Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH LAMOTRIGINE

Facility

$145.00

Service Code	HCPCS 80299
Hospital Charge Code	397073590
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	$18.85
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
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 LAMOTRIGINE

Facility

$145.00

Service Code	HCPCS 80299
Hospital Charge Code	397073590
Hospital Revenue Code	301
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$21.75
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

CHLAMYDIA ABCHLAMYDIA AB

Facility

$390.00

Service Code	HCPCS 86631
Hospital Charge Code	401386631A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CHLAMYDIA ABCHLAMYDIA AB

Facility

$390.00

Service Code	HCPCS 86631
Hospital Charge Code	401386631A
Hospital Revenue Code	302
Min. Negotiated Rate	$5.91
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.30
Rate for Payer: Aetna Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.31
Rate for Payer: Cigna Commercial	$11.82
Rate for Payer: Cigna Medicare Advantage	$5.91
Rate for Payer: Clover Medicare Advantage	$11.23
Rate for Payer: EmblemHealth Commercial	$35.46
Rate for Payer: Humana Medicare Advantage	$12.17
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	$11.82
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.53
Rate for Payer: Wellcare Medicare Advantage	$11.82

CHLAMYDIA AB PANEL IGG IGM I

Facility

$124.00

Service Code	HCPCS 86631
Hospital Charge Code	3000940A
Hospital Revenue Code	302
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

CHLAMYDIA AB PANEL IGG IGM I

Facility

$124.00

Service Code	HCPCS 86631
Hospital Charge Code	3000940A
Hospital Revenue Code	302
Min. Negotiated Rate	$5.91
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.30
Rate for Payer: Aetna Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.31
Rate for Payer: Cigna Commercial	$11.82
Rate for Payer: Cigna Medicare Advantage	$5.91
Rate for Payer: Clover Medicare Advantage	$11.23
Rate for Payer: EmblemHealth Commercial	$35.46
Rate for Payer: Humana Medicare Advantage	$12.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.82
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.53
Rate for Payer: Wellcare Medicare Advantage	$11.82

CHLAMYDIA AB PANEL IGG IGM II

Facility

$153.65

Service Code	HCPCS 86632
Hospital Charge Code	3000940B
Hospital Revenue Code	302
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$23.05
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

CHLAMYDIA AB PANEL IGG IGM II

Facility

$153.65

Service Code	HCPCS 86632
Hospital Charge Code	3000940B
Hospital Revenue Code	302
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.08
Rate for Payer: Aetna Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.68
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	$46.46
Rate for Payer: Cigna Commercial	$12.68
Rate for Payer: Cigna Medicare Advantage	$6.34
Rate for Payer: Clover Medicare Advantage	$12.05
Rate for Payer: EmblemHealth Commercial	$38.04
Rate for Payer: Humana Medicare Advantage	$13.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.68
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.44
Rate for Payer: Wellcare Medicare Advantage	$12.68

CHLAMYDIA,AMPLIF PROB TECH

Facility

$248.54

Service Code	HCPCS 87491
Hospital Charge Code	38478109
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	$32.31
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.28
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

CHLAMYDIA,AMPLIF PROB TECH

Facility

$248.54

Service Code	HCPCS 87491
Hospital Charge Code	38478109
Hospital Revenue Code	306
Min. Negotiated Rate	$37.28
Max. Negotiated Rate	$37.28
Rate for Payer: Qualcare PPO/HMO/WC	$37.28

CHLAMYDIA ANTIBODIES IGG

Facility

$124.00

Service Code	HCPCS 86631
Hospital Charge Code	3000945
Hospital Revenue Code	302
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

CHLAMYDIA ANTIBODIES IGG

Facility

$124.00

Service Code	HCPCS 86631
Hospital Charge Code	3000945
Hospital Revenue Code	302
Min. Negotiated Rate	$5.91
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.30
Rate for Payer: Aetna Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.31
Rate for Payer: Cigna Commercial	$11.82
Rate for Payer: Cigna Medicare Advantage	$5.91
Rate for Payer: Clover Medicare Advantage	$11.23
Rate for Payer: EmblemHealth Commercial	$35.46
Rate for Payer: Humana Medicare Advantage	$12.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.82
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.53
Rate for Payer: Wellcare Medicare Advantage	$11.82

CHLAMYDIA ANTIBODIES,IgM

Facility

$390.00

Service Code	HCPCS 86632
Hospital Charge Code	38476075
Hospital Revenue Code	302
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.08
Rate for Payer: Aetna Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.68
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	$46.46
Rate for Payer: Cigna Commercial	$12.68
Rate for Payer: Cigna Medicare Advantage	$6.34
Rate for Payer: Clover Medicare Advantage	$12.05
Rate for Payer: EmblemHealth Commercial	$38.04
Rate for Payer: Humana Medicare Advantage	$13.06
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	$12.68
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.44
Rate for Payer: Wellcare Medicare Advantage	$12.68

