Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH BENZENE BLOOD

Facility

$300.00

Service Code	HCPCS 84600
Hospital Charge Code	397073677
Hospital Revenue Code	301
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

CH BENZETROPINE

Facility

$492.00

Service Code	HCPCS 80299
Hospital Charge Code	397072033
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	$63.96
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.80
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 BENZETROPINE

Facility

$492.00

Service Code	HCPCS 80299
Hospital Charge Code	397072033
Hospital Revenue Code	301
Min. Negotiated Rate	$73.80
Max. Negotiated Rate	$73.80
Rate for Payer: Qualcare PPO/HMO/WC	$73.80

CH BENZODIAZEPINE CONF GC/MS

Facility

$233.00

Service Code	HCPCS 80346
Hospital Charge Code	397073061
Hospital Revenue Code	301
Min. Negotiated Rate	$34.95
Max. Negotiated Rate	$34.95
Rate for Payer: Qualcare PPO/HMO/WC	$34.95

CH BENZODIAZEPINE CONF GC/MS

Facility

$233.00

Service Code	HCPCS 80346
Hospital Charge Code	397073061
Hospital Revenue Code	301
Min. Negotiated Rate	$30.29
Max. Negotiated Rate	$116.50
Rate for Payer: Aetna Commercial	$69.90
Rate for Payer: Aetna Medicare Advantage	$69.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.41
Rate for Payer: Cigna Commercial	$116.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.29
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.95
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH BENZODIAZEPINES DAU

Facility

$44.00

Service Code	HCPCS 80346
Hospital Charge Code	397071279
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 BENZODIAZEPINES DAU

Facility

$44.00

Service Code	HCPCS 80346
Hospital Charge Code	397071279
Hospital Revenue Code	301
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

CH BETA 2-GLYCOPROT I(G,A,M)

Facility

$983.00

Service Code	HCPCS 86146
Hospital Charge Code	397071411
Hospital Revenue Code	302
Min. Negotiated Rate	$12.72
Max. Negotiated Rate	$147.45
Rate for Payer: Aetna Commercial	$82.46
Rate for Payer: Aetna Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.25
Rate for Payer: Cigna Commercial	$25.45
Rate for Payer: Cigna Medicare Advantage	$12.72
Rate for Payer: Clover Medicare Advantage	$24.18
Rate for Payer: EmblemHealth Commercial	$76.35
Rate for Payer: Humana Medicare Advantage	$26.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$26.98
Rate for Payer: Wellcare Medicare Advantage	$25.45

CH BETA 2-GLYCOPROT I(G,A,M)

Facility

$983.00

Service Code	HCPCS 86146
Hospital Charge Code	397071411
Hospital Revenue Code	302
Min. Negotiated Rate	$147.45
Max. Negotiated Rate	$147.45
Rate for Payer: Qualcare PPO/HMO/WC	$147.45

CH BETA 2 MICROGLOB CSF

Facility

$175.00

Service Code	HCPCS 82232
Hospital Charge Code	397072034
Hospital Revenue Code	301
Min. Negotiated Rate	$8.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.42
Rate for Payer: Aetna Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.28
Rate for Payer: Cigna Commercial	$16.18
Rate for Payer: Cigna Medicare Advantage	$8.09
Rate for Payer: Clover Medicare Advantage	$15.37
Rate for Payer: EmblemHealth Commercial	$48.54
Rate for Payer: Humana Medicare Advantage	$16.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.15
Rate for Payer: Wellcare Medicare Advantage	$16.18

CH BETA 2 MICROGLOB CSF

Facility

$175.00

Service Code	HCPCS 82232
Hospital Charge Code	397072034
Hospital Revenue Code	301
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

CH BETA 2 MICROGLOB S

Facility

$128.00

Service Code	HCPCS 82232
Hospital Charge Code	397072035
Hospital Revenue Code	301
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CH BETA 2 MICROGLOB S

Facility

$128.00

Service Code	HCPCS 82232
Hospital Charge Code	397072035
Hospital Revenue Code	301
Min. Negotiated Rate	$8.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.42
Rate for Payer: Aetna Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.28
Rate for Payer: Cigna Commercial	$16.18
Rate for Payer: Cigna Medicare Advantage	$8.09
Rate for Payer: Clover Medicare Advantage	$15.37
Rate for Payer: EmblemHealth Commercial	$48.54
Rate for Payer: Humana Medicare Advantage	$16.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.15
Rate for Payer: Wellcare Medicare Advantage	$16.18

CH BETA 2 MICROGLOB U

Facility

$128.00

Service Code	HCPCS 82232
Hospital Charge Code	397072036
Hospital Revenue Code	301
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CH BETA 2 MICROGLOB U

Facility

$128.00

Service Code	HCPCS 82232
Hospital Charge Code	397072036
Hospital Revenue Code	301
Min. Negotiated Rate	$8.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.42
Rate for Payer: Aetna Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.28
Rate for Payer: Cigna Commercial	$16.18
Rate for Payer: Cigna Medicare Advantage	$8.09
Rate for Payer: Clover Medicare Advantage	$15.37
Rate for Payer: EmblemHealth Commercial	$48.54
Rate for Payer: Humana Medicare Advantage	$16.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.15
Rate for Payer: Wellcare Medicare Advantage	$16.18

