.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.74
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.47
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.31
Rate for Payer: UnitedHealthcare Commercial	$1,994.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$437.76

ER PSYCHIATRIC DIAGNOSTIC EVAL

Facility

$623.75

Service Code	HCPCS 90791
Hospital Charge Code	5792250
Hospital Revenue Code	450
Min. Negotiated Rate	$93.56
Max. Negotiated Rate	$93.56
Rate for Payer: Qualcare PPO/HMO/WC	$93.56

ER PSYCHIATRIC DIAGNOSTIC EVAL

Facility

$623.75

Service Code	HCPCS 90791
Hospital Charge Code	5792250
Hospital Revenue Code	450
Min. Negotiated Rate	$81.09
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$187.12
Rate for Payer: Aetna Medicare Advantage	$187.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.06
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.09
Rate for Payer: Qualcare PPO/HMO/WC	$93.56

ER PULSE OXIMETRY-CONTINOUS

Facility

$313.00

Service Code	HCPCS 94761
Hospital Charge Code	5780305
Hospital Revenue Code	460
Min. Negotiated Rate	$5.01
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$93.90
Rate for Payer: Aetna Medicare Advantage	$93.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.81
Rate for Payer: Cigna Commercial	$5.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.69
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.95
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

ER PULSE OXIMETRY-CONTINOUS

Facility

$313.00

Service Code	HCPCS 94761
Hospital Charge Code	5780305
Hospital Revenue Code	460
Min. Negotiated Rate	$46.95
Max. Negotiated Rate	$46.95
Rate for Payer: Qualcare PPO/HMO/WC	$46.95

ER PULSE OXIMETRY CONT OVERNIG

Facility

$393.00

Service Code	HCPCS 94762
Hospital Charge Code	5780310
Hospital Revenue Code	460
Min. Negotiated Rate	$58.95
Max. Negotiated Rate	$58.95
Rate for Payer: Qualcare PPO/HMO/WC	$58.95

ER PULSE OXIMETRY CONT OVERNIG

Facility

$393.00

Service Code	HCPCS 94762
Hospital Charge Code	5780310
Hospital Revenue Code	460
Min. Negotiated Rate	$51.09
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$117.90
Rate for Payer: Aetna Medicare Advantage	$117.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.22
Rate for Payer: Cigna Commercial	$306.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.09
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.95
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

ER QUICKVUE INFLUENZA A

Facility

$125.00

Service Code	HCPCS 87804
Hospital Charge Code	5700680
Hospital Revenue Code	300
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

ER QUICKVUE INFLUENZA A

Facility

$125.00

Service Code	HCPCS 87804
Hospital Charge Code	5700680
Hospital Revenue Code	300
Min. Negotiated Rate	$8.28
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$53.62
Rate for Payer: Aetna Medicare Advantage	$16.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.64
Rate for Payer: Cigna Commercial	$16.55
Rate for Payer: Cigna Medicare Advantage	$8.28
Rate for Payer: Clover Medicare Advantage	$15.72
Rate for Payer: EmblemHealth Commercial	$49.65
Rate for Payer: Humana Medicare Advantage	$17.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.55
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.54
Rate for Payer: Wellcare Medicare Advantage	$16.55

ER QUICKVUE INFLUENZA B

Facility

$125.00

Service Code	HCPCS 87804
Hospital Charge Code	5700681
Hospital Revenue Code	300
Min. Negotiated Rate	$8.28
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$53.62
Rate for Payer: Aetna Medicare Advantage	$16.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.64
Rate for Payer: Cigna Commercial	$16.55
Rate for Payer: Cigna Medicare Advantage	$8.28
Rate for Payer: Clover Medicare Advantage	$15.72
Rate for Payer: EmblemHealth Commercial	$49.65
Rate for Payer: Humana Medicare Advantage	$17.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.55
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.54
Rate for Payer: Wellcare Medicare Advantage	$16.55

