Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH SMEAR COMPLEX STAIN

Facility

$107.00

Service Code	HCPCS 87209
Hospital Charge Code	397071451
Hospital Revenue Code	309
Min. Negotiated Rate	$8.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.26
Rate for Payer: Aetna Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.88
Rate for Payer: Cigna Commercial	$17.98
Rate for Payer: Cigna Medicare Advantage	$8.99
Rate for Payer: Clover Medicare Advantage	$17.08
Rate for Payer: EmblemHealth Commercial	$53.94
Rate for Payer: Humana Medicare Advantage	$18.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.06
Rate for Payer: Wellcare Medicare Advantage	$17.98

CH SODIUM

Facility

$40.00

Service Code	HCPCS 84295
Hospital Charge Code	397071107
Hospital Revenue Code	301
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.58
Rate for Payer: Aetna Medicare Advantage	$4.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.62
Rate for Payer: Cigna Commercial	$4.81
Rate for Payer: Cigna Medicare Advantage	$2.40
Rate for Payer: Clover Medicare Advantage	$4.57
Rate for Payer: EmblemHealth Commercial	$14.43
Rate for Payer: Humana Medicare Advantage	$4.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.10
Rate for Payer: Wellcare Medicare Advantage	$4.81

CH SODIUM

Facility

$40.00

Service Code	HCPCS 84295
Hospital Charge Code	397071107
Hospital Revenue Code	301
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CH SODIUM OTHER SOURCE

Facility

$30.00

Service Code	HCPCS 84302
Hospital Charge Code	397073682
Hospital Revenue Code	301
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

CH SODIUM OTHER SOURCE

Facility

$30.00

Service Code	HCPCS 84302
Hospital Charge Code	397073682
Hospital Revenue Code	301
Min. Negotiated Rate	$2.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.75
Rate for Payer: Aetna Medicare Advantage	$4.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.81
Rate for Payer: Cigna Commercial	$4.86
Rate for Payer: Cigna Medicare Advantage	$2.43
Rate for Payer: Clover Medicare Advantage	$4.62
Rate for Payer: EmblemHealth Commercial	$14.58
Rate for Payer: Humana Medicare Advantage	$5.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.86
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.15
Rate for Payer: Wellcare Medicare Advantage	$4.86

CH SODIUM RANDOM URINE

Facility

$97.57

Service Code	HCPCS 84300
Hospital Charge Code	397073111
Hospital Revenue Code	301
Min. Negotiated Rate	$14.64
Max. Negotiated Rate	$14.64
Rate for Payer: Qualcare PPO/HMO/WC	$14.64

CH SODIUM RANDOM URINE

Facility

$97.57

Service Code	HCPCS 84300
Hospital Charge Code	397073111
Hospital Revenue Code	301
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.39
Rate for Payer: Aetna Medicare Advantage	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.54
Rate for Payer: Cigna Commercial	$5.06
Rate for Payer: Cigna Medicare Advantage	$2.53
Rate for Payer: Clover Medicare Advantage	$4.81
Rate for Payer: EmblemHealth Commercial	$15.18
Rate for Payer: Humana Medicare Advantage	$5.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.68
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.64
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.06
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.36
Rate for Payer: Wellcare Medicare Advantage	$5.06

CH SODIUM URINE 24 HR

Facility

$78.00

Service Code	HCPCS 84300
Hospital Charge Code	397071255
Hospital Revenue Code	301
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.39
Rate for Payer: Aetna Medicare Advantage	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.54
Rate for Payer: Cigna Commercial	$5.06
Rate for Payer: Cigna Medicare Advantage	$2.53
Rate for Payer: Clover Medicare Advantage	$4.81
Rate for Payer: EmblemHealth Commercial	$15.18
Rate for Payer: Humana Medicare Advantage	$5.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.06
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.36
Rate for Payer: Wellcare Medicare Advantage	$5.06

CH SODIUM URINE 24 HR

Facility

$78.00

Service Code	HCPCS 84300
Hospital Charge Code	397071255
Hospital Revenue Code	301
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$11.70
Rate for Payer: Qualcare PPO/HMO/WC	$11.70

CH SOLUBLE LIVER AG

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	397043278
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH SOLUBLE LIVER AG

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	397043278
Hospital Revenue Code	301
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.95
Rate for Payer: Aetna Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.28
Rate for Payer: Cigna Commercial	$17.27
Rate for Payer: Cigna Medicare Advantage	$8.63
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
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	$17.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.31
Rate for Payer: Wellcare Medicare Advantage	$17.27

