Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

CH PLATELETS PHER IRRAD LEUK

Facility

$2,387.00

Service Code	HCPCS P9037
Hospital Charge Code	397031165
Hospital Revenue Code	390
Min. Negotiated Rate	$358.05
Max. Negotiated Rate	$358.05
Rate for Payer: Qualcare PPO/HMO/WC	$358.05

CH PLATELETS PHER IRRAD LEUK

Facility

$2,387.00

Service Code	HCPCS P9037
Hospital Charge Code	397031165
Hospital Revenue Code	390
Min. Negotiated Rate	$310.31
Max. Negotiated Rate	$1,586.44
Rate for Payer: Aetna Commercial	$716.10
Rate for Payer: Aetna Medicare Advantage	$716.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$608.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$608.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$608.68
Rate for Payer: Cigna Commercial	$1,586.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$310.31
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$358.05
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH PLATELETS RANDOM LEUKORED

Facility

$326.00

Service Code	HCPCS P9031
Hospital Charge Code	397031161
Hospital Revenue Code	390
Min. Negotiated Rate	$42.38
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$97.80
Rate for Payer: Aetna Medicare Advantage	$97.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.13
Rate for Payer: Cigna Commercial	$336.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.38
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.90
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH PLATELETS RANDOM LEUKORED

Facility

$326.00

Service Code	HCPCS P9031
Hospital Charge Code	397031161
Hospital Revenue Code	390
Min. Negotiated Rate	$48.90
Max. Negotiated Rate	$48.90
Rate for Payer: Qualcare PPO/HMO/WC	$48.90

CH PLATELETS RAN LEUKO IRRAD

Facility

$701.00

Service Code	HCPCS P9033
Hospital Charge Code	397031162
Hospital Revenue Code	390
Min. Negotiated Rate	$91.13
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$210.30
Rate for Payer: Aetna Medicare Advantage	$210.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.75
Rate for Payer: Cigna Commercial	$441.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.13
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.15
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH PLATELETS RAN LEUKO IRRAD

Facility

$701.00

Service Code	HCPCS P9033
Hospital Charge Code	397031162
Hospital Revenue Code	390
Min. Negotiated Rate	$105.15
Max. Negotiated Rate	$105.15
Rate for Payer: Qualcare PPO/HMO/WC	$105.15

CH PLETS PHER LEUK CMV NEG

Facility

$2,518.60

Service Code	HCPCS P9055
Hospital Charge Code	397031170
Hospital Revenue Code	390
Min. Negotiated Rate	$377.79
Max. Negotiated Rate	$377.79
Rate for Payer: Qualcare PPO/HMO/WC	$377.79

CH PLETS PHER LEUK CMV NEG

Facility

$2,518.60

Service Code	HCPCS P9055
Hospital Charge Code	397031170
Hospital Revenue Code	390
Min. Negotiated Rate	$327.42
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$755.58
Rate for Payer: Aetna Medicare Advantage	$755.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$642.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$642.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$642.24
Rate for Payer: Cigna Commercial	$583.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$327.42
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$377.79
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH PLT COUNT MANUAL

Facility

$60.00

Service Code	HCPCS 85032
Hospital Charge Code	397021075
Hospital Revenue Code	301
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	$5.61
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	$7.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
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 PLT COUNT MANUAL

Facility

$60.00

Service Code	HCPCS 85032
Hospital Charge Code	397021075
Hospital Revenue Code	301
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

CH PLTS PH LEUK CMV NEG IRRD

Facility

$4,463.55

Service Code	HCPCS P9053
Hospital Charge Code	397031168
Hospital Revenue Code	390
Min. Negotiated Rate	$580.26
Max. Negotiated Rate	$1,339.07
Rate for Payer: Aetna Commercial	$1,339.07
Rate for Payer: Aetna Medicare Advantage	$1,339.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,138.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,138.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,138.21
Rate for Payer: Cigna Commercial	$1,173.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$580.26
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$669.53
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH PLTS PH LEUK CMV NEG IRRD

Facility

$4,463.55

Service Code	HCPCS P9053
Hospital Charge Code	397031168
Hospital Revenue Code	390
Min. Negotiated Rate	$669.53
Max. Negotiated Rate	$669.53
Rate for Payer: Qualcare PPO/HMO/WC	$669.53

