Heights University Hospital

All Charges

Charge

Type

Setting

Price

EXC RECT TUM TRANSANAL PART

Facility

$22,676.60

Service Code	HCPCS 45171
Hospital Charge Code	16000980
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,802.98
Rate for Payer: Aetna Commercial	$6,802.98
Rate for Payer: Aetna Medicare Advantage	$6,802.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,782.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,782.53
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	$5,782.53
Rate for Payer: Cigna Commercial	$6,609.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,947.96
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,401.49
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXC RECT TUM TRANSANAL PART

Facility

$22,676.60

Service Code	HCPCS 45171
Hospital Charge Code	16000980
Hospital Revenue Code	360
Min. Negotiated Rate	$3,401.49
Max. Negotiated Rate	$3,401.49
Rate for Payer: Qualcare PPO/HMO/WC	$3,401.49

EXC RECURRENT WST GANGLION

Facility

$19,467.90

Service Code	HCPCS 25112
Hospital Charge Code	16000687
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$5,840.37
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	$3,829.26
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

EXC RECURRENT WST GANGLION

Facility

$19,467.90

Service Code	HCPCS 25112
Hospital Charge Code	16000687
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

EXC SHOULDER LES SC 3 CM/>

Facility

$6,443.85

Service Code	HCPCS 23071
Hospital Charge Code	16000301
Hospital Revenue Code	360
Min. Negotiated Rate	$837.70
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Commercial	$1,933.15
Rate for Payer: Aetna Medicare Advantage	$1,933.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,643.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,643.18
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	$1,643.18
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$837.70
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$966.58
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXC SHOULDER LES SC 3 CM/>

Facility

$6,443.85

Service Code	HCPCS 23071
Hospital Charge Code	16000301
Hospital Revenue Code	360
Min. Negotiated Rate	$966.58
Max. Negotiated Rate	$966.58
Rate for Payer: Qualcare PPO/HMO/WC	$966.58

EXC SHOULDER LES SC < 3 CM LT

Facility

$13,615.50

Service Code	HCPCS 23075
Hospital Charge Code	16000501
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 SHOULDER LES SC < 3 CM LT

Facility

$13,615.50

Service Code	HCPCS 23075
Hospital Charge Code	16000501
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 SHOULDER TUM DEEP 5 CM/>

Facility

$11,141.64

Service Code	HCPCS 23073
Hospital Charge Code	16000443
Hospital Revenue Code	360
Min. Negotiated Rate	$1,448.41
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$3,342.49
Rate for Payer: Aetna Medicare Advantage	$3,342.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,841.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,841.12
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	$2,841.12
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,448.41
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,671.25
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXC SHOULDER TUM DEEP 5 CM/>

Facility

$11,141.64

Service Code	HCPCS 23073
Hospital Charge Code	16000443
Hospital Revenue Code	360
Min. Negotiated Rate	$1,671.25
Max. Negotiated Rate	$1,671.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,671.25

EXC SHOULDER TUM DEEP< 5 CM B

Facility

$15,933.34

Service Code	HCPCS 23076
Hospital Charge Code	16000812
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$4,780.00
Rate for Payer: Aetna Medicare Advantage	$4,780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,063.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,063.00
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	$4,063.00
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,071.33
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,390.00
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

EXC SHOULDER TUM DEEP< 5 CM B

Facility

$15,933.34

Service Code	HCPCS 23076
Hospital Charge Code	16000812
Hospital Revenue Code	360
Min. Negotiated Rate	$2,390.00
Max. Negotiated Rate	$2,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,390.00

EXC SKIN ABD

Facility

$42,601.70

Service Code	HCPCS 15830
Hospital Charge Code	16000353
Hospital Revenue Code	360
Min. Negotiated Rate	$6,390.26
Max. Negotiated Rate	$6,390.26
Rate for Payer: Qualcare PPO/HMO/WC	$6,390.26

EXC SKIN ABD

Facility

$42,601.70

Service Code	HCPCS 15830
Hospital Charge Code	16000353
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$15,812.86
Rate for Payer: Aetna Commercial	$12,780.51
Rate for Payer: Aetna Medicare Advantage	$12,780.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,863.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,863.43
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	$10,863.43
Rate for Payer: Cigna Commercial	$15,812.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,538.22
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,390.26
Rate for Payer: UnitedHealthcare Commercial	$8,580.00

