Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH FACTOR 8/VIAL

Facility

$21.00

Service Code	HCPCS J7190
Hospital Charge Code	397031072
Hospital Revenue Code	636
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$5.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.08
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

CH FACTOR 8/VIAL

Facility

$21.00

Service Code	HCPCS J7190
Hospital Charge Code	397031072
Hospital Revenue Code	636
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$6.30
Rate for Payer: Aetna Commercial	$6.30
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.08
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

CH FACTOR II

Facility

$42.00

Service Code	HCPCS 85210
Hospital Charge Code	397073012
Hospital Revenue Code	305
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

CH FACTOR II

Facility

$42.00

Service Code	HCPCS 85210
Hospital Charge Code	397073012
Hospital Revenue Code	305
Min. Negotiated Rate	$5.46
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.06
Rate for Payer: Aetna Medicare Advantage	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.56
Rate for Payer: Cigna Commercial	$12.98
Rate for Payer: Cigna Medicare Advantage	$6.49
Rate for Payer: Clover Medicare Advantage	$12.33
Rate for Payer: EmblemHealth Commercial	$38.94
Rate for Payer: Humana Medicare Advantage	$13.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.76
Rate for Payer: Wellcare Medicare Advantage	$12.98

CH FACTOR IX

Facility

$242.00

Service Code	HCPCS 85250
Hospital Charge Code	397071190
Hospital Revenue Code	305
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

CH FACTOR IX

Facility

$242.00

Service Code	HCPCS 85250
Hospital Charge Code	397071190
Hospital Revenue Code	305
Min. Negotiated Rate	$9.52
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$61.69
Rate for Payer: Aetna Medicare Advantage	$19.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.76
Rate for Payer: Cigna Commercial	$19.04
Rate for Payer: Cigna Medicare Advantage	$9.52
Rate for Payer: Clover Medicare Advantage	$18.09
Rate for Payer: EmblemHealth Commercial	$57.12
Rate for Payer: Humana Medicare Advantage	$19.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.04
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.18
Rate for Payer: Wellcare Medicare Advantage	$19.04

CH FACTOR V

Facility

$205.00

Service Code	HCPCS 85220
Hospital Charge Code	397071196
Hospital Revenue Code	305
Min. Negotiated Rate	$30.75
Max. Negotiated Rate	$30.75
Rate for Payer: Qualcare PPO/HMO/WC	$30.75

CH FACTOR V

Facility

$205.00

Service Code	HCPCS 85220
Hospital Charge Code	397071196
Hospital Revenue Code	305
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.19
Rate for Payer: Aetna Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.67
Rate for Payer: Cigna Commercial	$17.65
Rate for Payer: Cigna Medicare Advantage	$8.82
Rate for Payer: Clover Medicare Advantage	$16.77
Rate for Payer: EmblemHealth Commercial	$52.95
Rate for Payer: Humana Medicare Advantage	$18.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.65
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.71
Rate for Payer: Wellcare Medicare Advantage	$17.65

CH FACTOR VII

Facility

$139.00

Service Code	HCPCS 85230
Hospital Charge Code	397071194
Hospital Revenue Code	305
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	$44.88
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	$18.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.85
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 FACTOR VII

Facility

$139.00

Service Code	HCPCS 85230
Hospital Charge Code	397071194
Hospital Revenue Code	305
Min. Negotiated Rate	$20.85
Max. Negotiated Rate	$20.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.85

CH FACTOR VIII

Facility

$264.00

Service Code	HCPCS 85240
Hospital Charge Code	397071192
Hospital Revenue Code	305
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	$44.88
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	$34.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.60
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 FACTOR VIII

Facility

$264.00

Service Code	HCPCS 85240
Hospital Charge Code	397071192
Hospital Revenue Code	305
Min. Negotiated Rate	$39.60
Max. Negotiated Rate	$39.60
Rate for Payer: Qualcare PPO/HMO/WC	$39.60

CH FACTOR X

Facility

$390.00

Service Code	HCPCS 85260
Hospital Charge Code	397071188
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH FACTOR X

Facility

$390.00

Service Code	HCPCS 85260
Hospital Charge Code	397071188
Hospital Revenue Code	305
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	$50.49
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	$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	$17.90
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.97
Rate for Payer: Wellcare Medicare Advantage	$17.90

CH FACTOR XI

Facility

$264.00

Service Code	HCPCS 85270
Hospital Charge Code	397071186
Hospital Revenue Code	305
Min. Negotiated Rate	$39.60
Max. Negotiated Rate	$39.60
Rate for Payer: Qualcare PPO/HMO/WC	$39.60

