Heights University Hospital

All Charges

Charge

Type

Setting

Price

Chronic Uticaria panel C

Facility

$390.00

Service Code	HCPCS 86376
Hospital Charge Code	39708021C
Hospital Revenue Code	302
Min. Negotiated Rate	$7.28
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.14
Rate for Payer: Aetna Medicare Advantage	$14.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.31
Rate for Payer: Cigna Commercial	$14.55
Rate for Payer: Cigna Medicare Advantage	$7.28
Rate for Payer: Clover Medicare Advantage	$13.82
Rate for Payer: EmblemHealth Commercial	$43.65
Rate for Payer: Humana Medicare Advantage	$14.99
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	$14.55
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.42
Rate for Payer: Wellcare Medicare Advantage	$14.55

Chronic Uticaria panel D

Facility

$390.00

Service Code	HCPCS 86800
Hospital Charge Code	39708021D
Hospital Revenue Code	302
Min. Negotiated Rate	$7.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$51.55
Rate for Payer: Aetna Medicare Advantage	$15.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.29
Rate for Payer: Cigna Commercial	$15.91
Rate for Payer: Cigna Medicare Advantage	$7.96
Rate for Payer: Clover Medicare Advantage	$15.11
Rate for Payer: EmblemHealth Commercial	$47.73
Rate for Payer: Humana Medicare Advantage	$16.39
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	$15.91
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.86
Rate for Payer: Wellcare Medicare Advantage	$15.91

Chronic Uticaria panel D

Facility

$390.00

Service Code	HCPCS 86800
Hospital Charge Code	39708021D
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CHRONOS 10cc

Facility

$2,960.20

Hospital Charge Code	270639428
Hospital Revenue Code	278
Min. Negotiated Rate	$444.03
Max. Negotiated Rate	$1,480.10
Rate for Payer: Aetna Commercial	$888.06
Rate for Payer: Aetna Medicare Advantage	$888.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$754.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$754.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$592.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$754.85
Rate for Payer: Cigna Commercial	$1,480.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$716.37
Rate for Payer: Qualcare PPO/HMO/WC	$444.03

CHRONOS 10cc

Facility

$2,960.20

Hospital Charge Code	270639428
Hospital Revenue Code	278
Min. Negotiated Rate	$444.03
Max. Negotiated Rate	$716.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$592.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$716.37
Rate for Payer: Qualcare PPO/HMO/WC	$444.03

CHRONOS GRANULE 1.4-2.8mm/20cc

Facility

$4,227.10

Hospital Charge Code	270645879
Hospital Revenue Code	278
Min. Negotiated Rate	$634.07
Max. Negotiated Rate	$1,022.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$845.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,022.96
Rate for Payer: Qualcare PPO/HMO/WC	$634.07

CHRONOS GRANULE 1.4-2.8mm/20cc

Facility

$4,227.10

Hospital Charge Code	270645879
Hospital Revenue Code	278
Min. Negotiated Rate	$634.07
Max. Negotiated Rate	$2,113.55
Rate for Payer: Aetna Commercial	$1,268.13
Rate for Payer: Aetna Medicare Advantage	$1,268.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,077.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,077.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$845.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,077.91
Rate for Payer: Cigna Commercial	$2,113.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,022.96
Rate for Payer: Qualcare PPO/HMO/WC	$634.07

CHRONULAC/10GM/15ML

Facility

$293.00

Hospital Charge Code	60632698
Hospital Revenue Code	250
Min. Negotiated Rate	$43.95
Max. Negotiated Rate	$43.95
Rate for Payer: Qualcare PPO/HMO/WC	$43.95

CHRONULAC/10GM/15ML

Facility

$293.00

Hospital Charge Code	60632698
Hospital Revenue Code	250
Min. Negotiated Rate	$38.09
Max. Negotiated Rate	$146.50
Rate for Payer: Aetna Commercial	$87.90
Rate for Payer: Aetna Medicare Advantage	$87.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.72
Rate for Payer: Cigna Commercial	$146.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.09
Rate for Payer: Oxford Commercial	$146.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.95
Rate for Payer: UnitedHealthcare Commercial	$146.50

CH ROSETTE TEST

Facility

$390.00

Service Code	HCPCS 85461
Hospital Charge Code	397031055
Hospital Revenue Code	305
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.33
Rate for Payer: Aetna Medicare Advantage	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.30
Rate for Payer: Cigna Commercial	$9.36
Rate for Payer: Cigna Medicare Advantage	$4.68
Rate for Payer: Clover Medicare Advantage	$8.89
Rate for Payer: EmblemHealth Commercial	$28.08
Rate for Payer: Humana Medicare Advantage	$9.64
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	$9.36
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.92
Rate for Payer: Wellcare Medicare Advantage	$9.36

