Heights University Hospital

All Charges

Charge

Type

Setting

Price

CHONDROFIX OC GRAFT, 11MM

Facility

$18,415.00

Hospital Charge Code	270665050
Hospital Revenue Code	270
Min. Negotiated Rate	$2,762.25
Max. Negotiated Rate	$2,762.25
Rate for Payer: Qualcare PPO/HMO/WC	$2,762.25

CHONDROFIX OC GRAFT, 11MM

Facility

$18,415.00

Hospital Charge Code	270665050
Hospital Revenue Code	270
Min. Negotiated Rate	$2,393.95
Max. Negotiated Rate	$9,207.50
Rate for Payer: Aetna Commercial	$5,524.50
Rate for Payer: Aetna Medicare Advantage	$5,524.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,695.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,695.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,695.82
Rate for Payer: Cigna Commercial	$9,207.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,393.95
Rate for Payer: Oxford Commercial	$9,207.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,762.25
Rate for Payer: UnitedHealthcare Commercial	$9,207.50

CHONDROITIN SOD HYALURNTE INJ

Facility

$1,010.96

Service Code	NDC 8065183905
Hospital Charge Code	60628087
Hospital Revenue Code	250
Min. Negotiated Rate	$151.64
Max. Negotiated Rate	$151.64
Rate for Payer: Qualcare PPO/HMO/WC	$151.64

CHONDROITIN SOD HYALURNTE INJ

Facility

$1,010.96

Service Code	NDC 8065183905
Hospital Charge Code	60628087
Hospital Revenue Code	250
Min. Negotiated Rate	$131.42
Max. Negotiated Rate	$505.48
Rate for Payer: Aetna Commercial	$303.29
Rate for Payer: Aetna Medicare Advantage	$303.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$257.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$257.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$257.79
Rate for Payer: Cigna Commercial	$505.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.42
Rate for Payer: Oxford Commercial	$505.48
Rate for Payer: Qualcare PPO/HMO/WC	$151.64
Rate for Payer: UnitedHealthcare Commercial	$505.48

CH OPIATES CONF GCMS

Facility

$318.00

Service Code	HCPCS 80300
Hospital Charge Code	397073076
Hospital Revenue Code	301
Min. Negotiated Rate	$47.70
Max. Negotiated Rate	$47.70
Rate for Payer: Qualcare PPO/HMO/WC	$47.70

CH OPIATES CONF GCMS

Facility

$318.00

Service Code	HCPCS 80300
Hospital Charge Code	397073076
Hospital Revenue Code	301
Min. Negotiated Rate	$41.34
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$95.40
Rate for Payer: Aetna Medicare Advantage	$95.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.09
Rate for Payer: Cigna Commercial	$159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.70
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH OPIATES DAU

Facility

$44.00

Service Code	HCPCS 80300
Hospital Charge Code	397071289
Hospital Revenue Code	301
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

CH OPIATES DAU

Facility

$44.00

Service Code	HCPCS 80300
Hospital Charge Code	397071289
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 OPIATES METAB BY GCMS

Facility

$107.00

Service Code	HCPCS 82542
Hospital Charge Code	397071475
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	$13.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
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 OPIATES METAB BY GCMS

Facility

$107.00

Service Code	HCPCS 82542
Hospital Charge Code	397071475
Hospital Revenue Code	301
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

CH ORGANISM ID MOLD

Facility

$139.00

Service Code	HCPCS 87107
Hospital Charge Code	397073601
Hospital Revenue Code	309
Min. Negotiated Rate	$5.16
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$33.44
Rate for Payer: Aetna Medicare Advantage	$10.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.81
Rate for Payer: Cigna Commercial	$10.32
Rate for Payer: Cigna Medicare Advantage	$5.16
Rate for Payer: Clover Medicare Advantage	$9.80
Rate for Payer: EmblemHealth Commercial	$30.96
Rate for Payer: Humana Medicare Advantage	$10.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.32
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.94
Rate for Payer: Wellcare Medicare Advantage	$10.32

CH ORGANISM ID MOLD

Facility

$139.00

Service Code	HCPCS 87107
Hospital Charge Code	397073601
Hospital Revenue Code	309
Min. Negotiated Rate	$20.85
Max. Negotiated Rate	$20.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.85

CH ORGANISM ID MYCOBACTERIA

Facility

$160.00

Service Code	HCPCS 87118
Hospital Charge Code	397073600
Hospital Revenue Code	309
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