CH PM-SCL ANTIBODY

Facility

$118.00

Service Code	HCPCS 86235
Hospital Charge Code	397071522
Hospital Revenue Code	302
Min. Negotiated Rate	$8.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.09
Rate for Payer: Aetna Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.70
Rate for Payer: Cigna Commercial	$17.93
Rate for Payer: Cigna Medicare Advantage	$8.96
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.01
Rate for Payer: Wellcare Medicare Advantage	$17.93

CH PM-SCL ANTIBODY

Facility

$118.00

Service Code	HCPCS 86235
Hospital Charge Code	397071522
Hospital Revenue Code	302
Min. Negotiated Rate	$17.70
Max. Negotiated Rate	$17.70
Rate for Payer: Qualcare PPO/HMO/WC	$17.70

CH POOLED PLASMA SD TREATED

Facility

$731.00

Service Code	HCPCS P9023
Hospital Charge Code	397031150
Hospital Revenue Code	390
Min. Negotiated Rate	$95.03
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$219.30
Rate for Payer: Aetna Medicare Advantage	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.41
Rate for Payer: Cigna Commercial	$130.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.03
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$109.65
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH POOLED PLASMA SD TREATED

Facility

$731.00

Service Code	HCPCS P9023
Hospital Charge Code	397031150
Hospital Revenue Code	390
Min. Negotiated Rate	$109.65
Max. Negotiated Rate	$109.65
Rate for Payer: Qualcare PPO/HMO/WC	$109.65

CH POOLING COMPONENT

Facility

$125.00

Service Code	HCPCS 86965
Hospital Charge Code	397031054
Hospital Revenue Code	300
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

CH POOLING COMPONENT

Facility

$125.00

Service Code	HCPCS 86965
Hospital Charge Code	397031054
Hospital Revenue Code	300
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH PORK (F26) IGE

Facility

$31.00

Service Code	HCPCS 86003
Hospital Charge Code	397071500
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	$4.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.65
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 PORK (F26) IGE

Facility

$31.00

Service Code	HCPCS 86003
Hospital Charge Code	397071500
Hospital Revenue Code	305
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$4.65
Rate for Payer: Qualcare PPO/HMO/WC	$4.65

CH PORPHOBILINOGEN QUANT

Facility

$60.00

Service Code	HCPCS 84110
Hospital Charge Code	397071253
Hospital Revenue Code	301
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$27.35
Rate for Payer: Aetna Medicare Advantage	$8.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.92
Rate for Payer: Cigna Commercial	$8.44
Rate for Payer: Cigna Medicare Advantage	$4.22
Rate for Payer: Clover Medicare Advantage	$8.02
Rate for Payer: EmblemHealth Commercial	$25.32
Rate for Payer: Humana Medicare Advantage	$8.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.44
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.95
Rate for Payer: Wellcare Medicare Advantage	$8.44

CH PORPHOBILINOGEN QUANT

Facility

$60.00

Service Code	HCPCS 84110
Hospital Charge Code	397071253
Hospital Revenue Code	301
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

CH PORPHYRINS QUANT & FRACT

Facility

$336.00

Service Code	HCPCS 84120
Hospital Charge Code	397071016
Hospital Revenue Code	301
Min. Negotiated Rate	$7.36
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.66
Rate for Payer: Aetna Medicare Advantage	$14.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.90
Rate for Payer: Cigna Commercial	$14.71
Rate for Payer: Cigna Medicare Advantage	$7.36
Rate for Payer: Clover Medicare Advantage	$13.97
Rate for Payer: EmblemHealth Commercial	$44.13
Rate for Payer: Humana Medicare Advantage	$15.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.68
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.71
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.59
Rate for Payer: Wellcare Medicare Advantage	$14.71

CH PORPHYRINS QUANT & FRACT

Facility

$336.00

Service Code	HCPCS 84120
Hospital Charge Code	397071016
Hospital Revenue Code	301
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$50.40
Rate for Payer: Qualcare PPO/HMO/WC	$50.40

Know your out-of-pocket cost for care.

All Charges