Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH STAIN, METHENAMINE SILVER

Facility

$526.40

Service Code	HCPCS 88312
Hospital Charge Code	397061066
Hospital Revenue Code	310
Min. Negotiated Rate	$62.63
Max. Negotiated Rate	$157.92
Rate for Payer: Aetna Commercial	$157.92
Rate for Payer: Aetna Medicare Advantage	$157.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$134.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$134.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$134.23
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$62.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.96
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH STAIN, MUCICARMINE

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	397061064
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 STAIN, MUCICARMINE

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	397061064
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

CH STAIN PAS

Facility

$390.00

Service Code	HCPCS 88312
Hospital Charge Code	397061367
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 STAIN PAS

Facility

$390.00

Service Code	HCPCS 88312
Hospital Charge Code	397061367
Hospital Revenue Code	310
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH STAIN, PAS

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	397061069
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 STAIN, PAS

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	397061069
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

CH STAIN, PTAH

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	397061057
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 STAIN, PTAH

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	397061057
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

CH STAIN, RETICULUM

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	397061068
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

CH STAIN, RETICULUM

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	397061068
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 STAIN, TRICHROME

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	397061060
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 STAIN, TRICHROME

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	397061060
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

CH STAIN, VERHOEFE ELASTICA

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	397061055
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

CH STAIN, VERHOEFE ELASTICA

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	397061055
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 STREP A ANTIGEN, THROAT

Facility

$75.10

Service Code	HCPCS 87430
Hospital Charge Code	397041337
Hospital Revenue Code	306
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.46
Rate for Payer: Aetna Medicare Advantage	$16.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.59
Rate for Payer: Cigna Commercial	$16.81
Rate for Payer: Cigna Medicare Advantage	$8.40
Rate for Payer: Clover Medicare Advantage	$15.97
Rate for Payer: EmblemHealth Commercial	$50.43
Rate for Payer: Humana Medicare Advantage	$17.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.27
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.82
Rate for Payer: Wellcare Medicare Advantage	$16.81

CH STREP A ANTIGEN, THROAT

Facility

$75.10

Service Code	HCPCS 87430
Hospital Charge Code	397041337
Hospital Revenue Code	306
Min. Negotiated Rate	$11.27
Max. Negotiated Rate	$11.27
Rate for Payer: Qualcare PPO/HMO/WC	$11.27

CH STRIATIONAL AUTOANTIBODY

Facility

$116.00

Service Code	HCPCS 86256
Hospital Charge Code	397073273
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

CH STRIATIONAL AUTOANTIBODY

Facility

$116.00

Service Code	HCPCS 86256
Hospital Charge Code	397073273
Hospital Revenue Code	302
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

CH SULFATIDE AUTOANTIBODY

Facility

$701.00

Service Code	HCPCS 83520
Hospital Charge Code	397073554
Hospital Revenue Code	301
Min. Negotiated Rate	$105.15
Max. Negotiated Rate	$105.15
Rate for Payer: Qualcare PPO/HMO/WC	$105.15

CH SULFATIDE AUTOANTIBODY

Facility

$701.00

Service Code	HCPCS 83520
Hospital Charge Code	397073554
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	$91.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.15
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 SULFONYLUREA

Facility

$621.00

Service Code	HCPCS 80300
Hospital Charge Code	397073666
Hospital Revenue Code	301
Min. Negotiated Rate	$93.15
Max. Negotiated Rate	$93.15
Rate for Payer: Qualcare PPO/HMO/WC	$93.15

CH SULFONYLUREA

Facility

$621.00

Service Code	HCPCS 80300
Hospital Charge Code	397073666
Hospital Revenue Code	301
Min. Negotiated Rate	$80.73
Max. Negotiated Rate	$310.50
Rate for Payer: Aetna Commercial	$186.30
Rate for Payer: Aetna Medicare Advantage	$186.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.35
Rate for Payer: Cigna Commercial	$310.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.15
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH SURESWAB VAGINO VGNIT PLS

Facility

$2,958.00

Hospital Charge Code	3970737
Hospital Revenue Code	301
Min. Negotiated Rate	$443.70
Max. Negotiated Rate	$443.70
Rate for Payer: Qualcare PPO/HMO/WC	$443.70

CH SURESWAB VAGINO VGNIT PLS

Facility

$2,958.00

Hospital Charge Code	3970737
Hospital Revenue Code	301
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$1,479.00
Rate for Payer: Aetna Commercial	$887.40
Rate for Payer: Aetna Medicare Advantage	$887.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$754.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$754.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$754.29
Rate for Payer: Cigna Commercial	$1,479.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$443.70
Rate for Payer: UnitedHealthcare Commercial	$114.00

Know your out-of-pocket cost for care.

All Charges