Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$1,282.34
Max. Negotiated Rate	$1,282.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,282.34

IR I&D DEEP THIGH OR KNEE

Facility

$8,548.96

Service Code	HCPCS 27301
Hospital Charge Code	2680090
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 THIGH OR KNEE

Facility

$8,548.96

Service Code	HCPCS 27301
Hospital Charge Code	2680090
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 THIGH OR KNEE

Facility

$8,548.96

Service Code	HCPCS 27301
Hospital Charge Code	7411369
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 THIGH OR KNEE

Facility

$8,548.96

Service Code	HCPCS 27301
Hospital Charge Code	7411369
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 HEMATOMA, SEROMA OR FLU

Facility

$8,036.95

Service Code	HCPCS 10140
Hospital Charge Code	2680001
Hospital Revenue Code	361
Min. Negotiated Rate	$1,044.80
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$2,411.09
Rate for Payer: Aetna Medicare Advantage	$2,411.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,049.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,049.42
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	$2,049.42
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,044.80
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,205.54
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR I&D HEMATOMA, SEROMA OR FLU

Facility

$5,456.19

Service Code	HCPCS 10140
Hospital Charge Code	7411335
Hospital Revenue Code	361
Min. Negotiated Rate	$709.30
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Commercial	$1,636.86
Rate for Payer: Aetna Medicare Advantage	$1,636.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,391.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,391.33
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	$1,391.33
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$709.30
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$818.43
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR I&D HEMATOMA, SEROMA OR FLU

Facility

$8,036.95

Service Code	HCPCS 10140
Hospital Charge Code	403410140
Hospital Revenue Code	481
Min. Negotiated Rate	$1,205.54
Max. Negotiated Rate	$1,205.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,205.54

IR I&D HEMATOMA, SEROMA OR FLU

Facility

$8,036.95

Service Code	HCPCS 10140
Hospital Charge Code	403410140
Hospital Revenue Code	481
Min. Negotiated Rate	$1,044.80
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$2,411.09
Rate for Payer: Aetna Medicare Advantage	$2,411.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,049.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,049.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,049.42
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,044.80
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,205.54
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR I&D HEMATOMA, SEROMA OR FLU

Facility

$8,036.95

Service Code	HCPCS 10140
Hospital Charge Code	2680001
Hospital Revenue Code	361
Min. Negotiated Rate	$1,205.54
Max. Negotiated Rate	$1,205.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,205.54

IR I&D HEMATOMA, SEROMA OR FLU

Facility

$5,456.19

Service Code	HCPCS 10140
Hospital Charge Code	7411335
Hospital Revenue Code	361
Min. Negotiated Rate	$818.43
Max. Negotiated Rate	$818.43
Rate for Payer: Qualcare PPO/HMO/WC	$818.43

IR-ID SENTINEL NODE-BI

Facility

$374.00

Service Code	HCPCS 3879250
Hospital Charge Code	7411814
Hospital Revenue Code	361
Min. Negotiated Rate	$48.62
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$112.20
Rate for Payer: Aetna Medicare Advantage	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.37
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	$95.37
Rate for Payer: Cigna Commercial	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.62
Rate for Payer: Qualcare PPO/HMO/WC	$56.10

IR-ID SENTINEL NODE-BI

Facility

$374.00

Service Code	HCPCS 3879250
Hospital Charge Code	2690580
Hospital Revenue Code	361
Min. Negotiated Rate	$48.62
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$112.20
Rate for Payer: Aetna Medicare Advantage	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.37
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	$95.37
Rate for Payer: Cigna Commercial	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.62
Rate for Payer: Qualcare PPO/HMO/WC	$56.10

IR-ID SENTINEL NODE-BI

Facility

$374.00

Service Code	HCPCS 3879250
Hospital Charge Code	7411814
Hospital Revenue Code	361
Min. Negotiated Rate	$56.10
Max. Negotiated Rate	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$56.10

IR-ID SENTINEL NODE-BI

Facility

$374.00

Service Code	HCPCS 3879250
Hospital Charge Code	2690580
Hospital Revenue Code	361
Min. Negotiated Rate	$56.10
Max. Negotiated Rate	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$56.10

IR-ID SENTINEL NODE-LT

Facility

$374.00

Service Code	HCPCS 38792LT
Hospital Charge Code	7411948
Hospital Revenue Code	361
Min. Negotiated Rate	$48.62
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$112.20
Rate for Payer: Aetna Medicare Advantage	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.37
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	$95.37
Rate for Payer: Cigna Commercial	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.62
Rate for Payer: Qualcare PPO/HMO/WC	$56.10

IR-ID SENTINEL NODE-LT

Facility

$374.00

Service Code	HCPCS 38792LT
Hospital Charge Code	2691490
Hospital Revenue Code	361
Min. Negotiated Rate	$56.10
Max. Negotiated Rate	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$56.10

IR-ID SENTINEL NODE-LT

Facility

$374.00

Service Code	HCPCS 38792LT
Hospital Charge Code	2691490
Hospital Revenue Code	361
Min. Negotiated Rate	$48.62
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$112.20
Rate for Payer: Aetna Medicare Advantage	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.37
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	$95.37
Rate for Payer: Cigna Commercial	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.62
Rate for Payer: Qualcare PPO/HMO/WC	$56.10

IR-ID SENTINEL NODE-LT

Facility

$374.00

Service Code	HCPCS 38792LT
Hospital Charge Code	7411948
Hospital Revenue Code	361
Min. Negotiated Rate	$56.10
Max. Negotiated Rate	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$56.10

IR-ID SENTINEL NODE-RT

Facility

$374.00

Service Code	HCPCS 38792RT
Hospital Charge Code	2691495
Hospital Revenue Code	361
Min. Negotiated Rate	$56.10
Max. Negotiated Rate	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$56.10

IR-ID SENTINEL NODE-RT

Facility

$374.00

Service Code	HCPCS 38792RT
Hospital Charge Code	7411949
Hospital Revenue Code	361
Min. Negotiated Rate	$56.10
Max. Negotiated Rate	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$56.10

IR-ID SENTINEL NODE-RT

Facility

$374.00

Service Code	HCPCS 38792RT
Hospital Charge Code	7411949
Hospital Revenue Code	361
Min. Negotiated Rate	$48.62
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$112.20
Rate for Payer: Aetna Medicare Advantage	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.37
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	$95.37
Rate for Payer: Cigna Commercial	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.62
Rate for Payer: Qualcare PPO/HMO/WC	$56.10

IR-ID SENTINEL NODE-RT

Facility

$374.00

Service Code	HCPCS 38792RT
Hospital Charge Code	2691495
Hospital Revenue Code	361
Min. Negotiated Rate	$48.62
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$112.20
Rate for Payer: Aetna Medicare Advantage	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.37
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	$95.37
Rate for Payer: Cigna Commercial	$187.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.62
Rate for Payer: Qualcare PPO/HMO/WC	$56.10

IR ILIAC ANEURISM ENDOVAS RPR

Facility

$4,000.00

Service Code	HCPCS 75954
Hospital Charge Code	7411734
Hospital Revenue Code	320
Min. Negotiated Rate	$520.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR ILIAC ANEURISM ENDOVAS RPR

Facility

$4,000.00

Service Code	HCPCS 75954
Hospital Charge Code	2011300
Hospital Revenue Code	320
Min. Negotiated Rate	$520.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$520.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

Know your out-of-pocket cost for care.

All Charges