Heights University Hospital

All Charges

Charge

Type

Setting

Price

EXCISION DIAM 2.1 - 3.0 CM

Facility

$7,903.25

Service Code	HCPCS 11423
Hospital Charge Code	412311423
Hospital Revenue Code	361
Min. Negotiated Rate	$1,185.49
Max. Negotiated Rate	$1,185.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,185.49

EXCISION DIAM 6-1.0 CM

Facility

$917.00

Service Code	HCPCS 11401
Hospital Charge Code	93950015
Hospital Revenue Code	761
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	$275.10
Rate for Payer: Aetna Medicare Advantage	$275.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$233.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$233.84
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	$233.84
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.21
Rate for Payer: Oxford Commercial	$458.50
Rate for Payer: Qualcare PPO/HMO/WC	$137.55
Rate for Payer: UnitedHealthcare Commercial	$458.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

EXCISION DIAM 6-1.0 CM

Facility

$917.00

Service Code	HCPCS 11401
Hospital Charge Code	93950015
Hospital Revenue Code	761
Min. Negotiated Rate	$137.55
Max. Negotiated Rate	$137.55
Rate for Payer: Qualcare PPO/HMO/WC	$137.55

EXCISION GRAFT EXTREMITY

Facility

$18,553.40

Service Code	HCPCS 35903
Hospital Charge Code	1600000724
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$5,566.02
Rate for Payer: Aetna Medicare Advantage	$5,566.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,731.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,731.12
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	$4,731.12
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,411.94
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,783.01
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EXCISION GRAFT EXTREMITY

Facility

$18,553.40

Service Code	HCPCS 35903
Hospital Charge Code	1600000724
Hospital Revenue Code	360
Min. Negotiated Rate	$2,783.01
Max. Negotiated Rate	$2,783.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,783.01

EXCISION OF MESENTERY LESION

Facility

$10,347.00

Service Code	HCPCS 44820
Hospital Charge Code	1600000666
Hospital Revenue Code	360
Min. Negotiated Rate	$883.25
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$3,104.10
Rate for Payer: Aetna Medicare Advantage	$3,104.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,638.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,638.49
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	$2,638.49
Rate for Payer: Cigna Commercial	$883.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,345.11
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,552.05
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EXCISION OF MESENTERY LESION

Facility

$10,347.00

Service Code	HCPCS 44820
Hospital Charge Code	1600000666
Hospital Revenue Code	360
Min. Negotiated Rate	$1,552.05
Max. Negotiated Rate	$1,552.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,552.05

EXCISION OF PENIS LESION(S)

Facility

$8,945.09

Service Code	HCPCS 54060
Hospital Charge Code	412354060
Hospital Revenue Code	361
Min. Negotiated Rate	$1,341.76
Max. Negotiated Rate	$1,341.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,341.76

EXCISION OF PENIS LESION(S)

Facility

$8,945.09

Service Code	HCPCS 54060
Hospital Charge Code	412354060
Hospital Revenue Code	361
Min. Negotiated Rate	$1,162.86
Max. Negotiated Rate	$4,913.48
Rate for Payer: Aetna Commercial	$2,683.53
Rate for Payer: Aetna Medicare Advantage	$2,683.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,281.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,281.00
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	$2,281.00
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,162.86
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,341.76
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

EXCISION OF PENIS LESIONS

Facility

$10,771.05

Service Code	HCPCS 54060
Hospital Charge Code	1600000655
Hospital Revenue Code	360
Min. Negotiated Rate	$1,400.24
Max. Negotiated Rate	$4,913.48
Rate for Payer: Aetna Commercial	$3,231.32
Rate for Payer: Aetna Medicare Advantage	$3,231.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,746.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,746.62
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	$2,746.62
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,400.24
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,615.66
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

EXCISION OF PENIS LESIONS

Facility

$10,771.05

Service Code	HCPCS 54060
Hospital Charge Code	1600000655
Hospital Revenue Code	360
Min. Negotiated Rate	$1,615.66
Max. Negotiated Rate	$1,615.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,615.66

