Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH EOSINOPHILE SMEAR NASAL

Facility

$390.00

Service Code	HCPCS 89190
Hospital Charge Code	397021077
Hospital Revenue Code	300
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.76
Rate for Payer: Aetna Medicare Advantage	$5.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.21
Rate for Payer: Cigna Commercial	$5.79
Rate for Payer: Cigna Medicare Advantage	$2.90
Rate for Payer: Clover Medicare Advantage	$5.50
Rate for Payer: EmblemHealth Commercial	$17.37
Rate for Payer: Humana Medicare Advantage	$5.96
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	$5.79
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.14
Rate for Payer: Wellcare Medicare Advantage	$5.79

CH EOSINOPHILE SMEAR UA/FEL

Facility

$72.00

Service Code	HCPCS 87205
Hospital Charge Code	397021285
Hospital Revenue Code	309
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.83
Rate for Payer: Aetna Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.65
Rate for Payer: Cigna Commercial	$4.27
Rate for Payer: Cigna Medicare Advantage	$2.13
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.53
Rate for Payer: Wellcare Medicare Advantage	$4.27

CH EOSINOPHILE SMEAR UA/FEL

Facility

$72.00

Service Code	HCPCS 87205
Hospital Charge Code	397021285
Hospital Revenue Code	309
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

CH EPINEPHRINE

Facility

$176.00

Service Code	HCPCS 82542
Hospital Charge Code	397073629
Hospital Revenue Code	301
Min. Negotiated Rate	$26.40
Max. Negotiated Rate	$26.40
Rate for Payer: Qualcare PPO/HMO/WC	$26.40

CH EPINEPHRINE

Facility

$176.00

Service Code	HCPCS 82542
Hospital Charge Code	397073629
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	$22.88
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.40
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 ERA PARAFFIN BLOCK 1ST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	397061014
Hospital Revenue Code	310
Min. Negotiated Rate	$162.34
Max. Negotiated Rate	$162.34
Rate for Payer: Qualcare PPO/HMO/WC	$162.34

CH ERA PARAFFIN BLOCK 1ST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	397061014
Hospital Revenue Code	310
Min. Negotiated Rate	$62.80
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$324.69
Rate for Payer: Aetna Medicare Advantage	$324.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.99
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$62.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.34
Rate for Payer: UnitedHealthcare Commercial	$114.00

CHERRY SYRUP

Facility

$111.02

Service Code	NDC 395266216
Hospital Charge Code	60628558
Hospital Revenue Code	250
Min. Negotiated Rate	$16.65
Max. Negotiated Rate	$16.65
Rate for Payer: Qualcare PPO/HMO/WC	$16.65

CHERRY SYRUP

Facility

$111.02

Service Code	NDC 395266216
Hospital Charge Code	60628558
Hospital Revenue Code	250
Min. Negotiated Rate	$14.43
Max. Negotiated Rate	$55.51
Rate for Payer: Aetna Commercial	$33.31
Rate for Payer: Aetna Medicare Advantage	$33.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.31
Rate for Payer: Cigna Commercial	$55.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.43
Rate for Payer: Oxford Commercial	$55.51
Rate for Payer: Qualcare PPO/HMO/WC	$16.65
Rate for Payer: UnitedHealthcare Commercial	$55.51

CHERRY SYRUP 1ML

Facility

$1.95

Hospital Charge Code	60628589
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

CHERRY SYRUP 1ML

Facility

$1.95

Hospital Charge Code	60628589
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.98
Rate for Payer: Aetna Commercial	$0.59
Rate for Payer: Aetna Medicare Advantage	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.50
Rate for Payer: Cigna Commercial	$0.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.25
Rate for Payer: Oxford Commercial	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.29
Rate for Payer: UnitedHealthcare Commercial	$0.98

CH ERYTHROCYTE PROTOPOR

Facility

$159.00

Service Code	HCPCS 84202
Hospital Charge Code	397071202
Hospital Revenue Code	301
Min. Negotiated Rate	$7.17
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.49
Rate for Payer: Aetna Medicare Advantage	$14.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.58
Rate for Payer: Cigna Commercial	$14.35
Rate for Payer: Cigna Medicare Advantage	$7.17
Rate for Payer: Clover Medicare Advantage	$13.63
Rate for Payer: EmblemHealth Commercial	$43.05
Rate for Payer: Humana Medicare Advantage	$14.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.21
Rate for Payer: Wellcare Medicare Advantage	$14.35

