Heights University Hospital

All Charges

Charge

Type

Setting

Price

REMOVE DEVITAL TISSUE WOUND

Facility

$1,319.00

Service Code	HCPCS 97602
Hospital Charge Code	412397602
Hospital Revenue Code	510
Min. Negotiated Rate	$197.85
Max. Negotiated Rate	$197.85
Rate for Payer: Qualcare PPO/HMO/WC	$197.85

REMOVE DIGIT NERVE LESION

Facility

$4,643.50

Service Code	HCPCS 64776
Hospital Charge Code	1600000713
Hospital Revenue Code	360
Min. Negotiated Rate	$603.65
Max. Negotiated Rate	$5,529.00
Rate for Payer: Qualcare PPO/HMO/WC	$696.52
Rate for Payer: UnitedHealthcare Commercial	$5,529.00
Rate for Payer: Aetna Commercial	$1,393.05
Rate for Payer: Aetna Medicare Advantage	$1,393.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,184.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,184.09
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	$1,184.09
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$603.65
Rate for Payer: Oxford Commercial	$4,871.00

REMOVE DIGIT NERVE LESION

Facility

$4,643.50

Service Code	HCPCS 64776
Hospital Charge Code	1600000713
Hospital Revenue Code	360
Min. Negotiated Rate	$696.52
Max. Negotiated Rate	$696.52
Rate for Payer: Qualcare PPO/HMO/WC	$696.52

REMOVE DRUG IMPLANT

Facility

$1,704.00

Service Code	HCPCS 11982
Hospital Charge Code	16000155
Hospital Revenue Code	360
Min. Negotiated Rate	$255.60
Max. Negotiated Rate	$255.60
Rate for Payer: Qualcare PPO/HMO/WC	$255.60

REMOVE DRUG IMPLANT

Facility

$1,704.00

Service Code	HCPCS 11982
Hospital Charge Code	16000155
Hospital Revenue Code	360
Min. Negotiated Rate	$221.52
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$511.20
Rate for Payer: Aetna Medicare Advantage	$511.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$434.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$434.52
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	$434.52
Rate for Payer: Cigna Commercial	$1,063.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.52
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$255.60
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

REMOVE ELBOW JOINT LINING-LT

Facility

$30,595.00

Service Code	HCPCS 24102
Hospital Charge Code	16000681
Hospital Revenue Code	360
Min. Negotiated Rate	$4,589.25
Max. Negotiated Rate	$4,589.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25

REMOVE ELBOW JOINT LINING-LT

Facility

$30,595.00

Service Code	HCPCS 24102
Hospital Charge Code	16000681
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$9,178.50
Rate for Payer: Aetna Commercial	$9,178.50
Rate for Payer: Aetna Medicare Advantage	$9,178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,801.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,801.73
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	$7,801.73
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,977.35
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REMOVE ELECTRD TRANSVENOUS

Facility

$20,101.20

Service Code	HCPCS 33244
Hospital Charge Code	411033244
Hospital Revenue Code	480
Min. Negotiated Rate	$363.93
Max. Negotiated Rate	$8,899.18
Rate for Payer: Aetna Commercial	$6,030.36
Rate for Payer: Aetna Medicare Advantage	$6,030.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,125.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,125.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$363.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,125.81
Rate for Payer: Cigna Commercial	$8,899.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,613.16
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,015.18
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

REMOVE ELECTRD TRANSVENOUS

Facility

$20,101.20

Service Code	HCPCS 33244
Hospital Charge Code	411033244
Hospital Revenue Code	480
Min. Negotiated Rate	$3,015.18
Max. Negotiated Rate	$3,015.18
Rate for Payer: Qualcare PPO/HMO/WC	$3,015.18

REMOVE EPIDIDYMIS

Facility

$16,246.84

Service Code	HCPCS 54830
Hospital Charge Code	1600000261
Hospital Revenue Code	360
Min. Negotiated Rate	$2,437.03
Max. Negotiated Rate	$2,437.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,437.03

REMOVE EPIDIDYMIS

Facility

$16,246.84

Service Code	HCPCS 54830
Hospital Charge Code	1600000261
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,394.37
Rate for Payer: Aetna Commercial	$4,874.05
Rate for Payer: Aetna Medicare Advantage	$4,874.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,142.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,142.94
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	$4,142.94
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,112.09
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,437.03
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

REMOVE EPIDIDYMIS LESION

Facility

$9,649.80

Service Code	HCPCS 54840
Hospital Charge Code	1600000260
Hospital Revenue Code	360
Min. Negotiated Rate	$1,254.47
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Commercial	$2,894.94
Rate for Payer: Aetna Medicare Advantage	$2,894.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,460.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,460.70
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	$2,460.70
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,254.47
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,447.47
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

