Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH GRAM STAIN

Facility

$546.91

Service Code	HCPCS 87205
Hospital Charge Code	397041064
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	$71.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.04
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 GRAM STAIN

Facility

$546.91

Service Code	HCPCS 87205
Hospital Charge Code	397041064
Hospital Revenue Code	309
Min. Negotiated Rate	$82.04
Max. Negotiated Rate	$82.04
Rate for Payer: Qualcare PPO/HMO/WC	$82.04

CH GRANULOCYTE APHERESIS

Facility

$12,480.00

Service Code	HCPCS P9050
Hospital Charge Code	397031040
Hospital Revenue Code	390
Min. Negotiated Rate	$1,872.00
Max. Negotiated Rate	$1,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,872.00

CH GRANULOCYTE APHERESIS

Facility

$12,480.00

Service Code	HCPCS P9050
Hospital Charge Code	397031040
Hospital Revenue Code	390
Min. Negotiated Rate	$666.00
Max. Negotiated Rate	$6,240.00
Rate for Payer: Aetna Commercial	$3,744.00
Rate for Payer: Aetna Medicare Advantage	$3,744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,182.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,182.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,182.40
Rate for Payer: Cigna Commercial	$6,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,622.40
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,872.00
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH GROWTH HORMONE

Facility

$390.00

Service Code	HCPCS 83003
Hospital Charge Code	397071247
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH GROWTH HORMONE

Facility

$390.00

Service Code	HCPCS 83003
Hospital Charge Code	397071247
Hospital Revenue Code	301
Min. Negotiated Rate	$8.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.01
Rate for Payer: Aetna Medicare Advantage	$16.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.67
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	$61.08
Rate for Payer: Cigna Commercial	$16.67
Rate for Payer: Cigna Medicare Advantage	$8.34
Rate for Payer: Clover Medicare Advantage	$15.84
Rate for Payer: EmblemHealth Commercial	$50.01
Rate for Payer: Humana Medicare Advantage	$17.17
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	$16.67
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.67
Rate for Payer: Wellcare Medicare Advantage	$16.67

CH HALDOL

Facility

$375.00

Service Code	HCPCS 80173
Hospital Charge Code	397073339
Hospital Revenue Code	301
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

CH HALDOL

Facility

$375.00

Service Code	HCPCS 80173
Hospital Charge Code	397073339
Hospital Revenue Code	301
Min. Negotiated Rate	$7.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$51.13
Rate for Payer: Aetna Medicare Advantage	$15.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.82
Rate for Payer: Cigna Commercial	$15.78
Rate for Payer: Cigna Medicare Advantage	$7.89
Rate for Payer: Clover Medicare Advantage	$14.99
Rate for Payer: EmblemHealth Commercial	$47.34
Rate for Payer: Humana Medicare Advantage	$16.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.73
Rate for Payer: Wellcare Medicare Advantage	$15.78

CH HAM TEST(HEMOLYSINS INCUB

Facility

$78.00

Service Code	HCPCS 86941
Hospital Charge Code	397021004
Hospital Revenue Code	302
Min. Negotiated Rate	$6.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.24
Rate for Payer: Aetna Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$12.11
Rate for Payer: Cigna Medicare Advantage	$6.05
Rate for Payer: Clover Medicare Advantage	$11.50
Rate for Payer: EmblemHealth Commercial	$36.33
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.84
Rate for Payer: Wellcare Medicare Advantage	$12.11

CH HAM TEST(HEMOLYSINS INCUB

Facility

$78.00

Service Code	HCPCS 86941
Hospital Charge Code	397021004
Hospital Revenue Code	302
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$11.70
Rate for Payer: Qualcare PPO/HMO/WC	$11.70

CH HAPTOGLOBIN

Facility

$79.00

Service Code	HCPCS 83010
Hospital Charge Code	397071221
Hospital Revenue Code	301
Min. Negotiated Rate	$6.29
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$40.76
Rate for Payer: Aetna Medicare Advantage	$12.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.09
Rate for Payer: Cigna Commercial	$12.58
Rate for Payer: Cigna Medicare Advantage	$6.29
Rate for Payer: Clover Medicare Advantage	$11.95
Rate for Payer: EmblemHealth Commercial	$37.74
Rate for Payer: Humana Medicare Advantage	$12.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.27
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.58
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.33
Rate for Payer: Wellcare Medicare Advantage	$12.58

