Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER-REDUCE TESTIS TORSION

Facility

$6,905.00

Service Code	HCPCS 54600
Hospital Charge Code	5790185
Hospital Revenue Code	450
Min. Negotiated Rate	$194.81
Max. Negotiated Rate	$8,394.37
Rate for Payer: Aetna Commercial	$2,071.50
Rate for Payer: Aetna Medicare Advantage	$2,071.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,760.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,760.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,760.78
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$897.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.75

ER-REDUCE TESTIS TORSION

Facility

$6,905.00

Service Code	HCPCS 54600
Hospital Charge Code	5790185
Hospital Revenue Code	450
Min. Negotiated Rate	$1,035.75
Max. Negotiated Rate	$1,035.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.75

ER REDUCT TOE MP DISC W/O ANES

Facility

$1,175.15

Service Code	HCPCS 28630
Hospital Charge Code	5700772
Hospital Revenue Code	450
Min. Negotiated Rate	$70.15
Max. Negotiated Rate	$587.42
Rate for Payer: Aetna Commercial	$352.55
Rate for Payer: Aetna Medicare Advantage	$352.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.66
Rate for Payer: Cigna Commercial	$587.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.77
Rate for Payer: Qualcare PPO/HMO/WC	$176.27

ER REDUCT TOE MP DISC W/O ANES

Facility

$1,175.15

Service Code	HCPCS 28630
Hospital Charge Code	5700772
Hospital Revenue Code	450
Min. Negotiated Rate	$176.27
Max. Negotiated Rate	$176.27
Rate for Payer: Qualcare PPO/HMO/WC	$176.27

ER REGIONAL BLOCK

Facility

$1,398.00

Service Code	HCPCS 64400
Hospital Charge Code	5700804
Hospital Revenue Code	450
Min. Negotiated Rate	$43.47
Max. Negotiated Rate	$730.97
Rate for Payer: Aetna Commercial	$419.40
Rate for Payer: Aetna Medicare Advantage	$419.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$356.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$356.49
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	$356.49
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.74
Rate for Payer: Qualcare PPO/HMO/WC	$209.70

ER REGIONAL BLOCK

Facility

$1,398.00

Service Code	HCPCS 64400
Hospital Charge Code	5700804
Hospital Revenue Code	450
Min. Negotiated Rate	$209.70
Max. Negotiated Rate	$209.70
Rate for Payer: Qualcare PPO/HMO/WC	$209.70

ER REM FB CONJUNCTIVA SUPERFAL

Facility

$528.85

Service Code	HCPCS 65205
Hospital Charge Code	5700418
Hospital Revenue Code	450
Min. Negotiated Rate	$79.33
Max. Negotiated Rate	$79.33
Rate for Payer: Qualcare PPO/HMO/WC	$79.33

ER REM FB CONJUNCTIVA SUPERFAL

Facility

$528.85

Service Code	HCPCS 65205
Hospital Charge Code	5700418
Hospital Revenue Code	450
Min. Negotiated Rate	$25.76
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$158.66
Rate for Payer: Aetna Medicare Advantage	$158.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$134.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$134.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$134.86
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.75
Rate for Payer: Qualcare PPO/HMO/WC	$79.33

ER REM FB OUTER EAR CAN W/O AN

Facility

$250.00

Service Code	HCPCS 69200
Hospital Charge Code	5700500
Hospital Revenue Code	450
Min. Negotiated Rate	$20.93
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
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	$63.75
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

ER REM FB OUTER EAR CAN W/O AN

Facility

$250.00

Service Code	HCPCS 69200
Hospital Charge Code	5700500
Hospital Revenue Code	450
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

ER REM FOREIGN BODY, SUBQ FOOT

Facility

$1,603.75

Service Code	HCPCS 28190
Hospital Charge Code	5700470
Hospital Revenue Code	450
Min. Negotiated Rate	$43.47
Max. Negotiated Rate	$1,686.34
Rate for Payer: Aetna Commercial	$481.12
Rate for Payer: Aetna Medicare Advantage	$481.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.96
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	$408.96
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.49
Rate for Payer: Qualcare PPO/HMO/WC	$240.56

ER REM FOREIGN BODY, SUBQ FOOT

Facility

$1,603.75

Service Code	HCPCS 28190
Hospital Charge Code	5700470
Hospital Revenue Code	450
Min. Negotiated Rate	$240.56
Max. Negotiated Rate	$240.56
Rate for Payer: Qualcare PPO/HMO/WC	$240.56

ER-REM NAIL/FINGER TIP-BI

Facility

$7,260.00

Service Code	HCPCS 11752
Hospital Charge Code	5790275
Hospital Revenue Code	450
Min. Negotiated Rate	$1,089.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,089.00

