Heights University Hospital

All Charges

Charge

Type

Setting

Price

SKIN SUB GRAFT FACE/NK/HF/G

Facility

$8,909.70

Service Code	HCPCS 15275
Hospital Charge Code	1600000379
Hospital Revenue Code	360
Min. Negotiated Rate	$1,158.26
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$2,672.91
Rate for Payer: Aetna Medicare Advantage	$2,672.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,271.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,271.97
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	$2,271.97
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,158.26
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,336.45
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

SKIN SUB GRAFT TRNK/ARM/LEG, 1

Facility

$7,013.50

Service Code	HCPCS 15271
Hospital Charge Code	160000241
Hospital Revenue Code	360
Min. Negotiated Rate	$1,052.03
Max. Negotiated Rate	$1,052.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,052.03

SKIN SUB GRAFT TRNK/ARM/LEG, 1

Facility

$7,013.50

Service Code	HCPCS 15271
Hospital Charge Code	160000241
Hospital Revenue Code	360
Min. Negotiated Rate	$911.75
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$2,104.05
Rate for Payer: Aetna Medicare Advantage	$2,104.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,788.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,788.44
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	$1,788.44
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$911.75
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,052.03
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

SKIN SUB GRFT T/ARM/LG CHILD

Facility

$12,712.96

Service Code	HCPCS 15273
Hospital Charge Code	16000784
Hospital Revenue Code	360
Min. Negotiated Rate	$1,652.68
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$3,813.89
Rate for Payer: Aetna Medicare Advantage	$3,813.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,241.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,241.80
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	$3,241.80
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,652.68
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,906.94
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

SKIN SUB GRFT T/ARM/LG CHILD

Facility

$12,712.96

Service Code	HCPCS 15273
Hospital Charge Code	16000784
Hospital Revenue Code	360
Min. Negotiated Rate	$1,906.94
Max. Negotiated Rate	$1,906.94
Rate for Payer: Qualcare PPO/HMO/WC	$1,906.94

SKIN TAG REMOVAL 1-15

Facility

$372.00

Service Code	HCPCS 11200
Hospital Charge Code	412311200
Hospital Revenue Code	761
Min. Negotiated Rate	$34.16
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$111.60
Rate for Payer: Aetna Medicare Advantage	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.86
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.36
Rate for Payer: Oxford Commercial	$186.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$186.00

SKIN TAG REMOVAL 1-15

Facility

$372.00

Service Code	HCPCS 11200
Hospital Charge Code	412311200
Hospital Revenue Code	761
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

SKIN TAG REMVL 1-15

Facility

$372.00

Service Code	HCPCS 11200
Hospital Charge Code	5780005
Hospital Revenue Code	450
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

SKIN TAG REMVL 1-15

Facility

$372.00

Service Code	HCPCS 11200
Hospital Charge Code	5780005
Hospital Revenue Code	450
Min. Negotiated Rate	$34.16
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$111.60
Rate for Payer: Aetna Medicare Advantage	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.86
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.36
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

SKIN TE

Facility

$11,000.00

Service Code	HCPCS Q4200
Hospital Charge Code	270688706
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$3,300.00
Rate for Payer: Aetna Medicare Advantage	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,805.00
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

SKIN TE

Facility

$20,750.00

Service Code	HCPCS Q4200
Hospital Charge Code	270689765
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$6,225.00
Rate for Payer: Aetna Commercial	$6,225.00
Rate for Payer: Aetna Medicare Advantage	$6,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,291.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,291.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,291.25
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,021.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,112.50

SKIN TE

Facility

$20,750.00

Service Code	HCPCS Q4200
Hospital Charge Code	270689765
Hospital Revenue Code	278
Min. Negotiated Rate	$3,112.50
Max. Negotiated Rate	$5,021.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,021.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,112.50

SKIN TE

Facility

$11,000.00

Service Code	HCPCS Q4200
Hospital Charge Code	270688706
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$2,662.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

SKIN TE PRODUCT 256SQCM

Facility

$92,500.00

Service Code	HCPCS Q4200
Hospital Charge Code	270690189
Hospital Revenue Code	278
Min. Negotiated Rate	$13,875.00
Max. Negotiated Rate	$22,385.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,385.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,875.00

SKIN TE PRODUCT 256SQCM

Facility

$92,500.00

Service Code	HCPCS Q4200
Hospital Charge Code	270690189
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$27,750.00
Rate for Payer: Aetna Commercial	$27,750.00
Rate for Payer: Aetna Medicare Advantage	$27,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,587.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,587.50
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22,385.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,875.00

SKIN TEST TB TINE

Facility

$36.45

Service Code	HCPCS 86580
Hospital Charge Code	2500396
Hospital Revenue Code	302
Min. Negotiated Rate	$4.74
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$10.94
Rate for Payer: Aetna Medicare Advantage	$10.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.29
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: Cigna Medicare Advantage	$6.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.47
Rate for Payer: UnitedHealthcare Commercial	$114.00

