Heights University Hospital

All Charges

Charge

Type

Setting

Price

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	303511102
Hospital Revenue Code	510
Min. Negotiated Rate	$155.17
Max. Negotiated Rate	$155.17
Rate for Payer: Qualcare PPO/HMO/WC	$155.17

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	303511102
Hospital Revenue Code	510
Min. Negotiated Rate	$66.11
Max. Negotiated Rate	$968.07
Rate for Payer: Aetna Commercial	$310.35
Rate for Payer: Aetna Medicare Advantage	$310.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$66.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.79
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.48
Rate for Payer: Qualcare PPO/HMO/WC	$155.17

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	412311102
Hospital Revenue Code	361
Min. Negotiated Rate	$155.17
Max. Negotiated Rate	$155.17
Rate for Payer: Qualcare PPO/HMO/WC	$155.17

TANGENTIAL BX SKIN 1ST LESION

Facility

$9,500.00

Service Code	HCPCS 11102
Hospital Charge Code	404311102
Hospital Revenue Code	361
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	450211102
Hospital Revenue Code	761
Min. Negotiated Rate	$155.17
Max. Negotiated Rate	$155.17
Rate for Payer: Qualcare PPO/HMO/WC	$155.17

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	450211103
Hospital Revenue Code	761
Min. Negotiated Rate	$19.21
Max. Negotiated Rate	$258.62
Rate for Payer: Aetna Commercial	$155.18
Rate for Payer: Aetna Medicare Advantage	$155.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.90
Rate for Payer: Cigna Commercial	$19.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.24
Rate for Payer: Oxford Commercial	$258.62
Rate for Payer: Qualcare PPO/HMO/WC	$77.59
Rate for Payer: UnitedHealthcare Commercial	$258.62

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	303511103
Hospital Revenue Code	510
Min. Negotiated Rate	$77.59
Max. Negotiated Rate	$77.59
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	395011103
Hospital Revenue Code	761
Min. Negotiated Rate	$19.21
Max. Negotiated Rate	$258.62
Rate for Payer: Aetna Commercial	$155.18
Rate for Payer: Aetna Medicare Advantage	$155.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.90
Rate for Payer: Cigna Commercial	$19.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.24
Rate for Payer: Oxford Commercial	$258.62
Rate for Payer: Qualcare PPO/HMO/WC	$77.59
Rate for Payer: UnitedHealthcare Commercial	$258.62

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	303511103
Hospital Revenue Code	510
Min. Negotiated Rate	$19.21
Max. Negotiated Rate	$155.18
Rate for Payer: Aetna Commercial	$155.18
Rate for Payer: Aetna Medicare Advantage	$155.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.90
Rate for Payer: Cigna Commercial	$19.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.24
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	412311103
Hospital Revenue Code	361
Min. Negotiated Rate	$19.21
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$155.18
Rate for Payer: Aetna Medicare Advantage	$155.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.90
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	$131.90
Rate for Payer: Cigna Commercial	$19.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.24
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$77.59
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	450211103
Hospital Revenue Code	761
Min. Negotiated Rate	$77.59
Max. Negotiated Rate	$77.59
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	395011103
Hospital Revenue Code	761
Min. Negotiated Rate	$77.59
Max. Negotiated Rate	$77.59
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	412311103
Hospital Revenue Code	361
Min. Negotiated Rate	$77.59
Max. Negotiated Rate	$77.59
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

TAP

Facility

$484.00

Hospital Charge Code	270335104
Hospital Revenue Code	272
Min. Negotiated Rate	$72.60
Max. Negotiated Rate	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$72.60

TAP

Facility

$484.00

Hospital Charge Code	270335104
Hospital Revenue Code	272
Min. Negotiated Rate	$62.92
Max. Negotiated Rate	$242.00
Rate for Payer: Aetna Commercial	$145.20
Rate for Payer: Aetna Medicare Advantage	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.42
Rate for Payer: Cigna Commercial	$242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.92
Rate for Payer: Oxford Commercial	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.60
Rate for Payer: UnitedHealthcare Commercial	$242.00

TAP 2.7mm 2346-028

Facility

$249.00

Service Code	HCPCS C1713
Hospital Charge Code	270610165
Hospital Revenue Code	278
Min. Negotiated Rate	$37.35
Max. Negotiated Rate	$124.50
Rate for Payer: Aetna Commercial	$74.70
Rate for Payer: Aetna Medicare Advantage	$74.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.49
Rate for Payer: Cigna Commercial	$124.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.26
Rate for Payer: Qualcare PPO/HMO/WC	$37.35

TAP 2.7mm 2346-028

Facility

$249.00

Service Code	HCPCS C1713
Hospital Charge Code	270610165
Hospital Revenue Code	278
Min. Negotiated Rate	$37.35
Max. Negotiated Rate	$60.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.26
Rate for Payer: Qualcare PPO/HMO/WC	$37.35

TAP 3.5MM 18MM

Facility

$773.65

Hospital Charge Code	270697902
Hospital Revenue Code	272
Min. Negotiated Rate	$100.57
Max. Negotiated Rate	$386.82
Rate for Payer: Aetna Commercial	$232.09
Rate for Payer: Aetna Medicare Advantage	$232.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.28
Rate for Payer: Cigna Commercial	$386.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.57
Rate for Payer: Oxford Commercial	$386.82
Rate for Payer: Qualcare PPO/HMO/WC	$116.05
Rate for Payer: UnitedHealthcare Commercial	$386.82

TAP 3.5MM 18MM

Facility

$773.65

Hospital Charge Code	270697902
Hospital Revenue Code	272
Min. Negotiated Rate	$116.05
Max. Negotiated Rate	$116.05
Rate for Payer: Qualcare PPO/HMO/WC	$116.05

TAP 3.5mm CORTEX SCREWS

Facility

$491.30

Service Code	HCPCS C1713
Hospital Charge Code	270604141
Hospital Revenue Code	278
Min. Negotiated Rate	$73.69
Max. Negotiated Rate	$245.65
Rate for Payer: Aetna Commercial	$147.39
Rate for Payer: Aetna Medicare Advantage	$147.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.28
Rate for Payer: Cigna Commercial	$245.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.89
Rate for Payer: Qualcare PPO/HMO/WC	$73.69

TAP 3.5mm CORTEX SCREWS

Facility

$491.30

Service Code	HCPCS C1713
Hospital Charge Code	270604141
Hospital Revenue Code	278
Min. Negotiated Rate	$73.69
Max. Negotiated Rate	$118.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.89
Rate for Payer: Qualcare PPO/HMO/WC	$73.69

TAP 3.5 QUICK RELEASE PLATE

Facility

$970.00

Hospital Charge Code	270638091
Hospital Revenue Code	278
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$234.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.74
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TAP 3.5 QUICK RELEASE PLATE

Facility

$970.00

Hospital Charge Code	270638091
Hospital Revenue Code	278
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$291.00
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.74
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TAP 3.5 X 45 FOR LOCKING SCREW

Facility

$500.00

Hospital Charge Code	270638100
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

TAP 3.5 X 45 FOR LOCKING SCREW

Facility

$500.00

Hospital Charge Code	270638100
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

Know your out-of-pocket cost for care.

All Charges