Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH GASTRIN LEVEL

Facility

$114.00

Service Code	HCPCS 82941
Hospital Charge Code	397071135
Hospital Revenue Code	301
Min. Negotiated Rate	$8.81
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.12
Rate for Payer: Aetna Medicare Advantage	$17.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.60
Rate for Payer: Cigna Commercial	$17.63
Rate for Payer: Cigna Medicare Advantage	$8.81
Rate for Payer: Clover Medicare Advantage	$16.75
Rate for Payer: EmblemHealth Commercial	$52.89
Rate for Payer: Humana Medicare Advantage	$18.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.63
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.69
Rate for Payer: Wellcare Medicare Advantage	$17.63

CH GASTRIN LEVEL

Facility

$114.00

Service Code	HCPCS 82941
Hospital Charge Code	397071135
Hospital Revenue Code	301
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$17.10
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

CH GENTAMICIN - PEAK

Facility

$390.00

Service Code	HCPCS 80170
Hospital Charge Code	397073144
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH GENTAMICIN - PEAK

Facility

$390.00

Service Code	HCPCS 80170
Hospital Charge Code	397073144
Hospital Revenue Code	301
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$53.07
Rate for Payer: Aetna Medicare Advantage	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.02
Rate for Payer: Cigna Commercial	$16.38
Rate for Payer: Cigna Medicare Advantage	$8.19
Rate for Payer: Clover Medicare Advantage	$15.56
Rate for Payer: EmblemHealth Commercial	$49.14
Rate for Payer: Humana Medicare Advantage	$16.87
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	$16.38
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.36
Rate for Payer: Wellcare Medicare Advantage	$16.38

CH GENTAMYCIN RANDOM

Facility

$390.00

Service Code	HCPCS 80170
Hospital Charge Code	397073181
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH GENTAMYCIN RANDOM

Facility

$390.00

Service Code	HCPCS 80170
Hospital Charge Code	397073181
Hospital Revenue Code	301
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$53.07
Rate for Payer: Aetna Medicare Advantage	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.02
Rate for Payer: Cigna Commercial	$16.38
Rate for Payer: Cigna Medicare Advantage	$8.19
Rate for Payer: Clover Medicare Advantage	$15.56
Rate for Payer: EmblemHealth Commercial	$49.14
Rate for Payer: Humana Medicare Advantage	$16.87
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	$16.38
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.36
Rate for Payer: Wellcare Medicare Advantage	$16.38

CH GENTAMYCIN THROUGH

Facility

$390.00

Service Code	HCPCS 80170
Hospital Charge Code	397071316
Hospital Revenue Code	301
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$53.07
Rate for Payer: Aetna Medicare Advantage	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.02
Rate for Payer: Cigna Commercial	$16.38
Rate for Payer: Cigna Medicare Advantage	$8.19
Rate for Payer: Clover Medicare Advantage	$15.56
Rate for Payer: EmblemHealth Commercial	$49.14
Rate for Payer: Humana Medicare Advantage	$16.87
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	$16.38
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.36
Rate for Payer: Wellcare Medicare Advantage	$16.38

CH GENTAMYCIN THROUGH

Facility

$390.00

Service Code	HCPCS 80170
Hospital Charge Code	397071316
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH GGTP

Facility

$140.00

Service Code	HCPCS 82977
Hospital Charge Code	397071128
Hospital Revenue Code	301
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$23.33
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.38
Rate for Payer: Cigna Commercial	$7.20
Rate for Payer: Cigna Medicare Advantage	$3.60
Rate for Payer: Clover Medicare Advantage	$6.84
Rate for Payer: EmblemHealth Commercial	$21.60
Rate for Payer: Humana Medicare Advantage	$7.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.20
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.63
Rate for Payer: Wellcare Medicare Advantage	$7.20

CH GGTP

Facility

$140.00

Service Code	HCPCS 82977
Hospital Charge Code	397071128
Hospital Revenue Code	301
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

CH GLIADIN AB (IGA)

Facility

$63.00

Service Code	HCPCS 83516
Hospital Charge Code	397071420
Hospital Revenue Code	301
Min. Negotiated Rate	$5.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.36
Rate for Payer: Aetna Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.25
Rate for Payer: Cigna Commercial	$11.53
Rate for Payer: Cigna Medicare Advantage	$5.76
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.19
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.22
Rate for Payer: Wellcare Medicare Advantage	$11.53

