Heights University Hospital

All Charges

Charge

Type

Setting

Price

WC BX SKIN, SQ TIS ADDL LESION

Facility

$241.10

Service Code	HCPCS 11101
Hospital Charge Code	9800120
Hospital Revenue Code	510
Min. Negotiated Rate	$31.34
Max. Negotiated Rate	$120.55
Rate for Payer: Aetna Commercial	$72.33
Rate for Payer: Aetna Medicare Advantage	$72.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.48
Rate for Payer: Cigna Commercial	$120.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.34
Rate for Payer: Qualcare PPO/HMO/WC	$36.16

WC BX SKIN, SQ TIS ADDL LESION

Facility

$241.10

Service Code	HCPCS 11101
Hospital Charge Code	9800120
Hospital Revenue Code	510
Min. Negotiated Rate	$36.16
Max. Negotiated Rate	$36.16
Rate for Payer: Qualcare PPO/HMO/WC	$36.16

WC BX SKIN, SQ TISSUE 1 LESION

Facility

$241.10

Service Code	HCPCS 11100
Hospital Charge Code	9800115
Hospital Revenue Code	510
Min. Negotiated Rate	$36.16
Max. Negotiated Rate	$36.16
Rate for Payer: Qualcare PPO/HMO/WC	$36.16

WC BX SKIN, SQ TISSUE 1 LESION

Facility

$241.10

Service Code	HCPCS 11100
Hospital Charge Code	9800115
Hospital Revenue Code	510
Min. Negotiated Rate	$31.34
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$72.33
Rate for Payer: Aetna Medicare Advantage	$72.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.48
Rate for Payer: Cigna Commercial	$120.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.34
Rate for Payer: Qualcare PPO/HMO/WC	$36.16
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

WC CIRCUMC CLAMP/DEV WDP/R-BLC

Facility

$2,768.00

Service Code	HCPCS 54150
Hospital Charge Code	83652115
Hospital Revenue Code	361
Min. Negotiated Rate	$359.84
Max. Negotiated Rate	$5,529.00
Rate for Payer: Aetna Commercial	$830.40
Rate for Payer: Aetna Medicare Advantage	$830.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$705.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$705.84
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	$705.84
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$359.84
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$415.20
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

WC CIRCUMC CLAMP/DEV WDP/R-BLC

Facility

$2,768.00

Service Code	HCPCS 54150
Hospital Charge Code	83652115
Hospital Revenue Code	361
Min. Negotiated Rate	$415.20
Max. Negotiated Rate	$415.20
Rate for Payer: Qualcare PPO/HMO/WC	$415.20

WC COLLAGEN DRSSNG 16SQ IN OR

Facility

$43.00

Service Code	HCPCS A6022
Hospital Charge Code	9808070
Hospital Revenue Code	272
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

WC COLLAGEN DRSSNG 16SQ IN OR

Facility

$43.00

Service Code	HCPCS A6022
Hospital Charge Code	9808070
Hospital Revenue Code	272
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$29.97
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$29.97
Rate for Payer: Cigna Medicare Advantage	$17.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$21.50

WC COM REP TRUNK 2.6CM-7.5CM

Facility

$2,370.40

Service Code	HCPCS 13101
Hospital Charge Code	9808325
Hospital Revenue Code	510
Min. Negotiated Rate	$355.56
Max. Negotiated Rate	$355.56
Rate for Payer: Qualcare PPO/HMO/WC	$355.56

WC COM REP TRUNK 2.6CM-7.5CM

Facility

$2,370.40

Service Code	HCPCS 13101
Hospital Charge Code	9808325
Hospital Revenue Code	510
Min. Negotiated Rate	$157.39
Max. Negotiated Rate	$1,760.02
Rate for Payer: Aetna Commercial	$711.12
Rate for Payer: Aetna Medicare Advantage	$711.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$604.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$604.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$604.45
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.15
Rate for Payer: Qualcare PPO/HMO/WC	$355.56

WC CUL ALL DER SUB/1ST 100 ADD

Facility

$1,183.95

Hospital Charge Code	9800270
Hospital Revenue Code	510
Min. Negotiated Rate	$153.91
Max. Negotiated Rate	$591.98
Rate for Payer: Aetna Commercial	$355.19
Rate for Payer: Aetna Medicare Advantage	$355.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.91
Rate for Payer: Cigna Commercial	$591.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.91
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC CUL ALL DER SUB/1ST 100 ADD

Facility

$1,183.95

Hospital Charge Code	9800270
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC CULTD ALLO DERM SUB/1ST 100