EXCISION PREPATELLAR BURSA

Facility

$19,467.90

Service Code	HCPCS 27340
Hospital Charge Code	16000560
Hospital Revenue Code	360
Min. Negotiated Rate	$2,920.18
Max. Negotiated Rate	$2,920.18
Rate for Payer: Qualcare PPO/HMO/WC	$2,920.18

EXCISION PREPATELLAR BURSA

Facility

$19,467.90

Service Code	HCPCS 27340
Hospital Charge Code	16000560
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$5,840.37
Rate for Payer: Aetna Medicare Advantage	$5,840.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,964.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,964.31
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	$4,964.31
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,530.83
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,920.18
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXCISOR FISCHER LARGE

Facility

$117.03

Hospital Charge Code	270654601
Hospital Revenue Code	272
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$17.55
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

EXCISOR FISCHER LARGE

Facility

$117.03

Hospital Charge Code	270654601
Hospital Revenue Code	272
Min. Negotiated Rate	$15.21
Max. Negotiated Rate	$58.52
Rate for Payer: Aetna Commercial	$35.11
Rate for Payer: Aetna Medicare Advantage	$35.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.84
Rate for Payer: Cigna Commercial	$58.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.21
Rate for Payer: Oxford Commercial	$58.52
Rate for Payer: Qualcare PPO/HMO/WC	$17.55
Rate for Payer: UnitedHealthcare Commercial	$58.52

EXCISOR FISCHER LARGE SHALLOW

Facility

$117.03

Hospital Charge Code	270608106
Hospital Revenue Code	272
Min. Negotiated Rate	$15.21
Max. Negotiated Rate	$58.52
Rate for Payer: Aetna Commercial	$35.11
Rate for Payer: Aetna Medicare Advantage	$35.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.84
Rate for Payer: Cigna Commercial	$58.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.21
Rate for Payer: Oxford Commercial	$58.52
Rate for Payer: Qualcare PPO/HMO/WC	$17.55
Rate for Payer: UnitedHealthcare Commercial	$58.52

EXCISOR FISCHER LARGE SHALLOW

Facility

$117.03

Hospital Charge Code	270608106
Hospital Revenue Code	272
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$17.55
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

EXCISOR FISCHER MEDIUM

Facility

$117.03

Hospital Charge Code	270608105
Hospital Revenue Code	272
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$17.55
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

EXCISOR FISCHER MEDIUM

Facility

$117.03

Hospital Charge Code	270608105
Hospital Revenue Code	272
Min. Negotiated Rate	$15.21
Max. Negotiated Rate	$58.52
Rate for Payer: Aetna Commercial	$35.11
Rate for Payer: Aetna Medicare Advantage	$35.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.84
Rate for Payer: Cigna Commercial	$58.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.21
Rate for Payer: Oxford Commercial	$58.52
Rate for Payer: Qualcare PPO/HMO/WC	$17.55
Rate for Payer: UnitedHealthcare Commercial	$58.52

EXCISOR FISCHER SMALL

Facility

$117.03

Hospital Charge Code	270608104
Hospital Revenue Code	272
Min. Negotiated Rate	$15.21
Max. Negotiated Rate	$58.52
Rate for Payer: Aetna Commercial	$35.11
Rate for Payer: Aetna Medicare Advantage	$35.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.84
Rate for Payer: Cigna Commercial	$58.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.21
Rate for Payer: Oxford Commercial	$58.52
Rate for Payer: Qualcare PPO/HMO/WC	$17.55
Rate for Payer: UnitedHealthcare Commercial	$58.52

EXCISOR FISCHER SMALL

Facility

$117.03

Hospital Charge Code	270608104
Hospital Revenue Code	272
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$17.55
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

EXC LEG/ANKLE LES SC 3 CM/> 50

Facility

$20,625.50

Service Code	HCPCS 27632
Hospital Charge Code	16000354
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 LEG/ANKLE LES SC 3 CM/> 50

Facility

$20,625.50

Service Code	HCPCS 27632
Hospital Charge Code	16000354
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 LEG/ANKLE TUM < 3 CM

Facility

$13,615.50

Service Code	HCPCS 27618
Hospital Charge Code	16000426
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 LEG/ANKLE TUM < 3 CM

Facility

$13,615.50

Service Code	HCPCS 27618
Hospital Charge Code	16000426
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

Know your out-of-pocket cost for care.

All Charges