CH GLIADIN AB (IGA)

Facility

$63.00

Service Code	HCPCS 83516
Hospital Charge Code	397071420
Hospital Revenue Code	301
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

CH GLIPIZIDE

Facility

$353.00

Service Code	HCPCS 80299
Hospital Charge Code	397071548
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	$45.89
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.95
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 GLIPIZIDE

Facility

$353.00

Service Code	HCPCS 80299
Hospital Charge Code	397071548
Hospital Revenue Code	301
Min. Negotiated Rate	$52.95
Max. Negotiated Rate	$52.95
Rate for Payer: Qualcare PPO/HMO/WC	$52.95

CH GLUCAGON

Facility

$390.00

Service Code	HCPCS 82943
Hospital Charge Code	397073559
Hospital Revenue Code	301
Min. Negotiated Rate	$7.14
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Medicare Advantage	$14.29
Rate for Payer: Aetna Commercial	$46.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.36
Rate for Payer: Cigna Commercial	$14.29
Rate for Payer: Cigna Medicare Advantage	$7.14
Rate for Payer: Clover Medicare Advantage	$13.58
Rate for Payer: EmblemHealth Commercial	$42.87
Rate for Payer: Humana Medicare Advantage	$14.72
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	$14.29
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.15
Rate for Payer: Wellcare Medicare Advantage	$14.29

CH GLUCAGON

Facility

$390.00

Service Code	HCPCS 82943
Hospital Charge Code	397073559
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH GLUCOMETER

Facility

$56.00

Service Code	HCPCS 82948
Hospital Charge Code	397073570
Hospital Revenue Code	301
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

CH GLUCOMETER

Facility

$56.00

Service Code	HCPCS 82948
Hospital Charge Code	397073570
Hospital Revenue Code	301
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$114.00
Rate for Payer: Cigna Commercial	$5.04
Rate for Payer: Cigna Medicare Advantage	$2.52
Rate for Payer: Aetna Commercial	$16.33
Rate for Payer: Aetna Medicare Advantage	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.47
Rate for Payer: Clover Medicare Advantage	$4.79
Rate for Payer: EmblemHealth Commercial	$15.12
Rate for Payer: Humana Medicare Advantage	$5.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.04
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.34
Rate for Payer: Wellcare Medicare Advantage	$5.04

CH GLUCOSE

Facility

$40.00

Service Code	HCPCS 82947
Hospital Charge Code	397071197
Hospital Revenue Code	301
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CH GLUCOSE

Facility

$40.00

Service Code	HCPCS 82947
Hospital Charge Code	397071197
Hospital Revenue Code	301
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$12.73
Rate for Payer: Aetna Medicare Advantage	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.40
Rate for Payer: Cigna Commercial	$3.93
Rate for Payer: Cigna Medicare Advantage	$1.97
Rate for Payer: Clover Medicare Advantage	$3.73
Rate for Payer: EmblemHealth Commercial	$11.79
Rate for Payer: Humana Medicare Advantage	$4.05
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
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.93
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.17
Rate for Payer: Wellcare Medicare Advantage	$3.93

CH GLUCOSE, 4HR SPECIMEN

Facility

$40.00

Service Code	HCPCS 8295291
Hospital Charge Code	397073261
Hospital Revenue Code	301
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	$20.00
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 GLUCOSE, 4HR SPECIMEN

Facility

$40.00

Service Code	HCPCS 8295291
Hospital Charge Code	397073261
Hospital Revenue Code	301
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CH GLUCOSE, 5HR SPECIMEN

Facility

$40.00

Service Code	HCPCS 8295291
Hospital Charge Code	397073267
Hospital Revenue Code	301
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CH GLUCOSE, 5HR SPECIMEN

Facility

$40.00

Service Code	HCPCS 8295291
Hospital Charge Code	397073267
Hospital Revenue Code	301
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	$20.00
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 GLUCOSE, 6HR SPECIMEN

Facility

$40.00

Service Code	HCPCS 8295291
Hospital Charge Code	397073270
Hospital Revenue Code	301
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

Know your out-of-pocket cost for care.

All Charges