Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH COOMBS C3D

Facility

$81.00

Service Code	HCPCS 86880
Hospital Charge Code	397031011
Hospital Revenue Code	300
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$140.48
Rate for Payer: Aetna Commercial	$17.46
Rate for Payer: Aetna Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.75
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$2.69
Rate for Payer: Clover Medicare Advantage	$5.12
Rate for Payer: EmblemHealth Commercial	$16.17
Rate for Payer: Humana Medicare Advantage	$5.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.71
Rate for Payer: Wellcare Medicare Advantage	$5.39

CH COOMBS IGG

Facility

$390.00

Service Code	HCPCS 86880
Hospital Charge Code	397031018
Hospital Revenue Code	300
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$140.48
Rate for Payer: Aetna Commercial	$17.46
Rate for Payer: Aetna Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.75
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$2.69
Rate for Payer: Clover Medicare Advantage	$5.12
Rate for Payer: EmblemHealth Commercial	$16.17
Rate for Payer: Humana Medicare Advantage	$5.55
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	$5.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.71
Rate for Payer: Wellcare Medicare Advantage	$5.39

CH COOMBS IGG

Facility

$390.00

Service Code	HCPCS 86880
Hospital Charge Code	397031018
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH COPPER SERUM

Facility

$111.00

Service Code	HCPCS 82525
Hospital Charge Code	397072053
Hospital Revenue Code	301
Min. Negotiated Rate	$6.21
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$40.21
Rate for Payer: Aetna Medicare Advantage	$12.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.41
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	$45.47
Rate for Payer: Cigna Commercial	$12.41
Rate for Payer: Cigna Medicare Advantage	$6.21
Rate for Payer: Clover Medicare Advantage	$11.79
Rate for Payer: EmblemHealth Commercial	$37.23
Rate for Payer: Humana Medicare Advantage	$12.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.41
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.15
Rate for Payer: Wellcare Medicare Advantage	$12.41

CH COPPER SERUM

Facility

$111.00

Service Code	HCPCS 82525
Hospital Charge Code	397072053
Hospital Revenue Code	301
Min. Negotiated Rate	$16.65
Max. Negotiated Rate	$16.65
Rate for Payer: Qualcare PPO/HMO/WC	$16.65

CH COPPER URINE

Facility

$177.00

Service Code	HCPCS 82525
Hospital Charge Code	397072052
Hospital Revenue Code	301
Min. Negotiated Rate	$6.21
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$40.21
Rate for Payer: Aetna Medicare Advantage	$12.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.41
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	$45.47
Rate for Payer: Cigna Commercial	$12.41
Rate for Payer: Cigna Medicare Advantage	$6.21
Rate for Payer: Clover Medicare Advantage	$11.79
Rate for Payer: EmblemHealth Commercial	$37.23
Rate for Payer: Humana Medicare Advantage	$12.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.01
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.41
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.15
Rate for Payer: Wellcare Medicare Advantage	$12.41

CH COPPER URINE

Facility

$177.00

Service Code	HCPCS 82525
Hospital Charge Code	397072052
Hospital Revenue Code	301
Min. Negotiated Rate	$26.55
Max. Negotiated Rate	$26.55
Rate for Payer: Qualcare PPO/HMO/WC	$26.55

CH CORTICOSTEROID 17 OH

Facility

$608.00

Service Code	HCPCS 83491
Hospital Charge Code	397071177
Hospital Revenue Code	301
Min. Negotiated Rate	$91.20
Max. Negotiated Rate	$91.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.20

CH CORTICOSTEROID 17 OH

Facility

$608.00

Service Code	HCPCS 83491
Hospital Charge Code	397071177
Hospital Revenue Code	301
Min. Negotiated Rate	$8.95
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.00
Rate for Payer: Aetna Medicare Advantage	$17.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.59
Rate for Payer: Cigna Commercial	$17.90
Rate for Payer: Cigna Medicare Advantage	$8.95
Rate for Payer: Clover Medicare Advantage	$17.00
Rate for Payer: EmblemHealth Commercial	$53.70
Rate for Payer: Humana Medicare Advantage	$18.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.04
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.90
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.97
Rate for Payer: Wellcare Medicare Advantage	$17.90

CH CORTISOL FREE 24 HR UR

Facility

$158.00

Service Code	HCPCS 82530
Hospital Charge Code	397073626
Hospital Revenue Code	301
Min. Negotiated Rate	$8.36
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.14
Rate for Payer: Aetna Medicare Advantage	$16.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.23
Rate for Payer: Cigna Commercial	$16.71
Rate for Payer: Cigna Medicare Advantage	$8.36
Rate for Payer: Clover Medicare Advantage	$15.87
Rate for Payer: EmblemHealth Commercial	$50.13
Rate for Payer: Humana Medicare Advantage	$17.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.71
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.71
Rate for Payer: Wellcare Medicare Advantage	$16.71

CH CORTISOL FREE 24 HR UR

Facility

$158.00

Service Code	HCPCS 82530
Hospital Charge Code	397073626
Hospital Revenue Code	301
Min. Negotiated Rate	$23.70
Max. Negotiated Rate	$23.70
Rate for Payer: Qualcare PPO/HMO/WC	$23.70

