Heights University Hospital

All Charges

Charge

Type

Setting

Price

REMOVE IMPACTED EAR WAX UNI

Facility

$229.14

Service Code	HCPCS 69210
Hospital Charge Code	1600000283
Hospital Revenue Code	360
Min. Negotiated Rate	$29.79
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$193.50
Rate for Payer: Aetna Commercial	$68.74
Rate for Payer: Aetna Medicare Advantage	$68.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.43
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	$58.43
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.79
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.37
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37
Rate for Payer: Wellpoint Medicaid Managed Care	$193.50

REMOVE IMPACTED EAR WAX UNI

Facility

$229.14

Service Code	HCPCS 69210
Hospital Charge Code	1600000283
Hospital Revenue Code	360
Min. Negotiated Rate	$34.37
Max. Negotiated Rate	$34.37
Rate for Payer: Qualcare PPO/HMO/WC	$34.37

REMOVE IN/EX HEM GROUPS 2+

Facility

$32,333.10

Service Code	HCPCS 46260
Hospital Charge Code	16000172
Hospital Revenue Code	360
Min. Negotiated Rate	$4,849.97
Max. Negotiated Rate	$4,849.97
Rate for Payer: Qualcare PPO/HMO/WC	$4,849.97

REMOVE IN/EX HEM GROUPS 2+

Facility

$32,333.10

Service Code	HCPCS 46260
Hospital Charge Code	16000172
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$9,699.93
Rate for Payer: Aetna Commercial	$9,699.93
Rate for Payer: Aetna Medicare Advantage	$9,699.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,244.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,244.94
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	$8,244.94
Rate for Payer: Cigna Commercial	$6,609.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,203.30
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,849.97
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

REMOVE IN/EX HEM GRP & FISS

Facility

$22,676.00

Service Code	HCPCS 46257
Hospital Charge Code	1600000628
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$6,802.80
Rate for Payer: Aetna Commercial	$6,802.80
Rate for Payer: Aetna Medicare Advantage	$6,802.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,782.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,782.38
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	$5,782.38
Rate for Payer: Cigna Commercial	$6,609.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,947.88
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,401.40
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

REMOVE IN/EX HEM GRP & FISS

Facility

$22,676.00

Service Code	HCPCS 46257
Hospital Charge Code	1600000628
Hospital Revenue Code	360
Min. Negotiated Rate	$3,401.40
Max. Negotiated Rate	$3,401.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,401.40

REMOVE INT/EXT HEM 1 GROUP

Facility

$22,676.60

Service Code	HCPCS 46255
Hospital Charge Code	1600000384
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 INT/EXT HEM 1 GROUP

Facility

$22,676.60

Service Code	HCPCS 46255
Hospital Charge Code	1600000384
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 INT/EXT HEM 2+GRPS & F

Facility

$22,676.60

Service Code	HCPCS 46261
Hospital Charge Code	1600000438
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 INT/EXT HEM 2+GRPS & F

Facility

$22,676.60

Service Code	HCPCS 46261
Hospital Charge Code	1600000438
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 INTRA AORTIC BALLN PERC

Facility

$180.00

Service Code	HCPCS 33968
Hospital Charge Code	74110038
Hospital Revenue Code	361
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$13,243.00
Rate for Payer: Aetna Commercial	$54.00
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
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	$45.90
Rate for Payer: Cigna Commercial	$32.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$11,667.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$13,243.00

REMOVE INTRA AORTIC BALLN PERC

Facility

$180.00

Service Code	HCPCS 33968
Hospital Charge Code	5100314
Hospital Revenue Code	361
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$13,243.00
Rate for Payer: Aetna Commercial	$54.00
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
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	$45.90
Rate for Payer: Cigna Commercial	$32.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$11,667.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$13,243.00

REMOVE INTRA AORTIC BALLN PERC

Facility

$180.00

Service Code	HCPCS 33968
Hospital Charge Code	74110038
Hospital Revenue Code	361
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

REMOVE INTRA AORTIC BALLN PERC

Facility

$180.00

Service Code	HCPCS 33968
Hospital Charge Code	5100314
Hospital Revenue Code	361
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

REMOVE INTRVAS FOREIGN BODY

Facility

$15,468.50

Service Code	HCPCS 37197
Hospital Charge Code	321037197
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
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	$3,944.47
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REMOVE INTRVAS FOREIGN BODY

Facility

$13,125.82

Service Code	HCPCS 37197
Hospital Charge Code	411037197
Hospital Revenue Code	361
Min. Negotiated Rate	$1,706.36
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,937.75
Rate for Payer: Aetna Medicare Advantage	$3,937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,347.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,347.08
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	$3,347.08
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.36
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,968.87
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REMOVE INTRVAS FOREIGN BODY

Facility

$13,125.82

Service Code	HCPCS 37197
Hospital Charge Code	366837197
Hospital Revenue Code	361
Min. Negotiated Rate	$1,968.87
Max. Negotiated Rate	$1,968.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,968.87

REMOVE INTRVAS FOREIGN BODY

Facility

$13,125.82

Service Code	HCPCS 37197
Hospital Charge Code	366837197
Hospital Revenue Code	361
Min. Negotiated Rate	$1,706.36
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,937.75
Rate for Payer: Aetna Medicare Advantage	$3,937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,347.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,347.08
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	$3,347.08
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.36
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,968.87
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REMOVE INTRVAS FOREIGN BODY

Facility

$15,468.50

Service Code	HCPCS 37197
Hospital Charge Code	5600228
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

REMOVE INTRVAS FOREIGN BODY

Facility

$15,468.50

Service Code	HCPCS 37197
Hospital Charge Code	5600228
Hospital Revenue Code	361
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$4,640.55
Rate for Payer: Aetna Medicare Advantage	$4,640.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,944.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,944.47
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	$3,944.47
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.90
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REMOVE INTRVAS FOREIGN BODY

Facility

$13,125.82

Service Code	HCPCS 37197
Hospital Charge Code	7411500
Hospital Revenue Code	361
Min. Negotiated Rate	$1,706.36
Max. Negotiated Rate	$7,519.21
Rate for Payer: Aetna Commercial	$3,937.75
Rate for Payer: Aetna Medicare Advantage	$3,937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,347.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,347.08
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	$3,347.08
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,706.36
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,968.87
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

REMOVE INTRVAS FOREIGN BODY

Facility

$15,468.50

Service Code	HCPCS 37197
Hospital Charge Code	321037197
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

REMOVE INTRVAS FOREIGN BODY

Facility

$13,125.82

Service Code	HCPCS 37197
Hospital Charge Code	411037197
Hospital Revenue Code	361
Min. Negotiated Rate	$1,968.87
Max. Negotiated Rate	$1,968.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,968.87

REMOVE INTRVAS FOREIGN BODY

Facility

$13,125.82

Service Code	HCPCS 37197
Hospital Charge Code	7411500
Hospital Revenue Code	361
Min. Negotiated Rate	$1,968.87
Max. Negotiated Rate	$1,968.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,968.87

REMOVE IUD

Facility

$2,913.65

Service Code	HCPCS 58301
Hospital Charge Code	160000204
Hospital Revenue Code	360
Min. Negotiated Rate	$437.05
Max. Negotiated Rate	$437.05
Rate for Payer: Qualcare PPO/HMO/WC	$437.05

Know your out-of-pocket cost for care.

All Charges