Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH D DIMER

Facility

$667.59

Service Code	HCPCS 85378
Hospital Charge Code	397021080
Hospital Revenue Code	305
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CH D DIMER

Facility

$667.59

Service Code	HCPCS 85378
Hospital Charge Code	397021080
Hospital Revenue Code	305
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.49
Rate for Payer: Aetna Medicare Advantage	$9.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.72
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	$35.61
Rate for Payer: Cigna Commercial	$9.72
Rate for Payer: Cigna Medicare Advantage	$4.86
Rate for Payer: Clover Medicare Advantage	$9.23
Rate for Payer: EmblemHealth Commercial	$29.16
Rate for Payer: Humana Medicare Advantage	$10.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.72
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.30
Rate for Payer: Wellcare Medicare Advantage	$9.72

CH DEOXYCORTISOL

Facility

$389.00

Service Code	HCPCS 82634
Hospital Charge Code	397071347
Hospital Revenue Code	301
Min. Negotiated Rate	$58.35
Max. Negotiated Rate	$58.35
Rate for Payer: Qualcare PPO/HMO/WC	$58.35

CH DEOXYCORTISOL

Facility

$389.00

Service Code	HCPCS 82634
Hospital Charge Code	397071347
Hospital Revenue Code	301
Min. Negotiated Rate	$14.64
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$94.87
Rate for Payer: Aetna Medicare Advantage	$29.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.28
Rate for Payer: Cigna Commercial	$29.28
Rate for Payer: Cigna Medicare Advantage	$14.64
Rate for Payer: Clover Medicare Advantage	$27.82
Rate for Payer: EmblemHealth Commercial	$87.84
Rate for Payer: Humana Medicare Advantage	$30.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.57
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.28
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$31.04
Rate for Payer: Wellcare Medicare Advantage	$29.28

CH DESIPRAMINE

Facility

$302.00

Service Code	HCPCS 80335
Hospital Charge Code	397071353
Hospital Revenue Code	301
Min. Negotiated Rate	$39.26
Max. Negotiated Rate	$151.00
Rate for Payer: Aetna Commercial	$90.60
Rate for Payer: Aetna Medicare Advantage	$90.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.01
Rate for Payer: Cigna Commercial	$151.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.26
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.30
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH DESIPRAMINE

Facility

$302.00

Service Code	HCPCS 80335
Hospital Charge Code	397071353
Hospital Revenue Code	301
Min. Negotiated Rate	$45.30
Max. Negotiated Rate	$45.30
Rate for Payer: Qualcare PPO/HMO/WC	$45.30

CH DESMOGLEIN ABS

Facility

$258.00

Service Code	HCPCS 83520
Hospital Charge Code	397073683
Hospital Revenue Code	301
Min. Negotiated Rate	$38.70
Max. Negotiated Rate	$38.70
Rate for Payer: Qualcare PPO/HMO/WC	$38.70

CH DESMOGLEIN ABS

Facility

$258.00

Service Code	HCPCS 83520
Hospital Charge Code	397073683
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	$33.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.70
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 DHEA S

Facility

$462.00

Service Code	HCPCS 82627
Hospital Charge Code	397072056
Hospital Revenue Code	301
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$72.03
Rate for Payer: Aetna Medicare Advantage	$22.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.45
Rate for Payer: Cigna Commercial	$22.23
Rate for Payer: Cigna Medicare Advantage	$11.12
Rate for Payer: Clover Medicare Advantage	$21.12
Rate for Payer: EmblemHealth Commercial	$66.69
Rate for Payer: Humana Medicare Advantage	$22.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.23
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$23.56
Rate for Payer: Wellcare Medicare Advantage	$22.23

CH DHEA S

Facility

$462.00

Service Code	HCPCS 82627
Hospital Charge Code	397072056
Hospital Revenue Code	301
Min. Negotiated Rate	$69.30
Max. Negotiated Rate	$69.30
Rate for Payer: Qualcare PPO/HMO/WC	$69.30

CH DHEA URINE 24 HR

Facility

$603.00

Service Code	HCPCS 82626
Hospital Charge Code	397073017
Hospital Revenue Code	301
Min. Negotiated Rate	$12.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$81.87
Rate for Payer: Aetna Medicare Advantage	$25.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.59
Rate for Payer: Cigna Commercial	$25.27
Rate for Payer: Cigna Medicare Advantage	$12.63
Rate for Payer: Clover Medicare Advantage	$24.01
Rate for Payer: EmblemHealth Commercial	$75.81
Rate for Payer: Humana Medicare Advantage	$26.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.39
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$26.79
Rate for Payer: Wellcare Medicare Advantage	$25.27

CH DHEA URINE 24 HR

Facility

$603.00

Service Code	HCPCS 82626
Hospital Charge Code	397073017
Hospital Revenue Code	301
Min. Negotiated Rate	$90.45
Max. Negotiated Rate	$90.45
Rate for Payer: Qualcare PPO/HMO/WC	$90.45

