Heights University Hospital

All Charges

Charge

Type

Setting

Price

CD55 - CD59

Facility

$105.00

Service Code	HCPCS 8818591
Hospital Charge Code	3035095D
Hospital Revenue Code	311
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.50
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.65
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

CD55 - CD59

Facility

$38.15

Hospital Charge Code	3035095A
Hospital Revenue Code	300
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$5.72
Rate for Payer: Qualcare PPO/HMO/WC	$5.72

CD55 - CD59

Facility

$38.15

Hospital Charge Code	3035095A
Hospital Revenue Code	300
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$11.45
Rate for Payer: Aetna Medicare Advantage	$11.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.73
Rate for Payer: Cigna Commercial	$19.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.96
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.72
Rate for Payer: UnitedHealthcare Commercial	$114.00

CD55 - CD59

Facility

$115.00

Service Code	HCPCS 88184
Hospital Charge Code	3035095C
Hospital Revenue Code	311
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

CD55 - CD59

Facility

$38.15

Hospital Charge Code	3035095B
Hospital Revenue Code	300
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$11.45
Rate for Payer: Aetna Medicare Advantage	$11.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.73
Rate for Payer: Cigna Commercial	$19.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.96
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.72
Rate for Payer: UnitedHealthcare Commercial	$114.00

CD55 - CD59

Facility

$38.15

Hospital Charge Code	3035095B
Hospital Revenue Code	300
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$5.72
Rate for Payer: Qualcare PPO/HMO/WC	$5.72

CD55 - CD59

Facility

$75.00

Service Code	HCPCS 88187
Hospital Charge Code	3035095G
Hospital Revenue Code	311
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$38.26
Rate for Payer: Cigna Medicare Advantage	$19.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$114.00

CD55 - CD59

Facility

$105.00

Service Code	HCPCS 8818591
Hospital Charge Code	3035095F
Hospital Revenue Code	311
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.50
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.65
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

CDC ANEROBE 5% SB WITH PEA

Facility

$50.40

Hospital Charge Code	270651816
Hospital Revenue Code	270
Min. Negotiated Rate	$7.56
Max. Negotiated Rate	$7.56
Rate for Payer: Qualcare PPO/HMO/WC	$7.56

CDC ANEROBE 5% SB WITH PEA

Facility

$50.40

Hospital Charge Code	270651816
Hospital Revenue Code	270
Min. Negotiated Rate	$6.55
Max. Negotiated Rate	$25.20
Rate for Payer: Aetna Commercial	$15.12
Rate for Payer: Aetna Medicare Advantage	$15.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.85
Rate for Payer: Cigna Commercial	$25.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.55
Rate for Payer: Oxford Commercial	$25.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.56
Rate for Payer: UnitedHealthcare Commercial	$25.20

CDC ANEROBE 5% SB W/KANAMYCIN

Facility

$53.20

Hospital Charge Code	270651815
Hospital Revenue Code	270
Min. Negotiated Rate	$7.98
Max. Negotiated Rate	$7.98
Rate for Payer: Qualcare PPO/HMO/WC	$7.98

CDC ANEROBE 5% SB W/KANAMYCIN

Facility

$53.20

Hospital Charge Code	270651815
Hospital Revenue Code	270
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$26.60
Rate for Payer: Aetna Commercial	$15.96
Rate for Payer: Aetna Medicare Advantage	$15.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.57
Rate for Payer: Cigna Commercial	$26.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.92
Rate for Payer: Oxford Commercial	$26.60
Rate for Payer: Qualcare PPO/HMO/WC	$7.98
Rate for Payer: UnitedHealthcare Commercial	$26.60

C/D CLAMP

Facility

$3,315.00

Hospital Charge Code	270656647
Hospital Revenue Code	272
Min. Negotiated Rate	$430.95
Max. Negotiated Rate	$1,657.50
Rate for Payer: Aetna Commercial	$994.50
Rate for Payer: Aetna Medicare Advantage	$994.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$845.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$845.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$845.33
Rate for Payer: Cigna Commercial	$1,657.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$430.95
Rate for Payer: Oxford Commercial	$1,657.50
Rate for Payer: Qualcare PPO/HMO/WC	$497.25
Rate for Payer: UnitedHealthcare Commercial	$1,657.50

