Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

CH DIPHTHERIA AB TITER

Facility

$249.00

Service Code	HCPCS 86648
Hospital Charge Code	397073628
Hospital Revenue Code	302
Min. Negotiated Rate	$37.35
Max. Negotiated Rate	$37.35
Rate for Payer: Qualcare PPO/HMO/WC	$37.35

CH DIPHTHERIA AB TITER

Facility

$249.00

Service Code	HCPCS 86648
Hospital Charge Code	397073628
Hospital Revenue Code	302
Min. Negotiated Rate	$7.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$49.28
Rate for Payer: Aetna Medicare Advantage	$15.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.73
Rate for Payer: Cigna Commercial	$15.21
Rate for Payer: Cigna Medicare Advantage	$7.61
Rate for Payer: Clover Medicare Advantage	$14.45
Rate for Payer: EmblemHealth Commercial	$45.63
Rate for Payer: Humana Medicare Advantage	$15.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.37
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.21
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.12
Rate for Payer: Wellcare Medicare Advantage	$15.21

CH DIRECT COOMBS (DAT)

Facility

$59.00

Service Code	HCPCS 86880
Hospital Charge Code	397031026
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	$7.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.85
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 DIRECT COOMBS (DAT)

Facility

$59.00

Service Code	HCPCS 86880
Hospital Charge Code	397031026
Hospital Revenue Code	300
Min. Negotiated Rate	$8.85
Max. Negotiated Rate	$8.85
Rate for Payer: Qualcare PPO/HMO/WC	$8.85

CH DISOPYRAMIDE

Facility

$183.00

Service Code	HCPCS 80299
Hospital Charge Code	397072058
Hospital Revenue Code	301
Min. Negotiated Rate	$27.45
Max. Negotiated Rate	$27.45
Rate for Payer: Qualcare PPO/HMO/WC	$27.45

CH DISOPYRAMIDE

Facility

$183.00

Service Code	HCPCS 80299
Hospital Charge Code	397072058
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	$23.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.45
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 DNASE-B AB

Facility

$213.00

Service Code	HCPCS 86215
Hospital Charge Code	397071549
Hospital Revenue Code	302
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	$34.59
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	$27.69
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.95
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

CH DNASE-B AB

Facility

$213.00

Service Code	HCPCS 86215
Hospital Charge Code	397071549
Hospital Revenue Code	302
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$31.95
Rate for Payer: Qualcare PPO/HMO/WC	$31.95

CH DOG EPITHELIA IGE

Facility

$32.00

Service Code	HCPCS 86003
Hospital Charge Code	397073669
Hospital Revenue Code	305
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

CH DOG EPITHELIA IGE

Facility

$32.00

Service Code	HCPCS 86003
Hospital Charge Code	397073669
Hospital Revenue Code	305
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.91
Rate for Payer: Aetna Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.13
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: Cigna Medicare Advantage	$2.61
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.53
Rate for Payer: Wellcare Medicare Advantage	$5.22

CH DOXEPIN

Facility

$254.00

Service Code	HCPCS 80335
Hospital Charge Code	397072059
Hospital Revenue Code	301
Min. Negotiated Rate	$38.10
Max. Negotiated Rate	$38.10
Rate for Payer: Qualcare PPO/HMO/WC	$38.10

CH DOXEPIN

Facility

$254.00

Service Code	HCPCS 80335
Hospital Charge Code	397072059
Hospital Revenue Code	301
Min. Negotiated Rate	$33.02
Max. Negotiated Rate	$127.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: Aetna Commercial	$76.20
Rate for Payer: Aetna Medicare Advantage	$76.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.77
Rate for Payer: Cigna Commercial	$127.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.02
Rate for Payer: Oxford Commercial	$101.00

CH DRUG CONFIRMATION

Facility

$313.00

Service Code	HCPCS 80102
Hospital Charge Code	397071032
Hospital Revenue Code	301
Min. Negotiated Rate	$46.95
Max. Negotiated Rate	$46.95
Rate for Payer: Qualcare PPO/HMO/WC	$46.95

CH DRUG CONFIRMATION

Facility

$313.00

Service Code	HCPCS 80102
Hospital Charge Code	397071032
Hospital Revenue Code	301
Min. Negotiated Rate	$40.69
Max. Negotiated Rate	$156.50
Rate for Payer: Aetna Commercial	$93.90
Rate for Payer: Aetna Medicare Advantage	$93.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.81
Rate for Payer: Cigna Commercial	$156.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.69
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.95
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH DRVVT SCREEN W/REFLEX

