Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH NUCLEIC ACID PROBE X3

Facility

$65.00

Service Code	HCPCS 83896
Hospital Charge Code	397073297
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

CH NUCLEIC ACID PROBE X3

Facility

$65.00

Service Code	HCPCS 83896
Hospital Charge Code	397073297
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 TRANSFER X2

Facility

$40.00

Service Code	HCPCS 83897
Hospital Charge Code	397073283
Hospital Revenue Code	301
Min. Negotiated Rate	$5.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$12.00
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH NUCLEIC ACID TRANSFER X2

Facility

$40.00

Service Code	HCPCS 83897
Hospital Charge Code	397073283
Hospital Revenue Code	301
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CH NUCLEOTIDASE 5

Facility

$106.00

Service Code	HCPCS 83915
Hospital Charge Code	397071041
Hospital Revenue Code	301
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$15.90
Rate for Payer: Qualcare PPO/HMO/WC	$15.90

CH NUCLEOTIDASE 5

Facility

$106.00

Service Code	HCPCS 83915
Hospital Charge Code	397071041
Hospital Revenue Code	301
Min. Negotiated Rate	$5.58
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$36.13
Rate for Payer: Aetna Medicare Advantage	$11.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.85
Rate for Payer: Cigna Commercial	$11.15
Rate for Payer: Cigna Medicare Advantage	$5.58
Rate for Payer: Clover Medicare Advantage	$10.59
Rate for Payer: EmblemHealth Commercial	$33.45
Rate for Payer: Humana Medicare Advantage	$11.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.78
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.15
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.82
Rate for Payer: Wellcare Medicare Advantage	$11.15

CH NUT PROFILE

Facility

$573.00

Service Code	HCPCS 86003
Hospital Charge Code	397073670
Hospital Revenue Code	305
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.91
Rate for Payer: Aetna Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.13
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: Cigna Medicare Advantage	$2.61
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.53
Rate for Payer: Wellcare Medicare Advantage	$5.22

CH NUT PROFILE

Facility

$573.00

Service Code	HCPCS 86003
Hospital Charge Code	397073670
Hospital Revenue Code	305
Min. Negotiated Rate	$85.95
Max. Negotiated Rate	$85.95
Rate for Payer: Qualcare PPO/HMO/WC	$85.95

CH OCCULT BLOOD, GASTRIC

Facility

$390.00

Service Code	HCPCS 82271
Hospital Charge Code	397073172
Hospital Revenue Code	301
Min. Negotiated Rate	$2.66
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.24
Rate for Payer: Aetna Medicare Advantage	$5.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.49
Rate for Payer: Cigna Commercial	$5.32
Rate for Payer: Cigna Medicare Advantage	$2.66
Rate for Payer: Clover Medicare Advantage	$5.05
Rate for Payer: EmblemHealth Commercial	$15.96
Rate for Payer: Humana Medicare Advantage	$5.48
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	$5.32
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.64
Rate for Payer: Wellcare Medicare Advantage	$5.32

CH OCCULT BLOOD, GASTRIC

Facility

$390.00

Service Code	HCPCS 82271
Hospital Charge Code	397073172
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH OCCULT BLOOD, STOOL

Facility

$390.00

Service Code	HCPCS 82270
Hospital Charge Code	397073027
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH OCCULT BLOOD, STOOL

Facility

$390.00

Service Code	HCPCS 82270
Hospital Charge Code	397073027
Hospital Revenue Code	301
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.19
Rate for Payer: Aetna Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.05
Rate for Payer: Cigna Commercial	$4.38
Rate for Payer: Cigna Medicare Advantage	$2.19
Rate for Payer: Clover Medicare Advantage	$4.16
Rate for Payer: EmblemHealth Commercial	$13.14
Rate for Payer: Humana Medicare Advantage	$4.51
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	$4.38
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.64
Rate for Payer: Wellcare Medicare Advantage	$4.38

CH OCCULT BLOOD, URINE

Facility

$35.00

Service Code	HCPCS 82271
Hospital Charge Code	397073026
Hospital Revenue Code	301
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

CH OCCULT BLOOD, URINE

Facility

$35.00

Service Code	HCPCS 82271
Hospital Charge Code	397073026
Hospital Revenue Code	301
Min. Negotiated Rate	$2.66
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.24
Rate for Payer: Aetna Medicare Advantage	$5.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.49
Rate for Payer: Cigna Commercial	$5.32
Rate for Payer: Cigna Medicare Advantage	$2.66
Rate for Payer: Clover Medicare Advantage	$5.05
Rate for Payer: EmblemHealth Commercial	$15.96
Rate for Payer: Humana Medicare Advantage	$5.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.55
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.32
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.64
Rate for Payer: Wellcare Medicare Advantage	$5.32

CHOICE DM BAR

Facility

$5.00

Hospital Charge Code	60635264
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

CHOICE DM BAR

Facility

$5.00

Hospital Charge Code	60635264
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

CHOLANGIOGRAM

Facility

$331.55

Service Code	HCPCS 47505
Hospital Charge Code	5100518
Hospital Revenue Code	361
Min. Negotiated Rate	$49.73
Max. Negotiated Rate	$49.73
Rate for Payer: Qualcare PPO/HMO/WC	$49.73

CHOLANGIOGRAM

Facility

$331.55

Service Code	HCPCS 47505
Hospital Charge Code	5100518
Hospital Revenue Code	361
Min. Negotiated Rate	$43.10
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$99.47
Rate for Payer: Aetna Medicare Advantage	$99.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.55
Rate for Payer: Cigna Commercial	$165.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.10
Rate for Payer: Qualcare PPO/HMO/WC	$49.73

CHOLANGIOGRAM S&I

Facility

$620.20

Service Code	HCPCS 74305
Hospital Charge Code	5100519
Hospital Revenue Code	320
Min. Negotiated Rate	$93.03
Max. Negotiated Rate	$93.03
Rate for Payer: Qualcare PPO/HMO/WC	$93.03

CHOLANGIOGRAM S&I

Facility

$620.20

Service Code	HCPCS 74305
Hospital Charge Code	5100519
Hospital Revenue Code	320
Min. Negotiated Rate	$80.63
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$186.06
Rate for Payer: Aetna Medicare Advantage	$186.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.15
Rate for Payer: Cigna Commercial	$310.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.63
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.03
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

CH OLANZAPINE

Facility

$285.00

Service Code	HCPCS 80299
Hospital Charge Code	397071361
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	$37.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.75
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 OLANZAPINE

Facility

$281.00

Service Code	HCPCS 80299
Hospital Charge Code	397073197
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	$36.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.15
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 OLANZAPINE

Facility

$281.00

Service Code	HCPCS 80299
Hospital Charge Code	397073197
Hospital Revenue Code	301
Min. Negotiated Rate	$42.15
Max. Negotiated Rate	$42.15
Rate for Payer: Qualcare PPO/HMO/WC	$42.15

CH OLANZAPINE

Facility

$285.00

Service Code	HCPCS 80299
Hospital Charge Code	397071361
Hospital Revenue Code	301
Min. Negotiated Rate	$42.75
Max. Negotiated Rate	$42.75
Rate for Payer: Qualcare PPO/HMO/WC	$42.75

CHOLECALCIFEROL 1,000 IU TAB

Facility

$4.00

Service Code	NDC 904582460
Hospital Charge Code	6063943190
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

Know your out-of-pocket cost for care.

All Charges