Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH PLAT CONC IRRADIATED

Facility

$440.00

Service Code	HCPCS P9032
Hospital Charge Code	397031044
Hospital Revenue Code	390
Min. Negotiated Rate	$57.20
Max. Negotiated Rate	$915.99
Rate for Payer: Aetna Commercial	$132.00
Rate for Payer: Aetna Medicare Advantage	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.20
Rate for Payer: Cigna Commercial	$915.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.20
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH PLAT CONC IRRADIATED

Facility

$440.00

Service Code	HCPCS P9032
Hospital Charge Code	397031044
Hospital Revenue Code	390
Min. Negotiated Rate	$66.00
Max. Negotiated Rate	$66.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.00

CH PLATELET AB, CIRCULATING

Facility

$662.00

Service Code	HCPCS 86022
Hospital Charge Code	397020002
Hospital Revenue Code	302
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$99.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

CH PLATELET AB, CIRCULATING

Facility

$662.00

Service Code	HCPCS 86022
Hospital Charge Code	397020002
Hospital Revenue Code	302
Min. Negotiated Rate	$9.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$59.52
Rate for Payer: Aetna Medicare Advantage	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.37
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	$67.31
Rate for Payer: Cigna Commercial	$18.37
Rate for Payer: Cigna Medicare Advantage	$9.19
Rate for Payer: Clover Medicare Advantage	$17.45
Rate for Payer: EmblemHealth Commercial	$55.11
Rate for Payer: Humana Medicare Advantage	$18.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.47
Rate for Payer: Wellcare Medicare Advantage	$18.37

CH PLATELET ASSOC AB IGG

Facility

$150.00

Service Code	HCPCS 86023
Hospital Charge Code	397073101
Hospital Revenue Code	302
Min. Negotiated Rate	$6.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$40.37
Rate for Payer: Aetna Medicare Advantage	$12.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.65
Rate for Payer: Cigna Commercial	$12.46
Rate for Payer: Cigna Medicare Advantage	$6.23
Rate for Payer: Clover Medicare Advantage	$11.84
Rate for Payer: EmblemHealth Commercial	$37.38
Rate for Payer: Humana Medicare Advantage	$12.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.46
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.21
Rate for Payer: Wellcare Medicare Advantage	$12.46

CH PLATELET ASSOC AB IGG

Facility

$150.00

Service Code	HCPCS 86023
Hospital Charge Code	397073101
Hospital Revenue Code	302
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

CH PLATELET ASSOC AB IGM

Facility

$205.00

Service Code	HCPCS 86023
Hospital Charge Code	397073102
Hospital Revenue Code	302
Min. Negotiated Rate	$30.75
Max. Negotiated Rate	$30.75
Rate for Payer: Qualcare PPO/HMO/WC	$30.75

CH PLATELET ASSOC AB IGM

Facility

$205.00

Service Code	HCPCS 86023
Hospital Charge Code	397073102
Hospital Revenue Code	302
Min. Negotiated Rate	$6.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$40.37
Rate for Payer: Aetna Medicare Advantage	$12.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.65
Rate for Payer: Cigna Commercial	$12.46
Rate for Payer: Cigna Medicare Advantage	$6.23
Rate for Payer: Clover Medicare Advantage	$11.84
Rate for Payer: EmblemHealth Commercial	$37.38
Rate for Payer: Humana Medicare Advantage	$12.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.65
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.46
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.21
Rate for Payer: Wellcare Medicare Advantage	$12.46

CH PLATELET CONCENTRATE

Facility

$244.00

Service Code	HCPCS P9019
Hospital Charge Code	397031002
Hospital Revenue Code	390
Min. Negotiated Rate	$31.72
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$73.20
Rate for Payer: Aetna Medicare Advantage	$73.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.22
Rate for Payer: Cigna Commercial	$123.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.72
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.60
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH PLATELET CONCENTRATE

Facility

$244.00

Service Code	HCPCS P9019
Hospital Charge Code	397031002
Hospital Revenue Code	390
Min. Negotiated Rate	$36.60
Max. Negotiated Rate	$36.60
Rate for Payer: Qualcare PPO/HMO/WC	$36.60

CH PLATELET COUNT

Facility

$27.00

Service Code	HCPCS 85049
Hospital Charge Code	397021052
Hospital Revenue Code	301
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

CH PLATELET COUNT

Facility

$27.00

Service Code	HCPCS 85049
Hospital Charge Code	397021052
Hospital Revenue Code	301
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.52
Rate for Payer: Aetna Medicare Advantage	$4.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.41
Rate for Payer: Cigna Commercial	$4.48
Rate for Payer: Cigna Medicare Advantage	$2.24
Rate for Payer: Clover Medicare Advantage	$4.26
Rate for Payer: EmblemHealth Commercial	$13.44
Rate for Payer: Humana Medicare Advantage	$4.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.51
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.75
Rate for Payer: Wellcare Medicare Advantage	$4.48

CH PLATELET FUNCTION TEST

Facility

$390.00

Service Code	HCPCS 85576
Hospital Charge Code	397021096
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH PLATELET FUNCTION TEST

