Heights University Hospital

All Charges

Charge

Type

Setting

Price

EXC EXT EAR,PARTIAL SPL REPAIR

Facility

$13,615.50

Service Code	HCPCS 69110
Hospital Charge Code	16000345
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 EXT EAR,PARTIAL SPL REPAIR

Facility

$13,615.50

Service Code	HCPCS 69110
Hospital Charge Code	16000345
Hospital Revenue Code	360
Min. Negotiated Rate	$1,770.02
Max. Negotiated Rate	$6,917.28
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	$6,917.28
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 EYLID LSN WO CLOSE/SML RPR

Facility

$7,645.60

Service Code	HCPCS 67840
Hospital Charge Code	16000774
Hospital Revenue Code	360
Min. Negotiated Rate	$993.93
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$2,293.68
Rate for Payer: Aetna Medicare Advantage	$2,293.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,949.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,949.63
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	$1,949.63
Rate for Payer: Cigna Commercial	$2,373.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$993.93
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,146.84
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

EXC EYLID LSN WO CLOSE/SML RPR

Facility

$7,645.60

Service Code	HCPCS 67840
Hospital Charge Code	16000774
Hospital Revenue Code	360
Min. Negotiated Rate	$1,146.84
Max. Negotiated Rate	$1,146.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,146.84

EXC FACE LES SBQ 2+ CM

Facility

$7,918.25

Service Code	HCPCS 21012
Hospital Charge Code	16000233
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 FACE LES SBQ 2+ CM

Facility

$7,918.25

Service Code	HCPCS 21012
Hospital Charge Code	16000233
Hospital Revenue Code	360
Min. Negotiated Rate	$1,029.37
Max. Negotiated Rate	$3,933.12
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	$3,933.12
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 FACE LES SC < 2 CM

Facility

$11,110.30

Service Code	HCPCS 21011
Hospital Charge Code	16000440
Hospital Revenue Code	360
Min. Negotiated Rate	$1,444.34
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$3,333.09
Rate for Payer: Aetna Medicare Advantage	$3,333.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,833.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,833.13
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	$2,833.13
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,444.34
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,666.55
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

EXC FACE LES SC < 2 CM

Facility

$11,110.30

Service Code	HCPCS 21011
Hospital Charge Code	16000440
Hospital Revenue Code	360
Min. Negotiated Rate	$1,666.55
Max. Negotiated Rate	$1,666.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,666.55

EXC FACE LES SC <2CM

Facility

$8,662.30

Service Code	HCPCS 21011
Hospital Charge Code	323021011
Hospital Revenue Code	450
Min. Negotiated Rate	$1,126.10
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,598.69
Rate for Payer: Aetna Medicare Advantage	$2,598.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,208.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,208.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,208.89
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,126.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,299.35

EXC FACE LES SC <2CM

Facility

$8,662.30

Service Code	HCPCS 21011
Hospital Charge Code	323021011
Hospital Revenue Code	450
Min. Negotiated Rate	$1,299.35
Max. Negotiated Rate	$1,299.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,299.35

EXC FACE MM B9MARG 0.5CM

Facility

$4,994.00

Service Code	HCPCS 11440
Hospital Charge Code	1600000700
Hospital Revenue Code	360
Min. Negotiated Rate	$649.22
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,498.20
Rate for Payer: Aetna Medicare Advantage	$1,498.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,273.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,273.47
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	$1,273.47
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$649.22
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$749.10
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

EXC FACE MM B9MARG 0.5CM

Facility

$4,994.00

Service Code	HCPCS 11440
Hospital Charge Code	1600000700
Hospital Revenue Code	360
Min. Negotiated Rate	$749.10
Max. Negotiated Rate	$749.10
Rate for Payer: Qualcare PPO/HMO/WC	$749.10

EXC FACE-MM B9+MARG 0.6-1 CM

Facility

$3,786.40

Service Code	HCPCS 11441
Hospital Charge Code	16000290
Hospital Revenue Code	360
Min. Negotiated Rate	$567.96
Max. Negotiated Rate	$567.96
Rate for Payer: Qualcare PPO/HMO/WC	$567.96

