Heights University Hospital

All Charges

Charge

Type

Setting

Price

RW ARTHROCENTESIS SM JNT/BURSA

Facility

$301.00

Service Code	HCPCS 20600
Hospital Charge Code	87502165
Hospital Revenue Code	761
Min. Negotiated Rate	$45.15
Max. Negotiated Rate	$45.15
Rate for Payer: Qualcare PPO/HMO/WC	$45.15

RW ARTHROCENTSIS INTRMDT JOINT

Facility

$329.00

Service Code	HCPCS 20605
Hospital Charge Code	84206085
Hospital Revenue Code	761
Min. Negotiated Rate	$29.30
Max. Negotiated Rate	$730.97
Rate for Payer: Aetna Commercial	$98.70
Rate for Payer: Aetna Medicare Advantage	$98.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.89
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.77
Rate for Payer: Oxford Commercial	$164.50
Rate for Payer: Qualcare PPO/HMO/WC	$49.35
Rate for Payer: UnitedHealthcare Commercial	$164.50

RW ARTHROCENTSIS INTRMDT JOINT

Facility

$329.00

Service Code	HCPCS 20605
Hospital Charge Code	84206085
Hospital Revenue Code	761
Min. Negotiated Rate	$49.35
Max. Negotiated Rate	$49.35
Rate for Payer: Qualcare PPO/HMO/WC	$49.35

RW ARTHROCENTSIS MAJOR JOINT

Facility

$1,091.00

Service Code	HCPCS 20610
Hospital Charge Code	84206090
Hospital Revenue Code	761
Min. Negotiated Rate	$45.06
Max. Negotiated Rate	$730.97
Rate for Payer: Aetna Commercial	$327.30
Rate for Payer: Aetna Medicare Advantage	$327.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$278.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$278.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$278.20
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.83
Rate for Payer: Oxford Commercial	$545.50
Rate for Payer: Qualcare PPO/HMO/WC	$163.65
Rate for Payer: UnitedHealthcare Commercial	$545.50

RW ARTHROCENTSIS MAJOR JOINT

Facility

$1,091.00

Service Code	HCPCS 20610
Hospital Charge Code	84206090
Hospital Revenue Code	761
Min. Negotiated Rate	$163.65
Max. Negotiated Rate	$163.65
Rate for Payer: Qualcare PPO/HMO/WC	$163.65

RW AUDIOMETRY

Facility

$194.00

Service Code	HCPCS 92552
Hospital Charge Code	84206275
Hospital Revenue Code	471
Min. Negotiated Rate	$25.22
Max. Negotiated Rate	$1,180.00
Rate for Payer: Aetna Commercial	$58.20
Rate for Payer: Aetna Medicare Advantage	$58.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.47
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.22
Rate for Payer: Oxford Commercial	$1,040.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.10
Rate for Payer: UnitedHealthcare Commercial	$1,180.00

RW AUDIOMETRY

Facility

$194.00

Service Code	HCPCS 92552
Hospital Charge Code	84206275
Hospital Revenue Code	471
Min. Negotiated Rate	$29.10
Max. Negotiated Rate	$29.10
Rate for Payer: Qualcare PPO/HMO/WC	$29.10

RW AUDIOMETRY

Facility

$194.00

Service Code	HCPCS 92522
Hospital Charge Code	87502275
Hospital Revenue Code	471
Min. Negotiated Rate	$25.22
Max. Negotiated Rate	$1,180.00
Rate for Payer: Aetna Commercial	$58.20
Rate for Payer: Aetna Medicare Advantage	$58.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.47
Rate for Payer: Cigna Commercial	$123.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.22
Rate for Payer: Oxford Commercial	$1,040.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.10
Rate for Payer: UnitedHealthcare Commercial	$1,180.00

RW AUDIOMETRY

Facility

$194.00

Service Code	HCPCS 92522
Hospital Charge Code	87502275
Hospital Revenue Code	471
Min. Negotiated Rate	$29.10
Max. Negotiated Rate	$29.10
Rate for Payer: Qualcare PPO/HMO/WC	$29.10

