Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH HEPATITIS C RNA:PCR (QUAN

Facility

$824.00

Service Code	HCPCS 87522
Hospital Charge Code	397073192
Hospital Revenue Code	306
Min. Negotiated Rate	$21.42
Max. Negotiated Rate	$228.14
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	$228.14
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	$107.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.60
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 HEPATITIS C RNA:PCR (QUAN

Facility

$824.00

Service Code	HCPCS 87522
Hospital Charge Code	397073192
Hospital Revenue Code	306
Min. Negotiated Rate	$123.60
Max. Negotiated Rate	$123.60
Rate for Payer: Qualcare PPO/HMO/WC	$123.60

CH HEPATITIS D AB

Facility

$170.00

Service Code	HCPCS 86692
Hospital Charge Code	397073034
Hospital Revenue Code	302
Min. Negotiated Rate	$8.58
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.60
Rate for Payer: Aetna Medicare Advantage	$17.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.16
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	$62.87
Rate for Payer: Cigna Commercial	$17.16
Rate for Payer: Cigna Medicare Advantage	$8.58
Rate for Payer: Clover Medicare Advantage	$16.30
Rate for Payer: EmblemHealth Commercial	$51.48
Rate for Payer: Humana Medicare Advantage	$17.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.16
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.19
Rate for Payer: Wellcare Medicare Advantage	$17.16

CH HEPATITIS D AB

Facility

$170.00

Service Code	HCPCS 86692
Hospital Charge Code	397073034
Hospital Revenue Code	302
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

CH HEPATITIS SCREEN

Facility

$246.00

Service Code	HCPCS 86709
Hospital Charge Code	397071281
Hospital Revenue Code	302
Min. Negotiated Rate	$5.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$36.48
Rate for Payer: Aetna Medicare Advantage	$11.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.26
Rate for Payer: Cigna Commercial	$11.26
Rate for Payer: Cigna Medicare Advantage	$5.63
Rate for Payer: Clover Medicare Advantage	$10.70
Rate for Payer: EmblemHealth Commercial	$33.78
Rate for Payer: Humana Medicare Advantage	$11.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.26
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.94
Rate for Payer: Wellcare Medicare Advantage	$11.26

CH HEPATITIS SCREEN

Facility

$246.00

Service Code	HCPCS 86709
Hospital Charge Code	397071281
Hospital Revenue Code	302
Min. Negotiated Rate	$36.90
Max. Negotiated Rate	$36.90
Rate for Payer: Qualcare PPO/HMO/WC	$36.90

CH HEPATITUS D ANITIGEN

Facility

$374.00

Service Code	HCPCS 87380
Hospital Charge Code	397071401
Hospital Revenue Code	306
Min. Negotiated Rate	$56.10
Max. Negotiated Rate	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$56.10

CH HEPATITUS D ANITIGEN

Facility

$374.00

Service Code	HCPCS 87380
Hospital Charge Code	397071401
Hospital Revenue Code	306
Min. Negotiated Rate	$9.18
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$59.49
Rate for Payer: Aetna Medicare Advantage	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.27
Rate for Payer: Cigna Commercial	$18.36
Rate for Payer: Cigna Medicare Advantage	$9.18
Rate for Payer: Clover Medicare Advantage	$17.44
Rate for Payer: EmblemHealth Commercial	$55.08
Rate for Payer: Humana Medicare Advantage	$18.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.36
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.46
Rate for Payer: Wellcare Medicare Advantage	$18.36

CH HEPTIMAX (R) HCV RNA

Facility

$1,125.00

Service Code	HCPCS 87522
Hospital Charge Code	397071505
Hospital Revenue Code	306
Min. Negotiated Rate	$21.42
Max. Negotiated Rate	$228.14
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	$228.14
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	$146.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
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 HEPTIMAX (R) HCV RNA

Facility

$1,125.00

Service Code	HCPCS 87522
Hospital Charge Code	397071505
Hospital Revenue Code	306
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

CH HERPES VIRUS 6,IGG,M CSF

Facility

$635.00

Service Code	HCPCS 86790
Hospital Charge Code	397073639
Hospital Revenue Code	302
Min. Negotiated Rate	$95.25
Max. Negotiated Rate	$95.25
Rate for Payer: Qualcare PPO/HMO/WC	$95.25

CH HERPES VIRUS 6,IGG,M CSF

Facility

$635.00

Service Code	HCPCS 86790
Hospital Charge Code	397073639
Hospital Revenue Code	302
Min. Negotiated Rate	$6.44
Max. Negotiated Rate	$443.55
Rate for Payer: Aetna Commercial	$41.73
Rate for Payer: Aetna Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$443.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.19
Rate for Payer: Cigna Commercial	$12.88
Rate for Payer: Cigna Medicare Advantage	$6.44
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.55
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$95.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.65
Rate for Payer: Wellcare Medicare Advantage	$12.88

