Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH METHADONE CONF

Facility

$695.00

Service Code	HCPCS 80300
Hospital Charge Code	397073157
Hospital Revenue Code	301
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$104.25
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

CH METHADONE DAU

Facility

$44.00

Service Code	HCPCS 80300
Hospital Charge Code	397071288
Hospital Revenue Code	301
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

CH METHADONE DAU

Facility

$44.00

Service Code	HCPCS 80300
Hospital Charge Code	397071288
Hospital Revenue Code	301
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.20
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.72
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH METHANOL, BLOOD

Facility

$667.59

Service Code	HCPCS 84600
Hospital Charge Code	397072157
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CH METHANOL, BLOOD

Facility

$667.59

Service Code	HCPCS 84600
Hospital Charge Code	397072157
Hospital Revenue Code	301
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.44
Rate for Payer: Aetna Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.69
Rate for Payer: Cigna Commercial	$17.11
Rate for Payer: Cigna Medicare Advantage	$8.55
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
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	$17.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.14
Rate for Payer: Wellcare Medicare Advantage	$17.11

CH METHOTREXATE

Facility

$258.00

Service Code	HCPCS 80299
Hospital Charge Code	397071018
Hospital Revenue Code	301
Min. Negotiated Rate	$38.70
Max. Negotiated Rate	$38.70
Rate for Payer: Qualcare PPO/HMO/WC	$38.70

CH METHOTREXATE

Facility

$258.00

Service Code	HCPCS 80299
Hospital Charge Code	397071018
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	$33.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.70
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 METHQUALONE CONF

Facility

$695.00

Service Code	HCPCS 80300
Hospital Charge Code	397073158
Hospital Revenue Code	301
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$104.25
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

CH METHQUALONE CONF

Facility

$695.00

Service Code	HCPCS 80300
Hospital Charge Code	397073158
Hospital Revenue Code	301
Min. Negotiated Rate	$90.35
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$208.50
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.25
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH METHYLMALONIC ACID

Facility

$357.00

Service Code	HCPCS 83918
Hospital Charge Code	397073275
Hospital Revenue Code	301
Min. Negotiated Rate	$11.80
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$76.46
Rate for Payer: Aetna Medicare Advantage	$23.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.47
Rate for Payer: Cigna Commercial	$23.60
Rate for Payer: Cigna Medicare Advantage	$11.80
Rate for Payer: Clover Medicare Advantage	$22.42
Rate for Payer: EmblemHealth Commercial	$70.80
Rate for Payer: Humana Medicare Advantage	$24.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.02
Rate for Payer: Wellcare Medicare Advantage	$23.60

CH METHYLMALONIC ACID

Facility

$357.00

Service Code	HCPCS 83921
Hospital Charge Code	397072112
Hospital Revenue Code	301
Min. Negotiated Rate	$10.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$68.72
Rate for Payer: Aetna Medicare Advantage	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.71
Rate for Payer: Cigna Commercial	$21.21
Rate for Payer: Cigna Medicare Advantage	$10.61
Rate for Payer: Clover Medicare Advantage	$20.15
Rate for Payer: EmblemHealth Commercial	$63.63
Rate for Payer: Humana Medicare Advantage	$21.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.21
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.48
Rate for Payer: Wellcare Medicare Advantage	$21.21

CH METHYLMALONIC ACID

Facility

$357.00

Service Code	HCPCS 83921
Hospital Charge Code	397072112
Hospital Revenue Code	301
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$53.55
Rate for Payer: Qualcare PPO/HMO/WC	$53.55

CH METHYLMALONIC ACID

Facility

$357.00

Service Code	HCPCS 83918
Hospital Charge Code	397073275
Hospital Revenue Code	301
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$53.55
Rate for Payer: Qualcare PPO/HMO/WC	$53.55

CH METHYLMALONIC ACID. SERUM

Facility

$176.00

Service Code	HCPCS 83921
Hospital Charge Code	397070002
Hospital Revenue Code	301
Min. Negotiated Rate	$26.40
Max. Negotiated Rate	$26.40
Rate for Payer: Qualcare PPO/HMO/WC	$26.40