CH CORTISOL, FREE, URINE

Facility

$1,386.00

Service Code	HCPCS 82530
Hospital Charge Code	397073148
Hospital Revenue Code	301
Min. Negotiated Rate	$8.36
Max. Negotiated Rate	$207.90
Rate for Payer: Aetna Commercial	$54.14
Rate for Payer: Aetna Medicare Advantage	$16.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.23
Rate for Payer: Cigna Commercial	$16.71
Rate for Payer: Cigna Medicare Advantage	$8.36
Rate for Payer: Clover Medicare Advantage	$15.87
Rate for Payer: EmblemHealth Commercial	$50.13
Rate for Payer: Humana Medicare Advantage	$17.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.18
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$207.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.71
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.71
Rate for Payer: Wellcare Medicare Advantage	$16.71

CH CORTISOL, FREE, URINE

Facility

$1,386.00

Service Code	HCPCS 82530
Hospital Charge Code	397073148
Hospital Revenue Code	301
Min. Negotiated Rate	$207.90
Max. Negotiated Rate	$207.90
Rate for Payer: Qualcare PPO/HMO/WC	$207.90

CH CORTISOL,TOTAL,PM

Facility

$110.00

Service Code	HCPCS 82533
Hospital Charge Code	397071264
Hospital Revenue Code	301
Min. Negotiated Rate	$8.15
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.81
Rate for Payer: Aetna Medicare Advantage	$16.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.72
Rate for Payer: Cigna Commercial	$16.30
Rate for Payer: Cigna Medicare Advantage	$8.15
Rate for Payer: Clover Medicare Advantage	$15.48
Rate for Payer: EmblemHealth Commercial	$48.90
Rate for Payer: Humana Medicare Advantage	$16.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.30
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.28
Rate for Payer: Wellcare Medicare Advantage	$16.30

CH CORTISOL,TOTAL,PM

Facility

$110.00

Service Code	HCPCS 82533
Hospital Charge Code	397071264
Hospital Revenue Code	301
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

CH CORTISO,TOTAL,AM

Facility

$110.00

Service Code	HCPCS 82533
Hospital Charge Code	397071263
Hospital Revenue Code	301
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

CH CORTISO,TOTAL,AM

Facility

$110.00

Service Code	HCPCS 82533
Hospital Charge Code	397071263
Hospital Revenue Code	301
Min. Negotiated Rate	$8.15
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.81
Rate for Payer: Aetna Medicare Advantage	$16.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.72
Rate for Payer: Cigna Commercial	$16.30
Rate for Payer: Cigna Medicare Advantage	$8.15
Rate for Payer: Clover Medicare Advantage	$15.48
Rate for Payer: EmblemHealth Commercial	$48.90
Rate for Payer: Humana Medicare Advantage	$16.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.30
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.28
Rate for Payer: Wellcare Medicare Advantage	$16.30

CH C PEPTIDE

Facility

$161.00

Service Code	HCPCS 84681
Hospital Charge Code	397071208
Hospital Revenue Code	301
Min. Negotiated Rate	$10.40
Max. Negotiated Rate	$114.00
Rate for Payer: Cigna Commercial	$20.81
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	$41.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.25
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	$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	$20.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.06
Rate for Payer: Wellcare Medicare Advantage	$20.81

CH C PEPTIDE

Facility

$161.00

Service Code	HCPCS 84681
Hospital Charge Code	397071208
Hospital Revenue Code	301
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$24.15
Rate for Payer: Qualcare PPO/HMO/WC	$24.15

CH CQ1B, ABS

Facility

$203.00

Service Code	HCPCS 83520
Hospital Charge Code	397072168
Hospital Revenue Code	301
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.95
Rate for Payer: Aetna Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.28
Rate for Payer: Cigna Commercial	$17.27
Rate for Payer: Cigna Medicare Advantage	$8.63
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.39
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.31
Rate for Payer: Wellcare Medicare Advantage	$17.27

CH CQ1B, ABS

Facility

$203.00

Service Code	HCPCS 83520
Hospital Charge Code	397072168
Hospital Revenue Code	301
Min. Negotiated Rate	$30.45
Max. Negotiated Rate	$30.45
Rate for Payer: Qualcare PPO/HMO/WC	$30.45

CH C REACTIVE PROTEIN

Facility

$167.00

Service Code	HCPCS 86140
Hospital Charge Code	397071290
Hospital Revenue Code	302
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.78
Rate for Payer: Aetna Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.98
Rate for Payer: Cigna Commercial	$5.18
Rate for Payer: Cigna Medicare Advantage	$2.59
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.71
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.49
Rate for Payer: Wellcare Medicare Advantage	$5.18

CH C REACTIVE PROTEIN

Facility

$167.00

Service Code	HCPCS 86140
Hospital Charge Code	397071290
Hospital Revenue Code	302
Min. Negotiated Rate	$25.05
Max. Negotiated Rate	$25.05
Rate for Payer: Qualcare PPO/HMO/WC	$25.05

CH CREATIN, 24 HR URINE

Facility

$44.00

Service Code	HCPCS 82540
Hospital Charge Code	397071481
Hospital Revenue Code	301
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.03
Rate for Payer: Aetna Medicare Advantage	$4.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.00
Rate for Payer: Cigna Commercial	$4.64
Rate for Payer: Cigna Medicare Advantage	$2.32
Rate for Payer: Clover Medicare Advantage	$4.41
Rate for Payer: EmblemHealth Commercial	$13.92
Rate for Payer: Humana Medicare Advantage	$4.78
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
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.92
Rate for Payer: Wellcare Medicare Advantage	$4.64

CH CREATIN, 24 HR URINE

Facility

$44.00

Service Code	HCPCS 82540
Hospital Charge Code	397071481
Hospital Revenue Code	301
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

Know your out-of-pocket cost for care.

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