Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH REFERRED ANTIGEN TESTING

Facility

$260.00

Service Code	HCPCS 86902
Hospital Charge Code	397031132
Hospital Revenue Code	300
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00

CH REFRRD ANTIBODY ID -BASIC

Facility

$1,004.00

Service Code	HCPCS 86870
Hospital Charge Code	397031130
Hospital Revenue Code	300
Min. Negotiated Rate	$150.60
Max. Negotiated Rate	$150.60
Rate for Payer: Qualcare PPO/HMO/WC	$150.60

CH REFRRD ANTIBODY ID -BASIC

Facility

$1,004.00

Service Code	HCPCS 86870
Hospital Charge Code	397031130
Hospital Revenue Code	300
Min. Negotiated Rate	$16.83
Max. Negotiated Rate	$853.60
Rate for Payer: Aetna Commercial	$301.20
Rate for Payer: Aetna Medicare Advantage	$301.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.02
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	$256.02
Rate for Payer: Cigna Commercial	$853.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.52
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.60
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH REFRRD ANTIBODY ID-COMPLX

Facility

$1,594.00

Service Code	HCPCS 86870
Hospital Charge Code	397031131
Hospital Revenue Code	300
Min. Negotiated Rate	$239.10
Max. Negotiated Rate	$239.10
Rate for Payer: Qualcare PPO/HMO/WC	$239.10

CH REFRRD ANTIBODY ID-COMPLX

Facility

$1,594.00

Service Code	HCPCS 86870
Hospital Charge Code	397031131
Hospital Revenue Code	300
Min. Negotiated Rate	$16.83
Max. Negotiated Rate	$853.60
Rate for Payer: Aetna Commercial	$478.20
Rate for Payer: Aetna Medicare Advantage	$478.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$406.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$406.47
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	$406.47
Rate for Payer: Cigna Commercial	$853.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.22
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$239.10
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH RENAL FUNCTION PANEL

Facility

$183.00

Service Code	HCPCS 80069
Hospital Charge Code	397073342
Hospital Revenue Code	301
Min. Negotiated Rate	$27.45
Max. Negotiated Rate	$27.45
Rate for Payer: Qualcare PPO/HMO/WC	$27.45

CH RENAL FUNCTION PANEL

Facility

$183.00

Service Code	HCPCS 80069
Hospital Charge Code	397073342
Hospital Revenue Code	301
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$28.12
Rate for Payer: Aetna Medicare Advantage	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.80
Rate for Payer: Cigna Commercial	$8.68
Rate for Payer: Cigna Medicare Advantage	$4.34
Rate for Payer: Clover Medicare Advantage	$8.25
Rate for Payer: EmblemHealth Commercial	$26.04
Rate for Payer: Humana Medicare Advantage	$8.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.68
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.20
Rate for Payer: Wellcare Medicare Advantage	$8.68

CH RENIN

Facility

$204.00

Service Code	HCPCS 84244
Hospital Charge Code	397072015
Hospital Revenue Code	301
Min. Negotiated Rate	$10.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$71.25
Rate for Payer: Aetna Medicare Advantage	$21.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.57
Rate for Payer: Cigna Commercial	$21.99
Rate for Payer: Cigna Medicare Advantage	$10.99
Rate for Payer: Clover Medicare Advantage	$20.89
Rate for Payer: EmblemHealth Commercial	$65.97
Rate for Payer: Humana Medicare Advantage	$22.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.52
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.99
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$23.31
Rate for Payer: Wellcare Medicare Advantage	$21.99

CH RENIN

Facility

$204.00

Service Code	HCPCS 84244
Hospital Charge Code	397072015
Hospital Revenue Code	301
Min. Negotiated Rate	$30.60
Max. Negotiated Rate	$30.60
Rate for Payer: Qualcare PPO/HMO/WC	$30.60

CH RETICULOCYTE COUNT

Facility

$59.00

Hospital Charge Code	397021018
Hospital Revenue Code	305
Min. Negotiated Rate	$8.85
Max. Negotiated Rate	$8.85
Rate for Payer: Qualcare PPO/HMO/WC	$8.85