REMOVE EPIDIDYMIS LESION

Facility

$9,649.80

Service Code	HCPCS 54840
Hospital Charge Code	1600000260
Hospital Revenue Code	360
Min. Negotiated Rate	$1,447.47
Max. Negotiated Rate	$1,447.47
Rate for Payer: Qualcare PPO/HMO/WC	$1,447.47

REMOVE EPIDIDYMIS LESION

Facility

$12,062.25

Service Code	HCPCS 54840
Hospital Charge Code	1600000322
Hospital Revenue Code	360
Min. Negotiated Rate	$1,809.34
Max. Negotiated Rate	$1,809.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,809.34

REMOVE EPIDIDYMIS LESION

Facility

$12,062.25

Service Code	HCPCS 54840
Hospital Charge Code	1600000322
Hospital Revenue Code	360
Min. Negotiated Rate	$1,568.09
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Commercial	$3,618.68
Rate for Payer: Aetna Medicare Advantage	$3,618.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,075.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,075.87
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	$3,075.87
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,568.09
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,809.34
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

REMOVE EXT HEM GROUPS 2+

Facility

$22,676.60

Service Code	HCPCS 46250
Hospital Charge Code	1600000455
Hospital Revenue Code	360
Min. Negotiated Rate	$3,401.49
Max. Negotiated Rate	$3,401.49
Rate for Payer: Qualcare PPO/HMO/WC	$3,401.49

REMOVE EXT HEM GROUPS 2+

Facility

$22,676.60

Service Code	HCPCS 46250
Hospital Charge Code	1600000455
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,802.98
Rate for Payer: Aetna Commercial	$6,802.98
Rate for Payer: Aetna Medicare Advantage	$6,802.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,782.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,782.53
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	$5,782.53
Rate for Payer: Cigna Commercial	$6,609.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,947.96
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,401.49
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

REMOVE EXTRA SPINE SEGMENT

Facility

$15,178.00

Service Code	HCPCS 22116
Hospital Charge Code	24001253
Hospital Revenue Code	360
Min. Negotiated Rate	$2,276.70
Max. Negotiated Rate	$2,276.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,276.70

REMOVE EXTRA SPINE SEGMENT

Facility

$15,178.00

Service Code	HCPCS 22116
Hospital Charge Code	1600000682
Hospital Revenue Code	360
Min. Negotiated Rate	$2,276.70
Max. Negotiated Rate	$2,276.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,276.70

REMOVE EXTRA SPINE SEGMENT

Facility

$15,178.00

Service Code	HCPCS 22116
Hospital Charge Code	24001253
Hospital Revenue Code	360
Min. Negotiated Rate	$136.41
Max. Negotiated Rate	$4,553.40
Rate for Payer: Aetna Commercial	$4,553.40
Rate for Payer: Aetna Medicare Advantage	$4,553.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,870.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,870.39
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	$3,870.39
Rate for Payer: Cigna Commercial	$136.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,973.14
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,276.70
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

REMOVE EXTRA SPINE SEGMENT

Facility

$15,178.00

Service Code	HCPCS 22116
Hospital Charge Code	1600000682
Hospital Revenue Code	360
Min. Negotiated Rate	$136.41
Max. Negotiated Rate	$4,553.40
Rate for Payer: Aetna Commercial	$4,553.40
Rate for Payer: Aetna Medicare Advantage	$4,553.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,870.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,870.39
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	$3,870.39
Rate for Payer: Cigna Commercial	$136.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,973.14
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,276.70
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

REMOVE FECAL IMPACTION OR FB

Facility

$21,472.19

Service Code	HCPCS 45915
Hospital Charge Code	16000486
Hospital Revenue Code	360
Min. Negotiated Rate	$3,220.83
Max. Negotiated Rate	$3,220.83
Rate for Payer: Qualcare PPO/HMO/WC	$3,220.83

REMOVE FECAL IMPACTION OR FB

Facility

$21,472.19

Service Code	HCPCS 45915
Hospital Charge Code	16000486
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,441.66
Rate for Payer: Aetna Commercial	$6,441.66
Rate for Payer: Aetna Medicare Advantage	$6,441.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,475.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,475.41
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	$5,475.41
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,791.38
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,220.83
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

REMOVE GROIN LYMPH NODES

Facility

$22,569.14

Service Code	HCPCS 38760
Hospital Charge Code	16000958
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$15,812.86
Rate for Payer: Aetna Commercial	$6,770.74
Rate for Payer: Aetna Medicare Advantage	$6,770.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,755.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,755.13
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	$5,755.13
Rate for Payer: Cigna Commercial	$15,812.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,933.99
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,385.37
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

REMOVE GROIN LYMPH NODES

Facility

$22,569.14

Service Code	HCPCS 38760
Hospital Charge Code	16000958
Hospital Revenue Code	360
Min. Negotiated Rate	$3,385.37
Max. Negotiated Rate	$3,385.37
Rate for Payer: Qualcare PPO/HMO/WC	$3,385.37

Know your out-of-pocket cost for care.

All Charges