Heights University Hospital

All Charges

Charge

Type

Setting

Price

OPD INDIVID NON MD 20-30 MIN

Facility

$275.00

Service Code	HCPCS 90832
Hospital Charge Code	87504015
Hospital Revenue Code	914
Min. Negotiated Rate	$35.75
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.75
Rate for Payer: Qualcare PPO/HMO/WC	$41.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$71.39

OPD INDIVID NON MD 20-30 MIN

Facility

$1,296.00

Service Code	HCPCS 90832
Hospital Charge Code	84310060
Hospital Revenue Code	914
Min. Negotiated Rate	$194.40
Max. Negotiated Rate	$194.40
Rate for Payer: Qualcare PPO/HMO/WC	$194.40

OPD INDIVID NON MD 20-30 MIN

Facility

$275.00

Service Code	HCPCS 90832
Hospital Charge Code	87504015
Hospital Revenue Code	914
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

OPD INDIVID NON MD 45-50 MIN

Facility

$1,423.80

Service Code	HCPCS 90834
Hospital Charge Code	84310070
Hospital Revenue Code	914
Min. Negotiated Rate	$94.46
Max. Negotiated Rate	$427.14
Rate for Payer: Aetna Commercial	$427.14
Rate for Payer: Aetna Medicare Advantage	$427.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.07
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.09
Rate for Payer: Qualcare PPO/HMO/WC	$213.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46

OPD INDIVID NON MD 45-50 MIN

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	87504025
Hospital Revenue Code	914
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$422.69
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$94.46

OPD INDIVID NON MD 45-50 MIN

Facility

$1,423.80

Service Code	HCPCS 90834
Hospital Charge Code	84310070
Hospital Revenue Code	914
Min. Negotiated Rate	$213.57
Max. Negotiated Rate	$213.57
Rate for Payer: Qualcare PPO/HMO/WC	$213.57

OPD INDIVID NON MD 45-50 MIN

Facility

$425.00

Service Code	HCPCS 90834
Hospital Charge Code	87504025
Hospital Revenue Code	914
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

OPD INDIVIDUAL MD 20-30MIN

Facility

$730.00

Service Code	HCPCS 90805
Hospital Charge Code	84310020
Hospital Revenue Code	914
Min. Negotiated Rate	$109.50
Max. Negotiated Rate	$109.50
Rate for Payer: Qualcare PPO/HMO/WC	$109.50

OPD INDIVIDUAL MD 20-30MIN

Facility

$730.00

Service Code	HCPCS 90805
Hospital Charge Code	84310020
Hospital Revenue Code	914
Min. Negotiated Rate	$94.90
Max. Negotiated Rate	$365.00
Rate for Payer: Aetna Commercial	$219.00
Rate for Payer: Aetna Medicare Advantage	$219.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.15
Rate for Payer: Cigna Commercial	$365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.90
Rate for Payer: Qualcare PPO/HMO/WC	$109.50

OPD PLAY TX NON MD 20-30 MIN

Facility

$491.00

Service Code	HCPCS 90810
Hospital Charge Code	84310030
Hospital Revenue Code	914
Min. Negotiated Rate	$63.83
Max. Negotiated Rate	$245.50
Rate for Payer: Aetna Commercial	$147.30
Rate for Payer: Aetna Medicare Advantage	$147.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.20
Rate for Payer: Cigna Commercial	$245.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.83
Rate for Payer: Qualcare PPO/HMO/WC	$73.65

OPD PLAY TX NON MD 20-30 MIN

Facility

$491.00

Service Code	HCPCS 90810
Hospital Charge Code	84310030
Hospital Revenue Code	914
Min. Negotiated Rate	$73.65
Max. Negotiated Rate	$73.65
Rate for Payer: Qualcare PPO/HMO/WC	$73.65

OPD PSYCHIATRIC EVALUATION

Facility

$1,296.00

Service Code	HCPCS 90801
Hospital Charge Code	84310010
Hospital Revenue Code	900
Min. Negotiated Rate	$168.48
Max. Negotiated Rate	$1,994.00
Rate for Payer: Aetna Commercial	$388.80
Rate for Payer: Aetna Medicare Advantage	$388.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.48
Rate for Payer: Cigna Commercial	$648.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.48
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$194.40
Rate for Payer: UnitedHealthcare Commercial	$1,994.00

