Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH NMO,IGG AB, ELISA

Facility

$1,171.00

Service Code	HCPCS 83516
Hospital Charge Code	397071533
Hospital Revenue Code	301
Min. Negotiated Rate	$5.76
Max. Negotiated Rate	$175.65
Rate for Payer: Cigna Commercial	$11.53
Rate for Payer: Cigna Medicare Advantage	$5.76
Rate for Payer: Aetna Commercial	$37.36
Rate for Payer: Aetna Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
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	$42.25
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.23
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$175.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.22
Rate for Payer: Wellcare Medicare Advantage	$11.53

CH NON FORMULAY CHARGE

Facility

$4.00

Service Code	NDC 0
Hospital Charge Code	606351008
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

CH NON FORMULAY CHARGE

Facility

$4.00

Service Code	NDC 0
Hospital Charge Code	606351008
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

CH NOREPINEPHRINE

Facility

$390.00

Service Code	HCPCS 82542
Hospital Charge Code	397073630
Hospital Revenue Code	301
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.05
Rate for Payer: Aetna Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.27
Rate for Payer: Cigna Commercial	$24.09
Rate for Payer: Cigna Medicare Advantage	$12.04
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
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	$24.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.54
Rate for Payer: Wellcare Medicare Advantage	$24.09

CH NOREPINEPHRINE

Facility

$390.00

Service Code	HCPCS 82542
Hospital Charge Code	397073630
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH NOROVIRUS STOOL

Facility

$1,058.00

Service Code	HCPCS 87449
Hospital Charge Code	397072167
Hospital Revenue Code	306
Min. Negotiated Rate	$158.70
Max. Negotiated Rate	$158.70
Rate for Payer: Qualcare PPO/HMO/WC	$158.70

CH NOROVIRUS STOOL

Facility

$1,058.00

Service Code	HCPCS 87449
Hospital Charge Code	397072167
Hospital Revenue Code	306
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$158.70
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	$137.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$158.70
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 NORTRIPTYLINE

Facility

$84.00

Service Code	HCPCS 80335
Hospital Charge Code	397072117
Hospital Revenue Code	301
Min. Negotiated Rate	$10.92
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$25.20
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
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

CH NORTRIPTYLINE

Facility

$84.00

Service Code	HCPCS 80335
Hospital Charge Code	397072117
Hospital Revenue Code	301
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

CH NTX

Facility

$171.00

Service Code	HCPCS 82523
Hospital Charge Code	397073556
Hospital Revenue Code	301
Min. Negotiated Rate	$25.65
Max. Negotiated Rate	$25.65
Rate for Payer: Qualcare PPO/HMO/WC	$25.65

CH NTX

Facility

$171.00

Service Code	HCPCS 82523
Hospital Charge Code	397073556
Hospital Revenue Code	301
Min. Negotiated Rate	$9.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.52
Rate for Payer: Aetna Medicare Advantage	$18.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.44
Rate for Payer: Cigna Commercial	$18.68
Rate for Payer: Cigna Medicare Advantage	$9.34
Rate for Payer: Clover Medicare Advantage	$17.75
Rate for Payer: EmblemHealth Commercial	$56.04
Rate for Payer: Humana Medicare Advantage	$19.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.23
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.68
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.80
Rate for Payer: Wellcare Medicare Advantage	$18.68

CH NUCLEI ACID, SIGNAL AMPLI

Facility

$113.00

Service Code	HCPCS 83908
Hospital Charge Code	397071200
Hospital Revenue Code	301
Min. Negotiated Rate	$16.95
Max. Negotiated Rate	$16.95
Rate for Payer: Qualcare PPO/HMO/WC	$16.95

CH NUCLEI ACID, SIGNAL AMPLI

Facility

$113.00

Service Code	HCPCS 83908
Hospital Charge Code	397071200
Hospital Revenue Code	301
Min. Negotiated Rate	$14.69
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$33.90
Rate for Payer: Aetna Medicare Advantage	$33.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.82
Rate for Payer: Cigna Commercial	$56.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.69
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.95
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH NUCLEIC ACID AMLICAT X3

Facility

$104.00

Service Code	HCPCS 83898
Hospital Charge Code	397073291
Hospital Revenue Code	301
Min. Negotiated Rate	$13.52
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.20
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.52
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH NUCLEIC ACID AMLICAT X3

Facility

$104.00

Service Code	HCPCS 83898
Hospital Charge Code	397073291
Hospital Revenue Code	301
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

CH NUCLEIC ACID AMPLIFICAT

Facility

$104.00

Service Code	HCPCS 83898
Hospital Charge Code	397073285
Hospital Revenue Code	301
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

CH NUCLEIC ACID AMPLIFICAT

Facility

$104.00

Service Code	HCPCS 83898
Hospital Charge Code	397073285
Hospital Revenue Code	301
Min. Negotiated Rate	$13.52
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.20
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.52
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH NUCLEIC ACID AMPLIFICATX4

Facility

$104.00

Service Code	HCPCS 83898
Hospital Charge Code	397073298
Hospital Revenue Code	301
Min. Negotiated Rate	$13.52
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.20
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.52
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH NUCLEIC ACID AMPLIFICATX4

Facility

$104.00

Service Code	HCPCS 83898
Hospital Charge Code	397073298
Hospital Revenue Code	301
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

CH NUCLEIC ACID HIGH RESOLUT

Facility

$101.00

Service Code	HCPCS 81240
Hospital Charge Code	397071417
Hospital Revenue Code	310
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$240.69
Rate for Payer: Aetna Commercial	$212.84
Rate for Payer: Aetna Medicare Advantage	$65.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$65.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.69
Rate for Payer: Cigna Commercial	$65.69
Rate for Payer: Cigna Medicare Advantage	$32.84
Rate for Payer: Clover Medicare Advantage	$62.41
Rate for Payer: EmblemHealth Commercial	$197.07
Rate for Payer: Humana Medicare Advantage	$67.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$65.69
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$69.63
Rate for Payer: Wellcare Medicare Advantage	$65.69

CH NUCLEIC ACID HIGH RESOLUT

Facility

$101.00

Service Code	HCPCS 81240
Hospital Charge Code	397071417
Hospital Revenue Code	310
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$15.15
Rate for Payer: Qualcare PPO/HMO/WC	$15.15

CH NUCLEIC ACID PROBE

Facility

$390.00

Service Code	HCPCS 81479
Hospital Charge Code	397073284
Hospital Revenue Code	306
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
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	$195.00
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 NUCLEIC ACID PROBE

Facility

$390.00

Service Code	HCPCS 81479
Hospital Charge Code	397073284
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH NUCLEIC ACID PROBE X2

Facility

$65.00

Service Code	HCPCS 83896
Hospital Charge Code	397073290
Hospital Revenue Code	301
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

CH NUCLEIC ACID PROBE X2

Facility

$65.00

Service Code	HCPCS 83896
Hospital Charge Code	397073290
Hospital Revenue Code	301
Min. Negotiated Rate	$8.45
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$19.50
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

Know your out-of-pocket cost for care.

All Charges