Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH BLOOD SPLIT UNIT

Facility

$693.00

Service Code	HCPCS P9011
Hospital Charge Code	397031160
Hospital Revenue Code	390
Min. Negotiated Rate	$103.95
Max. Negotiated Rate	$103.95
Rate for Payer: Qualcare PPO/HMO/WC	$103.95

CH BLOOD TRANSFUSION

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	397031003
Hospital Revenue Code	391
Min. Negotiated Rate	$210.56
Max. Negotiated Rate	$210.56
Rate for Payer: Qualcare PPO/HMO/WC	$210.56

CH BLOOD TRANSFUSION

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	397031003
Hospital Revenue Code	391
Min. Negotiated Rate	$182.49
Max. Negotiated Rate	$1,050.61
Rate for Payer: Aetna Commercial	$421.12
Rate for Payer: Aetna Medicare Advantage	$421.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.96
Rate for Payer: Cigna Commercial	$1,050.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.49
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.56
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH BLOOD WHOLE LEUK IRRAD

Facility

$815.00

Service Code	HCPCS P9056
Hospital Charge Code	397031171
Hospital Revenue Code	390
Min. Negotiated Rate	$105.95
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$244.50
Rate for Payer: Aetna Medicare Advantage	$244.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.82
Rate for Payer: Cigna Commercial	$197.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.95
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.25
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH BLOOD WHOLE LEUK IRRAD

Facility

$815.00

Service Code	HCPCS P9056
Hospital Charge Code	397031171
Hospital Revenue Code	390
Min. Negotiated Rate	$122.25
Max. Negotiated Rate	$122.25
Rate for Payer: Qualcare PPO/HMO/WC	$122.25

CH B PERTUSSIS CULTURE NASAL

Facility

$76.00

Service Code	HCPCS 87081
Hospital Charge Code	397071518
Hospital Revenue Code	309
Min. Negotiated Rate	$11.40
Max. Negotiated Rate	$11.40
Rate for Payer: Qualcare PPO/HMO/WC	$11.40

CH B PERTUSSIS CULTURE NASAL

Facility

$76.00

Service Code	HCPCS 87081
Hospital Charge Code	397071518
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	$9.88
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.40
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

CH C1 INHIBITOR FUNCTIONAL

Facility

$435.00

Service Code	HCPCS 86161
Hospital Charge Code	397073672
Hospital Revenue Code	302
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.88
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.97
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: Cigna Medicare Advantage	$6.00
Rate for Payer: Clover Medicare Advantage	$11.40
Rate for Payer: EmblemHealth Commercial	$36.00
Rate for Payer: Humana Medicare Advantage	$12.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.55
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$65.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.72
Rate for Payer: Wellcare Medicare Advantage	$12.00

CH C1 INHIBITOR FUNCTIONAL

Facility

$435.00

Service Code	HCPCS 86161
Hospital Charge Code	397073672
Hospital Revenue Code	302
Min. Negotiated Rate	$65.25
Max. Negotiated Rate	$65.25
Rate for Payer: Qualcare PPO/HMO/WC	$65.25

CH C3 FLUID

Facility

$239.00

Service Code	HCPCS 86160
Hospital Charge Code	397073337
Hospital Revenue Code	302
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.88
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.97
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: Cigna Medicare Advantage	$6.00
Rate for Payer: Clover Medicare Advantage	$11.40
Rate for Payer: EmblemHealth Commercial	$36.00
Rate for Payer: Humana Medicare Advantage	$12.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.72
Rate for Payer: Wellcare Medicare Advantage	$12.00

CH C3 FLUID

Facility

$239.00

Service Code	HCPCS 86160
Hospital Charge Code	397073337
Hospital Revenue Code	302
Min. Negotiated Rate	$35.85
Max. Negotiated Rate	$35.85
Rate for Payer: Qualcare PPO/HMO/WC	$35.85

CH C4 FLUID

Facility

$239.00

Service Code	HCPCS 86160
Hospital Charge Code	397073338
Hospital Revenue Code	302
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.88
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.97
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: Cigna Medicare Advantage	$6.00
Rate for Payer: Clover Medicare Advantage	$11.40
Rate for Payer: EmblemHealth Commercial	$36.00
Rate for Payer: Humana Medicare Advantage	$12.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.72
Rate for Payer: Wellcare Medicare Advantage	$12.00

