Heights University Hospital

All Charges

Charge

Type

Setting

Price

ANNUAL VISIT WHC*****

Facility

$49.50

Service Code	HCPCS 99395WF
Hospital Charge Code	9600012
Hospital Revenue Code	519
Min. Negotiated Rate	$6.43
Max. Negotiated Rate	$24.75
Rate for Payer: Aetna Commercial	$14.85
Rate for Payer: Aetna Medicare Advantage	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.62
Rate for Payer: Cigna Commercial	$24.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.43
Rate for Payer: Qualcare PPO/HMO/WC	$7.42

ANNUAL WELLNESS VISIT - FIRST

Facility

$543.00

Service Code	HCPCS G0438
Hospital Charge Code	87502680
Hospital Revenue Code	770
Min. Negotiated Rate	$70.59
Max. Negotiated Rate	$271.50
Rate for Payer: Aetna Commercial	$162.90
Rate for Payer: Aetna Medicare Advantage	$162.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.47
Rate for Payer: Cigna Commercial	$193.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.59
Rate for Payer: Oxford Commercial	$271.50
Rate for Payer: Qualcare PPO/HMO/WC	$81.45
Rate for Payer: UnitedHealthcare Commercial	$271.50

ANNUAL WELLNESS VISIT - FIRST

Facility

$543.00

Service Code	HCPCS G0438
Hospital Charge Code	87502680
Hospital Revenue Code	770
Min. Negotiated Rate	$81.45
Max. Negotiated Rate	$81.45
Rate for Payer: Qualcare PPO/HMO/WC	$81.45

ANNUAL WELLNESS VISIT-FIRST

Facility

$543.00

Service Code	HCPCS G0438
Hospital Charge Code	83652533
Hospital Revenue Code	770
Min. Negotiated Rate	$81.45
Max. Negotiated Rate	$81.45
Rate for Payer: Qualcare PPO/HMO/WC	$81.45

ANNUAL WELLNESS VISIT-FIRST

Facility

$543.00

Service Code	HCPCS G0438
Hospital Charge Code	83652533
Hospital Revenue Code	770
Min. Negotiated Rate	$70.59
Max. Negotiated Rate	$271.50
Rate for Payer: Aetna Commercial	$162.90
Rate for Payer: Aetna Medicare Advantage	$162.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.47
Rate for Payer: Cigna Commercial	$193.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.59
Rate for Payer: Oxford Commercial	$271.50
Rate for Payer: Qualcare PPO/HMO/WC	$81.45
Rate for Payer: UnitedHealthcare Commercial	$271.50

ANNUAL WELLNESS VISIT - SUBSQ

Facility

$364.00

Service Code	HCPCS G0439
Hospital Charge Code	87502685
Hospital Revenue Code	770
Min. Negotiated Rate	$47.32
Max. Negotiated Rate	$182.00
Rate for Payer: Aetna Commercial	$109.20
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.82
Rate for Payer: Cigna Commercial	$153.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.32
Rate for Payer: Oxford Commercial	$182.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Commercial	$182.00

ANNUAL WELLNESS VISIT - SUBSQ

Facility

$364.00

Service Code	HCPCS G0439
Hospital Charge Code	87502685
Hospital Revenue Code	770
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

ANNUAL WELLNESS VISIT-SUBSQ

Facility

$364.00

Service Code	HCPCS G0439
Hospital Charge Code	83652535
Hospital Revenue Code	770
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

ANNUAL WELLNESS VISIT-SUBSQ

Facility

$364.00

Service Code	HCPCS G0439
Hospital Charge Code	83652535
Hospital Revenue Code	770
Min. Negotiated Rate	$47.32
Max. Negotiated Rate	$182.00
Rate for Payer: Aetna Commercial	$109.20
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.82
Rate for Payer: Cigna Commercial	$153.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.32
Rate for Payer: Oxford Commercial	$182.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Commercial	$182.00

ANNUAL WELLNESS VST FIRST GE

Facility

$543.00

Service Code	HCPCS G0438
Hospital Charge Code	87502825
Hospital Revenue Code	770
Min. Negotiated Rate	$81.45
Max. Negotiated Rate	$81.45
Rate for Payer: Qualcare PPO/HMO/WC	$81.45

ANNUAL WELLNESS VST FIRST GE

Facility

$543.00

Service Code	HCPCS G0438
Hospital Charge Code	87502825
Hospital Revenue Code	770
Min. Negotiated Rate	$70.59
Max. Negotiated Rate	$271.50
Rate for Payer: Aetna Commercial	$162.90
Rate for Payer: Aetna Medicare Advantage	$162.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.47
Rate for Payer: Cigna Commercial	$193.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.59
Rate for Payer: Oxford Commercial	$271.50
Rate for Payer: Qualcare PPO/HMO/WC	$81.45
Rate for Payer: UnitedHealthcare Commercial	$271.50

ANNUAL WELLNESS VST SUBSQ GE

Facility

$364.00

Service Code	HCPCS G0439
Hospital Charge Code	87502830
Hospital Revenue Code	770
Min. Negotiated Rate	$47.32
Max. Negotiated Rate	$182.00
Rate for Payer: Aetna Commercial	$109.20
Rate for Payer: Aetna Medicare Advantage	$109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.82
Rate for Payer: Cigna Commercial	$153.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.32
Rate for Payer: Oxford Commercial	$182.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.60
Rate for Payer: UnitedHealthcare Commercial	$182.00

