Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH AMINO ACID PLASMA

Facility

$225.00

Service Code	HCPCS 82128
Hospital Charge Code	397073051
Hospital Revenue Code	301
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CH AMINO ACID PLASMA QT

Facility

$180.00

Service Code	HCPCS 82131
Hospital Charge Code	397071236
Hospital Revenue Code	301
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

CH AMINO ACID PLASMA QT

Facility

$180.00

Service Code	HCPCS 82131
Hospital Charge Code	397071236
Hospital Revenue Code	301
Min. Negotiated Rate	$11.49
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$74.46
Rate for Payer: Aetna Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.20
Rate for Payer: Cigna Commercial	$22.98
Rate for Payer: Cigna Medicare Advantage	$11.49
Rate for Payer: Clover Medicare Advantage	$21.83
Rate for Payer: EmblemHealth Commercial	$68.94
Rate for Payer: Humana Medicare Advantage	$23.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.36
Rate for Payer: Wellcare Medicare Advantage	$22.98

CH AMINO ACIDS

Facility

$105.00

Service Code	HCPCS 82139
Hospital Charge Code	397073251
Hospital Revenue Code	301
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

CH AMINO ACIDS

Facility

$105.00

Service Code	HCPCS 82139
Hospital Charge Code	397073251
Hospital Revenue Code	301
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.66
Rate for Payer: Aetna Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.81
Rate for Payer: Cigna Commercial	$16.87
Rate for Payer: Cigna Medicare Advantage	$8.44
Rate for Payer: Clover Medicare Advantage	$16.03
Rate for Payer: EmblemHealth Commercial	$50.61
Rate for Payer: Humana Medicare Advantage	$17.38
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
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.87
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.88
Rate for Payer: Wellcare Medicare Advantage	$16.87

CH AMINO ACID URINE SCR

Facility

$180.00

Service Code	HCPCS 82128
Hospital Charge Code	397071238
Hospital Revenue Code	301
Min. Negotiated Rate	$6.93
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$44.94
Rate for Payer: Aetna Medicare Advantage	$13.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.82
Rate for Payer: Cigna Commercial	$13.87
Rate for Payer: Cigna Medicare Advantage	$6.93
Rate for Payer: Clover Medicare Advantage	$13.18
Rate for Payer: EmblemHealth Commercial	$41.61
Rate for Payer: Humana Medicare Advantage	$14.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.87
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.70
Rate for Payer: Wellcare Medicare Advantage	$13.87

CH AMINO ACID URINE SCR

Facility

$180.00

Service Code	HCPCS 82128
Hospital Charge Code	397071238
Hospital Revenue Code	301
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

CH AMINODARONE

Facility

$89.00

Service Code	HCPCS 80299
Hospital Charge Code	397072027
Hospital Revenue Code	301
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$13.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.35

CH AMINODARONE

Facility

$89.00

Service Code	HCPCS 80299
Hospital Charge Code	397072027
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	$11.57
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.35
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 AMINOLEVULINIC ACID 24HR

Facility

$278.00

Service Code	HCPCS 82135
Hospital Charge Code	397071330
Hospital Revenue Code	301
Min. Negotiated Rate	$8.22
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$53.30
Rate for Payer: Aetna Medicare Advantage	$16.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.27
Rate for Payer: Cigna Commercial	$16.45
Rate for Payer: Cigna Medicare Advantage	$8.22
Rate for Payer: Clover Medicare Advantage	$15.63
Rate for Payer: EmblemHealth Commercial	$49.35
Rate for Payer: Humana Medicare Advantage	$16.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.44
Rate for Payer: Wellcare Medicare Advantage	$16.45

CH AMINOLEVULINIC ACID 24HR

Facility

$278.00

Service Code	HCPCS 82135
Hospital Charge Code	397071330
Hospital Revenue Code	301
Min. Negotiated Rate	$41.70
Max. Negotiated Rate	$41.70
Rate for Payer: Qualcare PPO/HMO/WC	$41.70

