Heights University Hospital

All Charges

Charge

Type

Setting

Price

WC REMOVE NAIL PLATE

Facility

$518.75

Service Code	HCPCS 11730
Hospital Charge Code	9800060
Hospital Revenue Code	510
Min. Negotiated Rate	$62.18
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$155.62
Rate for Payer: Aetna Medicare Advantage	$155.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.28
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.44
Rate for Payer: Qualcare PPO/HMO/WC	$77.81

WC REMOVE NAIL PLATE

Facility

$518.75

Service Code	HCPCS 11730
Hospital Charge Code	9800060
Hospital Revenue Code	510
Min. Negotiated Rate	$77.81
Max. Negotiated Rate	$77.81
Rate for Payer: Qualcare PPO/HMO/WC	$77.81

WC REMOVE NAIL PLATE ADDL

Facility

$256.25

Service Code	HCPCS 11732
Hospital Charge Code	9800065
Hospital Revenue Code	510
Min. Negotiated Rate	$16.14
Max. Negotiated Rate	$76.88
Rate for Payer: Aetna Commercial	$76.88
Rate for Payer: Aetna Medicare Advantage	$76.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.34
Rate for Payer: Cigna Commercial	$16.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.31
Rate for Payer: Qualcare PPO/HMO/WC	$38.44

WC REMOVE NAIL PLATE ADDL

Facility

$256.25

Service Code	HCPCS 11732
Hospital Charge Code	9800065
Hospital Revenue Code	510
Min. Negotiated Rate	$38.44
Max. Negotiated Rate	$38.44
Rate for Payer: Qualcare PPO/HMO/WC	$38.44

WC REST CNTC LAYR W/SILVER 4X

Facility

$29.40

Service Code	HCPCS A6207
Hospital Charge Code	9808100
Hospital Revenue Code	272
Min. Negotiated Rate	$3.82
Max. Negotiated Rate	$14.70
Rate for Payer: Aetna Commercial	$8.82
Rate for Payer: Aetna Medicare Advantage	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.50
Rate for Payer: Cigna Commercial	$10.47
Rate for Payer: Cigna Medicare Advantage	$6.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.82
Rate for Payer: Oxford Commercial	$14.70
Rate for Payer: Qualcare PPO/HMO/WC	$4.41
Rate for Payer: UnitedHealthcare Commercial	$14.70

WC REST CNTC LAYR W/SILVER 4X

Facility

$29.40

Service Code	HCPCS A6207
Hospital Charge Code	9808100
Hospital Revenue Code	272
Min. Negotiated Rate	$4.41
Max. Negotiated Rate	$4.41
Rate for Payer: Qualcare PPO/HMO/WC	$4.41

WC REST NONADHERENT 4X5-CONT

Facility

$30.90

Service Code	HCPCS A6207
Hospital Charge Code	9808095
Hospital Revenue Code	272
Min. Negotiated Rate	$4.02
Max. Negotiated Rate	$15.45
Rate for Payer: Aetna Commercial	$9.27
Rate for Payer: Aetna Medicare Advantage	$9.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.88
Rate for Payer: Cigna Commercial	$10.47
Rate for Payer: Cigna Medicare Advantage	$6.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.02
Rate for Payer: Oxford Commercial	$15.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.63
Rate for Payer: UnitedHealthcare Commercial	$15.45

WC REST NONADHERENT 4X5-CONT

Facility

$30.90

Service Code	HCPCS A6207
Hospital Charge Code	9808095
Hospital Revenue Code	272
Min. Negotiated Rate	$4.63
Max. Negotiated Rate	$4.63
Rate for Payer: Qualcare PPO/HMO/WC	$4.63

WC RHO D IMM GLOB IV 100 IU

Facility

$499.00

Hospital Charge Code	83652619
Hospital Revenue Code	636
Min. Negotiated Rate	$74.85
Max. Negotiated Rate	$249.50
Rate for Payer: Aetna Commercial	$149.70
Rate for Payer: Aetna Medicare Advantage	$149.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.25
Rate for Payer: Cigna Commercial	$249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.76
Rate for Payer: Qualcare PPO/HMO/WC	$74.85