Facility

$390.00

Service Code	HCPCS 85613
Hospital Charge Code	397071543
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH DRVVT SCREEN W/REFLEX

Facility

$390.00

Service Code	HCPCS 85613
Hospital Charge Code	397071543
Hospital Revenue Code	305
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.04
Rate for Payer: Aetna Medicare Advantage	$9.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.10
Rate for Payer: Cigna Commercial	$9.58
Rate for Payer: Cigna Medicare Advantage	$4.79
Rate for Payer: Clover Medicare Advantage	$9.10
Rate for Payer: EmblemHealth Commercial	$28.74
Rate for Payer: Humana Medicare Advantage	$9.87
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	$9.58
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.15
Rate for Payer: Wellcare Medicare Advantage	$9.58

CH DU TEST

Facility

$81.00

Service Code	HCPCS 86885
Hospital Charge Code	397031060
Hospital Revenue Code	300
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$12.15
Rate for Payer: Qualcare PPO/HMO/WC	$12.15

CH DU TEST

Facility

$81.00

Service Code	HCPCS 86885
Hospital Charge Code	397031060
Hospital Revenue Code	300
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$18.53
Rate for Payer: Aetna Medicare Advantage	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.96
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$2.86
Rate for Payer: Clover Medicare Advantage	$5.43
Rate for Payer: EmblemHealth Commercial	$17.16
Rate for Payer: Humana Medicare Advantage	$5.89
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	$5.72
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.06
Rate for Payer: Wellcare Medicare Advantage	$5.72

CH D XYLOSE PLASMA

Facility

$396.00

Service Code	HCPCS 84620
Hospital Charge Code	397071183
Hospital Revenue Code	301
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.83
Rate for Payer: Aetna Medicare Advantage	$12.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.30
Rate for Payer: Cigna Commercial	$12.91
Rate for Payer: Cigna Medicare Advantage	$6.46
Rate for Payer: Clover Medicare Advantage	$12.26
Rate for Payer: EmblemHealth Commercial	$38.73
Rate for Payer: Humana Medicare Advantage	$13.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.91
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.68
Rate for Payer: Wellcare Medicare Advantage	$12.91

CH D XYLOSE PLASMA

Facility

$396.00

Service Code	HCPCS 84620
Hospital Charge Code	397071183
Hospital Revenue Code	301
Min. Negotiated Rate	$59.40
Max. Negotiated Rate	$59.40
Rate for Payer: Qualcare PPO/HMO/WC	$59.40

CH D XYLOSE URINE

Facility

$258.00

Service Code	HCPCS 84620
Hospital Charge Code	397071301
Hospital Revenue Code	301
Min. Negotiated Rate	$38.70
Max. Negotiated Rate	$38.70
Rate for Payer: Qualcare PPO/HMO/WC	$38.70

CH D XYLOSE URINE

Facility

$258.00

Service Code	HCPCS 84620
Hospital Charge Code	397071301
Hospital Revenue Code	301
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.83
Rate for Payer: Aetna Medicare Advantage	$12.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.30
Rate for Payer: Cigna Commercial	$12.91
Rate for Payer: Cigna Medicare Advantage	$6.46
Rate for Payer: Clover Medicare Advantage	$12.26
Rate for Payer: EmblemHealth Commercial	$38.73
Rate for Payer: Humana Medicare Advantage	$13.30
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	$12.91
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.68
Rate for Payer: Wellcare Medicare Advantage	$12.91

CH EBV,DNA,QI,RT PCR

Facility

$828.00

Service Code	HCPCS 87798
Hospital Charge Code	397071389
Hospital Revenue Code	306
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$147.80
Rate for Payer: Aetna Commercial	$113.69
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.57
Rate for Payer: Cigna Commercial	$35.09
Rate for Payer: Cigna Medicare Advantage	$17.55
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$124.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

CH EBV,DNA,QI,RT PCR

Facility

$828.00

Service Code	HCPCS 87798
Hospital Charge Code	397071389
Hospital Revenue Code	306
Min. Negotiated Rate	$124.20
Max. Negotiated Rate	$124.20
Rate for Payer: Qualcare PPO/HMO/WC	$124.20

Know your out-of-pocket cost for care.

All Charges