CH SOMATOMEDIN C

Facility

$714.00

Service Code	HCPCS 84305
Hospital Charge Code	397072125
Hospital Revenue Code	301
Min. Negotiated Rate	$10.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$68.88
Rate for Payer: Aetna Medicare Advantage	$21.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.90
Rate for Payer: Cigna Commercial	$21.26
Rate for Payer: Cigna Medicare Advantage	$10.63
Rate for Payer: Clover Medicare Advantage	$20.20
Rate for Payer: EmblemHealth Commercial	$63.78
Rate for Payer: Humana Medicare Advantage	$21.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$107.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.26
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.54
Rate for Payer: Wellcare Medicare Advantage	$21.26

CH SOMATOMEDIN C

Facility

$714.00

Service Code	HCPCS 84305
Hospital Charge Code	397072125
Hospital Revenue Code	301
Min. Negotiated Rate	$107.10
Max. Negotiated Rate	$107.10
Rate for Payer: Qualcare PPO/HMO/WC	$107.10

CH SOMATOSTATIN

Facility

$158.00

Service Code	HCPCS 84307
Hospital Charge Code	397071472
Hospital Revenue Code	301
Min. Negotiated Rate	$23.70
Max. Negotiated Rate	$23.70
Rate for Payer: Qualcare PPO/HMO/WC	$23.70

CH SOMATOSTATIN

Facility

$158.00

Service Code	HCPCS 84307
Hospital Charge Code	397071472
Hospital Revenue Code	301
Min. Negotiated Rate	$9.14
Max. Negotiated Rate	$723.02
Rate for Payer: Aetna Better Health Medicaid	$708.84
Rate for Payer: Aetna Commercial	$59.23
Rate for Payer: Aetna Medicare Advantage	$18.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.98
Rate for Payer: Cigna Commercial	$18.28
Rate for Payer: Cigna Medicare Advantage	$9.14
Rate for Payer: Clover Medicare Advantage	$17.37
Rate for Payer: EmblemHealth Commercial	$54.84
Rate for Payer: Humana Medicare Advantage	$18.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.28
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.38
Rate for Payer: Wellcare Medicare Advantage	$18.28
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$723.02

CH SPECIAL CULTURE

Facility

$390.00

Service Code	HCPCS 87070
Hospital Charge Code	397071520
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	$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	$8.62
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.14
Rate for Payer: Wellcare Medicare Advantage	$8.62

CH SPECIAL CULTURE

Facility

$390.00

Service Code	HCPCS 87070
Hospital Charge Code	397071520
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH SPECIAL STAINS GROUP I

Facility

$390.00

Service Code	HCPCS 88312
Hospital Charge Code	397061366
Hospital Revenue Code	310
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$124.10
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$62.63
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

CH SPECIAL STAINS GROUP I

Facility

$390.00

Service Code	HCPCS 88312
Hospital Charge Code	397061366
Hospital Revenue Code	310
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH SPECIAL STAINS GROUP II

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	397061365
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

CH SPECIAL STAINS GROUP II

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	397061365
Hospital Revenue Code	310
Min. Negotiated Rate	$46.48
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$201.60
Rate for Payer: Aetna Medicare Advantage	$201.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$46.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.80
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH SPECIFIC GRAVITY FLUID

Facility

$25.00

Service Code	HCPCS 84315
Hospital Charge Code	397073166
Hospital Revenue Code	301
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

CH SPECIFIC GRAVITY FLUID

Facility

$25.00

Service Code	HCPCS 84315
Hospital Charge Code	397073166
Hospital Revenue Code	301
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$10.63
Rate for Payer: Aetna Medicare Advantage	$3.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.02
Rate for Payer: Cigna Commercial	$3.28
Rate for Payer: Cigna Medicare Advantage	$1.64
Rate for Payer: Clover Medicare Advantage	$3.12
Rate for Payer: EmblemHealth Commercial	$9.84
Rate for Payer: Humana Medicare Advantage	$3.38
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	$3.28
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.48
Rate for Payer: Wellcare Medicare Advantage	$3.28

CH SPECIFIC GRAVITY URINE

Facility

$22.00

Service Code	HCPCS 81003
Hospital Charge Code	397073028
Hospital Revenue Code	307
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.29
Rate for Payer: Aetna Medicare Advantage	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.24
Rate for Payer: Cigna Commercial	$2.25
Rate for Payer: Cigna Medicare Advantage	$1.12
Rate for Payer: Clover Medicare Advantage	$2.14
Rate for Payer: EmblemHealth Commercial	$6.75
Rate for Payer: Humana Medicare Advantage	$2.32
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	$2.25
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.38
Rate for Payer: Wellcare Medicare Advantage	$2.25

CH SPECIFIC GRAVITY URINE

Facility

$22.00

Service Code	HCPCS 81003
Hospital Charge Code	397073028
Hospital Revenue Code	307
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

Know your out-of-pocket cost for care.

All Charges