Heights University Hospital

All Charges

Charge

Type

Setting

Price

FP PARING BENIGN LES 1

Facility

$512.00

Service Code	HCPCS 11055
Hospital Charge Code	87502550
Hospital Revenue Code	761
Min. Negotiated Rate	$32.61
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$153.60
Rate for Payer: Aetna Medicare Advantage	$153.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.56
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.56
Rate for Payer: Oxford Commercial	$256.00
Rate for Payer: Qualcare PPO/HMO/WC	$76.80
Rate for Payer: UnitedHealthcare Commercial	$256.00

FP PARING BENIGN LES 1

Facility

$512.00

Service Code	HCPCS 11055
Hospital Charge Code	87502550
Hospital Revenue Code	761
Min. Negotiated Rate	$76.80
Max. Negotiated Rate	$76.80
Rate for Payer: Qualcare PPO/HMO/WC	$76.80

FP PARING BENIN 2-4 LESIONS

Facility

$650.00

Service Code	HCPCS 11056
Hospital Charge Code	83652021
Hospital Revenue Code	761
Min. Negotiated Rate	$36.59
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$195.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.50
Rate for Payer: Oxford Commercial	$325.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$325.00

FP PARING BENIN 2-4 LESIONS

Facility

$650.00

Service Code	HCPCS 11056
Hospital Charge Code	83652021
Hospital Revenue Code	761
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

FP PREV MED COUNSL-GRP 30 MIN

Facility

$45.00

Service Code	HCPCS 99411
Hospital Charge Code	83652509
Hospital Revenue Code	510
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

FP PREV MED COUNSL-GRP 30 MIN

Facility

$45.00

Service Code	HCPCS 99411
Hospital Charge Code	87502690
Hospital Revenue Code	510
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

FP PREV MED COUNSL-GRP 30 MIN

Facility

$45.00

Service Code	HCPCS 99411
Hospital Charge Code	83652509
Hospital Revenue Code	510
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$13.50
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.85
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

FP PREV MED COUNSL-GRP 30 MIN

Facility

$45.00

Service Code	HCPCS 99411
Hospital Charge Code	87502690
Hospital Revenue Code	510
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$22.50
Rate for Payer: Aetna Commercial	$13.50
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.85
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

FP PREV MED COUNSL grp 60 MIN

Facility

$62.00

Service Code	HCPCS 99412
Hospital Charge Code	87502695
Hospital Revenue Code	510
Min. Negotiated Rate	$8.06
Max. Negotiated Rate	$31.00
Rate for Payer: Aetna Commercial	$18.60
Rate for Payer: Aetna Medicare Advantage	$18.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.81
Rate for Payer: Cigna Commercial	$31.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.06
Rate for Payer: Qualcare PPO/HMO/WC	$9.30

FP PREV MED COUNSL grp 60 MIN

Facility

$62.00

Service Code	HCPCS 99412
Hospital Charge Code	87502695
Hospital Revenue Code	510
Min. Negotiated Rate	$9.30
Max. Negotiated Rate	$9.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.30

FP PREV MED COUNSL-GRP 60 MIN

Facility

$62.00

Service Code	HCPCS 99412
Hospital Charge Code	83652511
Hospital Revenue Code	510
Min. Negotiated Rate	$9.30
Max. Negotiated Rate	$9.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.30

FP PREV MED COUNSL-GRP 60 MIN

Facility

$62.00

Service Code	HCPCS 99412
Hospital Charge Code	83652511
Hospital Revenue Code	510
Min. Negotiated Rate	$8.06
Max. Negotiated Rate	$31.00
Rate for Payer: Aetna Commercial	$18.60
Rate for Payer: Aetna Medicare Advantage	$18.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.81
Rate for Payer: Cigna Commercial	$31.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.06
Rate for Payer: Qualcare PPO/HMO/WC	$9.30

FP PULSE OXIMETRY

Facility

$10.41

Service Code	HCPCS 94760
Hospital Charge Code	87502720
Hospital Revenue Code	460
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$1.56
Rate for Payer: Qualcare PPO/HMO/WC	$1.56

FP PULSE OXIMETRY

Facility

$10.41

Service Code	HCPCS 94760
Hospital Charge Code	87502720
Hospital Revenue Code	460
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$3.12
Rate for Payer: Aetna Medicare Advantage	$3.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.65
Rate for Payer: Cigna Commercial	$4.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.35
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.56
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

FP PUNCT ASPIRATION ABS/HEMT

Facility

$420.44

Service Code	HCPCS 10160
Hospital Charge Code	83652011
Hospital Revenue Code	761
Min. Negotiated Rate	$54.66
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$126.13
Rate for Payer: Aetna Medicare Advantage	$126.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.21
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.66
Rate for Payer: Oxford Commercial	$210.22
Rate for Payer: Qualcare PPO/HMO/WC	$63.07
Rate for Payer: UnitedHealthcare Commercial	$210.22
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

FP PUNCT ASPIRATION ABS/HEMT

Facility

$420.44

Service Code	HCPCS 10160
Hospital Charge Code	83652011
Hospital Revenue Code	761
Min. Negotiated Rate	$63.07
Max. Negotiated Rate	$63.07
Rate for Payer: Qualcare PPO/HMO/WC	$63.07

FP REM SKIN TAG 0-15 LESIONS

Facility

$283.16

Service Code	HCPCS 11200
Hospital Charge Code	83652031
Hospital Revenue Code	761
Min. Negotiated Rate	$42.47
Max. Negotiated Rate	$42.47
Rate for Payer: Qualcare PPO/HMO/WC	$42.47

FP REM SKIN TAG 0-15 LESIONS

Facility

$283.16

Service Code	HCPCS 11200
Hospital Charge Code	83652031
Hospital Revenue Code	761
Min. Negotiated Rate	$34.16
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$84.95
Rate for Payer: Aetna Medicare Advantage	$84.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.21
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.81
Rate for Payer: Oxford Commercial	$141.58
Rate for Payer: Qualcare PPO/HMO/WC	$42.47
Rate for Payer: UnitedHealthcare Commercial	$141.58

FP REPAIR COMPLEX 1.1-2.5CM

Facility

$114.00

Service Code	HCPCS 13131
Hospital Charge Code	83652073
Hospital Revenue Code	361
Min. Negotiated Rate	$14.82
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$34.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.07
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	$29.07
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.82
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.10
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

FP REPAIR COMPLEX 1.1-2.5CM

Facility

$114.00

Service Code	HCPCS 13131
Hospital Charge Code	83652073
Hospital Revenue Code	361
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$17.10
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

FP SCREENING VISUAL ACUITY,QUA

Facility

$35.00

Service Code	HCPCS 99173
Hospital Charge Code	83652391
Hospital Revenue Code	920
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$10.50
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.55
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

FP SCREENING VISUAL ACUITY,QUA

Facility

$35.00

Service Code	HCPCS 99173
Hospital Charge Code	87502660
Hospital Revenue Code	920
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$10.50
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.55
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

FP SCREENING VISUAL ACUITY,QUA

Facility

$35.00

Service Code	HCPCS 99173
Hospital Charge Code	87502660
Hospital Revenue Code	920
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

FP SCREENING VISUAL ACUITY,QUA

Facility

$35.00

Service Code	HCPCS 99173
Hospital Charge Code	83652391
Hospital Revenue Code	920
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

FP SMKNG&TOBACCO CESS COUNSLG

Facility

$123.00

Service Code	HCPCS 99406
Hospital Charge Code	83652505
Hospital Revenue Code	942
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$18.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

Know your out-of-pocket cost for care.

All Charges