Facility

$390.00

Service Code	HCPCS 85576
Hospital Charge Code	397021096
Hospital Revenue Code	305
Min. Negotiated Rate	$12.46
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$80.71
Rate for Payer: Aetna Medicare Advantage	$24.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.91
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	$91.27
Rate for Payer: Cigna Commercial	$24.91
Rate for Payer: Cigna Medicare Advantage	$12.46
Rate for Payer: Clover Medicare Advantage	$23.66
Rate for Payer: EmblemHealth Commercial	$74.73
Rate for Payer: Humana Medicare Advantage	$25.66
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	$24.91
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$26.40
Rate for Payer: Wellcare Medicare Advantage	$24.91

CH PLATELET GLYCOPROTEIN AB

Facility

$728.00

Service Code	HCPCS 86023
Hospital Charge Code	397023256
Hospital Revenue Code	302
Min. Negotiated Rate	$109.20
Max. Negotiated Rate	$109.20
Rate for Payer: Qualcare PPO/HMO/WC	$109.20

CH PLATELET GLYCOPROTEIN AB

Facility

$728.00

Service Code	HCPCS 86023
Hospital Charge Code	397023256
Hospital Revenue Code	302
Min. Negotiated Rate	$6.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$40.37
Rate for Payer: Aetna Medicare Advantage	$12.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.65
Rate for Payer: Cigna Commercial	$12.46
Rate for Payer: Cigna Medicare Advantage	$6.23
Rate for Payer: Clover Medicare Advantage	$11.84
Rate for Payer: EmblemHealth Commercial	$37.38
Rate for Payer: Humana Medicare Advantage	$12.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$109.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.46
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.21
Rate for Payer: Wellcare Medicare Advantage	$12.46

CH PLATELET PHERESIS

Facility

$2,388.66

Hospital Charge Code	397031037
Hospital Revenue Code	390
Min. Negotiated Rate	$358.30
Max. Negotiated Rate	$358.30
Rate for Payer: Qualcare PPO/HMO/WC	$358.30

CH PLATELET PHERESIS

Facility

$2,388.66

Hospital Charge Code	397031037
Hospital Revenue Code	390
Min. Negotiated Rate	$310.53
Max. Negotiated Rate	$1,194.33
Rate for Payer: Aetna Commercial	$716.60
Rate for Payer: Aetna Medicare Advantage	$716.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$609.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$609.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$609.11
Rate for Payer: Cigna Commercial	$1,194.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.53
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$358.30
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH PLATELET PHERESIS HLA

Facility

$2,936.00

Service Code	HCPCS P9052
Hospital Charge Code	397031039
Hospital Revenue Code	390
Min. Negotiated Rate	$440.40
Max. Negotiated Rate	$440.40
Rate for Payer: Qualcare PPO/HMO/WC	$440.40

CH PLATELET PHERESIS HLA

Facility

$2,936.00

Service Code	HCPCS P9052
Hospital Charge Code	397031039
Hospital Revenue Code	390
Min. Negotiated Rate	$381.68
Max. Negotiated Rate	$1,650.43
Rate for Payer: Aetna Commercial	$880.80
Rate for Payer: Aetna Medicare Advantage	$880.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$748.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$748.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$748.68
Rate for Payer: Cigna Commercial	$1,650.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.68
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$440.40
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH PLATELET PHERESIS REF'D

Facility

$2,401.00

Service Code	HCPCS P9035
Hospital Charge Code	397031038
Hospital Revenue Code	390
Min. Negotiated Rate	$360.15
Max. Negotiated Rate	$360.15
Rate for Payer: Qualcare PPO/HMO/WC	$360.15

CH PLATELET PHERESIS REF'D

Facility

$2,401.00

Service Code	HCPCS P9035
Hospital Charge Code	397031038
Hospital Revenue Code	390
Min. Negotiated Rate	$312.13
Max. Negotiated Rate	$1,192.48
Rate for Payer: Aetna Commercial	$720.30
Rate for Payer: Aetna Medicare Advantage	$720.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.25
Rate for Payer: Cigna Commercial	$1,192.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.13
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.15
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH PLATELETS PHERESIS IRRAD

Facility

$2,606.00

Service Code	HCPCS P9036
Hospital Charge Code	397031164
Hospital Revenue Code	390
Min. Negotiated Rate	$390.90
Max. Negotiated Rate	$390.90
Rate for Payer: Qualcare PPO/HMO/WC	$390.90

CH PLATELETS PHERESIS IRRAD

Facility

$2,606.00

Service Code	HCPCS P9036
Hospital Charge Code	397031164
Hospital Revenue Code	390
Min. Negotiated Rate	$338.78
Max. Negotiated Rate	$2,212.32
Rate for Payer: Aetna Commercial	$781.80
Rate for Payer: Aetna Medicare Advantage	$781.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$664.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$664.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$664.53
Rate for Payer: Cigna Commercial	$2,212.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.78
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$390.90
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH PLATELETS PHERESIS LEUKO

Facility

$5,626.57

Service Code	HCPCS P9035
Hospital Charge Code	397031163
Hospital Revenue Code	390
Min. Negotiated Rate	$666.00
Max. Negotiated Rate	$1,687.97
Rate for Payer: Aetna Commercial	$1,687.97
Rate for Payer: Aetna Medicare Advantage	$1,687.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,434.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,434.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,434.78
Rate for Payer: Cigna Commercial	$1,192.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$731.45
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$843.99
Rate for Payer: UnitedHealthcare Commercial	$756.00

Know your out-of-pocket cost for care.

All Charges