CH METHYLMALONIC ACID. SERUM

Facility

$176.00

Service Code	HCPCS 83921
Hospital Charge Code	397070002
Hospital Revenue Code	301
Min. Negotiated Rate	$10.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$68.72
Rate for Payer: Aetna Medicare Advantage	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.71
Rate for Payer: Cigna Commercial	$21.21
Rate for Payer: Cigna Medicare Advantage	$10.61
Rate for Payer: Clover Medicare Advantage	$20.15
Rate for Payer: EmblemHealth Commercial	$63.63
Rate for Payer: Humana Medicare Advantage	$21.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.88
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.21
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.48
Rate for Payer: Wellcare Medicare Advantage	$21.21

CH MEXILETINE

Facility

$85.00

Service Code	HCPCS 80299
Hospital Charge Code	397072113
Hospital Revenue Code	301
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

CH MEXILETINE

Facility

$85.00

Service Code	HCPCS 80299
Hospital Charge Code	397072113
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	$11.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
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 MI 2 AUTOANTIBODIES

Facility

$239.00

Service Code	HCPCS 86235
Hospital Charge Code	397071521
Hospital Revenue Code	302
Min. Negotiated Rate	$8.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.09
Rate for Payer: Aetna Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.70
Rate for Payer: Cigna Commercial	$17.93
Rate for Payer: Cigna Medicare Advantage	$8.96
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.01
Rate for Payer: Wellcare Medicare Advantage	$17.93

CH MI 2 AUTOANTIBODIES

Facility

$239.00

Service Code	HCPCS 86235
Hospital Charge Code	397071521
Hospital Revenue Code	302
Min. Negotiated Rate	$35.85
Max. Negotiated Rate	$35.85
Rate for Payer: Qualcare PPO/HMO/WC	$35.85

CH MICROALB/RANDOM UCREAT

Facility

$422.00

Service Code	HCPCS 82043
Hospital Charge Code	397073635
Hospital Revenue Code	307
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.73
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.18
Rate for Payer: Cigna Commercial	$5.78
Rate for Payer: Cigna Medicare Advantage	$2.89
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.13
Rate for Payer: Wellcare Medicare Advantage	$5.78

CH MICROALB/RANDOM UCREAT

Facility

$422.00

Service Code	HCPCS 82043
Hospital Charge Code	397073635
Hospital Revenue Code	307
Min. Negotiated Rate	$63.30
Max. Negotiated Rate	$63.30
Rate for Payer: Qualcare PPO/HMO/WC	$63.30

CH MICROALBUMIN 24HR URIN

Facility

$422.00

Service Code	HCPCS 82043
Hospital Charge Code	397073622
Hospital Revenue Code	307
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.73
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.18
Rate for Payer: Cigna Commercial	$5.78
Rate for Payer: Cigna Medicare Advantage	$2.89
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.13
Rate for Payer: Wellcare Medicare Advantage	$5.78

CH MICROALBUMIN 24HR URIN

Facility

$422.00

Service Code	HCPCS 82043
Hospital Charge Code	397073622
Hospital Revenue Code	307
Min. Negotiated Rate	$63.30
Max. Negotiated Rate	$63.30
Rate for Payer: Qualcare PPO/HMO/WC	$63.30

CH MICROALBUMIN 24H URINE

Facility

$422.00

Service Code	HCPCS 82043
Hospital Charge Code	397072012
Hospital Revenue Code	307
Min. Negotiated Rate	$63.30
Max. Negotiated Rate	$63.30
Rate for Payer: Qualcare PPO/HMO/WC	$63.30

CH MICROALBUMIN 24H URINE

Facility

$422.00

Service Code	HCPCS 82043
Hospital Charge Code	397072012
Hospital Revenue Code	307
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.73
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.18
Rate for Payer: Cigna Commercial	$5.78
Rate for Payer: Cigna Medicare Advantage	$2.89
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.13
Rate for Payer: Wellcare Medicare Advantage	$5.78

Know your out-of-pocket cost for care.

All Charges