CH DIAZEPAM

Facility

$226.00

Service Code	HCPCS 80346
Hospital Charge Code	397073119
Hospital Revenue Code	301
Min. Negotiated Rate	$33.90
Max. Negotiated Rate	$33.90
Rate for Payer: Qualcare PPO/HMO/WC	$33.90

CH DIAZEPAM

Facility

$226.00

Service Code	HCPCS 80346
Hospital Charge Code	397073119
Hospital Revenue Code	301
Min. Negotiated Rate	$29.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$67.80
Rate for Payer: Aetna Medicare Advantage	$67.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.63
Rate for Payer: Cigna Commercial	$113.00
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

CH DIBUCAINE NUMBER

Facility

$201.00

Service Code	HCPCS 82638
Hospital Charge Code	397072057
Hospital Revenue Code	301
Min. Negotiated Rate	$6.12
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.69
Rate for Payer: Aetna Medicare Advantage	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.88
Rate for Payer: Cigna Commercial	$12.25
Rate for Payer: Cigna Medicare Advantage	$6.12
Rate for Payer: Clover Medicare Advantage	$11.64
Rate for Payer: EmblemHealth Commercial	$36.75
Rate for Payer: Humana Medicare Advantage	$12.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.25
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.98
Rate for Payer: Wellcare Medicare Advantage	$12.25

CH DIBUCAINE NUMBER

Facility

$201.00

Service Code	HCPCS 82638
Hospital Charge Code	397072057
Hospital Revenue Code	301
Min. Negotiated Rate	$30.15
Max. Negotiated Rate	$30.15
Rate for Payer: Qualcare PPO/HMO/WC	$30.15

CH DIFFERENTIAL AUTO

Facility

$390.00

Service Code	HCPCS 85004
Hospital Charge Code	397021026
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH DIFFERENTIAL AUTO

Facility

$390.00

Service Code	HCPCS 85004
Hospital Charge Code	397021026
Hospital Revenue Code	301
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$20.96
Rate for Payer: Aetna Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.71
Rate for Payer: Cigna Commercial	$6.47
Rate for Payer: Cigna Medicare Advantage	$3.23
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
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	$6.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.86
Rate for Payer: Wellcare Medicare Advantage	$6.47

CH DIGITOXIN

Facility

$131.00

Service Code	HCPCS 80299
Hospital Charge Code	397071206
Hospital Revenue Code	301
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$19.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

CH DIGITOXIN

Facility

$131.00

Service Code	HCPCS 80299
Hospital Charge Code	397071206
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	$17.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.65
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 DIGOXIN

Facility

$83.00

Service Code	HCPCS 80162
Hospital Charge Code	397071149
Hospital Revenue Code	301
Min. Negotiated Rate	$6.64
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.03
Rate for Payer: Aetna Medicare Advantage	$13.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.66
Rate for Payer: Cigna Commercial	$13.28
Rate for Payer: Cigna Medicare Advantage	$6.64
Rate for Payer: Clover Medicare Advantage	$12.62
Rate for Payer: EmblemHealth Commercial	$39.84
Rate for Payer: Humana Medicare Advantage	$13.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.28
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.08
Rate for Payer: Wellcare Medicare Advantage	$13.28

CH DIGOXIN

Facility

$83.00

Service Code	HCPCS 80162
Hospital Charge Code	397071149
Hospital Revenue Code	301
Min. Negotiated Rate	$12.45
Max. Negotiated Rate	$12.45
Rate for Payer: Qualcare PPO/HMO/WC	$12.45

CH DIHYDROTESTOSTERONE SERUM

Facility

$132.00

Service Code	HCPCS 80327
Hospital Charge Code	397070006
Hospital Revenue Code	301
Min. Negotiated Rate	$17.16
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.60
Rate for Payer: Aetna Medicare Advantage	$39.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.66
Rate for Payer: Cigna Commercial	$66.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.16
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.80
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH DIHYDROTESTOSTERONE SERUM

Facility

$132.00

Service Code	HCPCS 80327
Hospital Charge Code	397070006
Hospital Revenue Code	301
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$19.80
Rate for Payer: Qualcare PPO/HMO/WC	$19.80

CH DILANTIN

Facility

$118.00

Service Code	HCPCS 80185
Hospital Charge Code	397071297
Hospital Revenue Code	301
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.93
Rate for Payer: Aetna Medicare Advantage	$13.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.55
Rate for Payer: Cigna Commercial	$13.25
Rate for Payer: Cigna Medicare Advantage	$6.62
Rate for Payer: Clover Medicare Advantage	$12.59
Rate for Payer: EmblemHealth Commercial	$39.75
Rate for Payer: Humana Medicare Advantage	$13.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.25
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.04
Rate for Payer: Wellcare Medicare Advantage	$13.25

Know your out-of-pocket cost for care.

All Charges