WC RHO D IMM GLOB IV 100 IU

Facility

$499.00

Hospital Charge Code	83652619
Hospital Revenue Code	636
Min. Negotiated Rate	$74.85
Max. Negotiated Rate	$120.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.76
Rate for Payer: Qualcare PPO/HMO/WC	$74.85

WC SILVERCEL 4 1/4FT X 8IN

Facility

$52.00

Service Code	HCPCS A6197
Hospital Charge Code	9808090
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

WC SILVERCEL 4 1/4FT X 8IN

Facility

$52.00

Service Code	HCPCS A6197
Hospital Charge Code	9808090
Hospital Revenue Code	272
Min. Negotiated Rate	$6.76
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$15.60
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$23.44
Rate for Payer: Cigna Medicare Advantage	$14.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.76
Rate for Payer: Oxford Commercial	$26.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$26.00

WC SILVERCEL 4FT X 8IN

Facility

$52.00

Service Code	HCPCS A6197
Hospital Charge Code	9808085
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

WC SILVERCEL 4FT X 8IN

Facility

$52.00

Service Code	HCPCS A6197
Hospital Charge Code	9808085
Hospital Revenue Code	272
Min. Negotiated Rate	$6.76
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$15.60
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$23.44
Rate for Payer: Cigna Medicare Advantage	$14.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.76
Rate for Payer: Oxford Commercial	$26.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$26.00

WC SILVERCEL ANTIMCB DRESNG 2X

Facility

$12.00

Service Code	HCPCS A6196
Hospital Charge Code	9808080
Hospital Revenue Code	272
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$10.49
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$10.49
Rate for Payer: Cigna Medicare Advantage	$6.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

WC SILVERCEL ANTIMCB DRESNG 2X

Facility

$12.00

Service Code	HCPCS A6196
Hospital Charge Code	9808080
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

WC SKIN SUB HD/FT/DG ADD 100

Facility

$1,183.95

Service Code	HCPCS 15278
Hospital Charge Code	9800215
Hospital Revenue Code	510
Min. Negotiated Rate	$40.68
Max. Negotiated Rate	$355.19
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) NJ Health	$40.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.91
Rate for Payer: Cigna Commercial	$52.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.91
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC SKIN SUB HD/FT/DG ADD 100

Facility

$1,183.95

Service Code	HCPCS 15278
Hospital Charge Code	9800215
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC SKIN SUB HD/FT/DG ADD 25C

Facility

$1,183.95

Service Code	HCPCS 15276KX
Hospital Charge Code	9800515
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 SKIN SUB HD/FT/DG ADD 25C

Facility

$1,183.95

Service Code	HCPCS 15276KX
Hospital Charge Code	9800515
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC SKIN SUB HD/FT/DG FIRST 100

Facility

$1,183.95

Service Code	HCPCS 15277
Hospital Charge Code	9800210
Hospital Revenue Code	510
Min. Negotiated Rate	$147.12
Max. Negotiated Rate	$4,913.48
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) NJ Health	$147.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.91
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.91
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC SKIN SUB HD/FT/DG FIRST 100

Facility

$1,183.95

Service Code	HCPCS 15277
Hospital Charge Code	9800210
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC SKIN SUB HD/FT/DG FIRST 25C

Facility

$1,183.95

Service Code	HCPCS 15275KX
Hospital Charge Code	9800510
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC SKIN SUB HD/FT/DG FIRST 25C

Facility

$1,183.95

Service Code	HCPCS 15275KX
Hospital Charge Code	9800510
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 SKIN SUB TR/AR/L ADD 100 CM

Facility

$1,183.95

Service Code	HCPCS 15274
Hospital Charge Code	9800205
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

Know your out-of-pocket cost for care.

All Charges