CHLAMYDIA ANTIBODIES,IgM

Facility

$390.00

Service Code	HCPCS 86632
Hospital Charge Code	38476075
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CHLAMYDIA ANTIBODIES,QUANT

Facility

$390.00

Service Code	HCPCS 86631
Hospital Charge Code	38476078
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CHLAMYDIA ANTIBODIES,QUANT

Facility

$390.00

Service Code	HCPCS 86631
Hospital Charge Code	38476078
Hospital Revenue Code	302
Min. Negotiated Rate	$5.91
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.30
Rate for Payer: Aetna Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.31
Rate for Payer: Cigna Commercial	$11.82
Rate for Payer: Cigna Medicare Advantage	$5.91
Rate for Payer: Clover Medicare Advantage	$11.23
Rate for Payer: EmblemHealth Commercial	$35.46
Rate for Payer: Humana Medicare Advantage	$12.17
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	$11.82
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.53
Rate for Payer: Wellcare Medicare Advantage	$11.82

CHLAMYDIA ANTIGEN DETECTION

Facility

$354.00

Service Code	HCPCS 87270
Hospital Charge Code	38475050
Hospital Revenue Code	309
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.82
Rate for Payer: Aetna Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.89
Rate for Payer: Cigna Commercial	$11.98
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.02
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.70
Rate for Payer: Wellcare Medicare Advantage	$11.98

CHLAMYDIA ANTIGEN DETECTION

Facility

$354.00

Service Code	HCPCS 87270
Hospital Charge Code	38475050
Hospital Revenue Code	309
Min. Negotiated Rate	$53.10
Max. Negotiated Rate	$53.10
Rate for Payer: Qualcare PPO/HMO/WC	$53.10

CHLAMYDIA ANTIGEN - SWAB

Facility

$125.00

Service Code	HCPCS 87449
Hospital Charge Code	3001005
Hospital Revenue Code	306
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

CHLAMYDIA ANTIGEN - SWAB

Facility

$125.00

Service Code	HCPCS 87449
Hospital Charge Code	3001005
Hospital Revenue Code	306
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.82
Rate for Payer: Aetna Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.89
Rate for Payer: Cigna Commercial	$11.98
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.70
Rate for Payer: Wellcare Medicare Advantage	$11.98

CHLAMYDIA CULTURE

Facility

$290.00

Service Code	HCPCS 87110
Hospital Charge Code	38475012
Hospital Revenue Code	309
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$63.50
Rate for Payer: Aetna Medicare Advantage	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.60
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	$71.81
Rate for Payer: Cigna Commercial	$19.60
Rate for Payer: Cigna Medicare Advantage	$9.80
Rate for Payer: Clover Medicare Advantage	$18.62
Rate for Payer: EmblemHealth Commercial	$58.80
Rate for Payer: Humana Medicare Advantage	$20.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.78
Rate for Payer: Wellcare Medicare Advantage	$19.60

CHLAMYDIA CULTURE

Facility

$290.00

Service Code	HCPCS 87110
Hospital Charge Code	38475012
Hospital Revenue Code	309
Min. Negotiated Rate	$43.50
Max. Negotiated Rate	$43.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.50

CHLAMYDIA/GC DNA PROBE

Facility

$354.45

Service Code	HCPCS 87490
Hospital Charge Code	3032325
Hospital Revenue Code	306
Min. Negotiated Rate	$11.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$73.71
Rate for Payer: Aetna Medicare Advantage	$22.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.36
Rate for Payer: Cigna Commercial	$22.75
Rate for Payer: Cigna Medicare Advantage	$11.38
Rate for Payer: Clover Medicare Advantage	$21.61
Rate for Payer: EmblemHealth Commercial	$68.25
Rate for Payer: Humana Medicare Advantage	$23.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.17
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.75
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.11
Rate for Payer: Wellcare Medicare Advantage	$22.75

CHLAMYDIA/GC DNA PROBE

Facility

$354.45

Service Code	HCPCS 87490
Hospital Charge Code	3032325
Hospital Revenue Code	306
Min. Negotiated Rate	$53.17
Max. Negotiated Rate	$53.17
Rate for Payer: Qualcare PPO/HMO/WC	$53.17

CHLAMYDIA/GC,SDA

Facility

$248.54

Service Code	HCPCS 87491
Hospital Charge Code	38479087
Hospital Revenue Code	306
Min. Negotiated Rate	$37.28
Max. Negotiated Rate	$37.28
Rate for Payer: Qualcare PPO/HMO/WC	$37.28

Know your out-of-pocket cost for care.

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