RW BRONCHODIALIDATOR ADMIN

Facility

$171.00

Service Code	HCPCS 171
Hospital Charge Code	87502290
Hospital Revenue Code	419
Min. Negotiated Rate	$25.65
Max. Negotiated Rate	$25.65
Rate for Payer: Qualcare PPO/HMO/WC	$25.65

RW BRONCHODIALIDATOR ADMIN

Facility

$171.00

Service Code	HCPCS 171
Hospital Charge Code	87502290
Hospital Revenue Code	419
Min. Negotiated Rate	$22.23
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$51.30
Rate for Payer: Aetna Medicare Advantage	$51.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.60
Rate for Payer: Cigna Commercial	$85.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.23
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.65
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

RW BRONCHODILATOR ADMIN

Facility

$278.20

Service Code	HCPCS 94644
Hospital Charge Code	87502880
Hospital Revenue Code	410
Min. Negotiated Rate	$41.73
Max. Negotiated Rate	$41.73
Rate for Payer: Qualcare PPO/HMO/WC	$41.73

RW BRONCHODILATOR ADMIN

Facility

$278.20

Service Code	HCPCS 94644
Hospital Charge Code	87502880
Hospital Revenue Code	410
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$83.46
Rate for Payer: Aetna Medicare Advantage	$83.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.94
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.17
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.73
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

RW BX SKIN & ADD LESION

Facility

$185.00

Service Code	HCPCS 11101
Hospital Charge Code	87502070
Hospital Revenue Code	761
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

RW BX SKIN & ADD LESION

Facility

$185.00

Service Code	HCPCS 11101
Hospital Charge Code	87502070
Hospital Revenue Code	761
Min. Negotiated Rate	$24.05
Max. Negotiated Rate	$92.50
Rate for Payer: Aetna Commercial	$55.50
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.05
Rate for Payer: Oxford Commercial	$92.50
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Commercial	$92.50

RW BX SKIN & ADDN'L LESION

Facility

$185.00

Service Code	HCPCS 11101
Hospital Charge Code	84206040
Hospital Revenue Code	761
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

RW BX SKIN & ADDN'L LESION

Facility

$185.00

Service Code	HCPCS 11101
Hospital Charge Code	84206040
Hospital Revenue Code	761
Min. Negotiated Rate	$24.05
Max. Negotiated Rate	$92.50
Rate for Payer: Aetna Commercial	$55.50
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.05
Rate for Payer: Oxford Commercial	$92.50
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Commercial	$92.50

RW BX SKIN IINGLE LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	875020065
Hospital Revenue Code	761
Min. Negotiated Rate	$79.56
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$183.60
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.56
Rate for Payer: Oxford Commercial	$306.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$306.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

RW BX SKIN IINGLE LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	875020065
Hospital Revenue Code	761
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

RW BX SKIN SINGLE LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	87502065
Hospital Revenue Code	761
Min. Negotiated Rate	$79.56
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$183.60
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.56
Rate for Payer: Oxford Commercial	$306.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$306.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

RW BX SKIN SINGLE LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	84206035
Hospital Revenue Code	761
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

RW BX SKIN SINGLE LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	84206035
Hospital Revenue Code	761
Min. Negotiated Rate	$79.56
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$183.60
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.56
Rate for Payer: Oxford Commercial	$306.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$306.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

RW BX SKIN SINGLE LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	87502065
Hospital Revenue Code	761
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

RW CERUMEN REMOVAL

Facility

$274.00

Service Code	HCPCS 69210
Hospital Charge Code	84206130
Hospital Revenue Code	761
Min. Negotiated Rate	$33.17
Max. Negotiated Rate	$197.37
Rate for Payer: Aetna Better Health Medicaid	$193.50
Rate for Payer: Aetna Commercial	$82.20
Rate for Payer: Aetna Medicare Advantage	$82.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.87
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.62
Rate for Payer: Oxford Commercial	$137.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.10
Rate for Payer: UnitedHealthcare Commercial	$137.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37

RW CERUMEN REMOVAL

Facility

$274.00

Hospital Charge Code	87502090
Hospital Revenue Code	761
Min. Negotiated Rate	$41.10
Max. Negotiated Rate	$41.10
Rate for Payer: Qualcare PPO/HMO/WC	$41.10

Know your out-of-pocket cost for care.

All Charges