Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH PH FECAL

Facility

$68.00

Service Code	HCPCS 83986
Hospital Charge Code	397071010
Hospital Revenue Code	301
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$11.60
Rate for Payer: Aetna Medicare Advantage	$3.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.58
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	$13.12
Rate for Payer: Cigna Commercial	$3.58
Rate for Payer: Cigna Medicare Advantage	$1.79
Rate for Payer: Clover Medicare Advantage	$3.40
Rate for Payer: EmblemHealth Commercial	$10.74
Rate for Payer: Humana Medicare Advantage	$3.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.58
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.79
Rate for Payer: Wellcare Medicare Advantage	$3.58

CH PHIL CHROM

Facility

$2,700.00

Service Code	HCPCS 83890
Hospital Charge Code	397073029
Hospital Revenue Code	301
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$405.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

CH PHIL CHROM

Facility

$2,700.00

Service Code	HCPCS 83890
Hospital Charge Code	397073029
Hospital Revenue Code	301
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$810.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH PHIL CHROM & DNA

Facility

$2,862.00

Service Code	HCPCS 81240
Hospital Charge Code	397073030
Hospital Revenue Code	310
Min. Negotiated Rate	$429.30
Max. Negotiated Rate	$429.30
Rate for Payer: Qualcare PPO/HMO/WC	$429.30

CH PHIL CHROM & DNA

Facility

$2,862.00

Service Code	HCPCS 81240
Hospital Charge Code	397073030
Hospital Revenue Code	310
Min. Negotiated Rate	$32.84
Max. Negotiated Rate	$429.30
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	$372.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$429.30
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 PHIL CHROM DNA PROBE

Facility

$1,181.00

Service Code	HCPCS 83912
Hospital Charge Code	397073100
Hospital Revenue Code	301
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$590.50
Rate for Payer: Aetna Commercial	$354.30
Rate for Payer: Aetna Medicare Advantage	$354.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$301.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$301.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.15
Rate for Payer: Cigna Commercial	$590.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$177.15
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH PHIL CHROM DNA PROBE

Facility

$1,181.00

Service Code	HCPCS 83912
Hospital Charge Code	397073100
Hospital Revenue Code	301
Min. Negotiated Rate	$177.15
Max. Negotiated Rate	$177.15
Rate for Payer: Qualcare PPO/HMO/WC	$177.15

CH PHOSPHATIDYSERINE (G,A,M)

Facility

$1,248.00

Service Code	HCPCS 86148
Hospital Charge Code	397071415
Hospital Revenue Code	302
Min. Negotiated Rate	$8.04
Max. Negotiated Rate	$187.20
Rate for Payer: Aetna Commercial	$52.07
Rate for Payer: Aetna Medicare Advantage	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.88
Rate for Payer: Cigna Commercial	$16.07
Rate for Payer: Cigna Medicare Advantage	$8.04
Rate for Payer: Clover Medicare Advantage	$15.27
Rate for Payer: EmblemHealth Commercial	$48.21
Rate for Payer: Humana Medicare Advantage	$16.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.24
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.07
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.03
Rate for Payer: Wellcare Medicare Advantage	$16.07

CH PHOSPHATIDYSERINE (G,A,M)

Facility

$1,248.00

Service Code	HCPCS 86148
Hospital Charge Code	397071415
Hospital Revenue Code	302
Min. Negotiated Rate	$187.20
Max. Negotiated Rate	$187.20
Rate for Payer: Qualcare PPO/HMO/WC	$187.20

CH PHOSPHOLIPIDS

Facility

$299.00

Service Code	HCPCS 84311
Hospital Charge Code	397073098
Hospital Revenue Code	301
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.24
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.68
Rate for Payer: Cigna Commercial	$8.10
Rate for Payer: Cigna Medicare Advantage	$4.05
Rate for Payer: Clover Medicare Advantage	$7.70
Rate for Payer: EmblemHealth Commercial	$24.30
Rate for Payer: Humana Medicare Advantage	$8.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.87
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.10
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.59
Rate for Payer: Wellcare Medicare Advantage	$8.10

CH PHOSPHOLIPIDS

Facility

$299.00

Service Code	HCPCS 84311
Hospital Charge Code	397073098
Hospital Revenue Code	301
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$44.85
Rate for Payer: Qualcare PPO/HMO/WC	$44.85

CH PHOSPHORUS

Facility

$141.80

Service Code	HCPCS 84100
Hospital Charge Code	397071267
Hospital Revenue Code	301
Min. Negotiated Rate	$21.27
Max. Negotiated Rate	$21.27
Rate for Payer: Qualcare PPO/HMO/WC	$21.27