CH ORGANISM ID MYCOBACTERIA

Facility

$160.00

Service Code	HCPCS 87118
Hospital Charge Code	397073600
Hospital Revenue Code	309
Min. Negotiated Rate	$7.30
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.34
Rate for Payer: Aetna Medicare Advantage	$14.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.53
Rate for Payer: Cigna Commercial	$14.61
Rate for Payer: Cigna Medicare Advantage	$7.30
Rate for Payer: Clover Medicare Advantage	$13.88
Rate for Payer: EmblemHealth Commercial	$43.83
Rate for Payer: Humana Medicare Advantage	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.61
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.49
Rate for Payer: Wellcare Medicare Advantage	$14.61

CH OSMOLALITY SERUM

Facility

$57.00

Service Code	HCPCS 83930
Hospital Charge Code	397071096
Hospital Revenue Code	301
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$21.42
Rate for Payer: Aetna Medicare Advantage	$6.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.22
Rate for Payer: Cigna Commercial	$6.61
Rate for Payer: Cigna Medicare Advantage	$3.31
Rate for Payer: Clover Medicare Advantage	$6.28
Rate for Payer: EmblemHealth Commercial	$19.83
Rate for Payer: Humana Medicare Advantage	$6.81
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	$6.61
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.01
Rate for Payer: Wellcare Medicare Advantage	$6.61

CH OSMOLALITY SERUM

Facility

$57.00

Service Code	HCPCS 83930
Hospital Charge Code	397071096
Hospital Revenue Code	301
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$8.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.55

CH OSMOMALITY URINE

Facility

$57.00

Service Code	HCPCS 83935
Hospital Charge Code	397073042
Hospital Revenue Code	301
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$22.10
Rate for Payer: Aetna Medicare Advantage	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.99
Rate for Payer: Cigna Commercial	$6.82
Rate for Payer: Cigna Medicare Advantage	$3.41
Rate for Payer: Clover Medicare Advantage	$6.48
Rate for Payer: EmblemHealth Commercial	$20.46
Rate for Payer: Humana Medicare Advantage	$7.02
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	$6.82
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.23
Rate for Payer: Wellcare Medicare Advantage	$6.82

CH OSMOMALITY URINE

Facility

$57.00

Service Code	HCPCS 83935
Hospital Charge Code	397073042
Hospital Revenue Code	301
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$8.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.55

CH OSTEOCALCIN

Facility

$551.00

Service Code	HCPCS 83937
Hospital Charge Code	397070018
Hospital Revenue Code	301
Min. Negotiated Rate	$82.65
Max. Negotiated Rate	$82.65
Rate for Payer: Qualcare PPO/HMO/WC	$82.65

CH OSTEOCALCIN

Facility

$551.00

Service Code	HCPCS 83937
Hospital Charge Code	397070018
Hospital Revenue Code	301
Min. Negotiated Rate	$14.93
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$96.71
Rate for Payer: Aetna Medicare Advantage	$29.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.37
Rate for Payer: Cigna Commercial	$29.85
Rate for Payer: Cigna Medicare Advantage	$14.93
Rate for Payer: Clover Medicare Advantage	$28.36
Rate for Payer: EmblemHealth Commercial	$89.55
Rate for Payer: Humana Medicare Advantage	$30.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.63
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.85
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$31.64
Rate for Payer: Wellcare Medicare Advantage	$29.85

CH OXALATE

Facility

$390.00

Service Code	HCPCS 83945
Hospital Charge Code	397071029
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH OXALATE

Facility

$390.00

Service Code	HCPCS 83945
Hospital Charge Code	397071029
Hospital Revenue Code	301
Min. Negotiated Rate	$7.22
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.82
Rate for Payer: Aetna Medicare Advantage	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.94
Rate for Payer: Cigna Commercial	$14.45
Rate for Payer: Cigna Medicare Advantage	$7.22
Rate for Payer: Clover Medicare Advantage	$13.73
Rate for Payer: EmblemHealth Commercial	$43.35
Rate for Payer: Humana Medicare Advantage	$14.88
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	$14.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.32
Rate for Payer: Wellcare Medicare Advantage	$14.45

CH OXCARBAZEPINE LEVEL

Facility

$198.00

Service Code	HCPCS 80299
Hospital Charge Code	397070001
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	$25.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.70
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 OXCARBAZEPINE LEVEL

Facility

$198.00

Service Code	HCPCS 80299
Hospital Charge Code	397070001
Hospital Revenue Code	301
Min. Negotiated Rate	$29.70
Max. Negotiated Rate	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$29.70

CH OXYCODONE SCR AND CONFIRM

Facility

$208.91

Service Code	HCPCS 80301
Hospital Charge Code	3970733
Hospital Revenue Code	301
Min. Negotiated Rate	$31.34
Max. Negotiated Rate	$31.34
Rate for Payer: Qualcare PPO/HMO/WC	$31.34

Know your out-of-pocket cost for care.

All Charges