Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH ISOLATION

Facility

$72.00

Service Code	HCPCS 81240
Hospital Charge Code	397073572
Hospital Revenue Code	310
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

CH JC VIRUS DNA, QN RT-PCR

Facility

$1,114.00

Service Code	HCPCS 87799
Hospital Charge Code	397071388
Hospital Revenue Code	306
Min. Negotiated Rate	$167.10
Max. Negotiated Rate	$167.10
Rate for Payer: Qualcare PPO/HMO/WC	$167.10

CH JC VIRUS DNA, QN RT-PCR

Facility

$1,114.00

Service Code	HCPCS 87799
Hospital Charge Code	397071388
Hospital Revenue Code	306
Min. Negotiated Rate	$21.42
Max. Negotiated Rate	$167.10
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	$144.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$167.10
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 KAPPA LAMBDA W CALC 24H U

Facility

$905.00

Hospital Charge Code	3970731
Hospital Revenue Code	301
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$452.50
Rate for Payer: Aetna Commercial	$271.50
Rate for Payer: Aetna Medicare Advantage	$271.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.78
Rate for Payer: Cigna Commercial	$452.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.65
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH KAPPA LAMBDA W CALC 24H U

Facility

$905.00

Hospital Charge Code	3970731
Hospital Revenue Code	301
Min. Negotiated Rate	$135.75
Max. Negotiated Rate	$135.75
Rate for Payer: Qualcare PPO/HMO/WC	$135.75

CH KETOGENIC 17 STEROID

Facility

$222.00

Service Code	HCPCS 83582
Hospital Charge Code	397073013
Hospital Revenue Code	301
Min. Negotiated Rate	$33.30
Max. Negotiated Rate	$33.30
Rate for Payer: Qualcare PPO/HMO/WC	$33.30

CH KETOGENIC 17 STEROID

Facility

$222.00

Service Code	HCPCS 83582
Hospital Charge Code	397073013
Hospital Revenue Code	301
Min. Negotiated Rate	$7.74
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$50.12
Rate for Payer: Aetna Medicare Advantage	$15.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.68
Rate for Payer: Cigna Commercial	$15.47
Rate for Payer: Cigna Medicare Advantage	$7.74
Rate for Payer: Clover Medicare Advantage	$14.70
Rate for Payer: EmblemHealth Commercial	$46.41
Rate for Payer: Humana Medicare Advantage	$15.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.40
Rate for Payer: Wellcare Medicare Advantage	$15.47

CH KETONES SERUM

Facility

$667.59

Service Code	HCPCS 82009
Hospital Charge Code	397071272
Hospital Revenue Code	301
Min. Negotiated Rate	$2.26
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.64
Rate for Payer: Aetna Medicare Advantage	$4.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.56
Rate for Payer: Cigna Commercial	$4.52
Rate for Payer: Cigna Medicare Advantage	$2.26
Rate for Payer: Clover Medicare Advantage	$4.29
Rate for Payer: EmblemHealth Commercial	$13.56
Rate for Payer: Humana Medicare Advantage	$4.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.52
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.79
Rate for Payer: Wellcare Medicare Advantage	$4.52

CH KETONES SERUM

Facility

$667.59

Service Code	HCPCS 82009
Hospital Charge Code	397071272
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CH KETOSTEROID - 17 FRACTION

Facility

$735.00

Service Code	HCPCS 83593
Hospital Charge Code	397072144
Hospital Revenue Code	301
Min. Negotiated Rate	$12.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$92.34
Rate for Payer: Aetna Medicare Advantage	$28.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$28.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.42
Rate for Payer: Cigna Commercial	$28.50
Rate for Payer: Cigna Medicare Advantage	$14.25
Rate for Payer: Clover Medicare Advantage	$27.07
Rate for Payer: EmblemHealth Commercial	$85.50
Rate for Payer: Humana Medicare Advantage	$29.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.55
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$110.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$28.50
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$30.21
Rate for Payer: Wellcare Medicare Advantage	$28.50

CH KETOSTEROID - 17 FRACTION

Facility

$735.00

Service Code	HCPCS 83593
Hospital Charge Code	397072144
Hospital Revenue Code	301
Min. Negotiated Rate	$110.25
Max. Negotiated Rate	$110.25
Rate for Payer: Qualcare PPO/HMO/WC	$110.25

CH KETOSTEROID - 17 TOTAL

Facility

$207.00

Service Code	HCPCS 83586
Hospital Charge Code	397072145
Hospital Revenue Code	301
Min. Negotiated Rate	$31.05
Max. Negotiated Rate	$31.05
Rate for Payer: Qualcare PPO/HMO/WC	$31.05