CH AMINOLEVULINIC ACID RANDM

Facility

$229.00

Service Code	HCPCS 82135
Hospital Charge Code	397073165
Hospital Revenue Code	301
Min. Negotiated Rate	$8.22
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$53.30
Rate for Payer: Aetna Medicare Advantage	$16.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.27
Rate for Payer: Cigna Commercial	$16.45
Rate for Payer: Cigna Medicare Advantage	$8.22
Rate for Payer: Clover Medicare Advantage	$15.63
Rate for Payer: EmblemHealth Commercial	$49.35
Rate for Payer: Humana Medicare Advantage	$16.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.44
Rate for Payer: Wellcare Medicare Advantage	$16.45

CH AMINOLEVULINIC ACID RANDM

Facility

$229.00

Service Code	HCPCS 82135
Hospital Charge Code	397073165
Hospital Revenue Code	301
Min. Negotiated Rate	$34.35
Max. Negotiated Rate	$34.35
Rate for Payer: Qualcare PPO/HMO/WC	$34.35

CH AMITRIP/NORTRIP

Facility

$150.00

Service Code	HCPCS 80335
Hospital Charge Code	397071234
Hospital Revenue Code	301
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

CH AMITRIP/NORTRIP

Facility

$150.00

Service Code	HCPCS 80335
Hospital Charge Code	397071234
Hospital Revenue Code	301
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH AMITRIPTYLINE & METABOLTE

Facility

$67.00

Service Code	HCPCS 88152
Hospital Charge Code	397071394
Hospital Revenue Code	311
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

CH AMITRIPTYLINE & METABOLTE

Facility

$67.00

Service Code	HCPCS 88152
Hospital Charge Code	397071394
Hospital Revenue Code	311
Min. Negotiated Rate	$8.71
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$89.55
Rate for Payer: Aetna Medicare Advantage	$27.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.27
Rate for Payer: Cigna Commercial	$27.64
Rate for Payer: Cigna Medicare Advantage	$13.82
Rate for Payer: Clover Medicare Advantage	$26.26
Rate for Payer: EmblemHealth Commercial	$82.92
Rate for Payer: Humana Medicare Advantage	$28.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.71
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$29.30
Rate for Payer: Wellcare Medicare Advantage	$27.64

CH AMMONIA

Facility

$90.00

Service Code	HCPCS 82140
Hospital Charge Code	397071137
Hospital Revenue Code	301
Min. Negotiated Rate	$7.29
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.21
Rate for Payer: Aetna Medicare Advantage	$14.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.57
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	$53.38
Rate for Payer: Cigna Commercial	$14.57
Rate for Payer: Cigna Medicare Advantage	$7.29
Rate for Payer: Clover Medicare Advantage	$13.84
Rate for Payer: EmblemHealth Commercial	$43.71
Rate for Payer: Humana Medicare Advantage	$15.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.57
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.44
Rate for Payer: Wellcare Medicare Advantage	$14.57

CH AMMONIA

Facility

$90.00

Service Code	HCPCS 82140
Hospital Charge Code	397071137
Hospital Revenue Code	301
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

CH AMPHETAMINE CONF

Facility

$695.00

Service Code	HCPCS 80300
Hospital Charge Code	397073155
Hospital Revenue Code	301
Min. Negotiated Rate	$90.35
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$208.50
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.25
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH AMPHETAMINE CONF

Facility

$695.00

Service Code	HCPCS 80300
Hospital Charge Code	397073155
Hospital Revenue Code	301
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$104.25
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

CH AMPHETAMINE DAU

Facility

$44.00

Service Code	HCPCS 80324
Hospital Charge Code	397071271
Hospital Revenue Code	301
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

CH AMPHETAMINE DAU

Facility

$44.00

Service Code	HCPCS 80324
Hospital Charge Code	397071271
Hospital Revenue Code	301
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.20
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.72
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH AMPLIFICATION

Facility

$162.00

Service Code	HCPCS 83901
Hospital Charge Code	397073563
Hospital Revenue Code	301
Min. Negotiated Rate	$24.30
Max. Negotiated Rate	$24.30
Rate for Payer: Qualcare PPO/HMO/WC	$24.30

CH AMPLIFICATION

Facility

$162.00

Service Code	HCPCS 83901
Hospital Charge Code	397073563
Hospital Revenue Code	301
Min. Negotiated Rate	$21.06
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.60
Rate for Payer: Aetna Medicare Advantage	$48.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.31
Rate for Payer: Cigna Commercial	$81.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.30
Rate for Payer: UnitedHealthcare Commercial	$114.00

Know your out-of-pocket cost for care.

All Charges