Heights University Hospital

All Charges

Charge

Type

Setting

Price

IR HIP,ARTHROGRAPHY,RAD S & I

Facility

$1,667.37

Service Code	HCPCS 73525
Hospital Charge Code	7411668
Hospital Revenue Code	322
Min. Negotiated Rate	$250.11
Max. Negotiated Rate	$250.11
Rate for Payer: Qualcare PPO/HMO/WC	$250.11

IR HIP,ARTHROGRAPHY,RAD S & I

Facility

$1,667.37

Service Code	HCPCS 73525
Hospital Charge Code	7411668
Hospital Revenue Code	322
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$1,627.00
Rate for Payer: Aetna Better Health Medicaid	$1,595.10
Rate for Payer: Aetna Commercial	$500.21
Rate for Payer: Aetna Medicare Advantage	$500.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$425.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$425.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$425.18
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.76
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.11
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,627.00

IR HSG TRAY

Facility

$30.00

Hospital Charge Code	4800870
Hospital Revenue Code	272
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$15.00
Rate for Payer: Aetna Commercial	$9.00
Rate for Payer: Aetna Medicare Advantage	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.65
Rate for Payer: Cigna Commercial	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$15.00

IR HSG TRAY

Facility

$30.00

Hospital Charge Code	4800870
Hospital Revenue Code	272
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

IR-HSTSALP/PGHY CTH/INTRO

Facility

$746.20

Service Code	HCPCS 58340
Hospital Charge Code	2670215
Hospital Revenue Code	361
Min. Negotiated Rate	$57.23
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$223.86
Rate for Payer: Aetna Medicare Advantage	$223.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$190.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$190.28
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	$190.28
Rate for Payer: Cigna Commercial	$57.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.01
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.93
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR-HSTSALP/PGHY CTH/INTRO

Facility

$746.20

Service Code	HCPCS 58340
Hospital Charge Code	7411636
Hospital Revenue Code	361
Min. Negotiated Rate	$111.93
Max. Negotiated Rate	$111.93
Rate for Payer: Qualcare PPO/HMO/WC	$111.93

IR-HSTSALP/PGHY CTH/INTRO

Facility

$746.20

Service Code	HCPCS 58340
Hospital Charge Code	321058340
Hospital Revenue Code	361
Min. Negotiated Rate	$111.93
Max. Negotiated Rate	$111.93
Rate for Payer: Qualcare PPO/HMO/WC	$111.93

IR-HSTSALP/PGHY CTH/INTRO

Facility

$746.20

Service Code	HCPCS 58340
Hospital Charge Code	2670215
Hospital Revenue Code	361
Min. Negotiated Rate	$111.93
Max. Negotiated Rate	$111.93
Rate for Payer: Qualcare PPO/HMO/WC	$111.93

IR-HSTSALP/PGHY CTH/INTRO

Facility

$746.20

Service Code	HCPCS 58340
Hospital Charge Code	321058340
Hospital Revenue Code	361
Min. Negotiated Rate	$57.23
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$223.86
Rate for Payer: Aetna Medicare Advantage	$223.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$190.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$190.28
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	$190.28
Rate for Payer: Cigna Commercial	$57.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.01
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.93
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR-HSTSALP/PGHY CTH/INTRO

Facility

$746.20

Service Code	HCPCS 58340
Hospital Charge Code	7411636
Hospital Revenue Code	361
Min. Negotiated Rate	$57.23
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$223.86
Rate for Payer: Aetna Medicare Advantage	$223.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$190.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$190.28
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	$190.28
Rate for Payer: Cigna Commercial	$57.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.01
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$111.93
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR-I&D ABCESS: COMPLEX

Facility

$530.00

Service Code	HCPCS 10061
Hospital Charge Code	2690001
Hospital Revenue Code	761
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$79.50
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

IR-I&D ABCESS: COMPLEX

Facility

$530.00

Service Code	HCPCS 10061
Hospital Charge Code	7411334
Hospital Revenue Code	761
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$79.50
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

IR-I&D ABCESS: COMPLEX

Facility

$530.00

Service Code	HCPCS 10061
Hospital Charge Code	2690001
Hospital Revenue Code	761
Min. Negotiated Rate	$68.90
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$159.00
Rate for Payer: Aetna Medicare Advantage	$159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.15
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.90
Rate for Payer: Oxford Commercial	$265.00
Rate for Payer: Qualcare PPO/HMO/WC	$79.50
Rate for Payer: UnitedHealthcare Commercial	$265.00

