Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH HCG

Facility

$633.00

Service Code	HCPCS 84702
Hospital Charge Code	397073240
Hospital Revenue Code	301
Min. Negotiated Rate	$94.95
Max. Negotiated Rate	$94.95
Rate for Payer: Qualcare PPO/HMO/WC	$94.95

CH HCG QUAL

Facility

$210.00

Service Code	HCPCS 84703
Hospital Charge Code	397071074
Hospital Revenue Code	301
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

CH HCG QUAL

Facility

$210.00

Service Code	HCPCS 84703
Hospital Charge Code	397071074
Hospital Revenue Code	301
Min. Negotiated Rate	$3.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$24.36
Rate for Payer: Aetna Medicare Advantage	$7.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.55
Rate for Payer: Cigna Commercial	$7.52
Rate for Payer: Cigna Medicare Advantage	$3.76
Rate for Payer: Clover Medicare Advantage	$7.14
Rate for Payer: EmblemHealth Commercial	$22.56
Rate for Payer: Humana Medicare Advantage	$7.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.52
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.97
Rate for Payer: Wellcare Medicare Advantage	$7.52

CH HCG, QUAN

Facility

$633.00

Service Code	HCPCS 84702
Hospital Charge Code	397073036
Hospital Revenue Code	301
Min. Negotiated Rate	$94.95
Max. Negotiated Rate	$94.95
Rate for Payer: Qualcare PPO/HMO/WC	$94.95

CH HCG, QUAN

Facility

$633.00

Service Code	HCPCS 84702
Hospital Charge Code	397073036
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

CH HDL

Facility

$92.00

Service Code	HCPCS 83718
Hospital Charge Code	397071078
Hospital Revenue Code	301
Min. Negotiated Rate	$4.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.54
Rate for Payer: Aetna Medicare Advantage	$8.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.01
Rate for Payer: Cigna Commercial	$8.19
Rate for Payer: Cigna Medicare Advantage	$4.09
Rate for Payer: Clover Medicare Advantage	$7.78
Rate for Payer: EmblemHealth Commercial	$24.57
Rate for Payer: Humana Medicare Advantage	$8.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.96
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.19
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.68
Rate for Payer: Wellcare Medicare Advantage	$8.19

CH HDL

Facility

$92.00

Service Code	HCPCS 83718
Hospital Charge Code	397071078
Hospital Revenue Code	301
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.80

CH HE4, OVARIAN CANCER

Facility

$1,075.00

Service Code	HCPCS 86305
Hospital Charge Code	397071532
Hospital Revenue Code	302
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$161.25
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

CH HE4, OVARIAN CANCER

Facility

$1,076.00

Service Code	HCPCS 86305
Hospital Charge Code	397071544
Hospital Revenue Code	302
Min. Negotiated Rate	$161.40
Max. Negotiated Rate	$161.40
Rate for Payer: Qualcare PPO/HMO/WC	$161.40

CH HE4, OVARIAN CANCER

Facility

$1,076.00

Service Code	HCPCS 86305
Hospital Charge Code	397071544
Hospital Revenue Code	302
Min. Negotiated Rate	$10.40
Max. Negotiated Rate	$161.40
Rate for Payer: Aetna Commercial	$67.42
Rate for Payer: Aetna Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.25
Rate for Payer: Cigna Commercial	$20.81
Rate for Payer: Cigna Medicare Advantage	$10.40
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.88
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$161.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.06
Rate for Payer: Wellcare Medicare Advantage	$20.81

CH HE4, OVARIAN CANCER

Facility

$1,075.00

Service Code	HCPCS 86305
Hospital Charge Code	397071532
Hospital Revenue Code	302
Min. Negotiated Rate	$10.40
Max. Negotiated Rate	$161.25
Rate for Payer: Aetna Commercial	$67.42
Rate for Payer: Aetna Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.25
Rate for Payer: Cigna Commercial	$20.81
Rate for Payer: Cigna Medicare Advantage	$10.40
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.06
Rate for Payer: Wellcare Medicare Advantage	$20.81

CH HEAPATITIS C RNA QUAL PCR

Facility

$390.00

Service Code	HCPCS 87521
Hospital Charge Code	397073591
Hospital Revenue Code	306
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$128.57
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	$71.06
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	$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	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

CH HEAPATITIS C RNA QUAL PCR

Facility

$390.00

Service Code	HCPCS 87521
Hospital Charge Code	397073591
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH HEMATOCRIT

