Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH OXYCODONE SCR AND CONFIRM

Facility

$208.91

Service Code	HCPCS 80301
Hospital Charge Code	3970733
Hospital Revenue Code	301
Min. Negotiated Rate	$27.16
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$62.67
Rate for Payer: Aetna Medicare Advantage	$62.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.27
Rate for Payer: Cigna Commercial	$104.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.16
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.34
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH PAIN MGT, MEPERIDINE, QN

Facility

$410.00

Hospital Charge Code	3970736
Hospital Revenue Code	301
Min. Negotiated Rate	$61.50
Max. Negotiated Rate	$61.50
Rate for Payer: Qualcare PPO/HMO/WC	$61.50

CH PAIN MGT, MEPERIDINE, QN

Facility

$410.00

Hospital Charge Code	3970736
Hospital Revenue Code	301
Min. Negotiated Rate	$53.30
Max. Negotiated Rate	$205.00
Rate for Payer: Aetna Commercial	$123.00
Rate for Payer: Aetna Medicare Advantage	$123.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.55
Rate for Payer: Cigna Commercial	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.50
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH PAIN MGT, TRAMADOL, QN

Facility

$410.00

Hospital Charge Code	3970735
Hospital Revenue Code	301
Min. Negotiated Rate	$53.30
Max. Negotiated Rate	$205.00
Rate for Payer: Aetna Commercial	$123.00
Rate for Payer: Aetna Medicare Advantage	$123.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.55
Rate for Payer: Cigna Commercial	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.50
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH PAIN MGT, TRAMADOL, QN

Facility

$410.00

Hospital Charge Code	3970735
Hospital Revenue Code	301
Min. Negotiated Rate	$61.50
Max. Negotiated Rate	$61.50
Rate for Payer: Qualcare PPO/HMO/WC	$61.50

CH PALL PL 100 FILTER

Facility

$173.00

Hospital Charge Code	397031065
Hospital Revenue Code	272
Min. Negotiated Rate	$22.49
Max. Negotiated Rate	$86.50
Rate for Payer: Aetna Commercial	$51.90
Rate for Payer: Aetna Medicare Advantage	$51.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.12
Rate for Payer: Cigna Commercial	$86.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.49
Rate for Payer: Oxford Commercial	$86.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.95
Rate for Payer: UnitedHealthcare Commercial	$86.50

CH PALL PL 100 FILTER

Facility

$173.00

Hospital Charge Code	397031065
Hospital Revenue Code	272
Min. Negotiated Rate	$25.95
Max. Negotiated Rate	$25.95
Rate for Payer: Qualcare PPO/HMO/WC	$25.95

CH PALL RC 100 FILTER

Facility

$173.00

Hospital Charge Code	397031063
Hospital Revenue Code	272
Min. Negotiated Rate	$22.49
Max. Negotiated Rate	$86.50
Rate for Payer: Aetna Commercial	$51.90
Rate for Payer: Aetna Medicare Advantage	$51.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.12
Rate for Payer: Cigna Commercial	$86.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.49
Rate for Payer: Oxford Commercial	$86.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.95
Rate for Payer: UnitedHealthcare Commercial	$86.50

CH PALL RC 100 FILTER

Facility

$173.00

Hospital Charge Code	397031063
Hospital Revenue Code	272
Min. Negotiated Rate	$25.95
Max. Negotiated Rate	$25.95
Rate for Payer: Qualcare PPO/HMO/WC	$25.95

CH PARAINFLUENZA VIRUS ABS

Facility

$130.00

Service Code	HCPCS 86790
Hospital Charge Code	397071466
Hospital Revenue Code	302
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$19.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.50

CH PARAINFLUENZA VIRUS ABS

Facility

$130.00

Service Code	HCPCS 86790
Hospital Charge Code	397071466
Hospital Revenue Code	302
Min. Negotiated Rate	$6.44
Max. Negotiated Rate	$443.55
Rate for Payer: Aetna Commercial	$41.73
Rate for Payer: Aetna Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$443.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.19
Rate for Payer: Cigna Commercial	$12.88
Rate for Payer: Cigna Medicare Advantage	$6.44
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.65
Rate for Payer: Wellcare Medicare Advantage	$12.88

CH PARAINFLUENZA VIRUS ABS

Facility

$203.00

Service Code	HCPCS 86790
Hospital Charge Code	397071405
Hospital Revenue Code	302
Min. Negotiated Rate	$30.45
Max. Negotiated Rate	$30.45
Rate for Payer: Qualcare PPO/HMO/WC	$30.45

