Heights University Hospital

All Charges

Charge

Type

Setting

Price

WC LC SKIN SUB HD/FT/DG 1ST100

Facility

$2,431.36

Service Code	HCPCS C5277
Hospital Charge Code	9808315
Hospital Revenue Code	510
Min. Negotiated Rate	$316.08
Max. Negotiated Rate	$1,215.68
Rate for Payer: Aetna Commercial	$729.41
Rate for Payer: Aetna Medicare Advantage	$729.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$620.00
Rate for Payer: Cigna Commercial	$1,215.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$316.08
Rate for Payer: Qualcare PPO/HMO/WC	$364.70

WC LC SKIN SUB HD/FT/DG 1ST25C

Facility

$2,431.36

Service Code	HCPCS C5275
Hospital Charge Code	9808305
Hospital Revenue Code	510
Min. Negotiated Rate	$316.08
Max. Negotiated Rate	$1,215.68
Rate for Payer: Aetna Commercial	$729.41
Rate for Payer: Aetna Medicare Advantage	$729.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$620.00
Rate for Payer: Cigna Commercial	$1,215.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$316.08
Rate for Payer: Qualcare PPO/HMO/WC	$364.70

WC LC SKIN SUB HD/FT/DG 1ST25C

Facility

$2,431.36

Service Code	HCPCS C5275
Hospital Charge Code	9808305
Hospital Revenue Code	510
Min. Negotiated Rate	$364.70
Max. Negotiated Rate	$364.70
Rate for Payer: Qualcare PPO/HMO/WC	$364.70

WC LC SKIN SUB HD/FT/DG ADD100

Facility

$1,183.95

Service Code	HCPCS C5278
Hospital Charge Code	9808320
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 LC SKIN SUB HD/FT/DG ADD100

Facility

$1,183.95

Service Code	HCPCS C5278
Hospital Charge Code	9808320
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC LC SKIN SUB HD/FT/DG ADD25C

Facility

$1,183.95

Service Code	HCPCS C5276
Hospital Charge Code	9808310
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 LC SKIN SUB HD/FT/DG ADD25C

Facility

$1,183.95

Service Code	HCPCS C5276
Hospital Charge Code	9808310
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC LC SKIN SUB TR/AR/L 1ST100C

Facility

$8,143.08

Service Code	HCPCS C5273
Hospital Charge Code	9808295
Hospital Revenue Code	510
Min. Negotiated Rate	$1,058.60
Max. Negotiated Rate	$4,071.54
Rate for Payer: Aetna Commercial	$2,442.92
Rate for Payer: Aetna Medicare Advantage	$2,442.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,076.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,076.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,076.49
Rate for Payer: Cigna Commercial	$4,071.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,221.46

WC LC SKIN SUB TR/AR/L 1ST100C

Facility

$8,143.08

Service Code	HCPCS C5273
Hospital Charge Code	9808295
Hospital Revenue Code	510
Min. Negotiated Rate	$1,221.46
Max. Negotiated Rate	$1,221.46
Rate for Payer: Qualcare PPO/HMO/WC	$1,221.46

WC LC SKIN SUB TR/AR/L 1ST25CM

Facility

$2,431.36

Service Code	HCPCS C5271
Hospital Charge Code	9808285
Hospital Revenue Code	510
Min. Negotiated Rate	$364.70
Max. Negotiated Rate	$364.70
Rate for Payer: Qualcare PPO/HMO/WC	$364.70

WC LC SKIN SUB TR/AR/L 1ST25CM

Facility

$2,431.36

Service Code	HCPCS C5271
Hospital Charge Code	9808285
Hospital Revenue Code	510
Min. Negotiated Rate	$316.08
Max. Negotiated Rate	$1,215.68
Rate for Payer: Aetna Commercial	$729.41
Rate for Payer: Aetna Medicare Advantage	$729.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$620.00
Rate for Payer: Cigna Commercial	$1,215.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$316.08
Rate for Payer: Qualcare PPO/HMO/WC	$364.70

WC LC SKIN SUB TR/AR/L ADD100C

Facility

$1,183.95

Service Code	HCPCS C5274
Hospital Charge Code	9808300
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC LC SKIN SUB TR/AR/L ADD100C

