Heights University Hospital

All Charges

Charge

Type

Setting

Price

RW NEW PT - VISIT - FOCUSED

Facility

$234.00

Service Code	HCPCS 99201
Hospital Charge Code	84206310
Hospital Revenue Code	510
Min. Negotiated Rate	$30.42
Max. Negotiated Rate	$117.00
Rate for Payer: Aetna Commercial	$70.20
Rate for Payer: Aetna Medicare Advantage	$70.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.67
Rate for Payer: Cigna Commercial	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.42
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

RW NEW PT - VISIT - FOCUSED

Facility

$234.00

Service Code	HCPCS 99201
Hospital Charge Code	84206310
Hospital Revenue Code	510
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$35.10
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

RW OFF VISIT EST PT MINIMAL

Facility

$114.00

Service Code	HCPCS 99211
Hospital Charge Code	87502225
Hospital Revenue Code	510
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$17.10
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

RW OFF VISIT EST PT MINIMAL

Facility

$114.00

Service Code	HCPCS 99211
Hospital Charge Code	87502225
Hospital Revenue Code	510
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$34.20
Rate for Payer: Aetna Commercial	$34.20
Rate for Payer: Aetna Medicare Advantage	$34.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.07
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.82
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

RW OFF VISIT FOCUSED NP

Facility

$234.00

Service Code	HCPCS 99201
Hospital Charge Code	87502200
Hospital Revenue Code	510
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$35.10
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

RW OFF VISIT FOCUSED NP

Facility

$234.00

Service Code	HCPCS 99201
Hospital Charge Code	87502200
Hospital Revenue Code	510
Min. Negotiated Rate	$30.42
Max. Negotiated Rate	$117.00
Rate for Payer: Aetna Commercial	$70.20
Rate for Payer: Aetna Medicare Advantage	$70.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.67
Rate for Payer: Cigna Commercial	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.42
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

RW PAIRING BENIGN 2-4 LESIONS

Facility

$650.00

Service Code	HCPCS 11056
Hospital Charge Code	87502145
Hospital Revenue Code	761
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

RW PAIRING BENIGN 2-4 LESIONS

Facility

$650.00

Service Code	HCPCS 11056
Hospital Charge Code	87502145
Hospital Revenue Code	761
Min. Negotiated Rate	$36.59
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$195.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.50
Rate for Payer: Oxford Commercial	$325.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$325.00

RW PAIRING BENIGN >4 LESIONS

Facility

$1,400.00

Service Code	HCPCS 11057
Hospital Charge Code	87502150
Hospital Revenue Code	761
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

RW PAIRING BENIGN >4 LESIONS

Facility

$1,400.00

Service Code	HCPCS 11057
Hospital Charge Code	87502150
Hospital Revenue Code	761
Min. Negotiated Rate	$45.25
Max. Negotiated Rate	$700.00
Rate for Payer: Aetna Commercial	$420.00
Rate for Payer: Aetna Medicare Advantage	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.00
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.00
Rate for Payer: Oxford Commercial	$700.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00
Rate for Payer: UnitedHealthcare Commercial	$700.00

RW PAIRING BENIGN LES SINGLE

Facility

$512.00

Service Code	HCPCS 11055
Hospital Charge Code	87502140
Hospital Revenue Code	761
Min. Negotiated Rate	$76.80
Max. Negotiated Rate	$76.80
Rate for Payer: Qualcare PPO/HMO/WC	$76.80

RW PAIRING BENIGN LES SINGLE

Facility

$512.00

Service Code	HCPCS 11055
Hospital Charge Code	87502140
Hospital Revenue Code	761
Min. Negotiated Rate	$32.61
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$153.60
Rate for Payer: Aetna Medicare Advantage	$153.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.56
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.56
Rate for Payer: Oxford Commercial	$256.00
Rate for Payer: Qualcare PPO/HMO/WC	$76.80
Rate for Payer: UnitedHealthcare Commercial	$256.00

RW PAP SMEAR

Facility

$143.00

Service Code	HCPCS Q0091
Hospital Charge Code	87502295
Hospital Revenue Code	770
Min. Negotiated Rate	$21.45
Max. Negotiated Rate	$21.45
Rate for Payer: Qualcare PPO/HMO/WC	$21.45

