Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH LEAD

Facility

$179.00

Service Code	HCPCS 83655
Hospital Charge Code	397071059
Hospital Revenue Code	301
Min. Negotiated Rate	$26.85
Max. Negotiated Rate	$26.85
Rate for Payer: Qualcare PPO/HMO/WC	$26.85

CH LEAD URINE

Facility

$114.00

Service Code	HCPCS 83655
Hospital Charge Code	397073244
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	$14.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.10
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

CH LEAD URINE

Facility

$114.00

Service Code	HCPCS 83655
Hospital Charge Code	397073244
Hospital Revenue Code	301
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$17.10
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

CH LEAD WHOLE BLOOD

Facility

$201.00

Service Code	HCPCS 83655
Hospital Charge Code	397073248
Hospital Revenue Code	301
Min. Negotiated Rate	$30.15
Max. Negotiated Rate	$30.15
Rate for Payer: Qualcare PPO/HMO/WC	$30.15

CH LEAD WHOLE BLOOD

Facility

$201.00

Service Code	HCPCS 83655
Hospital Charge Code	397073248
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	$26.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.15
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

CH LEGIONELLA URINE ANTIGEN

Facility

$125.00

Service Code	HCPCS 87449
Hospital Charge Code	397041077
Hospital Revenue Code	306
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

CH LEGIONELLA URINE ANTIGEN

Facility

$125.00

Service Code	HCPCS 87449
Hospital Charge Code	397041077
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

CH LEMS AUTOANTIBODY

Facility

$675.00

Service Code	HCPCS 83519
Hospital Charge Code	397073569
Hospital Revenue Code	301
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$101.25
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

CH LEMS AUTOANTIBODY

Facility

$675.00

Service Code	HCPCS 83519
Hospital Charge Code	397073569
Hospital Revenue Code	301
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$59.62
Rate for Payer: Aetna Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.42
Rate for Payer: Cigna Commercial	$18.40
Rate for Payer: Cigna Medicare Advantage	$9.20
Rate for Payer: Clover Medicare Advantage	$17.48
Rate for Payer: EmblemHealth Commercial	$55.20
Rate for Payer: Humana Medicare Advantage	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$101.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.40
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.50
Rate for Payer: Wellcare Medicare Advantage	$18.40

CH LEPTIN

Facility

$84.00

Service Code	HCPCS 82397
Hospital Charge Code	397071459
Hospital Revenue Code	301
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

CH LEPTIN

Facility

$84.00

Service Code	HCPCS 82397
Hospital Charge Code	397071459
Hospital Revenue Code	301
Min. Negotiated Rate	$7.06
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$45.75
Rate for Payer: Aetna Medicare Advantage	$14.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.12
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	$51.74
Rate for Payer: Cigna Commercial	$14.12
Rate for Payer: Cigna Medicare Advantage	$7.06
Rate for Payer: Clover Medicare Advantage	$13.41
Rate for Payer: EmblemHealth Commercial	$42.36
Rate for Payer: Humana Medicare Advantage	$14.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.12
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.97
Rate for Payer: Wellcare Medicare Advantage	$14.12

CH LEUKEMIA LYMPHOMA EVAL

Facility

$4,105.00

Hospital Charge Code	3970729
Hospital Revenue Code	301
Min. Negotiated Rate	$615.75
Max. Negotiated Rate	$615.75
Rate for Payer: Qualcare PPO/HMO/WC	$615.75

CH LEUKEMIA LYMPHOMA EVAL

Facility

$4,105.00

Hospital Charge Code	3970729
Hospital Revenue Code	301
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$2,052.50
Rate for Payer: Aetna Commercial	$1,231.50
Rate for Payer: Aetna Medicare Advantage	$1,231.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,046.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,046.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,046.78
Rate for Payer: Cigna Commercial	$2,052.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$533.65
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$615.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH LEUKEMIA/LYMPHOMA: MARROW

Facility

$1,335.00

Service Code	HCPCS 86359
Hospital Charge Code	397073203
Hospital Revenue Code	302
Min. Negotiated Rate	$200.25
Max. Negotiated Rate	$200.25
Rate for Payer: Qualcare PPO/HMO/WC	$200.25