EXC SKIN ABD ADD-ON

Facility

$42,601.70

Service Code	HCPCS 15847
Hospital Charge Code	16000438
Hospital Revenue Code	360
Min. Negotiated Rate	$6,390.26
Max. Negotiated Rate	$6,390.26
Rate for Payer: Qualcare PPO/HMO/WC	$6,390.26

EXC SKIN ABD ADD-ON

Facility

$42,601.70

Service Code	HCPCS 15847
Hospital Charge Code	16000438
Hospital Revenue Code	360
Min. Negotiated Rate	$1,487.00
Max. Negotiated Rate	$21,300.85
Rate for Payer: Aetna Commercial	$12,780.51
Rate for Payer: Aetna Medicare Advantage	$12,780.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,863.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,863.43
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	$10,863.43
Rate for Payer: Cigna Commercial	$21,300.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,538.22
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,390.26
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

EXC SKN HDRDNT ING SMPL/NTRM

Facility

$16,852.60

Service Code	HCPCS 11462
Hospital Charge Code	1600000500
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$5,055.78
Rate for Payer: Aetna Medicare Advantage	$5,055.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,297.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,297.41
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	$4,297.41
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,190.84
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,527.89
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXC SKN HDRDNT ING SMPL/NTRM

Facility

$16,852.60

Service Code	HCPCS 11462
Hospital Charge Code	1600000500
Hospital Revenue Code	360
Min. Negotiated Rate	$2,527.89
Max. Negotiated Rate	$2,527.89
Rate for Payer: Qualcare PPO/HMO/WC	$2,527.89

EXC S/N/H/F/G MAL+MRG 3.1-4

Facility

$6,322.68

Service Code	HCPCS 11624
Hospital Charge Code	16000777
Hospital Revenue Code	360
Min. Negotiated Rate	$948.40
Max. Negotiated Rate	$948.40
Rate for Payer: Qualcare PPO/HMO/WC	$948.40

EXC S/N/H/F/G MAL+MRG 3.1-4

Facility

$6,322.68

Service Code	HCPCS 11624
Hospital Charge Code	16000777
Hospital Revenue Code	360
Min. Negotiated Rate	$821.95
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$1,896.80
Rate for Payer: Aetna Medicare Advantage	$1,896.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,612.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,612.28
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	$1,612.28
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$821.95
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$948.40
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

EXC S/N/H/F/G MAL+MRG > 4 CM

Facility

$11,452.64

Service Code	HCPCS 11626
Hospital Charge Code	16000493
Hospital Revenue Code	360
Min. Negotiated Rate	$1,488.84
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$3,435.79
Rate for Payer: Aetna Medicare Advantage	$3,435.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,920.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,920.42
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	$2,920.42
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,488.84
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,717.90
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXC S/N/H/F/G MAL+MRG > 4 CM

Facility

$11,452.64

Service Code	HCPCS 11626
Hospital Charge Code	16000493
Hospital Revenue Code	360
Min. Negotiated Rate	$1,717.90
Max. Negotiated Rate	$1,717.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,717.90

EXCSN OF LNGL FRNM (FRENECTOMY

Facility

$6,474.80

Service Code	HCPCS 41115
Hospital Charge Code	16000583
Hospital Revenue Code	360
Min. Negotiated Rate	$841.72
Max. Negotiated Rate	$3,694.94
Rate for Payer: Aetna Commercial	$1,942.44
Rate for Payer: Aetna Medicare Advantage	$1,942.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.07
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	$1,651.07
Rate for Payer: Cigna Commercial	$3,694.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$841.72
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$971.22
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

EXCSN OF LNGL FRNM (FRENECTOMY

Facility

$6,474.80

Service Code	HCPCS 41115
Hospital Charge Code	16000583
Hospital Revenue Code	360
Min. Negotiated Rate	$971.22
Max. Negotiated Rate	$971.22
Rate for Payer: Qualcare PPO/HMO/WC	$971.22

EXC ST LESION EXT AUDITRY CNL

Facility

$13,615.50

Service Code	HCPCS 69145
Hospital Charge Code	16000528
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

Know your out-of-pocket cost for care.

All Charges