C/D CLAMP

Facility

$3,315.00

Hospital Charge Code	270656647
Hospital Revenue Code	272
Min. Negotiated Rate	$497.25
Max. Negotiated Rate	$497.25
Rate for Payer: Qualcare PPO/HMO/WC	$497.25

CDIFF CULT REFL TOXIN B RT PCR

Facility

$109.12

Service Code	HCPCS 87081
Hospital Charge Code	4013870813
Hospital Revenue Code	309
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$21.48
Rate for Payer: Aetna Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.29
Rate for Payer: Cigna Commercial	$6.63
Rate for Payer: Cigna Medicare Advantage	$3.31
Rate for Payer: Clover Medicare Advantage	$6.30
Rate for Payer: EmblemHealth Commercial	$19.89
Rate for Payer: Humana Medicare Advantage	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.19
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.37
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.63
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.03
Rate for Payer: Wellcare Medicare Advantage	$6.63

CDIFF CULT REFL TOXIN B RT PCR

Facility

$109.12

Service Code	HCPCS 87081
Hospital Charge Code	4013870813
Hospital Revenue Code	309
Min. Negotiated Rate	$16.37
Max. Negotiated Rate	$16.37
Rate for Payer: Qualcare PPO/HMO/WC	$16.37

C DIFFICILE TOX A & B

Facility

$390.00

Service Code	HCPCS 87324
Hospital Charge Code	3000944
Hospital Revenue Code	300
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.82
Rate for Payer: Aetna Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.89
Rate for Payer: Cigna Commercial	$11.98
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.70
Rate for Payer: Wellcare Medicare Advantage	$11.98

C DIFFICILE TOX A & B

Facility

$390.00

Service Code	HCPCS 87324
Hospital Charge Code	3000944
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

C DIFFICILE TOXIN B

Facility

$164.85

Service Code	HCPCS 87230
Hospital Charge Code	3000942
Hospital Revenue Code	300
Min. Negotiated Rate	$9.87
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$63.96
Rate for Payer: Aetna Medicare Advantage	$19.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.33
Rate for Payer: Cigna Commercial	$19.74
Rate for Payer: Cigna Medicare Advantage	$9.87
Rate for Payer: Clover Medicare Advantage	$18.75
Rate for Payer: EmblemHealth Commercial	$59.22
Rate for Payer: Humana Medicare Advantage	$20.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.73
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.92
Rate for Payer: Wellcare Medicare Advantage	$19.74

C DIFFICILE TOXIN B

Facility

$164.85

Service Code	HCPCS 87230
Hospital Charge Code	3000942
Hospital Revenue Code	300
Min. Negotiated Rate	$24.73
Max. Negotiated Rate	$24.73
Rate for Payer: Qualcare PPO/HMO/WC	$24.73

CD STRYKER ENDOSCOPY

Facility

$13.80

Hospital Charge Code	270657631
Hospital Revenue Code	270
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$6.90
Rate for Payer: Aetna Commercial	$4.14
Rate for Payer: Aetna Medicare Advantage	$4.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.52
Rate for Payer: Cigna Commercial	$6.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.79
Rate for Payer: Oxford Commercial	$6.90
Rate for Payer: Qualcare PPO/HMO/WC	$2.07
Rate for Payer: UnitedHealthcare Commercial	$6.90

CD STRYKER ENDOSCOPY

Facility

$13.80

Hospital Charge Code	270657631
Hospital Revenue Code	270
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$2.07
Rate for Payer: Qualcare PPO/HMO/WC	$2.07

CDX2 IHC

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	4016883420
Hospital Revenue Code	310
Min. Negotiated Rate	$62.80
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$324.69
Rate for Payer: Aetna Medicare Advantage	$324.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.99
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$62.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.34
Rate for Payer: UnitedHealthcare Commercial	$114.00

CDX2 IHC

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	4016883420
Hospital Revenue Code	310
Min. Negotiated Rate	$162.34
Max. Negotiated Rate	$162.34
Rate for Payer: Qualcare PPO/HMO/WC	$162.34

CEA***

Facility

$68.00

Hospital Charge Code	3010667
Hospital Revenue Code	309
Min. Negotiated Rate	$10.20
Max. Negotiated Rate	$10.20
Rate for Payer: Qualcare PPO/HMO/WC	$10.20

Know your out-of-pocket cost for care.

All Charges