Heights University Hospital

All Charges

Charge

Type

Setting

Price

FP DEST.CRYOTHERAPY LESIONS-14

Facility

$372.00

Service Code	HCPCS 17110
Hospital Charge Code	83652085
Hospital Revenue Code	761
Min. Negotiated Rate	$41.40
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$111.60
Rate for Payer: Aetna Medicare Advantage	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.86
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.36
Rate for Payer: Oxford Commercial	$186.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$186.00

FP DRESS/DEBRID LARGE

Facility

$612.00

Service Code	HCPCS 16030
Hospital Charge Code	87502520
Hospital Revenue Code	361
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

FP DRESS/DEBRID LARGE

Facility

$612.00

Service Code	HCPCS 16030
Hospital Charge Code	87502520
Hospital Revenue Code	361
Min. Negotiated Rate	$79.56
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$183.60
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
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	$156.06
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.56
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

FP DRESSING/DEBRID MEDIUM

Facility

$612.00

Service Code	HCPCS 16020
Hospital Charge Code	87502515
Hospital Revenue Code	761
Min. Negotiated Rate	$52.76
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$183.60
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.56
Rate for Payer: Oxford Commercial	$306.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$306.00

FP DRESSING/DEBRID MEDIUM

Facility

$612.00

Service Code	HCPCS 16020
Hospital Charge Code	87502515
Hospital Revenue Code	761
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

FP EKG 12 LEADS

Facility

$2,050.00

Service Code	HCPCS 93005
Hospital Charge Code	87502625
Hospital Revenue Code	730
Min. Negotiated Rate	$70.15
Max. Negotiated Rate	$615.00
Rate for Payer: Aetna Commercial	$615.00
Rate for Payer: Aetna Medicare Advantage	$615.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$522.75
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.50
Rate for Payer: Oxford Commercial	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$307.50
Rate for Payer: UnitedHealthcare Commercial	$603.00

FP EKG 12 LEADS

Facility

$2,050.00

Service Code	HCPCS 93005
Hospital Charge Code	87502625
Hospital Revenue Code	730
Min. Negotiated Rate	$307.50
Max. Negotiated Rate	$307.50
Rate for Payer: Qualcare PPO/HMO/WC	$307.50

FP EKG INTER & REPORT ONLY

Facility

$49.00

Service Code	HCPCS 93010
Hospital Charge Code	87502635
Hospital Revenue Code	730
Min. Negotiated Rate	$6.33
Max. Negotiated Rate	$603.00
Rate for Payer: Aetna Commercial	$14.70
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.49
Rate for Payer: Cigna Commercial	$9.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.37
Rate for Payer: Oxford Commercial	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.35
Rate for Payer: UnitedHealthcare Commercial	$603.00

FP EKG INTER & REPORT ONLY

Facility

$49.00

Service Code	HCPCS 93010
Hospital Charge Code	87502635
Hospital Revenue Code	730
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$7.35
Rate for Payer: Qualcare PPO/HMO/WC	$7.35

FP EKG W INTERPRETATION & RPT

Facility

$62.90

Service Code	HCPCS 93000
Hospital Charge Code	83652367
Hospital Revenue Code	730
Min. Negotiated Rate	$9.44
Max. Negotiated Rate	$9.44
Rate for Payer: Qualcare PPO/HMO/WC	$9.44

FP EKG W INTERPRETATION & RPT

Facility

$62.90

Service Code	HCPCS 93000
Hospital Charge Code	83652367
Hospital Revenue Code	730
Min. Negotiated Rate	$8.18
Max. Negotiated Rate	$603.00
Rate for Payer: Aetna Commercial	$18.87
Rate for Payer: Aetna Medicare Advantage	$18.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.04
Rate for Payer: Cigna Commercial	$17.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.18
Rate for Payer: Oxford Commercial	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.44
Rate for Payer: UnitedHealthcare Commercial	$603.00

FP ENALAPRIL 5MG TAB(VASOTEC)

Facility

$59.00

Hospital Charge Code	83652607
Hospital Revenue Code	637
Min. Negotiated Rate	$7.67
Max. Negotiated Rate	$29.50
Rate for Payer: Aetna Commercial	$17.70
Rate for Payer: Aetna Medicare Advantage	$17.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.04
Rate for Payer: Cigna Commercial	$29.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.67
Rate for Payer: Oxford Commercial	$29.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.85
Rate for Payer: UnitedHealthcare Commercial	$29.50

FP ENALAPRIL 5MG TAB(VASOTEC)

Facility

$59.00

Hospital Charge Code	83652607
Hospital Revenue Code	637
Min. Negotiated Rate	$8.85
Max. Negotiated Rate	$8.85
Rate for Payer: Qualcare PPO/HMO/WC	$8.85