CH KETOSTEROID - 17 TOTAL

Facility

$207.00

Service Code	HCPCS 83586
Hospital Charge Code	397072145
Hospital Revenue Code	301
Min. Negotiated Rate	$6.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.47
Rate for Payer: Aetna Medicare Advantage	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.90
Rate for Payer: Cigna Commercial	$12.80
Rate for Payer: Cigna Medicare Advantage	$6.40
Rate for Payer: Clover Medicare Advantage	$12.16
Rate for Payer: EmblemHealth Commercial	$38.40
Rate for Payer: Humana Medicare Advantage	$13.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.57
Rate for Payer: Wellcare Medicare Advantage	$12.80

CH KLEINHAUER BETKE TEST

Facility

$59.00

Service Code	HCPCS 85460
Hospital Charge Code	397031156
Hospital Revenue Code	305
Min. Negotiated Rate	$3.87
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$25.05
Rate for Payer: Aetna Medicare Advantage	$7.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.32
Rate for Payer: Cigna Commercial	$7.73
Rate for Payer: Cigna Medicare Advantage	$3.87
Rate for Payer: Clover Medicare Advantage	$7.34
Rate for Payer: EmblemHealth Commercial	$23.19
Rate for Payer: Humana Medicare Advantage	$7.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.73
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.19
Rate for Payer: Wellcare Medicare Advantage	$7.73

CH KLEINHAUER BETKE TEST

Facility

$59.00

Service Code	HCPCS 85460
Hospital Charge Code	397031156
Hospital Revenue Code	305
Min. Negotiated Rate	$8.85
Max. Negotiated Rate	$8.85
Rate for Payer: Qualcare PPO/HMO/WC	$8.85

CH LACTIC ACID

Facility

$113.65

Service Code	HCPCS 83605
Hospital Charge Code	397071061
Hospital Revenue Code	301
Min. Negotiated Rate	$5.79
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.49
Rate for Payer: Aetna Medicare Advantage	$11.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.57
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	$42.39
Rate for Payer: Cigna Commercial	$11.57
Rate for Payer: Cigna Medicare Advantage	$5.79
Rate for Payer: Clover Medicare Advantage	$10.99
Rate for Payer: EmblemHealth Commercial	$34.71
Rate for Payer: Humana Medicare Advantage	$11.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.57
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.26
Rate for Payer: Wellcare Medicare Advantage	$11.57

CH LACTIC ACID

Facility

$113.65

Service Code	HCPCS 83605
Hospital Charge Code	397071061
Hospital Revenue Code	301
Min. Negotiated Rate	$17.05
Max. Negotiated Rate	$17.05
Rate for Payer: Qualcare PPO/HMO/WC	$17.05

CHLAM GCAM I

Facility

$252.00

Service Code	HCPCS 87491
Hospital Charge Code	3036030A
Hospital Revenue Code	306
Min. Negotiated Rate	$37.80
Max. Negotiated Rate	$37.80
Rate for Payer: Qualcare PPO/HMO/WC	$37.80

CHLAM GCAM I

Facility

$252.00

Service Code	HCPCS 87491
Hospital Charge Code	3036030A
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	$37.18
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	$32.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.80
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

CHLAM GCAM II

Facility

$252.00

Service Code	HCPCS 87591
Hospital Charge Code	3036030B
Hospital Revenue Code	306
Min. Negotiated Rate	$37.80
Max. Negotiated Rate	$37.80
Rate for Payer: Qualcare PPO/HMO/WC	$37.80

CHLAM GCAM II

Facility

$252.00

Service Code	HCPCS 87591
Hospital Charge Code	3036030B
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	$70.50
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	$32.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.80
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

CHLAM GCAM III

Facility

$260.00

Service Code	HCPCS 87798
Hospital Charge Code	3036030C
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	$33.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00
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

CHLAM GCAM III

Facility

$260.00

Service Code	HCPCS 87798
Hospital Charge Code	3036030C
Hospital Revenue Code	306
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00

CH LAMICTAL

Facility

$413.00

Service Code	HCPCS 80299
Hospital Charge Code	397073349
Hospital Revenue Code	301
Min. Negotiated Rate	$61.95
Max. Negotiated Rate	$61.95
Rate for Payer: Qualcare PPO/HMO/WC	$61.95

CH LAMICTAL

Facility

$413.00

Service Code	HCPCS 80299
Hospital Charge Code	397073349
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	$53.69
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.95
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

Know your out-of-pocket cost for care.

All Charges