Heights University Hospital

All Charges

Charge

Type

Setting

Price

EXC BENIGN LES DIAM 3.1-4.0 CM

Facility

$7,392.00

Service Code	HCPCS 11424
Hospital Charge Code	75190070
Hospital Revenue Code	761
Min. Negotiated Rate	$149.35
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,217.60
Rate for Payer: Aetna Medicare Advantage	$2,217.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,884.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,884.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,884.96
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$960.96
Rate for Payer: Oxford Commercial	$3,696.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,108.80
Rate for Payer: UnitedHealthcare Commercial	$3,696.00

EXC BENIGN LES DIAM 3.1-4.0 CM

Facility

$7,392.00

Service Code	HCPCS 11424
Hospital Charge Code	75190070
Hospital Revenue Code	761
Min. Negotiated Rate	$1,108.80
Max. Negotiated Rate	$1,108.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,108.80

EXC BENIGN LES DIAM 3.1-4.0 CM

Facility

$7,070.14

Service Code	HCPCS 11404
Hospital Charge Code	75190050
Hospital Revenue Code	761
Min. Negotiated Rate	$1,060.52
Max. Negotiated Rate	$1,060.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.52

EXC BENIGN LES DIAM 3.1-4.0 CM

Facility

$7,070.14

Service Code	HCPCS 11404
Hospital Charge Code	75190050
Hospital Revenue Code	761
Min. Negotiated Rate	$77.28
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,121.04
Rate for Payer: Aetna Medicare Advantage	$2,121.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,802.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,802.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,802.89
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$919.12
Rate for Payer: Oxford Commercial	$3,535.07
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.52
Rate for Payer: UnitedHealthcare Commercial	$3,535.07

EXC BENIGN LES DIAM > 4.0 CM

Facility

$7,070.14

Service Code	HCPCS 11406
Hospital Charge Code	75190055
Hospital Revenue Code	761
Min. Negotiated Rate	$1,060.52
Max. Negotiated Rate	$1,060.52
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.52

EXC BENIGN LES DIAM > 4.0 CM

Facility

$7,070.14

Service Code	HCPCS 11406
Hospital Charge Code	75190055
Hospital Revenue Code	761
Min. Negotiated Rate	$77.28
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,121.04
Rate for Payer: Aetna Medicare Advantage	$2,121.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,802.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,802.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,802.89
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$919.12
Rate for Payer: Oxford Commercial	$3,535.07
Rate for Payer: Qualcare PPO/HMO/WC	$1,060.52
Rate for Payer: UnitedHealthcare Commercial	$3,535.07

EXC BENIGN LES DIAM > 4.0CM

Facility

$9,771.00

Service Code	HCPCS 11426
Hospital Charge Code	75190075
Hospital Revenue Code	761
Min. Negotiated Rate	$1,465.65
Max. Negotiated Rate	$1,465.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,465.65

EXC BENIGN LES DIAM > 4.0CM

Facility

$9,771.00

Service Code	HCPCS 11426
Hospital Charge Code	75190075
Hospital Revenue Code	761
Min. Negotiated Rate	$210.90
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$2,931.30
Rate for Payer: Aetna Medicare Advantage	$2,931.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,491.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,491.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,491.61
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.23
Rate for Payer: Oxford Commercial	$4,885.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,465.65
Rate for Payer: UnitedHealthcare Commercial	$4,885.50

EXC BEN LES TAL 0.6-1.0 CM

Facility

$2,403.20

Service Code	HCPCS 11401
Hospital Charge Code	5792277
Hospital Revenue Code	450
Min. Negotiated Rate	$51.26
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$720.96
Rate for Payer: Aetna Medicare Advantage	$720.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.82
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.42
Rate for Payer: Qualcare PPO/HMO/WC	$360.48
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

EXC BEN LES TAL 0.6-1.0 CM

Facility

$2,403.20

Service Code	HCPCS 11401
Hospital Charge Code	5792277
Hospital Revenue Code	450
Min. Negotiated Rate	$360.48
Max. Negotiated Rate	$360.48
Rate for Payer: Qualcare PPO/HMO/WC	$360.48

EXC BEN LES T/A/L,0.6-1.0CM

Facility

$3,972.54

Service Code	HCPCS 11401
Hospital Charge Code	16000255
Hospital Revenue Code	360
Min. Negotiated Rate	$516.43
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$1,191.76
Rate for Payer: Aetna Medicare Advantage	$1,191.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.00
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$516.43
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$595.88
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1,037.98

EXC BEN LES T/A/L,0.6-1.0CM

Facility

$3,972.54

Service Code	HCPCS 11401
Hospital Charge Code	16000255
Hospital Revenue Code	360
Min. Negotiated Rate	$595.88
Max. Negotiated Rate	$595.88
Rate for Payer: Qualcare PPO/HMO/WC	$595.88

