Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER REMOVAL INTRAURINE DEVICE

Facility

$1,621.70

Service Code	HCPCS 58301
Hospital Charge Code	5701004
Hospital Revenue Code	450
Min. Negotiated Rate	$210.82
Max. Negotiated Rate	$725.69
Rate for Payer: Aetna Commercial	$486.51
Rate for Payer: Aetna Medicare Advantage	$486.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$413.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$413.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$413.53
Rate for Payer: Cigna Commercial	$725.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.82
Rate for Payer: Qualcare PPO/HMO/WC	$243.25

ER REMOVAL NAIL PLATE

Facility

$415.00

Service Code	HCPCS 11730
Hospital Charge Code	5700465
Hospital Revenue Code	450
Min. Negotiated Rate	$62.25
Max. Negotiated Rate	$62.25
Rate for Payer: Qualcare PPO/HMO/WC	$62.25

ER REMOVAL NAIL PLATE

Facility

$415.00

Service Code	HCPCS 11730
Hospital Charge Code	5700465
Hospital Revenue Code	450
Min. Negotiated Rate	$53.95
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$124.50
Rate for Payer: Aetna Medicare Advantage	$124.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.83
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.95
Rate for Payer: Qualcare PPO/HMO/WC	$62.25

ER REMOV COREAL FB W/ SLIT LMP

Facility

$522.50

Service Code	HCPCS 65222
Hospital Charge Code	5700806
Hospital Revenue Code	450
Min. Negotiated Rate	$78.38
Max. Negotiated Rate	$78.38
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

ER REMOV COREAL FB W/ SLIT LMP

Facility

$522.50

Service Code	HCPCS 65222
Hospital Charge Code	5700806
Hospital Revenue Code	450
Min. Negotiated Rate	$55.20
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$156.75
Rate for Payer: Aetna Medicare Advantage	$156.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.24
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.92
Rate for Payer: Qualcare PPO/HMO/WC	$78.38

ER-REMOVE EYELID F/B-RT

Facility

$553.00

Hospital Charge Code	5792145
Hospital Revenue Code	450
Min. Negotiated Rate	$71.89
Max. Negotiated Rate	$276.50
Rate for Payer: Aetna Commercial	$165.90
Rate for Payer: Aetna Medicare Advantage	$165.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.01
Rate for Payer: Cigna Commercial	$276.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.89
Rate for Payer: Qualcare PPO/HMO/WC	$82.95

ER-REMOVE EYELID F/B-RT

Facility

$553.00

Hospital Charge Code	5792145
Hospital Revenue Code	450
Min. Negotiated Rate	$82.95
Max. Negotiated Rate	$82.95
Rate for Payer: Qualcare PPO/HMO/WC	$82.95

ER-REMOV F/B FOOT SUBQ-BI

Facility

$2,316.00

Hospital Charge Code	5790630
Hospital Revenue Code	450
Min. Negotiated Rate	$301.08
Max. Negotiated Rate	$1,158.00
Rate for Payer: Aetna Commercial	$694.80
Rate for Payer: Aetna Medicare Advantage	$694.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$590.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$590.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$590.58
Rate for Payer: Cigna Commercial	$1,158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.08
Rate for Payer: Qualcare PPO/HMO/WC	$347.40

ER-REMOV F/B FOOT SUBQ-BI

Facility

$2,316.00

Hospital Charge Code	5790630
Hospital Revenue Code	450
Min. Negotiated Rate	$347.40
Max. Negotiated Rate	$347.40
Rate for Payer: Qualcare PPO/HMO/WC	$347.40

ER-REM STENT URETER-BI

Facility

$324.00

Hospital Charge Code	5790840
Hospital Revenue Code	450
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

ER-REM STENT URETER-BI

Facility

$324.00

Hospital Charge Code	5790840
Hospital Revenue Code	450
Min. Negotiated Rate	$42.12
Max. Negotiated Rate	$162.00
Rate for Payer: Aetna Commercial	$97.20
Rate for Payer: Aetna Medicare Advantage	$97.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.62
Rate for Payer: Cigna Commercial	$162.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.12
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

ER REM TUNN CV CATH W/O PO/PUM

Facility

$3,630.70

Service Code	HCPCS 36589
Hospital Charge Code	5701002
Hospital Revenue Code	450
Min. Negotiated Rate	$107.78
Max. Negotiated Rate	$1,493.86
Rate for Payer: Aetna Commercial	$1,089.21
Rate for Payer: Aetna Medicare Advantage	$1,089.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$925.83
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.99
Rate for Payer: Qualcare PPO/HMO/WC	$544.61