OPD PSYCHIATRIC EVALUATION

Facility

$1,296.00

Service Code	HCPCS 90801
Hospital Charge Code	84310010
Hospital Revenue Code	900
Min. Negotiated Rate	$194.40
Max. Negotiated Rate	$194.40
Rate for Payer: Qualcare PPO/HMO/WC	$194.40

OPEN ANKLE JNT FUSION

Facility

$77,285.80

Service Code	HCPCS 27870
Hospital Charge Code	1600000297
Hospital Revenue Code	360
Min. Negotiated Rate	$11,592.87
Max. Negotiated Rate	$11,592.87
Rate for Payer: Qualcare PPO/HMO/WC	$11,592.87

OPEN ANKLE JNT FUSION

Facility

$77,285.80

Service Code	HCPCS 27870
Hospital Charge Code	1600000297
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$30,573.98
Rate for Payer: Aetna Commercial	$23,185.74
Rate for Payer: Aetna Medicare Advantage	$23,185.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,707.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,707.88
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	$19,707.88
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,047.15
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$11,592.87
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

OPEN BOWEL TO SKIN

Facility

$12,361.00

Service Code	HCPCS 44300
Hospital Charge Code	1600000634
Hospital Revenue Code	360
Min. Negotiated Rate	$1,606.93
Max. Negotiated Rate	$4,569.67
Rate for Payer: Aetna Commercial	$3,708.30
Rate for Payer: Aetna Medicare Advantage	$3,708.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,152.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,152.05
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	$3,152.05
Rate for Payer: Cigna Commercial	$4,569.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,606.93
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,854.15
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

OPEN BOWEL TO SKIN

Facility

$12,361.00

Service Code	HCPCS 44300
Hospital Charge Code	1600000634
Hospital Revenue Code	360
Min. Negotiated Rate	$1,854.15
Max. Negotiated Rate	$1,854.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,854.15

OPEN BX/EXC INGUINOFEM NODES

Facility

$18,038.36

Service Code	HCPCS 38531
Hospital Charge Code	160000223
Hospital Revenue Code	360
Min. Negotiated Rate	$2,705.75
Max. Negotiated Rate	$2,705.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,705.75

OPEN BX/EXC INGUINOFEM NODES

Facility

$18,038.36

Service Code	HCPCS 38531
Hospital Charge Code	160000223
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$9,324.19
Rate for Payer: Aetna Commercial	$5,411.51
Rate for Payer: Aetna Medicare Advantage	$5,411.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,599.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,599.78
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	$4,599.78
Rate for Payer: Cigna Commercial	$9,324.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,344.99
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,705.75
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

OPEN BX/EXC LN; INT MAMM NODE(

Facility

$15,259.20

Service Code	HCPCS 38530
Hospital Charge Code	16000957
Hospital Revenue Code	360
Min. Negotiated Rate	$2,288.88
Max. Negotiated Rate	$2,288.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,288.88

OPEN BX/EXC LN; INT MAMM NODE(

Facility

$15,259.20

Service Code	HCPCS 38530
Hospital Charge Code	16000957
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$9,324.19
Rate for Payer: Aetna Commercial	$4,577.76
Rate for Payer: Aetna Medicare Advantage	$4,577.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,891.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,891.10
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	$3,891.10
Rate for Payer: Cigna Commercial	$9,324.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,983.70
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,288.88
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

OPEN BX OR EXC LN,SUPERFICIAL

Facility

$24,074.90

Service Code	HCPCS 38500
Hospital Charge Code	16000265
Hospital Revenue Code	360
Min. Negotiated Rate	$3,611.24
Max. Negotiated Rate	$3,611.24
Rate for Payer: Qualcare PPO/HMO/WC	$3,611.24

OPEN BX OR EXC LN,SUPERFICIAL

Facility

$24,074.90

Service Code	HCPCS 38500
Hospital Charge Code	16000265
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$9,324.19
Rate for Payer: Aetna Commercial	$7,222.47
Rate for Payer: Aetna Medicare Advantage	$7,222.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,139.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,139.10
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	$6,139.10
Rate for Payer: Cigna Commercial	$9,324.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,129.74
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,611.24
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

OPEN CONNECTOR 30MM

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270699333
Hospital Revenue Code	278
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$1,028.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

OPEN CONNECTOR 30MM

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270699333
Hospital Revenue Code	278
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,275.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,028.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

Know your out-of-pocket cost for care.

All Charges