Heights University Hospital

All Charges

Charge

Type

Setting

Price

CFH WELLNESS EST PT >64 YRS

Facility

$97.00

Service Code	HCPCS 99397
Hospital Charge Code	83652495
Hospital Revenue Code	514
Min. Negotiated Rate	$12.61
Max. Negotiated Rate	$48.50
Rate for Payer: Aetna Commercial	$29.10
Rate for Payer: Aetna Medicare Advantage	$29.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.73
Rate for Payer: Cigna Commercial	$48.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.61
Rate for Payer: Qualcare PPO/HMO/WC	$14.55

CFH WELLNESS EST PT >64 YRS

Facility

$97.00

Service Code	HCPCS 99397
Hospital Charge Code	83652495
Hospital Revenue Code	514
Min. Negotiated Rate	$14.55
Max. Negotiated Rate	$14.55
Rate for Payer: Qualcare PPO/HMO/WC	$14.55

CFH WELLNESS NEW PT 18-39 YRS

Facility

$92.00

Service Code	HCPCS 99385
Hospital Charge Code	83652477
Hospital Revenue Code	514
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.80

CFH WELLNESS NEW PT 18-39 YRS

Facility

$92.00

Service Code	HCPCS 99385
Hospital Charge Code	83652477
Hospital Revenue Code	514
Min. Negotiated Rate	$11.96
Max. Negotiated Rate	$46.00
Rate for Payer: Aetna Commercial	$27.60
Rate for Payer: Aetna Medicare Advantage	$27.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.46
Rate for Payer: Cigna Commercial	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.96
Rate for Payer: Qualcare PPO/HMO/WC	$13.80

CFH WELLNESS NEW PT 40-64 YRS

Facility

$126.00

Service Code	HCPCS 99386
Hospital Charge Code	83652479
Hospital Revenue Code	514
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

CFH WELLNESS NEW PT 40-64 YRS

Facility

$126.00

Service Code	HCPCS 99386
Hospital Charge Code	83652479
Hospital Revenue Code	514
Min. Negotiated Rate	$16.38
Max. Negotiated Rate	$63.00
Rate for Payer: Aetna Commercial	$37.80
Rate for Payer: Aetna Medicare Advantage	$37.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.13
Rate for Payer: Cigna Commercial	$63.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.38
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

CFH WELLNESS NEW PT >64 YRS

Facility

$138.00

Service Code	HCPCS 99387
Hospital Charge Code	83652481
Hospital Revenue Code	514
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$20.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.70

CFH WELLNESS NEW PT >64 YRS

Facility

$138.00

Service Code	HCPCS 99387
Hospital Charge Code	83652481
Hospital Revenue Code	514
Min. Negotiated Rate	$17.94
Max. Negotiated Rate	$69.00
Rate for Payer: Aetna Commercial	$41.40
Rate for Payer: Aetna Medicare Advantage	$41.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.19
Rate for Payer: Cigna Commercial	$69.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$20.70

CH 17 HYDROXYPREGNENOLONE

Facility

$141.00

Service Code	HCPCS 84143
Hospital Charge Code	397073207
Hospital Revenue Code	301
Min. Negotiated Rate	$11.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$73.90
Rate for Payer: Aetna Medicare Advantage	$22.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.58
Rate for Payer: Cigna Commercial	$22.81
Rate for Payer: Cigna Medicare Advantage	$11.40
Rate for Payer: Clover Medicare Advantage	$21.67
Rate for Payer: EmblemHealth Commercial	$68.43
Rate for Payer: Humana Medicare Advantage	$23.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.33
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.18
Rate for Payer: Wellcare Medicare Advantage	$22.81

CH 17 HYDROXYPREGNENOLONE

Facility

$141.00

Service Code	HCPCS 84143
Hospital Charge Code	397073207
Hospital Revenue Code	301
Min. Negotiated Rate	$21.15
Max. Negotiated Rate	$21.15
Rate for Payer: Qualcare PPO/HMO/WC	$21.15

CH 17 OH PREGNENOLONE

Facility

$195.00

Service Code	HCPCS 83498
Hospital Charge Code	397073557
Hospital Revenue Code	301
Min. Negotiated Rate	$13.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$88.03
Rate for Payer: Aetna Medicare Advantage	$27.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.55
Rate for Payer: Cigna Commercial	$27.17
Rate for Payer: Cigna Medicare Advantage	$13.59
Rate for Payer: Clover Medicare Advantage	$25.81
Rate for Payer: EmblemHealth Commercial	$81.51
Rate for Payer: Humana Medicare Advantage	$27.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.17
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28.80
Rate for Payer: Wellcare Medicare Advantage	$27.17

CH 17 OH PREGNENOLONE

Facility

$195.00

Service Code	HCPCS 83498
Hospital Charge Code	397073557
Hospital Revenue Code	301
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$29.25
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