ER REM TUNN CV CATH W/O PO/PUM

Facility

$3,630.70

Service Code	HCPCS 36589
Hospital Charge Code	5701002
Hospital Revenue Code	450
Min. Negotiated Rate	$544.61
Max. Negotiated Rate	$544.61
Rate for Payer: Qualcare PPO/HMO/WC	$544.61

ER-REPAIR BLD VESS UP EXT

Facility

$10,555.00

Service Code	HCPCS 35206
Hospital Charge Code	5790090
Hospital Revenue Code	450
Min. Negotiated Rate	$1,583.25
Max. Negotiated Rate	$1,583.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,583.25

ER-REPAIR BLD VESS UP EXT

Facility

$10,555.00

Service Code	HCPCS 35206
Hospital Charge Code	5790090
Hospital Revenue Code	450
Min. Negotiated Rate	$471.50
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,166.50
Rate for Payer: Aetna Medicare Advantage	$3,166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,691.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,691.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$471.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,691.53
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,372.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,583.25

ER REPAIR FOOT TENDON

Facility

$17,434.95

Service Code	HCPCS 28200
Hospital Charge Code	5700824
Hospital Revenue Code	450
Min. Negotiated Rate	$198.39
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$5,230.48
Rate for Payer: Aetna Medicare Advantage	$5,230.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,445.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,445.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,445.91
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,266.54
Rate for Payer: Qualcare PPO/HMO/WC	$2,615.24

ER REPAIR FOOT TENDON

Facility

$17,434.95

Service Code	HCPCS 28200
Hospital Charge Code	5700824
Hospital Revenue Code	450
Min. Negotiated Rate	$2,615.24
Max. Negotiated Rate	$2,615.24
Rate for Payer: Qualcare PPO/HMO/WC	$2,615.24

ER REPAIR MOUTH/TONG UP TO 2.5

Facility

$346.00

Service Code	HCPCS 41250
Hospital Charge Code	5700276
Hospital Revenue Code	450
Min. Negotiated Rate	$51.90
Max. Negotiated Rate	$51.90
Rate for Payer: Qualcare PPO/HMO/WC	$51.90

ER REPAIR MOUTH/TONG UP TO 2.5

Facility

$346.00

Service Code	HCPCS 41250
Hospital Charge Code	5700276
Hospital Revenue Code	450
Min. Negotiated Rate	$44.98
Max. Negotiated Rate	$1,063.82
Rate for Payer: Aetna Commercial	$103.80
Rate for Payer: Aetna Medicare Advantage	$103.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.23
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.98
Rate for Payer: Qualcare PPO/HMO/WC	$51.90

ER REPAIR OF NAIL BED

Facility

$675.00

Service Code	HCPCS 11760
Hospital Charge Code	5700466
Hospital Revenue Code	450
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$101.25
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

ER REPAIR OF NAIL BED

Facility

$675.00

Service Code	HCPCS 11760
Hospital Charge Code	5700466
Hospital Revenue Code	450
Min. Negotiated Rate	$79.69
Max. Negotiated Rate	$1,760.02
Rate for Payer: Aetna Commercial	$202.50
Rate for Payer: Aetna Medicare Advantage	$202.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.12
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.75
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

ER REPAIR SUPERFCL WOUND-SUTUR

Facility

$1,248.49

Service Code	HCPCS 12001
Hospital Charge Code	5700280
Hospital Revenue Code	450
Min. Negotiated Rate	$187.27
Max. Negotiated Rate	$187.27
Rate for Payer: Qualcare PPO/HMO/WC	$187.27

ER REPAIR SUPERFCL WOUND-SUTUR

Facility

$1,248.49

Service Code	HCPCS 12001
Hospital Charge Code	5700280
Hospital Revenue Code	450
Min. Negotiated Rate	$43.70
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$374.55
Rate for Payer: Aetna Medicare Advantage	$374.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.36
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.30
Rate for Payer: Qualcare PPO/HMO/WC	$187.27

ER REPAIR SUPERFCL WOUND-SUTUR

Facility

$273.72

Service Code	HCPCS 12001
Hospital Charge Code	5700270
Hospital Revenue Code	450
Min. Negotiated Rate	$41.06
Max. Negotiated Rate	$41.06
Rate for Payer: Qualcare PPO/HMO/WC	$41.06

ER REPAIR SUPERFCL WOUND-SUTUR

Facility

$273.72

Service Code	HCPCS 12001
Hospital Charge Code	5700270
Hospital Revenue Code	450
Min. Negotiated Rate	$35.58
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$82.12
Rate for Payer: Aetna Medicare Advantage	$82.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.80
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.58
Rate for Payer: Qualcare PPO/HMO/WC	$41.06

Know your out-of-pocket cost for care.

All Charges