CH RETICULOCYTE COUNT

Facility

$59.00

Hospital Charge Code	397021018
Hospital Revenue Code	305
Min. Negotiated Rate	$7.67
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.70
Rate for Payer: Aetna Medicare Advantage	$17.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.04
Rate for Payer: Cigna Commercial	$29.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.85
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH REVERSE TRANSCRIPTION

Facility

$67.00

Service Code	HCPCS 83902
Hospital Charge Code	397073292
Hospital Revenue Code	301
Min. Negotiated Rate	$8.71
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$20.10
Rate for Payer: Aetna Medicare Advantage	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.09
Rate for Payer: Cigna Commercial	$33.50
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

CH REVERSE TRANSCRIPTION

Facility

$67.00

Service Code	HCPCS 83902
Hospital Charge Code	397073292
Hospital Revenue Code	301
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

CH REVERSE TRANSCRIPTION

Facility

$67.00

Service Code	HCPCS 83902
Hospital Charge Code	397073299
Hospital Revenue Code	301
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

CH REVERSE TRANSCRIPTION

Facility

$67.00

Service Code	HCPCS 83902
Hospital Charge Code	397073299
Hospital Revenue Code	301
Min. Negotiated Rate	$8.71
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$20.10
Rate for Payer: Aetna Medicare Advantage	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.09
Rate for Payer: Cigna Commercial	$33.50
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

CH RHOGAM

Facility

$139.25

Service Code	HCPCS J2792
Hospital Charge Code	397031022
Hospital Revenue Code	636
Min. Negotiated Rate	$20.89
Max. Negotiated Rate	$41.77
Rate for Payer: Aetna Commercial	$41.77
Rate for Payer: Aetna Medicare Advantage	$41.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.89

CH RHOGAM

Facility

$139.25

Service Code	HCPCS J2792
Hospital Charge Code	397031022
Hospital Revenue Code	636
Min. Negotiated Rate	$20.89
Max. Negotiated Rate	$33.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.89

CH RIFAMPIN (SERUM) HPLC

Facility

$390.00

Service Code	HCPCS 80299
Hospital Charge Code	397073660
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	$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	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

CH RIFAMPIN (SERUM) HPLC

Facility

$390.00

Service Code	HCPCS 80299
Hospital Charge Code	397073660
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH RISPERAL

Facility

$378.00

Service Code	HCPCS 80299
Hospital Charge Code	397073198
Hospital Revenue Code	301
Min. Negotiated Rate	$56.70
Max. Negotiated Rate	$56.70
Rate for Payer: Qualcare PPO/HMO/WC	$56.70

CH RISPERAL

Facility

$378.00

Service Code	HCPCS 80299
Hospital Charge Code	397073198
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	$49.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.70
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 RISPERDONE

Facility

$268.00

Service Code	HCPCS 80299
Hospital Charge Code	397071363
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	$34.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.20
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 RISPERDONE

Facility

$268.00

Service Code	HCPCS 80299
Hospital Charge Code	397071363
Hospital Revenue Code	301
Min. Negotiated Rate	$40.20
Max. Negotiated Rate	$40.20
Rate for Payer: Qualcare PPO/HMO/WC	$40.20

CH RISTOCETIN CO-FACTOR

Facility

$152.00

Service Code	HCPCS 85245
Hospital Charge Code	397073078
Hospital Revenue Code	305
Min. Negotiated Rate	$22.80
Max. Negotiated Rate	$22.80
Rate for Payer: Qualcare PPO/HMO/WC	$22.80

CH RISTOCETIN CO-FACTOR

Facility

$152.00

Service Code	HCPCS 85245
Hospital Charge Code	397073078
Hospital Revenue Code	305
Min. Negotiated Rate	$11.47
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$74.33
Rate for Payer: Aetna Medicare Advantage	$22.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.94
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	$84.05
Rate for Payer: Cigna Commercial	$22.94
Rate for Payer: Cigna Medicare Advantage	$11.47
Rate for Payer: Clover Medicare Advantage	$21.79
Rate for Payer: EmblemHealth Commercial	$68.82
Rate for Payer: Humana Medicare Advantage	$23.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.94
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.32
Rate for Payer: Wellcare Medicare Advantage	$22.94

Know your out-of-pocket cost for care.

All Charges