CH PHOSPHORUS

Facility

$141.80

Service Code	HCPCS 84100
Hospital Charge Code	397071267
Hospital Revenue Code	301
Min. Negotiated Rate	$2.37
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.36
Rate for Payer: Aetna Medicare Advantage	$4.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.74
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	$17.37
Rate for Payer: Cigna Commercial	$4.74
Rate for Payer: Cigna Medicare Advantage	$2.37
Rate for Payer: Clover Medicare Advantage	$4.50
Rate for Payer: EmblemHealth Commercial	$14.22
Rate for Payer: Humana Medicare Advantage	$4.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.27
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.02
Rate for Payer: Wellcare Medicare Advantage	$4.74

CH PHOSPHORUS URINE 24 HR

Facility

$390.00

Service Code	HCPCS 84105
Hospital Charge Code	397071311
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH PHOSPHORUS URINE 24 HR

Facility

$390.00

Service Code	HCPCS 84105
Hospital Charge Code	397071311
Hospital Revenue Code	301
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	$5.61
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	$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	$5.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.13
Rate for Payer: Wellcare Medicare Advantage	$5.78

CH PH URINE

Facility

$22.00

Service Code	HCPCS 83986
Hospital Charge Code	397071321
Hospital Revenue Code	301
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

CH PH URINE

Facility

$22.00

Service Code	HCPCS 83986
Hospital Charge Code	397071321
Hospital Revenue Code	301
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$11.60
Rate for Payer: Aetna Medicare Advantage	$3.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.58
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	$13.12
Rate for Payer: Cigna Commercial	$3.58
Rate for Payer: Cigna Medicare Advantage	$1.79
Rate for Payer: Clover Medicare Advantage	$3.40
Rate for Payer: EmblemHealth Commercial	$10.74
Rate for Payer: Humana Medicare Advantage	$3.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.58
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.79
Rate for Payer: Wellcare Medicare Advantage	$3.58

CH PILL/POWDER ID QL

Facility

$578.00

Service Code	HCPCS 80100
Hospital Charge Code	397073099
Hospital Revenue Code	301
Min. Negotiated Rate	$75.14
Max. Negotiated Rate	$289.00
Rate for Payer: Aetna Commercial	$173.40
Rate for Payer: Aetna Medicare Advantage	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.39
Rate for Payer: Cigna Commercial	$289.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.70
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH PILL/POWDER ID QL

Facility

$578.00

Service Code	HCPCS 80100
Hospital Charge Code	397073099
Hospital Revenue Code	301
Min. Negotiated Rate	$86.70
Max. Negotiated Rate	$86.70
Rate for Payer: Qualcare PPO/HMO/WC	$86.70

CH PLACEMENT IVC FILTER PERCU

Facility

$1,370.00

Service Code	HCPCS 75940
Hospital Charge Code	7411329
Hospital Revenue Code	320
Min. Negotiated Rate	$178.10
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$411.00
Rate for Payer: Aetna Medicare Advantage	$411.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.35
Rate for Payer: Cigna Commercial	$685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.10
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$205.50
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

CH PLACEMENT IVC FILTER PERCU

Facility

$1,370.00

Service Code	HCPCS 75940
Hospital Charge Code	7411329
Hospital Revenue Code	320
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$205.50
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

CH PLASMINOGEN ACTIV INHIB

Facility

$441.00

Service Code	HCPCS 85415
Hospital Charge Code	397021097
Hospital Revenue Code	305
Min. Negotiated Rate	$66.15
Max. Negotiated Rate	$66.15
Rate for Payer: Qualcare PPO/HMO/WC	$66.15

CH PLASMINOGEN ACTIV INHIB

Facility

$441.00

Service Code	HCPCS 85415
Hospital Charge Code	397021097
Hospital Revenue Code	305
Min. Negotiated Rate	$8.60
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.70
Rate for Payer: Aetna Medicare Advantage	$17.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.98
Rate for Payer: Cigna Commercial	$17.19
Rate for Payer: Cigna Medicare Advantage	$8.60
Rate for Payer: Clover Medicare Advantage	$16.33
Rate for Payer: EmblemHealth Commercial	$51.57
Rate for Payer: Humana Medicare Advantage	$17.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.33
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.19
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.22
Rate for Payer: Wellcare Medicare Advantage	$17.19

CH PLASMINOGEN ACTIVITY

Facility

$116.00

Service Code	HCPCS 85420
Hospital Charge Code	397073688
Hospital Revenue Code	305
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$21.16
Rate for Payer: Aetna Medicare Advantage	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.93
Rate for Payer: Cigna Commercial	$6.53
Rate for Payer: Cigna Medicare Advantage	$3.27
Rate for Payer: Clover Medicare Advantage	$6.20
Rate for Payer: EmblemHealth Commercial	$19.59
Rate for Payer: Humana Medicare Advantage	$6.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.53
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.92
Rate for Payer: Wellcare Medicare Advantage	$6.53

CH PLASMINOGEN ACTIVITY

Facility

$116.00

Service Code	HCPCS 85420
Hospital Charge Code	397073688
Hospital Revenue Code	305
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

Know your out-of-pocket cost for care.

All Charges