Heights University Hospital

All Charges

Charge

Type

Setting

Price

TISSUE CORNEA

Facility

$4,569.65

Hospital Charge Code	270608603
Hospital Revenue Code	278
Min. Negotiated Rate	$685.45
Max. Negotiated Rate	$2,284.82
Rate for Payer: Aetna Commercial	$1,370.89
Rate for Payer: Aetna Medicare Advantage	$1,370.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,165.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,165.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$913.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,165.26
Rate for Payer: Cigna Commercial	$2,284.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,105.86
Rate for Payer: Qualcare PPO/HMO/WC	$685.45

TISSUE CULT, ADDL STUDY

Facility

$156.00

Service Code	HCPCS 87253
Hospital Charge Code	38475118
Hospital Revenue Code	309
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$23.40
Rate for Payer: Qualcare PPO/HMO/WC	$23.40

TISSUE CULT, ADDL STUDY

Facility

$156.00

Service Code	HCPCS 87253
Hospital Charge Code	38475118
Hospital Revenue Code	309
Min. Negotiated Rate	$10.10
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$65.45
Rate for Payer: Aetna Medicare Advantage	$20.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.01
Rate for Payer: Cigna Commercial	$20.20
Rate for Payer: Cigna Medicare Advantage	$10.10
Rate for Payer: Clover Medicare Advantage	$19.19
Rate for Payer: EmblemHealth Commercial	$60.60
Rate for Payer: Humana Medicare Advantage	$20.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.20
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$21.41
Rate for Payer: Wellcare Medicare Advantage	$20.20

TISSUE CULT,NEOPLASTIC;BONE,BL

Facility

$894.49

Service Code	HCPCS 88237
Hospital Charge Code	38474056
Hospital Revenue Code	311
Min. Negotiated Rate	$71.88
Max. Negotiated Rate	$526.70
Rate for Payer: Aetna Commercial	$465.75
Rate for Payer: Aetna Medicare Advantage	$143.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$526.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$526.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$143.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$526.70
Rate for Payer: Cigna Commercial	$143.75
Rate for Payer: Cigna Medicare Advantage	$71.88
Rate for Payer: Clover Medicare Advantage	$136.56
Rate for Payer: EmblemHealth Commercial	$431.25
Rate for Payer: Humana Medicare Advantage	$148.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$134.17
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$143.75
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$152.38
Rate for Payer: Wellcare Medicare Advantage	$143.75

TISSUE CULT,NEOPLASTIC;BONE,BL

Facility

$894.49

Service Code	HCPCS 88237
Hospital Charge Code	38474056
Hospital Revenue Code	311
Min. Negotiated Rate	$134.17
Max. Negotiated Rate	$134.17
Rate for Payer: Qualcare PPO/HMO/WC	$134.17

TISSUE CULT NEOPLASTIC SOLID

Facility

$1,044.74

Service Code	HCPCS 88239
Hospital Charge Code	38477212
Hospital Revenue Code	311
Min. Negotiated Rate	$156.71
Max. Negotiated Rate	$156.71
Rate for Payer: Qualcare PPO/HMO/WC	$156.71

TISSUE CULT NEOPLASTIC SOLID

Facility

$1,044.74

Service Code	HCPCS 88239
Hospital Charge Code	38477212
Hospital Revenue Code	311
Min. Negotiated Rate	$73.76
Max. Negotiated Rate	$540.51
Rate for Payer: Aetna Commercial	$477.96
Rate for Payer: Aetna Medicare Advantage	$147.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$540.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$540.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$540.51
Rate for Payer: Cigna Commercial	$147.52
Rate for Payer: Cigna Medicare Advantage	$73.76
Rate for Payer: Clover Medicare Advantage	$140.14
Rate for Payer: EmblemHealth Commercial	$442.56
Rate for Payer: Humana Medicare Advantage	$151.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.71
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.52
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$156.37
Rate for Payer: Wellcare Medicare Advantage	$147.52

TISSUE CULT NON-NEOPLASTIC AMN

Facility

$1,042.85

Service Code	HCPCS 88235
Hospital Charge Code	38477211
Hospital Revenue Code	311
Min. Negotiated Rate	$75.15
Max. Negotiated Rate	$550.70
Rate for Payer: Aetna Commercial	$486.97
Rate for Payer: Aetna Medicare Advantage	$150.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$550.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$550.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$150.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$550.70
Rate for Payer: Cigna Commercial	$150.30
Rate for Payer: Cigna Medicare Advantage	$75.15
Rate for Payer: Clover Medicare Advantage	$142.78
Rate for Payer: EmblemHealth Commercial	$450.90
Rate for Payer: Humana Medicare Advantage	$154.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.57
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.43
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$150.30
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$159.32
Rate for Payer: Wellcare Medicare Advantage	$150.30

TISSUE CULT NON-NEOPLASTIC AMN

Facility

$1,042.85

Service Code	HCPCS 88235
Hospital Charge Code	38477211
Hospital Revenue Code	311
Min. Negotiated Rate	$156.43
Max. Negotiated Rate	$156.43
Rate for Payer: Qualcare PPO/HMO/WC	$156.43

