Heights University Hospital

All Charges

Charge

Type

Setting

Price

PUNCH BX SKIN EA ADD LESION

Facility

$517.25

Service Code	HCPCS 11105
Hospital Charge Code	303511105
Hospital Revenue Code	510
Min. Negotiated Rate	$23.16
Max. Negotiated Rate	$155.18
Rate for Payer: Aetna Commercial	$155.18
Rate for Payer: Aetna Medicare Advantage	$155.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.90
Rate for Payer: Cigna Commercial	$23.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.24
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

PUNCH BX SKIN EA ADD LESION

Facility

$517.25

Service Code	HCPCS 11105
Hospital Charge Code	450211105
Hospital Revenue Code	761
Min. Negotiated Rate	$77.59
Max. Negotiated Rate	$77.59
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

PUNCH BX SKIN EA ADD LESION

Facility

$517.25

Service Code	HCPCS 11105
Hospital Charge Code	395011105
Hospital Revenue Code	761
Min. Negotiated Rate	$77.59
Max. Negotiated Rate	$77.59
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

PUNCH BX SKIN EA ADD LESION

Facility

$517.25

Service Code	HCPCS 11105
Hospital Charge Code	412311105
Hospital Revenue Code	361
Min. Negotiated Rate	$77.59
Max. Negotiated Rate	$77.59
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

PUNCH BX SKIN EA ADD LESION

Facility

$517.25

Service Code	HCPCS 11105
Hospital Charge Code	395011105
Hospital Revenue Code	761
Min. Negotiated Rate	$23.16
Max. Negotiated Rate	$258.62
Rate for Payer: Aetna Commercial	$155.18
Rate for Payer: Aetna Medicare Advantage	$155.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.90
Rate for Payer: Cigna Commercial	$23.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.24
Rate for Payer: Oxford Commercial	$258.62
Rate for Payer: Qualcare PPO/HMO/WC	$77.59
Rate for Payer: UnitedHealthcare Commercial	$258.62

PUNCH BX SKIN EA SEP/ADDL

Facility

$368.14

Service Code	HCPCS 11105
Hospital Charge Code	160000201
Hospital Revenue Code	360
Min. Negotiated Rate	$55.22
Max. Negotiated Rate	$55.22
Rate for Payer: Qualcare PPO/HMO/WC	$55.22

PUNCH BX SKIN EA SEP/ADDL

Facility

$368.14

Service Code	HCPCS 11105
Hospital Charge Code	1600000510
Hospital Revenue Code	360
Min. Negotiated Rate	$55.22
Max. Negotiated Rate	$55.22
Rate for Payer: Qualcare PPO/HMO/WC	$55.22

PUNCH BX SKIN EA SEP/ADDL

Facility

$368.14

Service Code	HCPCS 11105
Hospital Charge Code	160000201
Hospital Revenue Code	360
Min. Negotiated Rate	$23.16
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$110.44
Rate for Payer: Aetna Medicare Advantage	$110.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.88
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	$93.88
Rate for Payer: Cigna Commercial	$23.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.86
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.22
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

PUNCH BX SKIN EA SEP/ADDL

Facility

$368.14

Service Code	HCPCS 11105
Hospital Charge Code	1600000510
Hospital Revenue Code	360
Min. Negotiated Rate	$23.16
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$110.44
Rate for Payer: Aetna Medicare Advantage	$110.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.88
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	$93.88
Rate for Payer: Cigna Commercial	$23.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.86
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.22
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

PUNCH BX SKIN SINGLE LESION

Facility

$2,160.92

Service Code	HCPCS 11104
Hospital Charge Code	16000346
Hospital Revenue Code	360
Min. Negotiated Rate	$280.92
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$648.28
Rate for Payer: Aetna Medicare Advantage	$648.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$551.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$551.03
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	$551.03
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$280.92
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.14
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

PUNCH BX SKIN SINGLE LESION

Facility

$2,160.92

Service Code	HCPCS 11104
Hospital Charge Code	16000346
Hospital Revenue Code	360
Min. Negotiated Rate	$324.14
Max. Negotiated Rate	$324.14
Rate for Payer: Qualcare PPO/HMO/WC	$324.14

PUNCH CORNEA 8.5 MM

Facility

$315.00

Hospital Charge Code	270657589
Hospital Revenue Code	270
Min. Negotiated Rate	$40.95
Max. Negotiated Rate	$157.50
Rate for Payer: Aetna Commercial	$94.50
Rate for Payer: Aetna Medicare Advantage	$94.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.33
Rate for Payer: Cigna Commercial	$157.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.95
Rate for Payer: Oxford Commercial	$157.50
Rate for Payer: Qualcare PPO/HMO/WC	$47.25
Rate for Payer: UnitedHealthcare Commercial	$157.50

PUNCH CORNEA 8.5 MM

Facility

$315.00

Hospital Charge Code	270657589
Hospital Revenue Code	270
Min. Negotiated Rate	$47.25
Max. Negotiated Rate	$47.25
Rate for Payer: Qualcare PPO/HMO/WC	$47.25