CH BETA-2 TRANSFERRIN, (BF)

Facility

$808.00

Service Code	HCPCS 86335
Hospital Charge Code	397071407
Hospital Revenue Code	302
Min. Negotiated Rate	$14.68
Max. Negotiated Rate	$121.20
Rate for Payer: Aetna Commercial	$95.09
Rate for Payer: Aetna Medicare Advantage	$29.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.54
Rate for Payer: Cigna Commercial	$29.35
Rate for Payer: Cigna Medicare Advantage	$14.68
Rate for Payer: Clover Medicare Advantage	$27.88
Rate for Payer: EmblemHealth Commercial	$88.05
Rate for Payer: Humana Medicare Advantage	$30.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.04
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$121.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$31.11
Rate for Payer: Wellcare Medicare Advantage	$29.35

CH BETA-2 TRANSFERRIN, (BF)

Facility

$808.00

Service Code	HCPCS 86335
Hospital Charge Code	397071407
Hospital Revenue Code	302
Min. Negotiated Rate	$121.20
Max. Negotiated Rate	$121.20
Rate for Payer: Qualcare PPO/HMO/WC	$121.20

CH BETA 2, TRANSFERRIN (BF)

Facility

$1,502.00

Service Code	HCPCS 86335
Hospital Charge Code	397073637
Hospital Revenue Code	302
Min. Negotiated Rate	$14.68
Max. Negotiated Rate	$225.30
Rate for Payer: Aetna Commercial	$95.09
Rate for Payer: Aetna Medicare Advantage	$29.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.54
Rate for Payer: Cigna Commercial	$29.35
Rate for Payer: Cigna Medicare Advantage	$14.68
Rate for Payer: Clover Medicare Advantage	$27.88
Rate for Payer: EmblemHealth Commercial	$88.05
Rate for Payer: Humana Medicare Advantage	$30.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.26
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$31.11
Rate for Payer: Wellcare Medicare Advantage	$29.35

CH BETA 2, TRANSFERRIN (BF)

Facility

$1,502.00

Service Code	HCPCS 86335
Hospital Charge Code	397073637
Hospital Revenue Code	302
Min. Negotiated Rate	$225.30
Max. Negotiated Rate	$225.30
Rate for Payer: Qualcare PPO/HMO/WC	$225.30

CH BICARBONATE, URINE RANDOM

Facility

$29.00

Service Code	HCPCS 82374
Hospital Charge Code	397071473
Hospital Revenue Code	301
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$4.35
Rate for Payer: Qualcare PPO/HMO/WC	$4.35

CH BICARBONATE, URINE RANDOM

Facility

$29.00

Service Code	HCPCS 82374
Hospital Charge Code	397071473
Hospital Revenue Code	301
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.81
Rate for Payer: Aetna Medicare Advantage	$4.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.88
Rate for Payer: Cigna Commercial	$4.88
Rate for Payer: Cigna Medicare Advantage	$2.44
Rate for Payer: Clover Medicare Advantage	$4.64
Rate for Payer: EmblemHealth Commercial	$14.64
Rate for Payer: Humana Medicare Advantage	$5.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.88
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.17
Rate for Payer: Wellcare Medicare Advantage	$4.88

CH BILE ACIDS

Facility

$216.00

Service Code	HCPCS 82240
Hospital Charge Code	397071349
Hospital Revenue Code	301
Min. Negotiated Rate	$32.40
Max. Negotiated Rate	$32.40
Rate for Payer: Qualcare PPO/HMO/WC	$32.40

CH BILE ACIDS

Facility

$216.00

Service Code	HCPCS 82240
Hospital Charge Code	397071349
Hospital Revenue Code	301
Min. Negotiated Rate	$10.64
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$86.12
Rate for Payer: Aetna Medicare Advantage	$26.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.39
Rate for Payer: Cigna Commercial	$26.58
Rate for Payer: Cigna Medicare Advantage	$13.29
Rate for Payer: Clover Medicare Advantage	$25.25
Rate for Payer: EmblemHealth Commercial	$79.74
Rate for Payer: Humana Medicare Advantage	$27.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.58
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28.17
Rate for Payer: Wellcare Medicare Advantage	$26.58

CH BILE ACIDS,FRACT-TOT,PREG

Facility

$549.00

Service Code	HCPCS 83789
Hospital Charge Code	397071397
Hospital Revenue Code	301
Min. Negotiated Rate	$82.35
Max. Negotiated Rate	$82.35
Rate for Payer: Qualcare PPO/HMO/WC	$82.35

CH BILE ACIDS,FRACT-TOT,PREG

Facility

$549.00

Service Code	HCPCS 83789
Hospital Charge Code	397071397
Hospital Revenue Code	301
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$114.00
Rate for Payer: Clover Medicare Advantage	$22.90
Rate for Payer: Aetna Commercial	$78.12
Rate for Payer: Aetna Medicare Advantage	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.11
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	$88.34
Rate for Payer: Cigna Commercial	$24.11
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: EmblemHealth Commercial	$72.33
Rate for Payer: Humana Medicare Advantage	$24.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.37
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.56
Rate for Payer: Wellcare Medicare Advantage	$24.11

Know your out-of-pocket cost for care.

All Charges