CH FACTOR XI

Facility

$264.00

Service Code	HCPCS 85270
Hospital Charge Code	397071186
Hospital Revenue Code	305
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	$50.49
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	$34.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.60
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 FACTOR XII

Facility

$337.00

Service Code	HCPCS 85280
Hospital Charge Code	397071184
Hospital Revenue Code	305
Min. Negotiated Rate	$50.55
Max. Negotiated Rate	$50.55
Rate for Payer: Qualcare PPO/HMO/WC	$50.55

CH FACTOR XII

Facility

$337.00

Service Code	HCPCS 85280
Hospital Charge Code	397071184
Hospital Revenue Code	305
Min. Negotiated Rate	$9.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$62.69
Rate for Payer: Aetna Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.90
Rate for Payer: Cigna Commercial	$19.35
Rate for Payer: Cigna Medicare Advantage	$9.68
Rate for Payer: Clover Medicare Advantage	$18.38
Rate for Payer: EmblemHealth Commercial	$58.05
Rate for Payer: Humana Medicare Advantage	$19.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.81
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.51
Rate for Payer: Wellcare Medicare Advantage	$19.35

CH FACTOR XIII

Facility

$205.00

Service Code	HCPCS 85291
Hospital Charge Code	397071338
Hospital Revenue Code	305
Min. Negotiated Rate	$30.75
Max. Negotiated Rate	$30.75
Rate for Payer: Qualcare PPO/HMO/WC	$30.75

CH FACTOR XIII

Facility

$205.00

Service Code	HCPCS 85291
Hospital Charge Code	397071338
Hospital Revenue Code	305
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$29.52
Rate for Payer: Aetna Medicare Advantage	$9.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.38
Rate for Payer: Cigna Commercial	$9.11
Rate for Payer: Cigna Medicare Advantage	$4.55
Rate for Payer: Clover Medicare Advantage	$8.65
Rate for Payer: EmblemHealth Commercial	$27.33
Rate for Payer: Humana Medicare Advantage	$9.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.65
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.66
Rate for Payer: Wellcare Medicare Advantage	$9.11

CH FECAL FAT/MUSCLE QL

Facility

$103.00

Service Code	HCPCS 82705
Hospital Charge Code	397073069
Hospital Revenue Code	301
Min. Negotiated Rate	$15.45
Max. Negotiated Rate	$15.45
Rate for Payer: Qualcare PPO/HMO/WC	$15.45

CH FECAL FAT/MUSCLE QL

Facility

$103.00

Service Code	HCPCS 82705
Hospital Charge Code	397073069
Hospital Revenue Code	301
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.52
Rate for Payer: Aetna Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.69
Rate for Payer: Cigna Commercial	$5.10
Rate for Payer: Cigna Medicare Advantage	$2.55
Rate for Payer: Clover Medicare Advantage	$4.84
Rate for Payer: EmblemHealth Commercial	$15.30
Rate for Payer: Humana Medicare Advantage	$5.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.39
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.10
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.41
Rate for Payer: Wellcare Medicare Advantage	$5.10

CH FECAL FAT QUANT

Facility

$311.00

Service Code	HCPCS 82710
Hospital Charge Code	397072069
Hospital Revenue Code	301
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.43
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.56
Rate for Payer: Cigna Commercial	$16.80
Rate for Payer: Cigna Medicare Advantage	$8.40
Rate for Payer: Clover Medicare Advantage	$15.96
Rate for Payer: EmblemHealth Commercial	$50.40
Rate for Payer: Humana Medicare Advantage	$17.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.81
Rate for Payer: Wellcare Medicare Advantage	$16.80

CH FECAL FAT QUANT

Facility

$311.00

Service Code	HCPCS 82710
Hospital Charge Code	397072069
Hospital Revenue Code	301
Min. Negotiated Rate	$46.65
Max. Negotiated Rate	$46.65
Rate for Payer: Qualcare PPO/HMO/WC	$46.65

CH FECAL GLOBULIN, MEDICARE

Facility

$94.00

Service Code	HCPCS 82274
Hospital Charge Code	397071462
Hospital Revenue Code	301
Min. Negotiated Rate	$7.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$51.58
Rate for Payer: Aetna Medicare Advantage	$15.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.33
Rate for Payer: Cigna Commercial	$15.92
Rate for Payer: Cigna Medicare Advantage	$7.96
Rate for Payer: Clover Medicare Advantage	$15.12
Rate for Payer: EmblemHealth Commercial	$47.76
Rate for Payer: Humana Medicare Advantage	$16.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.22
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.92
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.88
Rate for Payer: Wellcare Medicare Advantage	$15.92

Know your out-of-pocket cost for care.

All Charges