ER-REM NAIL/FINGER TIP-BI

Facility

$7,260.00

Service Code	HCPCS 11752
Hospital Charge Code	5790275
Hospital Revenue Code	450
Min. Negotiated Rate	$943.80
Max. Negotiated Rate	$3,630.00
Rate for Payer: Aetna Commercial	$2,178.00
Rate for Payer: Aetna Medicare Advantage	$2,178.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,851.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,851.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,851.30
Rate for Payer: Cigna Commercial	$3,630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$943.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,089.00

ER REM OF EMBEDDED FB EYELID

Facility

$673.75

Service Code	HCPCS 67938
Hospital Charge Code	5700673
Hospital Revenue Code	450
Min. Negotiated Rate	$101.06
Max. Negotiated Rate	$101.06
Rate for Payer: Qualcare PPO/HMO/WC	$101.06

ER REM OF EMBEDDED FB EYELID

Facility

$673.75

Service Code	HCPCS 67938
Hospital Charge Code	5700673
Hospital Revenue Code	450
Min. Negotiated Rate	$37.95
Max. Negotiated Rate	$755.86
Rate for Payer: Aetna Commercial	$202.12
Rate for Payer: Aetna Medicare Advantage	$202.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.81
Rate for Payer: Cigna Commercial	$755.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.59
Rate for Payer: Qualcare PPO/HMO/WC	$101.06

ER REMOVAL CAST FULL ARM/LEG L

Facility

$348.75

Service Code	HCPCS 29705LT
Hospital Charge Code	5700619
Hospital Revenue Code	450
Min. Negotiated Rate	$45.34
Max. Negotiated Rate	$174.38
Rate for Payer: Aetna Commercial	$104.62
Rate for Payer: Aetna Medicare Advantage	$104.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.93
Rate for Payer: Cigna Commercial	$174.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.34
Rate for Payer: Qualcare PPO/HMO/WC	$52.31

ER REMOVAL CAST FULL ARM/LEG L

Facility

$348.75

Service Code	HCPCS 29705LT
Hospital Charge Code	5700619
Hospital Revenue Code	450
Min. Negotiated Rate	$52.31
Max. Negotiated Rate	$52.31
Rate for Payer: Qualcare PPO/HMO/WC	$52.31

ER REMOVAL CAST FULL ARM/LEG R

Facility

$348.75

Service Code	HCPCS 29705RT
Hospital Charge Code	5700618
Hospital Revenue Code	450
Min. Negotiated Rate	$52.31
Max. Negotiated Rate	$52.31
Rate for Payer: Qualcare PPO/HMO/WC	$52.31

ER REMOVAL CAST FULL ARM/LEG R

Facility

$348.75

Service Code	HCPCS 29705RT
Hospital Charge Code	5700618
Hospital Revenue Code	450
Min. Negotiated Rate	$45.34
Max. Negotiated Rate	$174.38
Rate for Payer: Aetna Commercial	$104.62
Rate for Payer: Aetna Medicare Advantage	$104.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.93
Rate for Payer: Cigna Commercial	$174.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.34
Rate for Payer: Qualcare PPO/HMO/WC	$52.31

ER REMOVAL FB NASAL

Facility

$452.22

Service Code	HCPCS 30300
Hospital Charge Code	5700439
Hospital Revenue Code	450
Min. Negotiated Rate	$67.83
Max. Negotiated Rate	$67.83
Rate for Payer: Qualcare PPO/HMO/WC	$67.83

ER REMOVAL FB NASAL

Facility

$452.22

Service Code	HCPCS 30300
Hospital Charge Code	5700439
Hospital Revenue Code	450
Min. Negotiated Rate	$25.76
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$135.67
Rate for Payer: Aetna Medicare Advantage	$135.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.32
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.79
Rate for Payer: Qualcare PPO/HMO/WC	$67.83

ER REMOVAL FB PHARYNX

Facility

$201.25

Service Code	HCPCS 42809
Hospital Charge Code	5700649
Hospital Revenue Code	450
Min. Negotiated Rate	$26.16
Max. Negotiated Rate	$1,063.82
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	$83.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.32
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.16
Rate for Payer: Qualcare PPO/HMO/WC	$30.19

ER REMOVAL FB PHARYNX

Facility

$201.25

Service Code	HCPCS 42809
Hospital Charge Code	5700649
Hospital Revenue Code	450
Min. Negotiated Rate	$30.19
Max. Negotiated Rate	$30.19
Rate for Payer: Qualcare PPO/HMO/WC	$30.19

ER REMOVAL INTRAURINE DEVICE

Facility

$1,621.70

Service Code	HCPCS 58301
Hospital Charge Code	5701004
Hospital Revenue Code	450
Min. Negotiated Rate	$243.25
Max. Negotiated Rate	$243.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.25

Know your out-of-pocket cost for care.

All Charges