Heights University Hospital

All Charges

Charge

Type

Setting

Price

SKIN ULCERS WITHOUT CC/MCC

Facility

$36,981.72

Service Code	MSDRG 594
Min. Negotiated Rate	$9,459.03
Max. Negotiated Rate	$36,981.72
Rate for Payer: Aetna Commercial	$29,228.40
Rate for Payer: Aetna Medicare Advantage	$9,459.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,777.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,777.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,327.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21,777.93
Rate for Payer: Cigna Commercial	$18,654.40
Rate for Payer: Cigna Medicare Advantage	$12,327.24
Rate for Payer: Clover Medicare Advantage	$11,710.88
Rate for Payer: EmblemHealth Commercial	$36,981.72
Rate for Payer: Humana Medicare Advantage	$12,697.06
Rate for Payer: Oxford Commercial	$11,658.46
Rate for Payer: UnitedHealthcare Commercial	$13,233.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,327.24
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13,066.87
Rate for Payer: Wellcare Medicare Advantage	$12,327.24

SKN FL GRFT FCE/GNT/HF=<20SQCM

Facility

$17,100.51

Service Code	HCPCS 15240
Hospital Charge Code	1600000799
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$5,130.15
Rate for Payer: Aetna Commercial	$5,130.15
Rate for Payer: Aetna Medicare Advantage	$5,130.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,360.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,360.63
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	$4,360.63
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,223.07
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,565.08
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

SKN FL GRFT FCE/GNT/HF=<20SQCM

Facility

$17,100.51

Service Code	HCPCS 15240
Hospital Charge Code	1600000799
Hospital Revenue Code	360
Min. Negotiated Rate	$2,565.08
Max. Negotiated Rate	$2,565.08
Rate for Payer: Qualcare PPO/HMO/WC	$2,565.08

SKN SP AGRF F/N/H/G100SQ CM/1B

Facility

$26,848.40

Service Code	HCPCS 15120
Hospital Charge Code	1600000474
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,439.01
Rate for Payer: Aetna Commercial	$8,054.52
Rate for Payer: Aetna Medicare Advantage	$8,054.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,846.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,846.34
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	$6,846.34
Rate for Payer: Cigna Commercial	$8,439.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,490.29
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,027.26
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

SKN SP AGRF F/N/H/G100SQ CM/1B

Facility

$26,848.40

Service Code	HCPCS 15120
Hospital Charge Code	1600000474
Hospital Revenue Code	360
Min. Negotiated Rate	$4,027.26
Max. Negotiated Rate	$4,027.26
Rate for Payer: Qualcare PPO/HMO/WC	$4,027.26

SKN SPLT A-GRFT F/N/HF/G ADD

Facility

$7,580.00

Service Code	HCPCS 15121
Hospital Charge Code	1600000378
Hospital Revenue Code	360
Min. Negotiated Rate	$1,137.00
Max. Negotiated Rate	$1,137.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,137.00

SKN SPLT A-GRFT F/N/HF/G ADD

Facility

$7,580.00

Service Code	HCPCS 15121
Hospital Charge Code	1600000378
Hospital Revenue Code	360
Min. Negotiated Rate	$130.71
Max. Negotiated Rate	$2,274.00
Rate for Payer: Aetna Commercial	$2,274.00
Rate for Payer: Aetna Medicare Advantage	$2,274.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,932.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,932.90
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	$1,932.90
Rate for Payer: Cigna Commercial	$130.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$985.40
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,137.00
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SKULL COMPLETE

Facility

$5,100.00

Service Code	HCPCS 70260
Hospital Charge Code	94061015
Hospital Revenue Code	320
Min. Negotiated Rate	$51.42
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Better Health Medicaid	$399.88
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88

SKULL COMPLETE

Facility

$5,100.00

Service Code	HCPCS 70260
Hospital Charge Code	94061015
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

SKULL LESS THAN 4 VWS

Facility

$5,100.00

Service Code	HCPCS 70250
Hospital Charge Code	94061013
Hospital Revenue Code	320
Min. Negotiated Rate	$35.21
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Better Health Medicaid	$309.88
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$316.08

SKULL LESS THAN 4 VWS

Facility

$5,100.00

Service Code	HCPCS 70250
Hospital Charge Code	94061013
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

SKWAVE LITHO W/ANGIO&ATHERECT

Facility

$50,061.70

Service Code	HCPCS C9766
Hospital Charge Code	4046C9766
Hospital Revenue Code	481
Min. Negotiated Rate	$7,509.26
Max. Negotiated Rate	$7,509.26
Rate for Payer: Qualcare PPO/HMO/WC	$7,509.26