ER QUICKVUE INFLUENZA B

Facility

$125.00

Service Code	HCPCS 87804
Hospital Charge Code	5700681
Hospital Revenue Code	300
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

ER RABIES VACCINE, IM

Facility

$762.50

Service Code	HCPCS 90675
Hospital Charge Code	5700448
Hospital Revenue Code	636
Min. Negotiated Rate	$114.38
Max. Negotiated Rate	$228.75
Rate for Payer: Aetna Commercial	$228.75
Rate for Payer: Aetna Medicare Advantage	$228.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$194.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$194.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$194.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.53
Rate for Payer: Qualcare PPO/HMO/WC	$114.38

ER RABIES VACCINE, IM

Facility

$762.50

Service Code	HCPCS 90675
Hospital Charge Code	5700448
Hospital Revenue Code	636
Min. Negotiated Rate	$114.38
Max. Negotiated Rate	$184.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$184.53
Rate for Payer: Qualcare PPO/HMO/WC	$114.38

ER-RADIAL HEAD DISLOC-BIL

Facility

$612.00

Hospital Charge Code	5790410
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER-RADIAL HEAD DISLOC-BIL

Facility

$612.00

Hospital Charge Code	5790410
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-RECON NAIL BED W/GRAFT

Facility

$4,227.00

Service Code	HCPCS 11762
Hospital Charge Code	5790010
Hospital Revenue Code	450
Min. Negotiated Rate	$117.96
Max. Negotiated Rate	$4,913.48
Rate for Payer: Aetna Commercial	$1,268.10
Rate for Payer: Aetna Medicare Advantage	$1,268.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,077.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,077.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,077.88
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$549.51
Rate for Payer: Qualcare PPO/HMO/WC	$634.05

ER-RECON NAIL BED W/GRAFT

Facility

$4,227.00

Service Code	HCPCS 11762
Hospital Charge Code	5790010
Hospital Revenue Code	450
Min. Negotiated Rate	$634.05
Max. Negotiated Rate	$634.05
Rate for Payer: Qualcare PPO/HMO/WC	$634.05

ER-RECTUM PROCED OTHER

Facility

$2,462.25

Service Code	HCPCS 45999
Hospital Charge Code	5790150
Hospital Revenue Code	450
Min. Negotiated Rate	$369.34
Max. Negotiated Rate	$369.34
Rate for Payer: Qualcare PPO/HMO/WC	$369.34

ER-RECTUM PROCED OTHER

Facility

$2,462.25

Service Code	HCPCS 45999
Hospital Charge Code	5790150
Hospital Revenue Code	450
Min. Negotiated Rate	$320.09
Max. Negotiated Rate	$2,214.60
Rate for Payer: Aetna Commercial	$738.67
Rate for Payer: Aetna Medicare Advantage	$738.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$627.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$627.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$627.87
Rate for Payer: Cigna Commercial	$2,214.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.09
Rate for Payer: Qualcare PPO/HMO/WC	$369.34

ER RED RECTAL PROLAPSE

Facility

$2,904.15

Service Code	HCPCS 45900
Hospital Charge Code	5792281
Hospital Revenue Code	450
Min. Negotiated Rate	$435.62
Max. Negotiated Rate	$435.62
Rate for Payer: Qualcare PPO/HMO/WC	$435.62

ER RED RECTAL PROLAPSE

Facility

$2,904.15

Service Code	HCPCS 45900
Hospital Charge Code	5792281
Hospital Revenue Code	450
Min. Negotiated Rate	$20.93
Max. Negotiated Rate	$2,214.60
Rate for Payer: Aetna Commercial	$871.25
Rate for Payer: Aetna Medicare Advantage	$871.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$740.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$740.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$740.56
Rate for Payer: Cigna Commercial	$2,214.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$377.54
Rate for Payer: Qualcare PPO/HMO/WC	$435.62

Know your out-of-pocket cost for care.

All Charges