CH C4 FLUID

Facility

$239.00

Service Code	HCPCS 86160
Hospital Charge Code	397073338
Hospital Revenue Code	302
Min. Negotiated Rate	$35.85
Max. Negotiated Rate	$35.85
Rate for Payer: Qualcare PPO/HMO/WC	$35.85

CH C7

Facility

$308.00

Service Code	HCPCS 86160
Hospital Charge Code	397073565
Hospital Revenue Code	302
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$46.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.20

CH C7

Facility

$308.00

Service Code	HCPCS 86160
Hospital Charge Code	397073565
Hospital Revenue Code	302
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.88
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.97
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: Cigna Medicare Advantage	$6.00
Rate for Payer: Clover Medicare Advantage	$11.40
Rate for Payer: EmblemHealth Commercial	$36.00
Rate for Payer: Humana Medicare Advantage	$12.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.04
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.72
Rate for Payer: Wellcare Medicare Advantage	$12.00

CH CA 125

Facility

$214.00

Service Code	HCPCS 86304
Hospital Charge Code	397073117
Hospital Revenue Code	302
Min. Negotiated Rate	$32.10
Max. Negotiated Rate	$32.10
Rate for Payer: Qualcare PPO/HMO/WC	$32.10

CH CA 125

Facility

$214.00

Service Code	HCPCS 86304
Hospital Charge Code	397073117
Hospital Revenue Code	302
Min. Negotiated Rate	$10.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$67.42
Rate for Payer: Aetna Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.25
Rate for Payer: Cigna Commercial	$20.81
Rate for Payer: Cigna Medicare Advantage	$10.40
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.06
Rate for Payer: Wellcare Medicare Advantage	$20.81

CH CA125 FLUID

Facility

$261.65

Service Code	HCPCS 86304
Hospital Charge Code	397073216
Hospital Revenue Code	302
Min. Negotiated Rate	$10.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$67.42
Rate for Payer: Aetna Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.25
Rate for Payer: Cigna Commercial	$20.81
Rate for Payer: Cigna Medicare Advantage	$10.40
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.01
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.06
Rate for Payer: Wellcare Medicare Advantage	$20.81

CH CA125 FLUID

Facility

$261.65

Service Code	HCPCS 86304
Hospital Charge Code	397073216
Hospital Revenue Code	302
Min. Negotiated Rate	$39.25
Max. Negotiated Rate	$39.25
Rate for Payer: Qualcare PPO/HMO/WC	$39.25

CH CA 15-3

Facility

$390.00

Service Code	HCPCS 86300
Hospital Charge Code	397072002
Hospital Revenue Code	302
Min. Negotiated Rate	$10.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$67.42
Rate for Payer: Aetna Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.25
Rate for Payer: Cigna Commercial	$20.81
Rate for Payer: Cigna Medicare Advantage	$10.40
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
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	$20.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.06
Rate for Payer: Wellcare Medicare Advantage	$20.81

CH CA 15-3

Facility

$390.00

Service Code	HCPCS 86300
Hospital Charge Code	397072002
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH CA 19-9

Facility

$126.00

Service Code	HCPCS 86301
Hospital Charge Code	397072001
Hospital Revenue Code	302
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

CH CA 19-9

Facility

$126.00

Service Code	HCPCS 86301
Hospital Charge Code	397072001
Hospital Revenue Code	302
Min. Negotiated Rate	$10.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$67.42
Rate for Payer: Aetna Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.25
Rate for Payer: Cigna Commercial	$20.81
Rate for Payer: Cigna Medicare Advantage	$10.40
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.06
Rate for Payer: Wellcare Medicare Advantage	$20.81

CH CA 27-29

Facility

$149.00

Service Code	HCPCS 86300
Hospital Charge Code	397073212
Hospital Revenue Code	302
Min. Negotiated Rate	$22.35
Max. Negotiated Rate	$22.35
Rate for Payer: Qualcare PPO/HMO/WC	$22.35

CH CA 27-29

Facility

$149.00

Service Code	HCPCS 86300
Hospital Charge Code	397073212
Hospital Revenue Code	302
Min. Negotiated Rate	$10.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$67.42
Rate for Payer: Aetna Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.25
Rate for Payer: Cigna Commercial	$20.81
Rate for Payer: Cigna Medicare Advantage	$10.40
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.37
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.06
Rate for Payer: Wellcare Medicare Advantage	$20.81

Know your out-of-pocket cost for care.

All Charges