Facility

$1,183.95

Service Code	HCPCS C5274
Hospital Charge Code	9808300
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 LC SKIN SUB TR/AR/L ADD25CM

Facility

$1,183.95

Service Code	HCPCS C5272
Hospital Charge Code	9808290
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC LC SKIN SUB TR/AR/L ADD25CM

Facility

$1,183.95

Service Code	HCPCS C5272
Hospital Charge Code	9808290
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 LEVEL 1 FOLLOW-UP VISIT

Facility

$311.00

Service Code	HCPCS 99211
Hospital Charge Code	9800355
Hospital Revenue Code	510
Min. Negotiated Rate	$8.30
Max. Negotiated Rate	$93.30
Rate for Payer: Aetna Commercial	$93.30
Rate for Payer: Aetna Medicare Advantage	$93.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.31
Rate for Payer: Cigna Commercial	$8.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.43
Rate for Payer: Qualcare PPO/HMO/WC	$46.65

WC LEVEL 1 FOLLOW-UP VISIT

Facility

$311.00

Service Code	HCPCS 99211
Hospital Charge Code	9800355
Hospital Revenue Code	510
Min. Negotiated Rate	$46.65
Max. Negotiated Rate	$46.65
Rate for Payer: Qualcare PPO/HMO/WC	$46.65

WC LEVEL 1 FOLLOWUP VIST+MOD25

Facility

$311.00

Service Code	HCPCS 9921125
Hospital Charge Code	9800360
Hospital Revenue Code	510
Min. Negotiated Rate	$40.43
Max. Negotiated Rate	$155.50
Rate for Payer: Aetna Commercial	$93.30
Rate for Payer: Aetna Medicare Advantage	$93.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.31
Rate for Payer: Cigna Commercial	$155.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.43
Rate for Payer: Qualcare PPO/HMO/WC	$46.65

WC LEVEL 1 FOLLOWUP VIST+MOD25

Facility

$311.00

Service Code	HCPCS 9921125
Hospital Charge Code	9800360
Hospital Revenue Code	510
Min. Negotiated Rate	$46.65
Max. Negotiated Rate	$46.65
Rate for Payer: Qualcare PPO/HMO/WC	$46.65

WC LEVEL 1 I&D FB REMOVAL

Facility

$1,061.25

Service Code	HCPCS 10120
Hospital Charge Code	9800020
Hospital Revenue Code	510
Min. Negotiated Rate	$91.25
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$318.38
Rate for Payer: Aetna Medicare Advantage	$318.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$270.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$270.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$270.62
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.96
Rate for Payer: Qualcare PPO/HMO/WC	$159.19
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

WC LEVEL 1 I&D FB REMOVAL

Facility

$1,061.25

Service Code	HCPCS 10120
Hospital Charge Code	9800020
Hospital Revenue Code	510
Min. Negotiated Rate	$159.19
Max. Negotiated Rate	$159.19
Rate for Payer: Qualcare PPO/HMO/WC	$159.19

WC LEVEL 1 I&D PUNCTURE DRAIN

Facility

$450.00

Service Code	HCPCS 10160
Hospital Charge Code	9800015
Hospital Revenue Code	510
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

WC LEVEL 1 I&D PUNCTURE DRAIN

Facility

$450.00

Service Code	HCPCS 10160
Hospital Charge Code	9800015
Hospital Revenue Code	510
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$135.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$83.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

WC LEVEL 1 I&D - SKIN ABCESS

Facility

$641.65

Service Code	HCPCS 10060
Hospital Charge Code	9800010
Hospital Revenue Code	510
Min. Negotiated Rate	$96.25
Max. Negotiated Rate	$96.25
Rate for Payer: Qualcare PPO/HMO/WC	$96.25

WC LEVEL 1 I&D - SKIN ABCESS

Facility

$641.65

Service Code	HCPCS 10060
Hospital Charge Code	9800010
Hospital Revenue Code	510
Min. Negotiated Rate	$29.34
Max. Negotiated Rate	$962.01
Rate for Payer: Aetna Better Health Medicaid	$943.15
Rate for Payer: Aetna Commercial	$192.50
Rate for Payer: Aetna Medicare Advantage	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.62
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.41
Rate for Payer: Qualcare PPO/HMO/WC	$96.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$962.01

Know your out-of-pocket cost for care.

All Charges