Facility

$20.00

Service Code	HCPCS 85014
Hospital Charge Code	397021016
Hospital Revenue Code	305
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.68
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.37
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	$8.68
Rate for Payer: Cigna Commercial	$2.37
Rate for Payer: Cigna Medicare Advantage	$1.19
Rate for Payer: Clover Medicare Advantage	$2.25
Rate for Payer: EmblemHealth Commercial	$7.11
Rate for Payer: Humana Medicare Advantage	$2.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.51
Rate for Payer: Wellcare Medicare Advantage	$2.37

CH HEMATOCRIT

Facility

$20.00

Service Code	HCPCS 85014
Hospital Charge Code	397021016
Hospital Revenue Code	305
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

CH HEMATOCRIT

Facility

$20.00

Service Code	HCPCS 85014
Hospital Charge Code	397021296
Hospital Revenue Code	305
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

CH HEMATOCRIT

Facility

$20.00

Service Code	HCPCS 85014
Hospital Charge Code	397021296
Hospital Revenue Code	305
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.68
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.37
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	$8.68
Rate for Payer: Cigna Commercial	$2.37
Rate for Payer: Cigna Medicare Advantage	$1.19
Rate for Payer: Clover Medicare Advantage	$2.25
Rate for Payer: EmblemHealth Commercial	$7.11
Rate for Payer: Humana Medicare Advantage	$2.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.51
Rate for Payer: Wellcare Medicare Advantage	$2.37

CH HEMATOCRIT FLUID

Facility

$20.00

Service Code	HCPCS 85014
Hospital Charge Code	397021293
Hospital Revenue Code	305
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.68
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.37
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	$8.68
Rate for Payer: Cigna Commercial	$2.37
Rate for Payer: Cigna Medicare Advantage	$1.19
Rate for Payer: Clover Medicare Advantage	$2.25
Rate for Payer: EmblemHealth Commercial	$7.11
Rate for Payer: Humana Medicare Advantage	$2.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.51
Rate for Payer: Wellcare Medicare Advantage	$2.37

CH HEMATOCRIT FLUID

Facility

$20.00

Service Code	HCPCS 85014
Hospital Charge Code	397021293
Hospital Revenue Code	305
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

CH HEMODIALYSIS

Facility

$2,868.64

Service Code	HCPCS 90935
Hospital Charge Code	93655005
Hospital Revenue Code	801
Min. Negotiated Rate	$372.92
Max. Negotiated Rate	$1,634.39
Rate for Payer: Aetna Commercial	$860.59
Rate for Payer: Aetna Medicare Advantage	$860.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$731.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$731.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$731.50
Rate for Payer: Cigna Commercial	$1,634.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.92
Rate for Payer: Oxford Commercial	$1,434.32
Rate for Payer: Qualcare PPO/HMO/WC	$430.30
Rate for Payer: UnitedHealthcare Commercial	$1,434.32

CH HEMODIALYSIS

Facility

$2,868.64

Service Code	HCPCS 90935
Hospital Charge Code	93655005
Hospital Revenue Code	801
Min. Negotiated Rate	$430.30
Max. Negotiated Rate	$430.30
Rate for Payer: Qualcare PPO/HMO/WC	$430.30

CH HEMOGLOBIN

Facility

$21.00

Service Code	HCPCS 85018
Hospital Charge Code	397021048
Hospital Revenue Code	305
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

CH HEMOGLOBIN

Facility

$21.00

Service Code	HCPCS 85018
Hospital Charge Code	397021295
Hospital Revenue Code	305
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.68
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.68
Rate for Payer: Cigna Commercial	$2.37
Rate for Payer: Cigna Medicare Advantage	$1.19
Rate for Payer: Clover Medicare Advantage	$2.25
Rate for Payer: EmblemHealth Commercial	$7.11
Rate for Payer: Humana Medicare Advantage	$2.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.51
Rate for Payer: Wellcare Medicare Advantage	$2.37

CH HEMOGLOBIN

Facility

$21.00

Service Code	HCPCS 85018
Hospital Charge Code	397021048
Hospital Revenue Code	305
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.68
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.68
Rate for Payer: Cigna Commercial	$2.37
Rate for Payer: Cigna Medicare Advantage	$1.19
Rate for Payer: Clover Medicare Advantage	$2.25
Rate for Payer: EmblemHealth Commercial	$7.11
Rate for Payer: Humana Medicare Advantage	$2.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.51
Rate for Payer: Wellcare Medicare Advantage	$2.37

CH HEMOGLOBIN

Facility

$21.00

Service Code	HCPCS 85018
Hospital Charge Code	397021295
Hospital Revenue Code	305
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

Know your out-of-pocket cost for care.

All Charges