CH ROSETTE TEST

Facility

$390.00

Service Code	HCPCS 85461
Hospital Charge Code	397031055
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CHROSOME COUNT 5C,1KW BANDING

Facility

$1,251.60

Service Code	HCPCS 88261
Hospital Charge Code	38477215
Hospital Revenue Code	311
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$968.54
Rate for Payer: Aetna Commercial	$856.46
Rate for Payer: Aetna Medicare Advantage	$264.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$968.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$968.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$264.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$968.54
Rate for Payer: Cigna Commercial	$264.34
Rate for Payer: Cigna Medicare Advantage	$132.17
Rate for Payer: Clover Medicare Advantage	$251.12
Rate for Payer: EmblemHealth Commercial	$793.02
Rate for Payer: Humana Medicare Advantage	$272.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.71
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.74
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$264.34
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$280.20
Rate for Payer: Wellcare Medicare Advantage	$264.34

CHROSOME COUNT 5C,1KW BANDING

Facility

$1,251.60

Service Code	HCPCS 88261
Hospital Charge Code	38477215
Hospital Revenue Code	311
Min. Negotiated Rate	$187.74
Max. Negotiated Rate	$187.74
Rate for Payer: Qualcare PPO/HMO/WC	$187.74

CH ROTAVIRUS AG

Facility

$390.00

Service Code	HCPCS 87425
Hospital Charge Code	397041145
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH ROTAVIRUS AG

Facility

$390.00

Service Code	HCPCS 87425
Hospital Charge Code	397041145
Hospital Revenue Code	306
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.82
Rate for Payer: Aetna Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.89
Rate for Payer: Cigna Commercial	$11.98
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
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	$11.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.70
Rate for Payer: Wellcare Medicare Advantage	$11.98

CH RUBELLA AB IGG

Facility

$667.59

Service Code	HCPCS 86762
Hospital Charge Code	397041197
Hospital Revenue Code	302
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.72
Rate for Payer: Cigna Commercial	$14.39
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

CH RUBELLA AB IGG

Facility

$667.59

Service Code	HCPCS 86762
Hospital Charge Code	397041197
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CH RUBELLA AB (IGG) QUANT

Facility

$25.00

Service Code	HCPCS 86762
Hospital Charge Code	397071413
Hospital Revenue Code	302
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

CH RUBELLA AB (IGG) QUANT

Facility

$25.00

Service Code	HCPCS 86762
Hospital Charge Code	397071413
Hospital Revenue Code	302
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.72
Rate for Payer: Cigna Commercial	$14.39
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

CH SALICYLATE

Facility

$194.00

Service Code	HCPCS 80329
Hospital Charge Code	397071280
Hospital Revenue Code	301
Min. Negotiated Rate	$25.22
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.20
Rate for Payer: Aetna Medicare Advantage	$58.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.47
Rate for Payer: Cigna Commercial	$97.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.22
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.10
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH SALICYLATE

Facility

$194.00

Service Code	HCPCS 80329
Hospital Charge Code	397071280
Hospital Revenue Code	301
Min. Negotiated Rate	$29.10
Max. Negotiated Rate	$29.10
Rate for Payer: Qualcare PPO/HMO/WC	$29.10

CH SECOND MRSA SCREEN

Facility

$667.59

Service Code	HCPCS 87070
Hospital Charge Code	397043274
Hospital Revenue Code	306
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CH SECOND MRSA SCREEN

Facility

$667.59

Service Code	HCPCS 87070
Hospital Charge Code	397043274
Hospital Revenue Code	306
Min. Negotiated Rate	$4.31
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$27.93
Rate for Payer: Aetna Medicare Advantage	$8.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.62
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	$31.58
Rate for Payer: Cigna Commercial	$8.62
Rate for Payer: Cigna Medicare Advantage	$4.31
Rate for Payer: Clover Medicare Advantage	$8.19
Rate for Payer: EmblemHealth Commercial	$25.86
Rate for Payer: Humana Medicare Advantage	$8.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.62
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.14
Rate for Payer: Wellcare Medicare Advantage	$8.62

CH SEDIMENTATION RATE-AUTO

Facility

$80.00

Service Code	HCPCS 85652
Hospital Charge Code	397021010
Hospital Revenue Code	305
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

CH SEDIMENTATION RATE-AUTO

Facility

$80.00

Service Code	HCPCS 85652
Hospital Charge Code	397021010
Hospital Revenue Code	305
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$8.75
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.89
Rate for Payer: Cigna Commercial	$2.70
Rate for Payer: Cigna Medicare Advantage	$1.35
Rate for Payer: Clover Medicare Advantage	$2.56
Rate for Payer: EmblemHealth Commercial	$8.10
Rate for Payer: Humana Medicare Advantage	$2.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.70
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.86
Rate for Payer: Wellcare Medicare Advantage	$2.70

Know your out-of-pocket cost for care.

All Charges