CH PARAINFLUENZA VIRUS ABS

Facility

$203.00

Service Code	HCPCS 86790
Hospital Charge Code	397071405
Hospital Revenue Code	302
Min. Negotiated Rate	$6.44
Max. Negotiated Rate	$443.55
Rate for Payer: Aetna Commercial	$41.73
Rate for Payer: Aetna Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$443.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.19
Rate for Payer: Cigna Commercial	$12.88
Rate for Payer: Cigna Medicare Advantage	$6.44
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.39
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.65
Rate for Payer: Wellcare Medicare Advantage	$12.88

CH PARASITE IDENTIFICATION

Facility

$67.00

Service Code	HCPCS 87169
Hospital Charge Code	397071383
Hospital Revenue Code	309
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.96
Rate for Payer: Aetna Medicare Advantage	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.79
Rate for Payer: Cigna Commercial	$4.31
Rate for Payer: Cigna Medicare Advantage	$2.15
Rate for Payer: Clover Medicare Advantage	$4.09
Rate for Payer: EmblemHealth Commercial	$12.93
Rate for Payer: Humana Medicare Advantage	$4.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.71
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.31
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.57
Rate for Payer: Wellcare Medicare Advantage	$4.31

CH PARASITE IDENTIFICATION

Facility

$67.00

Service Code	HCPCS 87169
Hospital Charge Code	397071383
Hospital Revenue Code	309
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

CH PARASITES BLOOD SMEAR

Facility

$78.00

Service Code	HCPCS 87207
Hospital Charge Code	397020001
Hospital Revenue Code	309
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$19.41
Rate for Payer: Aetna Medicare Advantage	$5.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.95
Rate for Payer: Cigna Commercial	$5.99
Rate for Payer: Cigna Medicare Advantage	$3.00
Rate for Payer: Clover Medicare Advantage	$5.69
Rate for Payer: EmblemHealth Commercial	$17.97
Rate for Payer: Humana Medicare Advantage	$6.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.99
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.35
Rate for Payer: Wellcare Medicare Advantage	$5.99

CH PARASITES BLOOD SMEAR

Facility

$78.00

Service Code	HCPCS 87207
Hospital Charge Code	397020001
Hospital Revenue Code	309
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$11.70
Rate for Payer: Qualcare PPO/HMO/WC	$11.70

CH PARATHYROID HORMONE

Facility

$1,427.00

Service Code	HCPCS 83970
Hospital Charge Code	397071025
Hospital Revenue Code	301
Min. Negotiated Rate	$214.05
Max. Negotiated Rate	$214.05
Rate for Payer: Qualcare PPO/HMO/WC	$214.05

CH PARATHYROID HORMONE

Facility

$1,427.00

Service Code	HCPCS 83970
Hospital Charge Code	397071025
Hospital Revenue Code	301
Min. Negotiated Rate	$20.64
Max. Negotiated Rate	$214.05
Rate for Payer: Aetna Commercial	$133.75
Rate for Payer: Aetna Medicare Advantage	$41.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.25
Rate for Payer: Cigna Commercial	$41.28
Rate for Payer: Cigna Medicare Advantage	$20.64
Rate for Payer: Clover Medicare Advantage	$39.22
Rate for Payer: EmblemHealth Commercial	$123.84
Rate for Payer: Humana Medicare Advantage	$42.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.51
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$214.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$41.28
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$43.76
Rate for Payer: Wellcare Medicare Advantage	$41.28

CH PAROXETINE

Facility

$85.00

Service Code	HCPCS 80299
Hospital Charge Code	397071362
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 PAROXETINE

Facility

$85.00

Service Code	HCPCS 80299
Hospital Charge Code	397071362
Hospital Revenue Code	301
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

CH PARROT/PKEET DROP(E77)IGE

Facility

$114.00

Service Code	HCPCS 86003
Hospital Charge Code	397073634
Hospital Revenue Code	305
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$17.10
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

CH PARROT/PKEET DROP(E77)IGE

Facility

$114.00

Service Code	HCPCS 86003
Hospital Charge Code	397073634
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	$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	$5.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.53
Rate for Payer: Wellcare Medicare Advantage	$5.22

CH PAXIL

Facility

$85.00

Service Code	HCPCS 80299
Hospital Charge Code	397071024
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 PAXIL

Facility

$85.00

Service Code	HCPCS 80299
Hospital Charge Code	397071024
Hospital Revenue Code	301
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

Know your out-of-pocket cost for care.

All Charges