IR-I&D ABCESS: COMPLEX

Facility

$530.00

Service Code	HCPCS 10061
Hospital Charge Code	7411334
Hospital Revenue Code	761
Min. Negotiated Rate	$68.90
Max. Negotiated Rate	$968.07
Rate for Payer: Qualcare PPO/HMO/WC	$79.50
Rate for Payer: Aetna Commercial	$159.00
Rate for Payer: Aetna Medicare Advantage	$159.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.15
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.90
Rate for Payer: Oxford Commercial	$265.00
Rate for Payer: UnitedHealthcare Commercial	$265.00

IR I&D ABSCESS DEEP LEG OR ANK

Facility

$8,548.96

Service Code	HCPCS 27603
Hospital Charge Code	2680100
Hospital Revenue Code	361
Min. Negotiated Rate	$1,282.34
Max. Negotiated Rate	$1,282.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.34

IR I&D ABSCESS DEEP LEG OR ANK

Facility

$8,548.96

Service Code	HCPCS 27603
Hospital Charge Code	7411371
Hospital Revenue Code	361
Min. Negotiated Rate	$1,111.36
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$2,564.69
Rate for Payer: Aetna Medicare Advantage	$2,564.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,179.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,179.98
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	$2,179.98
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,111.36
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.34
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

IR I&D ABSCESS DEEP LEG OR ANK

Facility

$8,548.96

Service Code	HCPCS 27603
Hospital Charge Code	7411371
Hospital Revenue Code	361
Min. Negotiated Rate	$1,282.34
Max. Negotiated Rate	$1,282.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.34

IR I&D ABSCESS DEEP LEG OR ANK

Facility

$8,548.96

Service Code	HCPCS 27603
Hospital Charge Code	2680100
Hospital Revenue Code	361
Min. Negotiated Rate	$1,111.36
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$2,564.69
Rate for Payer: Aetna Medicare Advantage	$2,564.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,179.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,179.98
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	$2,179.98
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,111.36
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.34
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

IR I&D DEEP ABSCESS NECK/THORA

Facility

$8,548.96

Service Code	HCPCS 21501
Hospital Charge Code	2680045
Hospital Revenue Code	361
Min. Negotiated Rate	$1,282.34
Max. Negotiated Rate	$1,282.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.34

IR I&D DEEP ABSCESS NECK/THORA

Facility

$8,548.96

Service Code	HCPCS 21501
Hospital Charge Code	2680045
Hospital Revenue Code	361
Min. Negotiated Rate	$1,111.36
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$2,564.69
Rate for Payer: Aetna Medicare Advantage	$2,564.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,179.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,179.98
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	$2,179.98
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,111.36
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.34
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

IR I&D DEEP ABSCESS NECK/THORA

Facility

$8,548.96

Service Code	HCPCS 20501
Hospital Charge Code	7411350
Hospital Revenue Code	361
Min. Negotiated Rate	$1,282.34
Max. Negotiated Rate	$1,282.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.34

IR I&D DEEP ABSCESS NECK/THORA

Facility

$8,548.96

Service Code	HCPCS 20501
Hospital Charge Code	7411350
Hospital Revenue Code	361
Min. Negotiated Rate	$33.42
Max. Negotiated Rate	$2,564.69
Rate for Payer: Aetna Commercial	$2,564.69
Rate for Payer: Aetna Medicare Advantage	$2,564.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,179.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,179.98
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	$2,179.98
Rate for Payer: Cigna Commercial	$33.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,111.36
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.34
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

IR I&D DEEP ABSCESS UP ARM/ELB

Facility

$8,548.96

Service Code	HCPCS 23930
Hospital Charge Code	7411361
Hospital Revenue Code	361
Min. Negotiated Rate	$1,282.34
Max. Negotiated Rate	$1,282.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.34

IR I&D DEEP ABSCESS UP ARM/ELB

Facility

$8,548.96

Service Code	HCPCS 23930
Hospital Charge Code	7411361
Hospital Revenue Code	361
Min. Negotiated Rate	$1,111.36
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$2,564.69
Rate for Payer: Aetna Medicare Advantage	$2,564.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,179.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,179.98
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	$2,179.98
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,111.36
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.34
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

IR I&D DEEP ABSCESS UP ARM/ELB

Facility

$8,548.96

Service Code	HCPCS 23930
Hospital Charge Code	2680060
Hospital Revenue Code	361
Min. Negotiated Rate	$1,111.36
Max. Negotiated Rate	$6,917.28
Rate for Payer: Aetna Commercial	$2,564.69
Rate for Payer: Aetna Medicare Advantage	$2,564.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,179.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,179.98
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	$2,179.98
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,111.36
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.34
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

Know your out-of-pocket cost for care.

All Charges