Heights University Hospital

All Charges

Charge

Type

Setting

Price

EXC FOREARM LES SC < 3 CM LT

Facility

$13,615.50

Service Code	HCPCS 25075
Hospital Charge Code	16000444
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 FOREARM LES SC < 3 CM LT

Facility

$13,615.50

Service Code	HCPCS 25075
Hospital Charge Code	16000444
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 FOREARM TUM DEEP < 3 CM

Facility

$7,196.28

Service Code	HCPCS 25076
Hospital Charge Code	16000829
Hospital Revenue Code	360
Min. Negotiated Rate	$935.52
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,158.88
Rate for Payer: Aetna Medicare Advantage	$2,158.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,835.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,835.05
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	$1,835.05
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$935.52
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,079.44
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

EXC FOREARM TUM DEEP < 3 CM

Facility

$7,196.28

Service Code	HCPCS 25076
Hospital Charge Code	16000829
Hospital Revenue Code	360
Min. Negotiated Rate	$1,079.44
Max. Negotiated Rate	$1,079.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,079.44

EXC FOREARM TUM DEEP 3 CM/>

Facility

$20,625.50

Service Code	HCPCS 25073
Hospital Charge Code	16000615
Hospital Revenue Code	360
Min. Negotiated Rate	$3,093.82
Max. Negotiated Rate	$3,093.82
Rate for Payer: Qualcare PPO/HMO/WC	$3,093.82

EXC FOREARM TUM DEEP 3 CM/>

Facility

$20,625.50

Service Code	HCPCS 25073
Hospital Charge Code	16000615
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

EXC HAND LES SC < 1.5 CM

Facility

$13,615.50

Service Code	HCPCS 26115
Hospital Charge Code	16000396
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 HAND LES SC < 1.5 CM

Facility

$13,615.50

Service Code	HCPCS 26115
Hospital Charge Code	16000396
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 HAND LES SC 1.5 CM/>

Facility

$20,625.50

Service Code	HCPCS 26111
Hospital Charge Code	16000445
Hospital Revenue Code	360
Min. Negotiated Rate	$3,093.82
Max. Negotiated Rate	$3,093.82
Rate for Payer: Qualcare PPO/HMO/WC	$3,093.82

EXC HAND LES SC 1.5 CM/>

Facility

$20,625.50

Service Code	HCPCS 26111
Hospital Charge Code	16000445
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,187.65
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	$3,933.12
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

EXC HAND TUM DEEP < 1.5 CM

Facility

$13,615.50

Service Code	HCPCS 26116
Hospital Charge Code	16000842
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 HAND TUM DEEP < 1.5 CM

Facility

$13,615.50

Service Code	HCPCS 26116
Hospital Charge Code	16000842
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

EXCHANGE ARTERIAL CATH

Facility

$8,667.00

Service Code	HCPCS 37209
Hospital Charge Code	7411137
Hospital Revenue Code	361
Min. Negotiated Rate	$1,300.05
Max. Negotiated Rate	$1,300.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,300.05

EXCHANGE ARTERIAL CATH

Facility

$8,667.00

Service Code	HCPCS 37209
Hospital Charge Code	7411137
Hospital Revenue Code	361
Min. Negotiated Rate	$1,126.71
Max. Negotiated Rate	$4,333.50
Rate for Payer: Aetna Commercial	$2,600.10
Rate for Payer: Aetna Medicare Advantage	$2,600.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,210.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,210.09
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	$2,210.09
Rate for Payer: Cigna Commercial	$4,333.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,126.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,300.05

EXCHANGE BILIARY DRG CATH

Facility

$17,259.20

Service Code	HCPCS 47536
Hospital Charge Code	2600236
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$5,177.76
Rate for Payer: Aetna Medicare Advantage	$5,177.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,401.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,401.10
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	$4,401.10
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,243.70
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EXCHANGE BILIARY DRG CATH

Facility

$12,827.31

Service Code	HCPCS 47536
Hospital Charge Code	2011567
Hospital Revenue Code	361
Min. Negotiated Rate	$1,924.10
Max. Negotiated Rate	$1,924.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,924.10

EXCHANGE BILIARY DRG CATH

Facility

$17,259.20

Service Code	HCPCS 47536
Hospital Charge Code	321047536
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$5,177.76
Rate for Payer: Aetna Medicare Advantage	$5,177.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,401.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,401.10
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	$4,401.10
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,243.70
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EXCHANGE BILIARY DRG CATH

Facility

$12,827.31

Service Code	HCPCS 47536
Hospital Charge Code	7411565
Hospital Revenue Code	361
Min. Negotiated Rate	$1,667.55
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$3,848.19
Rate for Payer: Aetna Medicare Advantage	$3,848.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,270.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,270.96
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	$3,270.96
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,667.55
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,924.10
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EXCHANGE BILIARY DRG CATH

Facility

$12,827.31

Service Code	HCPCS 47536
Hospital Charge Code	7411565
Hospital Revenue Code	361
Min. Negotiated Rate	$1,924.10
Max. Negotiated Rate	$1,924.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,924.10

EXCHANGE BILIARY DRG CATH

Facility

$17,067.55

Service Code	HCPCS 47536
Hospital Charge Code	411047536
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$5,120.27
Rate for Payer: Aetna Medicare Advantage	$5,120.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,352.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,352.23
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	$4,352.23
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,218.78
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,560.13
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EXCHANGE BILIARY DRG CATH

Facility

$17,259.20

Service Code	HCPCS 47536
Hospital Charge Code	2600236
Hospital Revenue Code	361
Min. Negotiated Rate	$2,588.88
Max. Negotiated Rate	$2,588.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

EXCHANGE BILIARY DRG CATH

Facility

$12,827.31

Service Code	HCPCS 47536
Hospital Charge Code	2011567
Hospital Revenue Code	361
Min. Negotiated Rate	$1,667.55
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$3,848.19
Rate for Payer: Aetna Medicare Advantage	$3,848.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,270.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,270.96
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	$3,270.96
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,667.55
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,924.10
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EXCHANGE BILIARY DRG CATH

Facility

$17,067.55

Service Code	HCPCS 47536
Hospital Charge Code	411047536
Hospital Revenue Code	361
Min. Negotiated Rate	$2,560.13
Max. Negotiated Rate	$2,560.13
Rate for Payer: Qualcare PPO/HMO/WC	$2,560.13

EXCHANGE BILIARY DRG CATH

Facility

$17,067.55

Service Code	HCPCS 47536
Hospital Charge Code	366847536
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,526.35
Rate for Payer: Aetna Commercial	$5,120.27
Rate for Payer: Aetna Medicare Advantage	$5,120.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,352.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,352.23
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	$4,352.23
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,218.78
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,560.13
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EXCHANGE BILIARY DRG CATH

Facility

$17,259.20

Service Code	HCPCS 47536
Hospital Charge Code	321047536
Hospital Revenue Code	361
Min. Negotiated Rate	$2,588.88
Max. Negotiated Rate	$2,588.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

Know your out-of-pocket cost for care.

All Charges