Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH TESTOSTERONE FREE

Facility

$180.00

Service Code	HCPCS 84402
Hospital Charge Code	397073302
Hospital Revenue Code	301
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

CH THALLIUM BLOOD

Facility

$171.00

Service Code	HCPCS 83018
Hospital Charge Code	397073678
Hospital Revenue Code	301
Min. Negotiated Rate	$25.65
Max. Negotiated Rate	$25.65
Rate for Payer: Qualcare PPO/HMO/WC	$25.65

CH THALLIUM BLOOD

Facility

$171.00

Service Code	HCPCS 83018
Hospital Charge Code	397073678
Hospital Revenue Code	301
Min. Negotiated Rate	$10.98
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$71.15
Rate for Payer: Aetna Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
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	$80.46
Rate for Payer: Cigna Commercial	$21.96
Rate for Payer: Cigna Medicare Advantage	$10.98
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.23
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$23.28
Rate for Payer: Wellcare Medicare Advantage	$21.96

CH THC DAU

Facility

$44.00

Service Code	HCPCS 80300
Hospital Charge Code	397071293
Hospital Revenue Code	301
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.20
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.72
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH THC DAU

Facility

$44.00

Service Code	HCPCS 80300
Hospital Charge Code	397071293
Hospital Revenue Code	301
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

CH THC, URINE (RANDOM)

Facility

$37.00

Service Code	HCPCS 80300
Hospital Charge Code	397071367
Hospital Revenue Code	301
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$11.10
Rate for Payer: Aetna Medicare Advantage	$11.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.44
Rate for Payer: Cigna Commercial	$18.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.81
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.55
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH THC, URINE (RANDOM)

Facility

$37.00

Service Code	HCPCS 80300
Hospital Charge Code	397071367
Hospital Revenue Code	301
Min. Negotiated Rate	$5.55
Max. Negotiated Rate	$5.55
Rate for Payer: Qualcare PPO/HMO/WC	$5.55

CH THEOPHYLLINE

Facility

$128.00

Service Code	HCPCS 80198
Hospital Charge Code	397071103
Hospital Revenue Code	301
Min. Negotiated Rate	$7.07
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$45.81
Rate for Payer: Aetna Medicare Advantage	$14.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.81
Rate for Payer: Cigna Commercial	$14.14
Rate for Payer: Cigna Medicare Advantage	$7.07
Rate for Payer: Clover Medicare Advantage	$13.43
Rate for Payer: EmblemHealth Commercial	$42.42
Rate for Payer: Humana Medicare Advantage	$14.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.14
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.99
Rate for Payer: Wellcare Medicare Advantage	$14.14

CH THEOPHYLLINE

Facility

$128.00

Service Code	HCPCS 80198
Hospital Charge Code	397071103
Hospital Revenue Code	301
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CH THER PLASMA APHERESIS

Facility

$12,480.00

Service Code	HCPCS 36514
Hospital Charge Code	397031175
Hospital Revenue Code	361
Min. Negotiated Rate	$1,622.40
Max. Negotiated Rate	$3,744.00
Rate for Payer: Aetna Commercial	$3,744.00
Rate for Payer: Aetna Medicare Advantage	$3,744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,182.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,182.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,182.40
Rate for Payer: Cigna Commercial	$3,708.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,622.40
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,872.00
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CH THER PLASMA APHERESIS

Facility

$12,480.00

Service Code	HCPCS 36514
Hospital Charge Code	397031175
Hospital Revenue Code	361
Min. Negotiated Rate	$1,872.00
Max. Negotiated Rate	$1,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,872.00

CH THIOCYANATE SERUM

Facility

$226.00

Service Code	HCPCS 84430
Hospital Charge Code	397073093
Hospital Revenue Code	301
Min. Negotiated Rate	$5.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.68
Rate for Payer: Aetna Medicare Advantage	$11.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.61
Rate for Payer: Cigna Commercial	$11.63
Rate for Payer: Cigna Medicare Advantage	$5.82
Rate for Payer: Clover Medicare Advantage	$11.05
Rate for Payer: EmblemHealth Commercial	$34.89
Rate for Payer: Humana Medicare Advantage	$11.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.63
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.33
Rate for Payer: Wellcare Medicare Advantage	$11.63

