Heights University Hospital

All Charges

Charge

Type

Setting

Price

CHLAMYDIA PANEL VII

Facility

$667.59

Service Code	HCPCS 86632
Hospital Charge Code	39990141G
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CHLAMYDIA PANEL VII

Facility

$667.59

Service Code	HCPCS 86632
Hospital Charge Code	39990141G
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	$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	$12.68
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.44
Rate for Payer: Wellcare Medicare Advantage	$12.68

CHLAMYDIA PANEL VIII

Facility

$667.59

Service Code	HCPCS 86632
Hospital Charge Code	39990141H
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	$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	$12.68
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.44
Rate for Payer: Wellcare Medicare Advantage	$12.68

CHLAMYDIA PANEL VIII

Facility

$667.59

Service Code	HCPCS 86632
Hospital Charge Code	39990141H
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CHLAMYDIA QUANT

Facility

$247.54

Service Code	HCPCS 87492
Hospital Charge Code	38478110
Hospital Revenue Code	306
Min. Negotiated Rate	$37.13
Max. Negotiated Rate	$37.13
Rate for Payer: Qualcare PPO/HMO/WC	$37.13

CHLAMYDIA QUANT

Facility

$247.54

Service Code	HCPCS 87492
Hospital Charge Code	38478110
Hospital Revenue Code	306
Min. Negotiated Rate	$26.73
Max. Negotiated Rate	$195.91
Rate for Payer: Aetna Commercial	$173.24
Rate for Payer: Aetna Medicare Advantage	$53.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$53.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.91
Rate for Payer: Cigna Commercial	$53.47
Rate for Payer: Cigna Medicare Advantage	$26.73
Rate for Payer: Clover Medicare Advantage	$50.80
Rate for Payer: EmblemHealth Commercial	$160.41
Rate for Payer: Humana Medicare Advantage	$55.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.18
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.13
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$53.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$56.68
Rate for Payer: Wellcare Medicare Advantage	$53.47

CHLAMYDIA THROAT APTIMA

Facility

$175.45

Service Code	HCPCS 87491
Hospital Charge Code	401087491
Hospital Revenue Code	306
Min. Negotiated Rate	$26.32
Max. Negotiated Rate	$26.32
Rate for Payer: Qualcare PPO/HMO/WC	$26.32

CHLAMYDIA THROAT APTIMA

Facility

$175.45

Service Code	HCPCS 87491
Hospital Charge Code	401087491
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	$22.81
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.32
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 TRACHOMATIS AB IFA

Facility

$153.65

Service Code	HCPCS 86632
Hospital Charge Code	3006566
Hospital Revenue Code	302
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$23.05
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

CHLAMYDIA TRACHOMATIS AB IFA

Facility

$153.65

Service Code	HCPCS 86632
Hospital Charge Code	3006566
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 TRACHOMATIS AB IGM

Facility

$153.65

Service Code	HCPCS 86632
Hospital Charge Code	3000950
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 TRACHOMATIS AB IGM

Facility

$153.65

Service Code	HCPCS 86632
Hospital Charge Code	3000950
Hospital Revenue Code	302
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$23.05
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

CHLAMYDIA TRACHOMITIS

Facility

$390.00

Service Code	HCPCS 87491
Hospital Charge Code	39708053B
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	$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

CHLAMYDIA TRACHOMITIS

Facility

$390.00

Service Code	HCPCS 87491
Hospital Charge Code	39708053B
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CHLAMYDIA TWAR***

Facility

$247.00

Hospital Charge Code	3010949
Hospital Revenue Code	306
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

CHLAMYDIA TWAR***

Facility

$247.00

Hospital Charge Code	3010949
Hospital Revenue Code	306
Min. Negotiated Rate	$32.11
Max. Negotiated Rate	$123.50
Rate for Payer: Aetna Commercial	$74.10
Rate for Payer: Aetna Medicare Advantage	$74.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.98
Rate for Payer: Cigna Commercial	$123.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.05
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH LD FLUID

Facility

$57.00

Service Code	HCPCS 83615
Hospital Charge Code	397073044
Hospital Revenue Code	301
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$19.57
Rate for Payer: Aetna Medicare Advantage	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.04
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	$22.13
Rate for Payer: Cigna Commercial	$6.04
Rate for Payer: Cigna Medicare Advantage	$3.02
Rate for Payer: Clover Medicare Advantage	$5.74
Rate for Payer: EmblemHealth Commercial	$18.12
Rate for Payer: Humana Medicare Advantage	$6.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.04
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.40
Rate for Payer: Wellcare Medicare Advantage	$6.04

CH LD FLUID

Facility

$57.00

Service Code	HCPCS 83615
Hospital Charge Code	397073044
Hospital Revenue Code	301
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$8.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.55

CH LD ISOENZYMES

Facility

$149.00

Service Code	HCPCS 83625
Hospital Charge Code	397073032
Hospital Revenue Code	301
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.44
Rate for Payer: Aetna Medicare Advantage	$12.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.86
Rate for Payer: Cigna Commercial	$12.79
Rate for Payer: Cigna Medicare Advantage	$6.39
Rate for Payer: Clover Medicare Advantage	$12.15
Rate for Payer: EmblemHealth Commercial	$38.37
Rate for Payer: Humana Medicare Advantage	$13.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.37
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.79
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.56
Rate for Payer: Wellcare Medicare Advantage	$12.79

CH LD ISOENZYMES

Facility

$149.00

Service Code	HCPCS 83625
Hospital Charge Code	397073032
Hospital Revenue Code	301
Min. Negotiated Rate	$22.35
Max. Negotiated Rate	$22.35
Rate for Payer: Qualcare PPO/HMO/WC	$22.35

CH LD (LDH)

Facility

$75.00

Service Code	HCPCS 83615
Hospital Charge Code	397071088
Hospital Revenue Code	301
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$19.57
Rate for Payer: Aetna Medicare Advantage	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.04
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	$22.13
Rate for Payer: Cigna Commercial	$6.04
Rate for Payer: Cigna Medicare Advantage	$3.02
Rate for Payer: Clover Medicare Advantage	$5.74
Rate for Payer: EmblemHealth Commercial	$18.12
Rate for Payer: Humana Medicare Advantage	$6.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.04
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.40
Rate for Payer: Wellcare Medicare Advantage	$6.04

CH LD (LDH)

Facility

$75.00

Service Code	HCPCS 83615
Hospital Charge Code	397071088
Hospital Revenue Code	301
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

CH LDL DIRECT

Facility

$195.00

Service Code	HCPCS 8372191
Hospital Charge Code	397073214
Hospital Revenue Code	301
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$29.25
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

CH LDL DIRECT

Facility

$195.00

Service Code	HCPCS 8372191
Hospital Charge Code	397073214
Hospital Revenue Code	301
Min. Negotiated Rate	$25.35
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.50
Rate for Payer: Aetna Medicare Advantage	$58.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.73
Rate for Payer: Cigna Commercial	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.25
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH LEAD

Facility

$179.00

Service Code	HCPCS 83655
Hospital Charge Code	397071059
Hospital Revenue Code	301
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	$16.83
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	$23.27
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.85
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

Know your out-of-pocket cost for care.

All Charges