SKIN TEST TB TINE

Facility

$36.45

Service Code	HCPCS 86580
Hospital Charge Code	2500396
Hospital Revenue Code	302
Min. Negotiated Rate	$5.47
Max. Negotiated Rate	$5.47
Rate for Payer: Qualcare PPO/HMO/WC	$5.47

SKIN TISSUE REARRANGEMENT

Facility

$16,286.20

Service Code	HCPCS 14000
Hospital Charge Code	16000190
Hospital Revenue Code	360
Min. Negotiated Rate	$64.50
Max. Negotiated Rate	$4,913.48
Rate for Payer: Aetna Better Health Medicaid	$64.50
Rate for Payer: Aetna Commercial	$4,885.86
Rate for Payer: Aetna Medicare Advantage	$4,885.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,152.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,152.98
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	$4,152.98
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.21
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,442.93
Rate for Payer: UnitedHealthcare Commercial	$3,687.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$65.79
Rate for Payer: Wellpoint Medicaid Managed Care	$64.50

SKIN TISSUE REARRANGEMENT

Facility

$16,286.20

Service Code	HCPCS 14000
Hospital Charge Code	16000190
Hospital Revenue Code	360
Min. Negotiated Rate	$2,442.93
Max. Negotiated Rate	$2,442.93
Rate for Payer: Qualcare PPO/HMO/WC	$2,442.93

SKIN ULCERS

Facility

$23,770.53

Service Code	APR-DRG 3804
Min. Negotiated Rate	$18,303.49
Max. Negotiated Rate	$23,770.53
Rate for Payer: Aetna Better Health Medicaid	$23,304.44
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,770.53
Rate for Payer: Wellpoint Medicaid Managed Care	$18,303.49

SKIN ULCERS

Facility

$7,256.45

Service Code	APR-DRG 3801
Min. Negotiated Rate	$5,380.83
Max. Negotiated Rate	$7,256.45
Rate for Payer: Aetna Better Health Medicaid	$7,114.17
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,256.45
Rate for Payer: Wellpoint Medicaid Managed Care	$5,380.83

SKIN ULCERS

Facility

$13,661.85

Service Code	APR-DRG 3803
Min. Negotiated Rate	$9,324.35
Max. Negotiated Rate	$13,661.85
Rate for Payer: Aetna Better Health Medicaid	$13,393.97
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,661.85
Rate for Payer: Wellpoint Medicaid Managed Care	$9,324.35

SKIN ULCERS

Facility

$9,347.60

Service Code	APR-DRG 3802
Min. Negotiated Rate	$6,450.74
Max. Negotiated Rate	$9,347.60
Rate for Payer: Aetna Better Health Medicaid	$9,164.31
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,347.60
Rate for Payer: Wellpoint Medicaid Managed Care	$6,450.74

SKIN ULCERS WITH CC

Facility

$46,255.47

Service Code	MSDRG 593
Min. Negotiated Rate	$12,945.60
Max. Negotiated Rate	$46,255.47
Rate for Payer: Aetna Commercial	$40,001.90
Rate for Payer: Aetna Medicare Advantage	$12,945.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,356.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,356.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,418.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33,356.07
Rate for Payer: Cigna Commercial	$25,530.36
Rate for Payer: Cigna Medicare Advantage	$15,418.49
Rate for Payer: Clover Medicare Advantage	$14,647.57
Rate for Payer: EmblemHealth Commercial	$46,255.47
Rate for Payer: Humana Medicare Advantage	$15,881.04
Rate for Payer: Oxford Commercial	$15,955.74
Rate for Payer: UnitedHealthcare Commercial	$18,111.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,418.49
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16,343.60
Rate for Payer: Wellcare Medicare Advantage	$15,418.49

SKIN ULCERS WITH MCC

Facility

$67,995.72

Service Code	MSDRG 592
Min. Negotiated Rate	$21,119.12
Max. Negotiated Rate	$67,995.72
Rate for Payer: Aetna Commercial	$65,258.08
Rate for Payer: Aetna Medicare Advantage	$21,119.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57,615.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57,615.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,665.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57,615.03
Rate for Payer: Cigna Commercial	$41,649.59
Rate for Payer: Cigna Medicare Advantage	$22,665.24
Rate for Payer: Clover Medicare Advantage	$21,531.98
Rate for Payer: EmblemHealth Commercial	$67,995.72
Rate for Payer: Humana Medicare Advantage	$23,345.20
Rate for Payer: Oxford Commercial	$26,029.78
Rate for Payer: UnitedHealthcare Commercial	$29,546.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,665.24
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24,025.15
Rate for Payer: Wellcare Medicare Advantage	$22,665.24

Know your out-of-pocket cost for care.

All Charges