RW PAP SMEAR

Facility

$143.00

Service Code	HCPCS Q0091
Hospital Charge Code	87502295
Hospital Revenue Code	770
Min. Negotiated Rate	$18.59
Max. Negotiated Rate	$71.50
Rate for Payer: Aetna Commercial	$42.90
Rate for Payer: Aetna Medicare Advantage	$42.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.47
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.59
Rate for Payer: Oxford Commercial	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$21.45
Rate for Payer: UnitedHealthcare Commercial	$71.50

RW PAP SMEAR

Facility

$143.00

Hospital Charge Code	83652627
Hospital Revenue Code	770
Min. Negotiated Rate	$21.45
Max. Negotiated Rate	$21.45
Rate for Payer: Qualcare PPO/HMO/WC	$21.45

RW PAP SMEAR

Facility

$143.00

Hospital Charge Code	83652627
Hospital Revenue Code	770
Min. Negotiated Rate	$18.59
Max. Negotiated Rate	$71.50
Rate for Payer: Aetna Commercial	$42.90
Rate for Payer: Aetna Medicare Advantage	$42.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.47
Rate for Payer: Cigna Commercial	$71.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.59
Rate for Payer: Oxford Commercial	$71.50
Rate for Payer: Qualcare PPO/HMO/WC	$21.45
Rate for Payer: UnitedHealthcare Commercial	$71.50

RW PARING BENIGN 2-4 LESION

Facility

$1,208.00

Service Code	HCPCS 11750
Hospital Charge Code	87502135
Hospital Revenue Code	761
Min. Negotiated Rate	$141.00
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$362.40
Rate for Payer: Aetna Medicare Advantage	$362.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.04
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.04
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$181.20
Rate for Payer: UnitedHealthcare Commercial	$604.00

RW PARING BENIGN 2-4 LESION

Facility

$1,208.00

Service Code	HCPCS 11750
Hospital Charge Code	87502135
Hospital Revenue Code	761
Min. Negotiated Rate	$181.20
Max. Negotiated Rate	$181.20
Rate for Payer: Qualcare PPO/HMO/WC	$181.20

RW PARING BENIGN 2 TO 4 LESION

Facility

$650.00

Service Code	HCPCS 11056
Hospital Charge Code	83652023
Hospital Revenue Code	761
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

RW PARING BENIGN 2 TO 4 LESION

Facility

$650.00

Service Code	HCPCS 11056
Hospital Charge Code	83652023
Hospital Revenue Code	761
Min. Negotiated Rate	$36.59
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$195.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.50
Rate for Payer: Oxford Commercial	$325.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$325.00

RW PARING BENIGN >4 LESIONS

Facility

$1,400.00

Service Code	HCPCS 11057
Hospital Charge Code	84206030
Hospital Revenue Code	761
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

RW PARING BENIGN >4 LESIONS

Facility

$1,400.00

Service Code	HCPCS 11057
Hospital Charge Code	84206030
Hospital Revenue Code	761
Min. Negotiated Rate	$45.25
Max. Negotiated Rate	$700.00
Rate for Payer: Aetna Commercial	$420.00
Rate for Payer: Aetna Medicare Advantage	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.00
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.00
Rate for Payer: Oxford Commercial	$700.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00
Rate for Payer: UnitedHealthcare Commercial	$700.00

RW PARING BENIGN LESION,SINGLE

Facility

$512.00

Service Code	HCPCS 11055
Hospital Charge Code	84206025
Hospital Revenue Code	761
Min. Negotiated Rate	$76.80
Max. Negotiated Rate	$76.80
Rate for Payer: Qualcare PPO/HMO/WC	$76.80

RW PARING BENIGN LESION,SINGLE

Facility

$512.00

Service Code	HCPCS 11055
Hospital Charge Code	84206025
Hospital Revenue Code	761
Min. Negotiated Rate	$32.61
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$153.60
Rate for Payer: Aetna Medicare Advantage	$153.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.56
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.56
Rate for Payer: Oxford Commercial	$256.00
Rate for Payer: Qualcare PPO/HMO/WC	$76.80
Rate for Payer: UnitedHealthcare Commercial	$256.00

RW PEAKFLOW

Facility

$241.00

Service Code	HCPCS 94150
Hospital Charge Code	84206290
Hospital Revenue Code	460
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$36.15
Rate for Payer: Qualcare PPO/HMO/WC	$36.15

Know your out-of-pocket cost for care.

All Charges