CH 17-OH PROGESTERONE

Facility

$168.00

Service Code	HCPCS 83498
Hospital Charge Code	397073594
Hospital Revenue Code	301
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$25.20
Rate for Payer: Qualcare PPO/HMO/WC	$25.20

CH 17-OH PROGESTERONE

Facility

$168.00

Service Code	HCPCS 83498
Hospital Charge Code	397073594
Hospital Revenue Code	301
Min. Negotiated Rate	$13.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$88.03
Rate for Payer: Aetna Medicare Advantage	$27.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.55
Rate for Payer: Cigna Commercial	$27.17
Rate for Payer: Cigna Medicare Advantage	$13.59
Rate for Payer: Clover Medicare Advantage	$25.81
Rate for Payer: EmblemHealth Commercial	$81.51
Rate for Payer: Humana Medicare Advantage	$27.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.17
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28.80
Rate for Payer: Wellcare Medicare Advantage	$27.17

CH 2-METHYLCITIC ACID

Facility

$226.00

Service Code	HCPCS 82542
Hospital Charge Code	397073276
Hospital Revenue Code	301
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.05
Rate for Payer: Aetna Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.27
Rate for Payer: Cigna Commercial	$24.09
Rate for Payer: Cigna Medicare Advantage	$12.04
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.54
Rate for Payer: Wellcare Medicare Advantage	$24.09

CH 2-METHYLCITIC ACID

Facility

$226.00

Service Code	HCPCS 82542
Hospital Charge Code	397073276
Hospital Revenue Code	301
Min. Negotiated Rate	$33.90
Max. Negotiated Rate	$33.90
Rate for Payer: Qualcare PPO/HMO/WC	$33.90

CH 5-NUCLEOTIDASE

Facility

$161.00

Service Code	HCPCS 83915
Hospital Charge Code	397073593
Hospital Revenue Code	301
Min. Negotiated Rate	$5.58
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$36.13
Rate for Payer: Aetna Medicare Advantage	$11.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.15
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	$40.85
Rate for Payer: Cigna Commercial	$11.15
Rate for Payer: Cigna Medicare Advantage	$5.58
Rate for Payer: Clover Medicare Advantage	$10.59
Rate for Payer: EmblemHealth Commercial	$33.45
Rate for Payer: Humana Medicare Advantage	$11.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.15
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.82
Rate for Payer: Wellcare Medicare Advantage	$11.15

CH 5-NUCLEOTIDASE

Facility

$161.00

Service Code	HCPCS 83915
Hospital Charge Code	397073593
Hospital Revenue Code	301
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$24.15
Rate for Payer: Qualcare PPO/HMO/WC	$24.15

CH AB ABSORPTION

Facility

$325.00

Service Code	HCPCS 86850
Hospital Charge Code	397031056
Hospital Revenue Code	300
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

CH AB ABSORPTION

Facility

$325.00

Service Code	HCPCS 86850
Hospital Charge Code	397031056
Hospital Revenue Code	300
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$124.10
Rate for Payer: Aetna Commercial	$31.65
Rate for Payer: Aetna Medicare Advantage	$9.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.80
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$4.88
Rate for Payer: Clover Medicare Advantage	$9.28
Rate for Payer: EmblemHealth Commercial	$29.31
Rate for Payer: Humana Medicare Advantage	$10.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.36
Rate for Payer: Wellcare Medicare Advantage	$9.77

CH AB ELUTION

Facility

$125.00

Service Code	HCPCS 86860
Hospital Charge Code	397031057
Hospital Revenue Code	300
Min. Negotiated Rate	$8.64
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH AB ELUTION

Facility

$125.00

Service Code	HCPCS 86860
Hospital Charge Code	397031057
Hospital Revenue Code	300
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

CH ABILIFY

Facility

$595.00

Service Code	HCPCS 80299
Hospital Charge Code	397073671
Hospital Revenue Code	301
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

CH ABILIFY

Facility

$595.00

Service Code	HCPCS 80299
Hospital Charge Code	397073671
Hospital Revenue Code	301
Min. Negotiated Rate	$89.25
Max. Negotiated Rate	$89.25
Rate for Payer: Qualcare PPO/HMO/WC	$89.25

CH ABO BLOOD TYPING

Facility

$626.42

Service Code	HCPCS 86900
Hospital Charge Code	397031153
Hospital Revenue Code	300
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$9.69
Rate for Payer: Aetna Medicare Advantage	$2.99
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) Medicare Advantage	$2.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$1.50
Rate for Payer: Clover Medicare Advantage	$2.84
Rate for Payer: EmblemHealth Commercial	$8.97
Rate for Payer: Humana Medicare Advantage	$3.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.96
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.99
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.17
Rate for Payer: Wellcare Medicare Advantage	$2.99

Know your out-of-pocket cost for care.

All Charges