CH HAPTOGLOBIN

Facility

$79.00

Service Code	HCPCS 83010
Hospital Charge Code	397071221
Hospital Revenue Code	301
Min. Negotiated Rate	$11.85
Max. Negotiated Rate	$11.85
Rate for Payer: Qualcare PPO/HMO/WC	$11.85

CH HB CORE AB W(IGM) RFX

Facility

$42.00

Service Code	HCPCS 86704
Hospital Charge Code	397071428
Hospital Revenue Code	302
Min. Negotiated Rate	$5.46
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
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	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

CH HB CORE AB W(IGM) RFX

Facility

$42.00

Service Code	HCPCS 86704
Hospital Charge Code	397071428
Hospital Revenue Code	302
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

CH HBG S NEG BLD

Facility

$820.00

Service Code	HCPCS P9021
Hospital Charge Code	397031047
Hospital Revenue Code	390
Min. Negotiated Rate	$106.60
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$246.00
Rate for Payer: Aetna Medicare Advantage	$246.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.10
Rate for Payer: Cigna Commercial	$350.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.60
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.00
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH HBG S NEG BLD

Facility

$820.00

Service Code	HCPCS P9021
Hospital Charge Code	397031047
Hospital Revenue Code	390
Min. Negotiated Rate	$123.00
Max. Negotiated Rate	$123.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.00

CH H. BRAZILIENSIS (K82) IGE

Facility

$110.00

Service Code	HCPCS 86003
Hospital Charge Code	397071432
Hospital Revenue Code	305
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

CH H. BRAZILIENSIS (K82) IGE

Facility

$31.00

Service Code	HCPCS 86003
Hospital Charge Code	397071506
Hospital Revenue Code	305
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$4.65
Rate for Payer: Qualcare PPO/HMO/WC	$4.65

CH H. BRAZILIENSIS (K82) IGE

Facility

$31.00

Service Code	HCPCS 86003
Hospital Charge Code	397071506
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	$4.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.65
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 H. BRAZILIENSIS (K82) IGE

Facility

$110.00

Service Code	HCPCS 86003
Hospital Charge Code	397071432
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	$14.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
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 HBSAG W/REFLEX CONF

Facility

$62.00

Service Code	HCPCS 87340
Hospital Charge Code	397071453
Hospital Revenue Code	306
Min. Negotiated Rate	$5.17
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$33.47
Rate for Payer: Aetna Medicare Advantage	$10.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.85
Rate for Payer: Cigna Commercial	$10.33
Rate for Payer: Cigna Medicare Advantage	$5.17
Rate for Payer: Clover Medicare Advantage	$9.81
Rate for Payer: EmblemHealth Commercial	$30.99
Rate for Payer: Humana Medicare Advantage	$10.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.33
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.95
Rate for Payer: Wellcare Medicare Advantage	$10.33

CH HBSAG W/REFLEX CONF

Facility

$62.00

Service Code	HCPCS 87340
Hospital Charge Code	397071453
Hospital Revenue Code	306
Min. Negotiated Rate	$9.30
Max. Negotiated Rate	$9.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.30

CH HBV,DNA,QN,PCR

Facility

$265.00

Service Code	HCPCS 87517
Hospital Charge Code	397073599
Hospital Revenue Code	306
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$39.75
Rate for Payer: Qualcare PPO/HMO/WC	$39.75

CH HBV,DNA,QN,PCR

Facility

$265.00

Service Code	HCPCS 87517
Hospital Charge Code	397073599
Hospital Revenue Code	306
Min. Negotiated Rate	$21.42
Max. Negotiated Rate	$156.97
Rate for Payer: Aetna Commercial	$138.80
Rate for Payer: Aetna Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.97
Rate for Payer: Cigna Commercial	$42.84
Rate for Payer: Cigna Medicare Advantage	$21.42
Rate for Payer: Clover Medicare Advantage	$40.70
Rate for Payer: EmblemHealth Commercial	$128.52
Rate for Payer: Humana Medicare Advantage	$44.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$45.41
Rate for Payer: Wellcare Medicare Advantage	$42.84

CH HCG

Facility

$633.00

Service Code	HCPCS 84702
Hospital Charge Code	397073240
Hospital Revenue Code	301
Min. Negotiated Rate	$7.53
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.76
Rate for Payer: Aetna Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.14
Rate for Payer: Cigna Commercial	$15.05
Rate for Payer: Cigna Medicare Advantage	$7.53
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.29
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.95
Rate for Payer: Wellcare Medicare Advantage	$15.05

Know your out-of-pocket cost for care.

All Charges