CH ERYTHROCYTE PROTOPOR

Facility

$159.00

Service Code	HCPCS 84202
Hospital Charge Code	397071202
Hospital Revenue Code	301
Min. Negotiated Rate	$23.85
Max. Negotiated Rate	$23.85
Rate for Payer: Qualcare PPO/HMO/WC	$23.85

CH ERYTHROPOIETIN

Facility

$184.00

Service Code	HCPCS 82668
Hospital Charge Code	397073009
Hospital Revenue Code	301
Min. Negotiated Rate	$9.39
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.88
Rate for Payer: Aetna Medicare Advantage	$18.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$18.79
Rate for Payer: Cigna Medicare Advantage	$9.39
Rate for Payer: Clover Medicare Advantage	$17.85
Rate for Payer: EmblemHealth Commercial	$56.37
Rate for Payer: Humana Medicare Advantage	$19.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.79
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.92
Rate for Payer: Wellcare Medicare Advantage	$18.79

CH ERYTHROPOIETIN

Facility

$184.00

Service Code	HCPCS 82668
Hospital Charge Code	397073009
Hospital Revenue Code	301
Min. Negotiated Rate	$27.60
Max. Negotiated Rate	$27.60
Rate for Payer: Qualcare PPO/HMO/WC	$27.60

CHEST 3 VIEWS

Facility

$5,100.00

Service Code	HCPCS 71047
Hospital Charge Code	2003072
Hospital Revenue Code	320
Min. Negotiated Rate	$44.99
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

CHEST 3 VIEWS

Facility

$5,100.00

Service Code	HCPCS 71047
Hospital Charge Code	2003072
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

CHEST 4 OR > VIEWS

Facility

$5,100.00

Service Code	HCPCS 71048
Hospital Charge Code	94061041
Hospital Revenue Code	324
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

CHEST 4 OR > VIEWS

Facility

$5,100.00

Service Code	HCPCS 71048
Hospital Charge Code	2003073
Hospital Revenue Code	324
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

CHEST 4 OR > VIEWS

Facility

$5,100.00

Service Code	HCPCS 71048
Hospital Charge Code	94061041
Hospital Revenue Code	324
Min. Negotiated Rate	$48.26
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

CHEST 4 OR > VIEWS

Facility

$5,100.00

Service Code	HCPCS 71048
Hospital Charge Code	2003073
Hospital Revenue Code	324
Min. Negotiated Rate	$48.26
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

CHEST DRAIN THOR-KLEX DUAL

Facility

$697.00

Hospital Charge Code	270331048
Hospital Revenue Code	272
Min. Negotiated Rate	$104.55
Max. Negotiated Rate	$104.55
Rate for Payer: Qualcare PPO/HMO/WC	$104.55

CHEST DRAIN THOR-KLEX DUAL

Facility

$697.00

Hospital Charge Code	270331048
Hospital Revenue Code	272
Min. Negotiated Rate	$90.61
Max. Negotiated Rate	$348.50
Rate for Payer: Aetna Commercial	$209.10
Rate for Payer: Aetna Medicare Advantage	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.74
Rate for Payer: Cigna Commercial	$348.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.61
Rate for Payer: Oxford Commercial	$348.50
Rate for Payer: Qualcare PPO/HMO/WC	$104.55
Rate for Payer: UnitedHealthcare Commercial	$348.50

CHEST/MEDIASTINUM

Facility

$6,700.00

Service Code	HCPCS 76604
Hospital Charge Code	94061159
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

CHEST/MEDIASTINUM

Facility

$6,700.00

Service Code	HCPCS 76604
Hospital Charge Code	94061159
Hospital Revenue Code	402
Min. Negotiated Rate	$65.45
Max. Negotiated Rate	$2,010.00
Rate for Payer: Aetna Commercial	$2,010.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$871.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$1,981.00

Know your out-of-pocket cost for care.

All Charges