TISSUE EXAMNTN BY KOH SLIDE

Facility

$30.00

Service Code	HCPCS 87220
Hospital Charge Code	38477027
Hospital Revenue Code	309
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.83
Rate for Payer: Aetna Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.65
Rate for Payer: Cigna Commercial	$4.27
Rate for Payer: Cigna Medicare Advantage	$2.13
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.53
Rate for Payer: Wellcare Medicare Advantage	$4.27

TISSUE EXAMNTN BY KOH SLIDE

Facility

$30.00

Service Code	HCPCS 87220
Hospital Charge Code	38477027
Hospital Revenue Code	309
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

TISSUE EXPAND ALLOX2 360-430CC

Facility

$9,000.00

Service Code	HCPCS C1789
Hospital Charge Code	270695704
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$4,500.00
Rate for Payer: Aetna Commercial	$2,700.00
Rate for Payer: Aetna Medicare Advantage	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,295.00
Rate for Payer: Cigna Commercial	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

TISSUE EXPAND ALLOX2 360-430CC

Facility

$9,000.00

Service Code	HCPCS C1789
Hospital Charge Code	270695704
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$2,178.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

TISSUE EXPANDER 400CC

Facility

$5,650.00

Hospital Charge Code	270663196
Hospital Revenue Code	278
Min. Negotiated Rate	$847.50
Max. Negotiated Rate	$1,367.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,367.30
Rate for Payer: Qualcare PPO/HMO/WC	$847.50

TISSUE EXPANDER 400CC

Facility

$5,650.00

Hospital Charge Code	270663196
Hospital Revenue Code	278
Min. Negotiated Rate	$847.50
Max. Negotiated Rate	$2,825.00
Rate for Payer: Aetna Commercial	$1,695.00
Rate for Payer: Aetna Medicare Advantage	$1,695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,440.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,440.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,440.75
Rate for Payer: Cigna Commercial	$2,825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,367.30
Rate for Payer: Qualcare PPO/HMO/WC	$847.50

TISSUE EXPANDER 500CC

Facility

$5,650.00

Hospital Charge Code	270663197
Hospital Revenue Code	278
Min. Negotiated Rate	$847.50
Max. Negotiated Rate	$2,825.00
Rate for Payer: Aetna Commercial	$1,695.00
Rate for Payer: Aetna Medicare Advantage	$1,695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,440.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,440.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,440.75
Rate for Payer: Cigna Commercial	$2,825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,367.30
Rate for Payer: Qualcare PPO/HMO/WC	$847.50

TISSUE EXPANDER 500CC

Facility

$5,650.00

Hospital Charge Code	270663197
Hospital Revenue Code	278
Min. Negotiated Rate	$847.50
Max. Negotiated Rate	$1,367.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,367.30
Rate for Payer: Qualcare PPO/HMO/WC	$847.50

TISSUE EXPANDER 650cc W/TABS

Facility

$6,750.00

Hospital Charge Code	270674353
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,025.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

TISSUE EXPANDER 650cc W/TABS

Facility

$6,750.00

Hospital Charge Code	270674353
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

TISSUE EXPANDER HI PRO 475CC

Facility

$10,625.00

Hospital Charge Code	270675145
Hospital Revenue Code	278
Min. Negotiated Rate	$1,593.75
Max. Negotiated Rate	$2,571.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,571.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.75

TISSUE EXPANDER HI PRO 475CC

Facility

$10,625.00

Hospital Charge Code	270675145
Hospital Revenue Code	278
Min. Negotiated Rate	$1,593.75
Max. Negotiated Rate	$5,312.50
Rate for Payer: Aetna Commercial	$3,187.50
Rate for Payer: Aetna Medicare Advantage	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,709.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,709.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,709.38
Rate for Payer: Cigna Commercial	$5,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,571.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.75

TISSUE EXPANDER HI PRO 500CC

Facility

$10,625.00

Hospital Charge Code	270675146
Hospital Revenue Code	278
Min. Negotiated Rate	$1,593.75
Max. Negotiated Rate	$2,571.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,571.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.75

TISSUE EXPANDER HI PRO 500CC

Facility

$10,625.00

Hospital Charge Code	270675146
Hospital Revenue Code	278
Min. Negotiated Rate	$1,593.75
Max. Negotiated Rate	$5,312.50
Rate for Payer: Aetna Commercial	$3,187.50
Rate for Payer: Aetna Medicare Advantage	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,709.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,709.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,709.38
Rate for Payer: Cigna Commercial	$5,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,571.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.75

TISSUE EXPANDER HI PRO 600CC

Facility

$10,625.00

Hospital Charge Code	270675147
Hospital Revenue Code	278
Min. Negotiated Rate	$1,593.75
Max. Negotiated Rate	$5,312.50
Rate for Payer: Aetna Commercial	$3,187.50
Rate for Payer: Aetna Medicare Advantage	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,709.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,709.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,709.38
Rate for Payer: Cigna Commercial	$5,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,571.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.75

TISSUE EXPANDER HI PRO 600CC

Facility

$10,625.00

Hospital Charge Code	270675147
Hospital Revenue Code	278
Min. Negotiated Rate	$1,593.75
Max. Negotiated Rate	$2,571.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,571.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.75

Know your out-of-pocket cost for care.

All Charges