CH HERPES VIRUS 8 DNA QL PCR

Facility

$828.00

Service Code	HCPCS 87798
Hospital Charge Code	397071517
Hospital Revenue Code	306
Min. Negotiated Rate	$124.20
Max. Negotiated Rate	$124.20
Rate for Payer: Qualcare PPO/HMO/WC	$124.20

CH HERPES VIRUS 8 DNA QL PCR

Facility

$828.00

Service Code	HCPCS 87798
Hospital Charge Code	397071517
Hospital Revenue Code	306
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$147.80
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	$147.80
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	$107.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$124.20
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 HGB ELECTROPHORESIS

Facility

$235.00

Service Code	HCPCS 83020
Hospital Charge Code	397071002
Hospital Revenue Code	301
Min. Negotiated Rate	$6.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.70
Rate for Payer: Aetna Medicare Advantage	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.16
Rate for Payer: Cigna Commercial	$12.87
Rate for Payer: Cigna Medicare Advantage	$6.43
Rate for Payer: Clover Medicare Advantage	$12.23
Rate for Payer: EmblemHealth Commercial	$38.61
Rate for Payer: Humana Medicare Advantage	$13.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.55
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.87
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.64
Rate for Payer: Wellcare Medicare Advantage	$12.87

CH HGB ELECTROPHORESIS

Facility

$235.00

Service Code	HCPCS 83020
Hospital Charge Code	397071002
Hospital Revenue Code	301
Min. Negotiated Rate	$35.25
Max. Negotiated Rate	$35.25
Rate for Payer: Qualcare PPO/HMO/WC	$35.25

CH HGB & HCT

Facility

$30.00

Service Code	HCPCS 85018
Hospital Charge Code	397021089
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	$3.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
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 HGB & HCT

Facility

$30.00

Service Code	HCPCS 85018
Hospital Charge Code	397021089
Hospital Revenue Code	305
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

CH HGB & HCT FLUID

Facility

$45.00

Service Code	HCPCS 85018
Hospital Charge Code	397021086
Hospital Revenue Code	305
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

CH HGB & HCT FLUID

Facility

$45.00

Service Code	HCPCS 85018
Hospital Charge Code	397021086
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	$5.85
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
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 H. INFLUENZA TYPE B (IGG)

Facility

$536.00

Service Code	HCPCS 86684
Hospital Charge Code	397073642
Hospital Revenue Code	302
Min. Negotiated Rate	$80.40
Max. Negotiated Rate	$80.40
Rate for Payer: Qualcare PPO/HMO/WC	$80.40

CH H. INFLUENZA TYPE B (IGG)

Facility

$536.00

Service Code	HCPCS 86684
Hospital Charge Code	397073642
Hospital Revenue Code	302
Min. Negotiated Rate	$7.92
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$51.32
Rate for Payer: Aetna Medicare Advantage	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.04
Rate for Payer: Cigna Commercial	$15.84
Rate for Payer: Cigna Medicare Advantage	$7.92
Rate for Payer: Clover Medicare Advantage	$15.05
Rate for Payer: EmblemHealth Commercial	$47.52
Rate for Payer: Humana Medicare Advantage	$16.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.68
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$80.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.84
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.79
Rate for Payer: Wellcare Medicare Advantage	$15.84

CH HISTAMINE PLASMA

Facility

$736.00

Service Code	HCPCS 83088
Hospital Charge Code	397071340
Hospital Revenue Code	301
Min. Negotiated Rate	$14.77
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$95.68
Rate for Payer: Aetna Medicare Advantage	$29.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.20
Rate for Payer: Cigna Commercial	$29.53
Rate for Payer: Cigna Medicare Advantage	$14.77
Rate for Payer: Clover Medicare Advantage	$28.05
Rate for Payer: EmblemHealth Commercial	$88.59
Rate for Payer: Humana Medicare Advantage	$30.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.68
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$110.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.53
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$31.30
Rate for Payer: Wellcare Medicare Advantage	$29.53

CH HISTAMINE PLASMA

Facility

$736.00

Service Code	HCPCS 83088
Hospital Charge Code	397071340
Hospital Revenue Code	301
Min. Negotiated Rate	$110.40
Max. Negotiated Rate	$110.40
Rate for Payer: Qualcare PPO/HMO/WC	$110.40

CH HISTAMINE RELEASE (CU)

Facility

$97.00

Service Code	HCPCS 86343
Hospital Charge Code	397071442
Hospital Revenue Code	302
Min. Negotiated Rate	$14.55
Max. Negotiated Rate	$14.55
Rate for Payer: Qualcare PPO/HMO/WC	$14.55

Know your out-of-pocket cost for care.

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