PUNCH CORNEA DON 7.25MM

Facility

$430.45

Hospital Charge Code	270600214
Hospital Revenue Code	272
Min. Negotiated Rate	$55.96
Max. Negotiated Rate	$215.22
Rate for Payer: Aetna Commercial	$129.13
Rate for Payer: Aetna Medicare Advantage	$129.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.76
Rate for Payer: Cigna Commercial	$215.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.96
Rate for Payer: Oxford Commercial	$215.22
Rate for Payer: Qualcare PPO/HMO/WC	$64.57
Rate for Payer: UnitedHealthcare Commercial	$215.22

PUNCH CORNEA DON 7.25MM

Facility

$430.45

Hospital Charge Code	270600214
Hospital Revenue Code	272
Min. Negotiated Rate	$64.57
Max. Negotiated Rate	$64.57
Rate for Payer: Qualcare PPO/HMO/WC	$64.57

PUNCH CORNEA DON 8.0MM

Facility

$345.00

Hospital Charge Code	270600223
Hospital Revenue Code	272
Min. Negotiated Rate	$51.75
Max. Negotiated Rate	$51.75
Rate for Payer: Qualcare PPO/HMO/WC	$51.75

PUNCH CORNEA DON 8.0MM

Facility

$345.00

Hospital Charge Code	270600223
Hospital Revenue Code	272
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$172.50
Rate for Payer: Aetna Commercial	$103.50
Rate for Payer: Aetna Medicare Advantage	$103.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.97
Rate for Payer: Cigna Commercial	$172.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.85
Rate for Payer: Oxford Commercial	$172.50
Rate for Payer: Qualcare PPO/HMO/WC	$51.75
Rate for Payer: UnitedHealthcare Commercial	$172.50

PUNCH CORNEA DONO 7.5MM

Facility

$360.00

Hospital Charge Code	270600215
Hospital Revenue Code	272
Min. Negotiated Rate	$46.80
Max. Negotiated Rate	$180.00
Rate for Payer: Aetna Commercial	$108.00
Rate for Payer: Aetna Medicare Advantage	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.80
Rate for Payer: Cigna Commercial	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.80
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$180.00

PUNCH CORNEA DONO 7.5MM

Facility

$360.00

Hospital Charge Code	270600215
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

PUNCH CORNEA DONO 7.7MM

Facility

$430.45

Hospital Charge Code	270600222
Hospital Revenue Code	272
Min. Negotiated Rate	$64.57
Max. Negotiated Rate	$64.57
Rate for Payer: Qualcare PPO/HMO/WC	$64.57

PUNCH CORNEA DONO 7.7MM

Facility

$430.45

Hospital Charge Code	270600222
Hospital Revenue Code	272
Min. Negotiated Rate	$55.96
Max. Negotiated Rate	$215.22
Rate for Payer: Aetna Commercial	$129.13
Rate for Payer: Aetna Medicare Advantage	$129.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.76
Rate for Payer: Cigna Commercial	$215.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.96
Rate for Payer: Oxford Commercial	$215.22
Rate for Payer: Qualcare PPO/HMO/WC	$64.57
Rate for Payer: UnitedHealthcare Commercial	$215.22

PUNCH CORNEA DONO 8.5MM

Facility

$430.45

Hospital Charge Code	270600225
Hospital Revenue Code	272
Min. Negotiated Rate	$55.96
Max. Negotiated Rate	$215.22
Rate for Payer: Aetna Commercial	$129.13
Rate for Payer: Aetna Medicare Advantage	$129.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.76
Rate for Payer: Cigna Commercial	$215.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.96
Rate for Payer: Oxford Commercial	$215.22
Rate for Payer: Qualcare PPO/HMO/WC	$64.57
Rate for Payer: UnitedHealthcare Commercial	$215.22

PUNCH CORNEA DONO 8.5MM

Facility

$430.45

Hospital Charge Code	270600225
Hospital Revenue Code	272
Min. Negotiated Rate	$64.57
Max. Negotiated Rate	$64.57
Rate for Payer: Qualcare PPO/HMO/WC	$64.57

PUNCH CORNEA DONO 8.5MM

Facility

$430.45

Hospital Charge Code	270600227
Hospital Revenue Code	272
Min. Negotiated Rate	$64.57
Max. Negotiated Rate	$64.57
Rate for Payer: Qualcare PPO/HMO/WC	$64.57

PUNCH CORNEA DONO 8.5MM

Facility

$430.45

Hospital Charge Code	270600227
Hospital Revenue Code	272
Min. Negotiated Rate	$55.96
Max. Negotiated Rate	$215.22
Rate for Payer: Aetna Commercial	$129.13
Rate for Payer: Aetna Medicare Advantage	$129.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.76
Rate for Payer: Cigna Commercial	$215.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.96
Rate for Payer: Oxford Commercial	$215.22
Rate for Payer: Qualcare PPO/HMO/WC	$64.57
Rate for Payer: UnitedHealthcare Commercial	$215.22

Know your out-of-pocket cost for care.

All Charges