EXC FACE-MM B9+MARG 0.6-1 CM

Facility

$3,786.40

Service Code	HCPCS 11441
Hospital Charge Code	16000290
Hospital Revenue Code	360
Min. Negotiated Rate	$492.23
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,135.92
Rate for Payer: Aetna Medicare Advantage	$1,135.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$965.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$965.53
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	$965.53
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$492.23
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$567.96
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

EXC FACE-MM B9+MARG 1.1-2 CM

Facility

$7,917.64

Service Code	HCPCS 11442
Hospital Charge Code	16000268
Hospital Revenue Code	360
Min. Negotiated Rate	$1,187.65
Max. Negotiated Rate	$1,187.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.65

EXC FACE-MM B9+MARG 1.1-2 CM

Facility

$7,917.64

Service Code	HCPCS 11442
Hospital Charge Code	16000268
Hospital Revenue Code	360
Min. Negotiated Rate	$1,029.29
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$2,375.29
Rate for Payer: Aetna Medicare Advantage	$2,375.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,019.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,019.00
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	$2,019.00
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,029.29
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.65
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

EXC FACE-MM B9+MARG 2.1-3 CM

Facility

$7,917.30

Service Code	HCPCS 11443
Hospital Charge Code	16000284
Hospital Revenue Code	360
Min. Negotiated Rate	$1,029.25
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,375.19
Rate for Payer: Aetna Medicare Advantage	$2,375.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,018.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,018.91
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	$2,018.91
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,029.25
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.60
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

EXC FACE-MM B9+MARG 2.1-3 CM

Facility

$7,917.30

Service Code	HCPCS 11443
Hospital Charge Code	16000284
Hospital Revenue Code	360
Min. Negotiated Rate	$1,187.60
Max. Negotiated Rate	$1,187.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.60

EXC FACE-MM B9+MARG 3.1-4CM E4

Facility

$7,917.30

Service Code	HCPCS 11444
Hospital Charge Code	16000465
Hospital Revenue Code	360
Min. Negotiated Rate	$1,187.60
Max. Negotiated Rate	$1,187.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.60

EXC FACE-MM B9+MARG 3.1-4CM E4

Facility

$7,917.30

Service Code	HCPCS 11444
Hospital Charge Code	16000465
Hospital Revenue Code	360
Min. Negotiated Rate	$1,029.25
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,375.19
Rate for Payer: Aetna Medicare Advantage	$2,375.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,018.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,018.91
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	$2,018.91
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,029.25
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.60
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

EXC FACE-MM B9+MARG > 4 CM

Facility

$22,279.93

Service Code	HCPCS 11446
Hospital Charge Code	16000418
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$6,683.98
Rate for Payer: Aetna Medicare Advantage	$6,683.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,681.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,681.38
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	$5,681.38
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,896.39
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,341.99
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXC FACE-MM B9+MARG > 4 CM

Facility

$22,279.93

Service Code	HCPCS 11446
Hospital Charge Code	16000418
Hospital Revenue Code	360
Min. Negotiated Rate	$3,341.99
Max. Negotiated Rate	$3,341.99
Rate for Payer: Qualcare PPO/HMO/WC	$3,341.99

EXC FACE TUM DEEP 2 CM/>

Facility

$7,612.30

Service Code	HCPCS 21014
Hospital Charge Code	16000671
Hospital Revenue Code	360
Min. Negotiated Rate	$989.60
Max. Negotiated Rate	$6,917.28
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	$6,917.28
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 FACE TUM DEEP 2 CM/>

Facility

$7,612.30

Service Code	HCPCS 21014
Hospital Charge Code	16000671
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 FACE TUM DEEP 2+ CM

Facility

$20,625.50

Service Code	HCPCS 21016
Hospital Charge Code	16000797
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$6,187.65
Rate for Payer: Aetna Medicare Advantage	$6,187.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,259.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,259.50
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	$5,259.50
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,681.32
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,093.82
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

Know your out-of-pocket cost for care.

All Charges