CH LEUKEMIA/LYMPHOMA: MARROW

Facility

$1,335.00

Service Code	HCPCS 86359
Hospital Charge Code	397073203
Hospital Revenue Code	302
Min. Negotiated Rate	$18.86
Max. Negotiated Rate	$200.25
Rate for Payer: Aetna Commercial	$122.25
Rate for Payer: Aetna Medicare Advantage	$37.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.24
Rate for Payer: Cigna Commercial	$37.73
Rate for Payer: Cigna Medicare Advantage	$18.86
Rate for Payer: Clover Medicare Advantage	$35.84
Rate for Payer: EmblemHealth Commercial	$113.19
Rate for Payer: Humana Medicare Advantage	$38.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.55
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$200.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$37.73
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$39.99
Rate for Payer: Wellcare Medicare Advantage	$37.73

CH LEUKOCYTE ALK PHOS

Facility

$390.00

Service Code	HCPCS 85540
Hospital Charge Code	397021050
Hospital Revenue Code	305
Min. Negotiated Rate	$4.30
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$27.86
Rate for Payer: Aetna Medicare Advantage	$8.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.51
Rate for Payer: Cigna Commercial	$8.60
Rate for Payer: Cigna Medicare Advantage	$4.30
Rate for Payer: Clover Medicare Advantage	$8.17
Rate for Payer: EmblemHealth Commercial	$25.80
Rate for Payer: Humana Medicare Advantage	$8.86
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	$8.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.12
Rate for Payer: Wellcare Medicare Advantage	$8.60

CH LEUKOCYTE ALK PHOS

Facility

$390.00

Service Code	HCPCS 85540
Hospital Charge Code	397021050
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH LEUKOCYTE REMOVAL

Facility

$701.00

Service Code	HCPCS P9016
Hospital Charge Code	397031048
Hospital Revenue Code	390
Min. Negotiated Rate	$91.13
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$210.30
Rate for Payer: Aetna Medicare Advantage	$210.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.75
Rate for Payer: Cigna Commercial	$431.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.13
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.15
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH LEUKOCYTE REMOVAL

Facility

$701.00

Service Code	HCPCS P9016
Hospital Charge Code	397031048
Hospital Revenue Code	390
Min. Negotiated Rate	$105.15
Max. Negotiated Rate	$105.15
Rate for Payer: Qualcare PPO/HMO/WC	$105.15

CH LEUKOCYTES FECAL

Facility

$390.00

Service Code	HCPCS 89055
Hospital Charge Code	397071121
Hospital Revenue Code	300
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.83
Rate for Payer: Aetna Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.65
Rate for Payer: Cigna Commercial	$4.27
Rate for Payer: Cigna Medicare Advantage	$2.13
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
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	$4.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.53
Rate for Payer: Wellcare Medicare Advantage	$4.27

CH LEUKOCYTES FECAL

Facility

$390.00

Service Code	HCPCS 89055
Hospital Charge Code	397071121
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH LEVEL 1 - GROSS ONLY

Facility

$390.00

Service Code	HCPCS 88300
Hospital Charge Code	397061000
Hospital Revenue Code	310
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH LEVEL 1 - GROSS ONLY

Facility

$390.00

Service Code	HCPCS 88300
Hospital Charge Code	397061000
Hospital Revenue Code	310
Min. Negotiated Rate	$9.33
Max. Negotiated Rate	$117.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: Cigna Medicare Advantage	$9.33
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

CH LEVEL 2 - GROSS & MICRO

Facility

$418.00

Service Code	HCPCS 88302
Hospital Charge Code	397061364
Hospital Revenue Code	310
Min. Negotiated Rate	$62.70
Max. Negotiated Rate	$62.70
Rate for Payer: Qualcare PPO/HMO/WC	$62.70

CH LEVEL 2 - GROSS & MICRO

Facility

$418.00

Service Code	HCPCS 88302
Hospital Charge Code	397061364
Hospital Revenue Code	310
Min. Negotiated Rate	$18.55
Max. Negotiated Rate	$125.40
Rate for Payer: Aetna Commercial	$125.40
Rate for Payer: Aetna Medicare Advantage	$125.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.59
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$18.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.70
Rate for Payer: UnitedHealthcare Commercial	$114.00

Know your out-of-pocket cost for care.

All Charges