Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH CYSTATHIONINE

Facility

$226.00

Service Code	HCPCS 82542
Hospital Charge Code	397073278
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 CYSTICERCUS

Facility

$195.00

Service Code	HCPCS 86682
Hospital Charge Code	397072154
Hospital Revenue Code	302
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$29.25
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

CH CYSTICERCUS

Facility

$195.00

Service Code	HCPCS 86682
Hospital Charge Code	397072154
Hospital Revenue Code	302
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.15
Rate for Payer: Aetna Medicare Advantage	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.67
Rate for Payer: Cigna Commercial	$13.01
Rate for Payer: Cigna Medicare Advantage	$6.50
Rate for Payer: Clover Medicare Advantage	$12.36
Rate for Payer: EmblemHealth Commercial	$39.03
Rate for Payer: Humana Medicare Advantage	$13.40
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	$13.01
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.79
Rate for Payer: Wellcare Medicare Advantage	$13.01

CH CYTOLOGY, ASPIRATES

Facility

$806.00

Service Code	HCPCS 88173
Hospital Charge Code	397061046
Hospital Revenue Code	311
Min. Negotiated Rate	$94.39
Max. Negotiated Rate	$241.80
Rate for Payer: Aetna Commercial	$241.80
Rate for Payer: Aetna Medicare Advantage	$241.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.53
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$94.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.78
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.90
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH CYTOLOGY, ASPIRATES

Facility

$806.00

Service Code	HCPCS 88173
Hospital Charge Code	397061046
Hospital Revenue Code	311
Min. Negotiated Rate	$120.90
Max. Negotiated Rate	$120.90
Rate for Payer: Qualcare PPO/HMO/WC	$120.90

CH CYTOLOGY, ASPIRATE SMR

Facility

$390.00

Service Code	HCPCS 88172
Hospital Charge Code	397061049
Hospital Revenue Code	311
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH CYTOLOGY, ASPIRATE SMR

Facility

$390.00

Service Code	HCPCS 88172
Hospital Charge Code	397061049
Hospital Revenue Code	311
Min. Negotiated Rate	$30.27
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$30.27
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

CH CYTOLOGY, BRONCH BRUSH

Facility

$425.00

Service Code	HCPCS 8810491
Hospital Charge Code	397061045
Hospital Revenue Code	311
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH CYTOLOGY, BRONCH BRUSH

Facility

$425.00

Service Code	HCPCS 8810491
Hospital Charge Code	397061045
Hospital Revenue Code	311
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CH CYTOLOGY, BRONCH WASH

Facility

$425.00

Service Code	HCPCS 8810491
Hospital Charge Code	397061044
Hospital Revenue Code	311
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH CYTOLOGY, BRONCH WASH

Facility

$425.00

Service Code	HCPCS 8810491
Hospital Charge Code	397061044
Hospital Revenue Code	311
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CH CYTOLOGY, CSF

Facility

$425.00

Service Code	HCPCS 88104
Hospital Charge Code	397061041
Hospital Revenue Code	311
Min. Negotiated Rate	$47.88
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$47.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH CYTOLOGY, CSF

Facility

$425.00

Service Code	HCPCS 88104
Hospital Charge Code	397061041
Hospital Revenue Code	311
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CH CYTOLOGY, FLUID

Facility

$425.00

Service Code	HCPCS 88104
Hospital Charge Code	397061004
Hospital Revenue Code	311
Min. Negotiated Rate	$47.88
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$47.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH CYTOLOGY, FLUID

Facility

$425.00

Service Code	HCPCS 88104
Hospital Charge Code	397061004
Hospital Revenue Code	311
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CH CYTOLOGY, SEMEN

Facility

$390.00

Service Code	HCPCS 88160
Hospital Charge Code	397061047
Hospital Revenue Code	311
Min. Negotiated Rate	$46.43
Max. Negotiated Rate	$117.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: Cigna Medicare Advantage	$46.43
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

CH CYTOLOGY, SEMEN

Facility

$390.00

Service Code	HCPCS 88160
Hospital Charge Code	397061047
Hospital Revenue Code	311
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH CYTOLOGY, SPUTUM

Facility

$425.00

Service Code	HCPCS 88104
Hospital Charge Code	397061043
Hospital Revenue Code	311
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CH CYTOLOGY, SPUTUM

Facility

$425.00

Service Code	HCPCS 88104
Hospital Charge Code	397061043
Hospital Revenue Code	311
Min. Negotiated Rate	$47.88
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$47.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH CYTOLOGY, URINE

Facility

$425.00

Service Code	HCPCS 88104
Hospital Charge Code	397061042
Hospital Revenue Code	311
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CH CYTOLOGY, URINE

Facility

$425.00

Service Code	HCPCS 88104
Hospital Charge Code	397061042
Hospital Revenue Code	311
Min. Negotiated Rate	$47.88
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$47.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH CYTO/MOLECULAR REPORT

Facility

$40.00

Service Code	HCPCS 88291
Hospital Charge Code	397073336
Hospital Revenue Code	310
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CH CYTO/MOLECULAR REPORT

Facility

$40.00

Service Code	HCPCS 88291
Hospital Charge Code	397073332
Hospital Revenue Code	310
Min. Negotiated Rate	$5.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$12.00
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$36.64
Rate for Payer: Cigna Medicare Advantage	$18.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH CYTO/MOLECULAR REPORT

Facility

$40.00

Service Code	HCPCS 88291
Hospital Charge Code	397073332
Hospital Revenue Code	310
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CH CYTO/MOLECULAR REPORT

Facility

$40.00

Service Code	HCPCS 88291
Hospital Charge Code	397073336
Hospital Revenue Code	310
Min. Negotiated Rate	$5.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Aetna Commercial	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$36.64
Rate for Payer: Cigna Medicare Advantage	$18.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$114.00

Know your out-of-pocket cost for care.

All Charges