Facility

$1,183.95

Hospital Charge Code	9800265
Hospital Revenue Code	510
Min. Negotiated Rate	$153.91
Max. Negotiated Rate	$591.98
Rate for Payer: Aetna Commercial	$355.19
Rate for Payer: Aetna Medicare Advantage	$355.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.91
Rate for Payer: Cigna Commercial	$591.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.91
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC CULTD ALLO DERM SUB/1ST 100

Facility

$1,183.95

Hospital Charge Code	9800265
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC CULTURD ALL SKIN SUB<25 ADD

Facility

$1,183.95

Hospital Charge Code	9800240
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC CULTURD ALL SKIN SUB<25 ADD

Facility

$1,183.95

Hospital Charge Code	9800240
Hospital Revenue Code	510
Min. Negotiated Rate	$153.91
Max. Negotiated Rate	$591.98
Rate for Payer: Aetna Commercial	$355.19
Rate for Payer: Aetna Medicare Advantage	$355.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.91
Rate for Payer: Cigna Commercial	$591.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.91
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC CULTURED ALLOGN SKIN SUB<25

Facility

$1,183.95

Hospital Charge Code	9800235
Hospital Revenue Code	510
Min. Negotiated Rate	$153.91
Max. Negotiated Rate	$591.98
Rate for Payer: Aetna Commercial	$355.19
Rate for Payer: Aetna Medicare Advantage	$355.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.91
Rate for Payer: Cigna Commercial	$591.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.91
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC CULTURED ALLOGN SKIN SUB<25

Facility

$1,183.95

Hospital Charge Code	9800235
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC DEBRID BONE ADDL 20 SQCM

Facility

$3,472.65

Service Code	HCPCS 11047
Hospital Charge Code	9800098
Hospital Revenue Code	510
Min. Negotiated Rate	$520.90
Max. Negotiated Rate	$520.90
Rate for Payer: Qualcare PPO/HMO/WC	$520.90

WC DEBRID BONE ADDL 20 SQCM

Facility

$3,472.65

Service Code	HCPCS 11047
Hospital Charge Code	9800098
Hospital Revenue Code	510
Min. Negotiated Rate	$57.07
Max. Negotiated Rate	$1,041.80
Rate for Payer: Aetna Commercial	$1,041.80
Rate for Payer: Aetna Medicare Advantage	$1,041.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$885.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$885.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$885.53
Rate for Payer: Cigna Commercial	$92.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$451.44
Rate for Payer: Qualcare PPO/HMO/WC	$520.90

WC DEBRIDEMENT EX ECZEMATOUS 1

Facility

$1,147.40

Service Code	HCPCS 11000
Hospital Charge Code	9808001
Hospital Revenue Code	361
Min. Negotiated Rate	$149.16
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$1,607.24
Rate for Payer: Aetna Commercial	$344.22
Rate for Payer: Aetna Medicare Advantage	$344.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$292.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$292.59
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	$292.59
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.16
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.11
Rate for Payer: UnitedHealthcare Commercial	$1,686.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,639.38
Rate for Payer: Wellpoint Medicaid Managed Care	$1,607.24

WC DEBRIDEMENT EX ECZEMATOUS 1

Facility

$1,147.40

Service Code	HCPCS 11000
Hospital Charge Code	9808001
Hospital Revenue Code	361
Min. Negotiated Rate	$172.11
Max. Negotiated Rate	$172.11
Rate for Payer: Qualcare PPO/HMO/WC	$172.11

WC DEBRIDEMENT SKIN FULL THICK

Facility

$843.05

Hospital Charge Code	9800080
Hospital Revenue Code	510
Min. Negotiated Rate	$126.46
Max. Negotiated Rate	$126.46
Rate for Payer: Qualcare PPO/HMO/WC	$126.46

WC DEBRIDEMENT SKIN FULL THICK

Facility

$843.05

Hospital Charge Code	9800080
Hospital Revenue Code	510
Min. Negotiated Rate	$109.60
Max. Negotiated Rate	$421.52
Rate for Payer: Aetna Commercial	$252.91
Rate for Payer: Aetna Medicare Advantage	$252.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.98
Rate for Payer: Cigna Commercial	$421.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.60
Rate for Payer: Qualcare PPO/HMO/WC	$126.46

WC DEBRIDEMENT SKIN PART THICK

Facility

$843.05

Hospital Charge Code	9800075
Hospital Revenue Code	510
Min. Negotiated Rate	$126.46
Max. Negotiated Rate	$126.46
Rate for Payer: Qualcare PPO/HMO/WC	$126.46

Know your out-of-pocket cost for care.

All Charges