ANNUAL WELLNESS VST SUBSQ GE

Facility

$364.00

Service Code	HCPCS G0439
Hospital Charge Code	87502830
Hospital Revenue Code	770
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Qualcare PPO/HMO/WC	$54.60

ANNULOTOMY KNIFE

Facility

$7,420.00

Hospital Charge Code	270696761
Hospital Revenue Code	272
Min. Negotiated Rate	$964.60
Max. Negotiated Rate	$3,710.00
Rate for Payer: Aetna Commercial	$2,226.00
Rate for Payer: Aetna Medicare Advantage	$2,226.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,892.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,892.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,892.10
Rate for Payer: Cigna Commercial	$3,710.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$964.60
Rate for Payer: Oxford Commercial	$3,710.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,113.00
Rate for Payer: UnitedHealthcare Commercial	$3,710.00

ANNULOTOMY KNIFE

Facility

$7,420.00

Hospital Charge Code	270696761
Hospital Revenue Code	272
Min. Negotiated Rate	$1,113.00
Max. Negotiated Rate	$1,113.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,113.00

ANOGENITAL EXAM CHILD

Facility

$59.00

Service Code	HCPCS 99170
Hospital Charge Code	5780315
Hospital Revenue Code	450
Min. Negotiated Rate	$7.67
Max. Negotiated Rate	$481.45
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	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.67
Rate for Payer: Qualcare PPO/HMO/WC	$8.85

ANOGENITAL EXAM CHILD

Facility

$59.00

Service Code	HCPCS 99170
Hospital Charge Code	5780315
Hospital Revenue Code	450
Min. Negotiated Rate	$8.85
Max. Negotiated Rate	$8.85
Rate for Payer: Qualcare PPO/HMO/WC	$8.85

ANOSCOPE HALF FOBER OPTIC

Facility

$3,008.75

Hospital Charge Code	270658897
Hospital Revenue Code	272
Min. Negotiated Rate	$391.14
Max. Negotiated Rate	$1,504.38
Rate for Payer: Aetna Commercial	$902.62
Rate for Payer: Aetna Medicare Advantage	$902.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$767.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$767.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$767.23
Rate for Payer: Cigna Commercial	$1,504.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$391.14
Rate for Payer: Oxford Commercial	$1,504.38
Rate for Payer: Qualcare PPO/HMO/WC	$451.31
Rate for Payer: UnitedHealthcare Commercial	$1,504.38

ANOSCOPE HALF FOBER OPTIC

Facility

$3,008.75

Hospital Charge Code	270658897
Hospital Revenue Code	272
Min. Negotiated Rate	$451.31
Max. Negotiated Rate	$451.31
Rate for Payer: Qualcare PPO/HMO/WC	$451.31

ANOSCOPY & BIOPSY

Facility

$9,798.35

Service Code	HCPCS 46606
Hospital Charge Code	87502930
Hospital Revenue Code	761
Min. Negotiated Rate	$1,469.75
Max. Negotiated Rate	$1,469.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,469.75

ANOSCOPY & BIOPSY

Facility

$9,798.35

Service Code	HCPCS 46606
Hospital Charge Code	87502930
Hospital Revenue Code	761
Min. Negotiated Rate	$25.76
Max. Negotiated Rate	$4,899.18
Rate for Payer: Aetna Commercial	$2,939.51
Rate for Payer: Aetna Medicare Advantage	$2,939.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,498.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,498.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,498.58
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,273.79
Rate for Payer: Oxford Commercial	$4,899.18
Rate for Payer: Qualcare PPO/HMO/WC	$1,469.75
Rate for Payer: UnitedHealthcare Commercial	$4,899.18

ANOSCOPY DIAGNOSTIC

Facility

$696.50

Service Code	HCPCS 46600
Hospital Charge Code	87502816
Hospital Revenue Code	761
Min. Negotiated Rate	$18.40
Max. Negotiated Rate	$348.25
Rate for Payer: Aetna Commercial	$208.95
Rate for Payer: Aetna Medicare Advantage	$208.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.61
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.55
Rate for Payer: Oxford Commercial	$348.25
Rate for Payer: Qualcare PPO/HMO/WC	$104.47
Rate for Payer: UnitedHealthcare Commercial	$348.25

ANOSCOPY DIAGNOSTIC

Facility

$696.50

Service Code	HCPCS 46600
Hospital Charge Code	87502816
Hospital Revenue Code	761
Min. Negotiated Rate	$104.47
Max. Negotiated Rate	$104.47
Rate for Payer: Qualcare PPO/HMO/WC	$104.47

ANOSCOPY DX

Facility

$1,167.00

Service Code	HCPCS 46600
Hospital Charge Code	1600000703
Hospital Revenue Code	360
Min. Negotiated Rate	$151.71
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$350.10
Rate for Payer: Aetna Medicare Advantage	$350.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$297.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$297.58
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	$297.58
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.71
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$175.05
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

ANOSCOPY DX

Facility

$1,167.00

Service Code	HCPCS 46600
Hospital Charge Code	1600000703
Hospital Revenue Code	360
Min. Negotiated Rate	$175.05
Max. Negotiated Rate	$175.05
Rate for Payer: Qualcare PPO/HMO/WC	$175.05

Know your out-of-pocket cost for care.

All Charges