EXC BEN LES T/A/L 1.1-2.0CM

Facility

$4,744.00

Service Code	HCPCS 11042
Hospital Charge Code	160000240
Hospital Revenue Code	360
Min. Negotiated Rate	$711.60
Max. Negotiated Rate	$711.60
Rate for Payer: Qualcare PPO/HMO/WC	$711.60

EXC BEN LES T/A/L 1.1-2.0CM

Facility

$4,151.00

Service Code	HCPCS 11402
Hospital Charge Code	1600000386
Hospital Revenue Code	360
Min. Negotiated Rate	$622.65
Max. Negotiated Rate	$622.65
Rate for Payer: Qualcare PPO/HMO/WC	$622.65

EXC BEN LES T/A/L 1.1-2.0CM

Facility

$4,151.00

Service Code	HCPCS 11402
Hospital Charge Code	1600000386
Hospital Revenue Code	360
Min. Negotiated Rate	$539.63
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,245.30
Rate for Payer: Aetna Medicare Advantage	$1,245.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,058.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,058.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,058.51
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$539.63
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$622.65
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

EXC BEN LES T/A/L 1.1-2.0CM

Facility

$4,744.00

Service Code	HCPCS 11042
Hospital Charge Code	160000240
Hospital Revenue Code	360
Min. Negotiated Rate	$616.72
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$1,423.20
Rate for Payer: Aetna Medicare Advantage	$1,423.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,209.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,209.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,209.72
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$616.72
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$711.60
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1,037.98

EXC BEN LES T/A/L,2.1-3.0CM

Facility

$7,918.25

Service Code	HCPCS 11403
Hospital Charge Code	16000189
Hospital Revenue Code	360
Min. Negotiated Rate	$1,029.37
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$2,375.47
Rate for Payer: Aetna Medicare Advantage	$2,375.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,019.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,019.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,019.15
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,029.37
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.74
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

EXC BEN LES T/A/L,2.1-3.0CM

Facility

$7,918.25

Service Code	HCPCS 11403
Hospital Charge Code	16000189
Hospital Revenue Code	360
Min. Negotiated Rate	$1,187.74
Max. Negotiated Rate	$1,187.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.74

EXC BEN LES T/A/L,3.1-4.0CM

Facility

$16,853.95

Service Code	HCPCS 11404
Hospital Charge Code	16000204
Hospital Revenue Code	360
Min. Negotiated Rate	$2,528.09
Max. Negotiated Rate	$2,528.09
Rate for Payer: Qualcare PPO/HMO/WC	$2,528.09

EXC BEN LES T/A/L,3.1-4.0CM

Facility

$16,853.95

Service Code	HCPCS 11404
Hospital Charge Code	16000204
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$5,056.19
Rate for Payer: Aetna Commercial	$5,056.19
Rate for Payer: Aetna Medicare Advantage	$5,056.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,297.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,297.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,297.76
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,191.01
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,528.09
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

EXC BEN LES T/A/L,> 4.0CM

Facility

$13,615.50

Service Code	HCPCS 11406
Hospital Charge Code	16000181
Hospital Revenue Code	360
Min. Negotiated Rate	$2,042.33
Max. Negotiated Rate	$2,042.33
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33

EXC BEN LES T/A/L,> 4.0CM

Facility

$13,615.50

Service Code	HCPCS 11406
Hospital Charge Code	16000181
Hospital Revenue Code	360
Min. Negotiated Rate	$1,770.02
Max. Negotiated Rate	$4,084.65
Rate for Payer: Aetna Commercial	$4,084.65
Rate for Payer: Aetna Medicare Advantage	$4,084.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,471.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,471.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,471.95
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.02
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

EXC BLES S/N/EX G,0.5CM/<

Facility

$7,612.30

Service Code	HCPCS 11420
Hospital Charge Code	16000227
Hospital Revenue Code	360
Min. Negotiated Rate	$989.60
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,283.69
Rate for Payer: Aetna Medicare Advantage	$2,283.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,941.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,941.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,941.14
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$989.60
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,141.85
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

EXC BLES S/N/EX G,0.5CM/<

Facility

$7,612.30

Service Code	HCPCS 11420
Hospital Charge Code	16000227
Hospital Revenue Code	360
Min. Negotiated Rate	$1,141.85
Max. Negotiated Rate	$1,141.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,141.85

EXC BLES S/N/EX G,0.6-1.0CM

Facility

$7,612.30

Service Code	HCPCS 11421
Hospital Charge Code	16000320
Hospital Revenue Code	360
Min. Negotiated Rate	$1,141.85
Max. Negotiated Rate	$1,141.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,141.85

Know your out-of-pocket cost for care.

All Charges