FP EXC BENIGN LESION SKIN TAG

Facility

$678.00

Service Code	HCPCS 11400
Hospital Charge Code	83652037
Hospital Revenue Code	761
Min. Negotiated Rate	$37.95
Max. Negotiated Rate	$1,686.34
Rate for Payer: Aetna Commercial	$203.40
Rate for Payer: Aetna Medicare Advantage	$203.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.89
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.14
Rate for Payer: Oxford Commercial	$339.00
Rate for Payer: Qualcare PPO/HMO/WC	$101.70
Rate for Payer: UnitedHealthcare Commercial	$339.00

FP EXC BENIGN LESION SKIN TAG

Facility

$678.00

Service Code	HCPCS 11400
Hospital Charge Code	83652037
Hospital Revenue Code	761
Min. Negotiated Rate	$101.70
Max. Negotiated Rate	$101.70
Rate for Payer: Qualcare PPO/HMO/WC	$101.70

FP EXC DIAM OVER 4.0

Facility

$440.80

Service Code	HCPCS 11406
Hospital Charge Code	87502465
Hospital Revenue Code	761
Min. Negotiated Rate	$57.30
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$132.24
Rate for Payer: Aetna Medicare Advantage	$132.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.40
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.30
Rate for Payer: Oxford Commercial	$220.40
Rate for Payer: Qualcare PPO/HMO/WC	$66.12
Rate for Payer: UnitedHealthcare Commercial	$220.40

FP EXC DIAM OVER 4.0

Facility

$440.80

Service Code	HCPCS 11406
Hospital Charge Code	87502465
Hospital Revenue Code	761
Min. Negotiated Rate	$66.12
Max. Negotiated Rate	$66.12
Rate for Payer: Qualcare PPO/HMO/WC	$66.12

FP EXC OTHER BENIGN LES 0.5 CM

Facility

$745.00

Service Code	HCPCS 11440
Hospital Charge Code	87502470
Hospital Revenue Code	761
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$111.75
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

FP EXC OTHER BENIGN LES 0.5 CM

Facility

$745.00

Service Code	HCPCS 11440
Hospital Charge Code	87502470
Hospital Revenue Code	761
Min. Negotiated Rate	$43.47
Max. Negotiated Rate	$1,686.34
Rate for Payer: Aetna Commercial	$223.50
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.85
Rate for Payer: Oxford Commercial	$372.50
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Commercial	$372.50

FP EXC.OTHER BENIGN LES 0.5 CM

Facility

$745.00

Service Code	HCPCS 11440
Hospital Charge Code	83652047
Hospital Revenue Code	761
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$111.75
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

FP EXC.OTHER BENIGN LES 0.5 CM

Facility

$745.00

Service Code	HCPCS 11440
Hospital Charge Code	83652047
Hospital Revenue Code	761
Min. Negotiated Rate	$43.47
Max. Negotiated Rate	$1,686.34
Rate for Payer: Aetna Commercial	$223.50
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.85
Rate for Payer: Oxford Commercial	$372.50
Rate for Payer: Qualcare PPO/HMO/WC	$111.75
Rate for Payer: UnitedHealthcare Commercial	$372.50

FP EXC PILONIDAL CYST

Facility

$15,496.15

Service Code	HCPCS 11770
Hospital Charge Code	87502500
Hospital Revenue Code	761
Min. Negotiated Rate	$173.65
Max. Negotiated Rate	$7,748.07
Rate for Payer: Aetna Commercial	$4,648.85
Rate for Payer: Aetna Medicare Advantage	$4,648.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,951.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,951.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$173.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,951.52
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,014.50
Rate for Payer: Oxford Commercial	$7,748.07
Rate for Payer: Qualcare PPO/HMO/WC	$2,324.42
Rate for Payer: UnitedHealthcare Commercial	$7,748.07

FP EXC PILONIDAL CYST

Facility

$15,496.15

Service Code	HCPCS 11770
Hospital Charge Code	87502500
Hospital Revenue Code	761
Min. Negotiated Rate	$2,324.42
Max. Negotiated Rate	$2,324.42
Rate for Payer: Qualcare PPO/HMO/WC	$2,324.42

FP EXC SKIN & SUBC HIDRADENIT

Facility

$2,052.00

Service Code	HCPCS 11450
Hospital Charge Code	87502475
Hospital Revenue Code	761
Min. Negotiated Rate	$158.52
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$615.60
Rate for Payer: Aetna Medicare Advantage	$615.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$523.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$523.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$523.26
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.76
Rate for Payer: Oxford Commercial	$1,026.00
Rate for Payer: Qualcare PPO/HMO/WC	$307.80
Rate for Payer: UnitedHealthcare Commercial	$1,026.00

FP EXC SKIN & SUBC HIDRADENIT

Facility

$2,052.00

Service Code	HCPCS 11450
Hospital Charge Code	87502475
Hospital Revenue Code	761
Min. Negotiated Rate	$307.80
Max. Negotiated Rate	$307.80
Rate for Payer: Qualcare PPO/HMO/WC	$307.80

Know your out-of-pocket cost for care.

All Charges