Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

EXC SYNOVIUAL CYST POPLTEAL SP

Facility

$105,850.92

Service Code	HCPCS 27345
Hospital Charge Code	16000880
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$31,755.28
Rate for Payer: Aetna Commercial	$31,755.28
Rate for Payer: Aetna Medicare Advantage	$31,755.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,991.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,991.98
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	$26,991.98
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,760.62
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$15,877.64
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXC SYNOVIUAL CYST POPLTEAL SP

Facility

$105,850.92

Service Code	HCPCS 27345
Hospital Charge Code	16000880
Hospital Revenue Code	360
Min. Negotiated Rate	$15,877.64
Max. Negotiated Rate	$15,877.64
Rate for Payer: Qualcare PPO/HMO/WC	$15,877.64

EXC TARSAL/METATRAS CYST/TUMOR

Facility

$21,064.35

Service Code	HCPCS 28104
Hospital Charge Code	16000282
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$6,319.31
Rate for Payer: Aetna Medicare Advantage	$6,319.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,371.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,371.41
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	$5,371.41
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,738.37
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.65
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXC TARSAL/METATRAS CYST/TUMOR

Facility

$21,064.35

Service Code	HCPCS 28104
Hospital Charge Code	16000282
Hospital Revenue Code	360
Min. Negotiated Rate	$3,159.65
Max. Negotiated Rate	$3,159.65
Rate for Payer: Qualcare PPO/HMO/WC	$3,159.65

EXC THIGH/KNEE LES SC 3 CM/>

Facility

$16,680.90

Service Code	HCPCS 27337
Hospital Charge Code	16000238
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$5,004.27
Rate for Payer: Aetna Medicare Advantage	$5,004.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,253.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,253.63
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	$4,253.63
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,168.52
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,502.14
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXC THIGH/KNEE LES SC 3 CM/>

Facility

$16,680.90

Service Code	HCPCS 27337
Hospital Charge Code	16000238
Hospital Revenue Code	360
Min. Negotiated Rate	$2,502.14
Max. Negotiated Rate	$2,502.14
Rate for Payer: Qualcare PPO/HMO/WC	$2,502.14

EXC THIGH/KNEE LES SC < 3CM

Facility

$20,625.50

Service Code	HCPCS 27327
Hospital Charge Code	16000413
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 THIGH/KNEE LES SC < 3CM

Facility

$20,625.50

Service Code	HCPCS 27327
Hospital Charge Code	16000413
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 THIGH/KNEE TUM DEEP <5CM

Facility

$13,615.50

Service Code	HCPCS 27328
Hospital Charge Code	16000559
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 THIGH/KNEE TUM DEEP <5CM

Facility

$13,615.50

Service Code	HCPCS 27328
Hospital Charge Code	16000559
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 THIGH/KNEE TUM DEP 5CM/>

Facility

$9,686.20

Service Code	HCPCS 27339
Hospital Charge Code	16000477
Hospital Revenue Code	360
Min. Negotiated Rate	$1,452.93
Max. Negotiated Rate	$1,452.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,452.93

EXC THIGH/KNEE TUM DEP 5CM/>

Facility

$9,686.20

Service Code	HCPCS 27339
Hospital Charge Code	16000477
Hospital Revenue Code	360
Min. Negotiated Rate	$1,259.21
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$2,905.86
Rate for Payer: Aetna Medicare Advantage	$2,905.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,469.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,469.98
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	$2,469.98
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,259.21
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,452.93
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXC TIB/FIB BONE CYST/TUMOR

Facility

$30,663.00

Service Code	HCPCS 27635
Hospital Charge Code	16000891
Hospital Revenue Code	360
Min. Negotiated Rate	$4,599.45
Max. Negotiated Rate	$4,599.45
Rate for Payer: Qualcare PPO/HMO/WC	$4,599.45

EXC TIB/FIB BONE CYST/TUMOR

Facility

$30,663.00

Service Code	HCPCS 27635
Hospital Charge Code	16000891
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$9,198.90
Rate for Payer: Aetna Commercial	$9,198.90
Rate for Payer: Aetna Medicare Advantage	$9,198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,819.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,819.06
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	$7,819.06
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.19
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,599.45
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EXC TIB/FIG CYST/TMR W AUTGRFT

Facility

$30,595.00

Service Code	HCPCS 27637
Hospital Charge Code	16000712
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$17,279.91
Rate for Payer: Aetna Commercial	$9,178.50
Rate for Payer: Aetna Medicare Advantage	$9,178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,801.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,801.73
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	$7,801.73
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,977.35
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

EXC TIB/FIG CYST/TMR W AUTGRFT

Facility

$30,595.00

Service Code	HCPCS 27637
Hospital Charge Code	16000712
Hospital Revenue Code	360
Min. Negotiated Rate	$4,589.25
Max. Negotiated Rate	$4,589.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25

EXC TNDN SHTH LES HND/FING F1

Facility

$16,001.80

Service Code	HCPCS 26160
Hospital Charge Code	16000350
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$4,800.54
Rate for Payer: Aetna Commercial	$4,800.54
Rate for Payer: Aetna Medicare Advantage	$4,800.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,080.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,080.46
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	$4,080.46
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,080.23
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.27
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

EXC TNDN SHTH LES HND/FING F1

Facility

$16,001.80

Service Code	HCPCS 26160
Hospital Charge Code	16000350
Hospital Revenue Code	360
Min. Negotiated Rate	$2,400.27
Max. Negotiated Rate	$2,400.27
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.27

EXC TNDN SHTH LESIN LEG/ANK RT

Facility

$21,417.75

Service Code	HCPCS 27630
Hospital Charge Code	16000510
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$6,425.32
Rate for Payer: Aetna Medicare Advantage	$6,425.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,461.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,461.53
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	$5,461.53
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,784.31
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,212.66
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXC TNDN SHTH LESIN LEG/ANK RT

Facility

$21,417.75

Service Code	HCPCS 27630
Hospital Charge Code	16000510
Hospital Revenue Code	360
Min. Negotiated Rate	$3,212.66
Max. Negotiated Rate	$3,212.66
Rate for Payer: Qualcare PPO/HMO/WC	$3,212.66

EXC/TRANSPOS PTERYGIUM,W GRAFT

Facility

$20,773.00

Service Code	HCPCS 65426
Hospital Charge Code	16000773
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,231.90
Rate for Payer: Aetna Commercial	$6,231.90
Rate for Payer: Aetna Medicare Advantage	$6,231.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,297.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,297.11
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	$5,297.11
Rate for Payer: Cigna Commercial	$5,661.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,700.49
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,115.95
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

EXC/TRANSPOS PTERYGIUM,W GRAFT

Facility

$20,773.00

Service Code	HCPCS 65426
Hospital Charge Code	16000773
Hospital Revenue Code	360
Min. Negotiated Rate	$3,115.95
Max. Negotiated Rate	$3,115.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,115.95

EXC TR--EXT B9+MARG 0.5CM/<

Facility

$3,786.40

Service Code	HCPCS 11400
Hospital Charge Code	16000216
Hospital Revenue Code	360
Min. Negotiated Rate	$567.96
Max. Negotiated Rate	$567.96
Rate for Payer: Qualcare PPO/HMO/WC	$567.96

EXC TR--EXT B9+MARG 0.5CM/<

Facility

$3,786.40

Service Code	HCPCS 11400
Hospital Charge Code	16000216
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

Know your out-of-pocket cost for care.

All Charges