SKWAVE LITHO W/ANGIO&ATHERECT

Facility

$50,061.70

Service Code	HCPCS C9766
Hospital Charge Code	4046C9766
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$43,654.87
Rate for Payer: Aetna Commercial	$15,018.51
Rate for Payer: Aetna Medicare Advantage	$15,018.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,765.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,765.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,765.73
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,508.02
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,509.26
Rate for Payer: UnitedHealthcare Commercial	$10,997.00

SKYLITE BASKET 2.4F

Facility

$850.00

Hospital Charge Code	270682480
Hospital Revenue Code	272
Min. Negotiated Rate	$110.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$425.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$425.00

SKYLITE BASKET 2.4F

Facility

$850.00

Hospital Charge Code	270682480
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SLAP RASP

Facility

$1,725.00

Hospital Charge Code	270656573
Hospital Revenue Code	272
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$258.75
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SLAP RASP

Facility

$1,725.00

Hospital Charge Code	270656573
Hospital Revenue Code	272
Min. Negotiated Rate	$224.25
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$517.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.25
Rate for Payer: Oxford Commercial	$862.50
Rate for Payer: Qualcare PPO/HMO/WC	$258.75
Rate for Payer: UnitedHealthcare Commercial	$862.50

SLCTIV CATH VEIN,2ND ORDR FAM

Facility

$1,980.80

Service Code	HCPCS 36012
Hospital Charge Code	16000944
Hospital Revenue Code	360
Min. Negotiated Rate	$297.12
Max. Negotiated Rate	$297.12
Rate for Payer: Qualcare PPO/HMO/WC	$297.12

SLCTIV CATH VEIN,2ND ORDR FAM

Facility

$1,980.80

Service Code	HCPCS 36012
Hospital Charge Code	16000944
Hospital Revenue Code	360
Min. Negotiated Rate	$165.24
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$594.24
Rate for Payer: Aetna Medicare Advantage	$594.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$505.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$505.10
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	$505.10
Rate for Payer: Cigna Commercial	$165.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.50
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$297.12
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SLCTV WND DEBRIDEM 20 CM OR <

Facility

$630.15

Service Code	HCPCS 97597
Hospital Charge Code	160000220
Hospital Revenue Code	360
Min. Negotiated Rate	$81.92
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$189.04
Rate for Payer: Aetna Medicare Advantage	$189.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.69
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	$160.69
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.92
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.52
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SLCTV WND DEBRIDEM 20 CM OR <

Facility

$630.15

Service Code	HCPCS 97597
Hospital Charge Code	160000220
Hospital Revenue Code	360
Min. Negotiated Rate	$94.52
Max. Negotiated Rate	$94.52
Rate for Payer: Qualcare PPO/HMO/WC	$94.52

SLCTV WND DEBRIDEM ADDL 20C

Facility

$361.65

Service Code	HCPCS 97598
Hospital Charge Code	1600000377
Hospital Revenue Code	360
Min. Negotiated Rate	$54.25
Max. Negotiated Rate	$54.25
Rate for Payer: Qualcare PPO/HMO/WC	$54.25

SLCTV WND DEBRIDEM ADDL 20C

Facility

$361.65

Service Code	HCPCS 97598
Hospital Charge Code	1600000377
Hospital Revenue Code	360
Min. Negotiated Rate	$23.41
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$108.50
Rate for Payer: Aetna Medicare Advantage	$108.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.22
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	$92.22
Rate for Payer: Cigna Commercial	$23.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.01
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.25
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SLEEP STUDY ATTENDED

Facility

$40,000.00

Service Code	HCPCS 95807
Hospital Charge Code	405295807
Hospital Revenue Code	920
Min. Negotiated Rate	$6,000.00
Max. Negotiated Rate	$6,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00

SLEEP STUDY ATTENDED

Facility

$40,000.00

Service Code	HCPCS 95807
Hospital Charge Code	405295807
Hospital Revenue Code	920
Min. Negotiated Rate	$281.75
Max. Negotiated Rate	$12,000.00
Rate for Payer: Aetna Commercial	$12,000.00
Rate for Payer: Aetna Medicare Advantage	$12,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$281.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,200.00
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,200.00
Rate for Payer: Oxford Commercial	$10,292.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00
Rate for Payer: UnitedHealthcare Commercial	$11,682.00

Know your out-of-pocket cost for care.

All Charges