CH THIOCYANATE SERUM

Facility

$226.00

Service Code	HCPCS 84430
Hospital Charge Code	397073093
Hospital Revenue Code	301
Min. Negotiated Rate	$33.90
Max. Negotiated Rate	$33.90
Rate for Payer: Qualcare PPO/HMO/WC	$33.90

CH THIOCYANATE URINE

Facility

$139.00

Service Code	HCPCS 84430
Hospital Charge Code	397073092
Hospital Revenue Code	301
Min. Negotiated Rate	$5.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.68
Rate for Payer: Aetna Medicare Advantage	$11.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.61
Rate for Payer: Cigna Commercial	$11.63
Rate for Payer: Cigna Medicare Advantage	$5.82
Rate for Payer: Clover Medicare Advantage	$11.05
Rate for Payer: EmblemHealth Commercial	$34.89
Rate for Payer: Humana Medicare Advantage	$11.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.63
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.33
Rate for Payer: Wellcare Medicare Advantage	$11.63

CH THIOCYANATE URINE

Facility

$139.00

Service Code	HCPCS 84430
Hospital Charge Code	397073092
Hospital Revenue Code	301
Min. Negotiated Rate	$20.85
Max. Negotiated Rate	$20.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.85

CH THIORIDAZINE

Facility

$144.00

Service Code	HCPCS 80342
Hospital Charge Code	397072128
Hospital Revenue Code	301
Min. Negotiated Rate	$18.72
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.20
Rate for Payer: Aetna Medicare Advantage	$43.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.72
Rate for Payer: Cigna Commercial	$72.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.72
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.60
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH THIORIDAZINE

Facility

$144.00

Service Code	HCPCS 80342
Hospital Charge Code	397072128
Hospital Revenue Code	301
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.60

CH THROMBIN TIME

Facility

$78.00

Service Code	HCPCS 85670
Hospital Charge Code	397021032
Hospital Revenue Code	305
Min. Negotiated Rate	$2.88
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.69
Rate for Payer: Aetna Medicare Advantage	$5.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.14
Rate for Payer: Cigna Commercial	$5.77
Rate for Payer: Cigna Medicare Advantage	$2.88
Rate for Payer: Clover Medicare Advantage	$5.48
Rate for Payer: EmblemHealth Commercial	$17.31
Rate for Payer: Humana Medicare Advantage	$5.94
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	$5.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.12
Rate for Payer: Wellcare Medicare Advantage	$5.77

CH THROMBIN TIME

Facility

$78.00

Service Code	HCPCS 85670
Hospital Charge Code	397021032
Hospital Revenue Code	305
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$11.70
Rate for Payer: Qualcare PPO/HMO/WC	$11.70

CH THROMBOPHILIA W/REF HR2

Facility

$1,939.00

Hospital Charge Code	3970730
Hospital Revenue Code	301
Min. Negotiated Rate	$290.85
Max. Negotiated Rate	$290.85
Rate for Payer: Qualcare PPO/HMO/WC	$290.85

CH THROMBOPHILIA W/REF HR2

Facility

$1,939.00

Hospital Charge Code	3970730
Hospital Revenue Code	301
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$969.50
Rate for Payer: Aetna Commercial	$581.70
Rate for Payer: Aetna Medicare Advantage	$581.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$494.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$494.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$494.44
Rate for Payer: Cigna Commercial	$969.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$290.85
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH THYOXINE BIND GLOBULN TBG

Facility

$180.00

Service Code	HCPCS 84442
Hospital Charge Code	397072130
Hospital Revenue Code	301
Min. Negotiated Rate	$7.39
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.89
Rate for Payer: Aetna Medicare Advantage	$14.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.78
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	$54.15
Rate for Payer: Cigna Commercial	$14.78
Rate for Payer: Cigna Medicare Advantage	$7.39
Rate for Payer: Clover Medicare Advantage	$14.04
Rate for Payer: EmblemHealth Commercial	$44.34
Rate for Payer: Humana Medicare Advantage	$15.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.67
Rate for Payer: Wellcare Medicare Advantage	$14.78

CH THYOXINE BIND GLOBULN TBG

Facility

$180.00

Service Code	HCPCS 84442
Hospital Charge Code	397072130
Hospital Revenue Code	301
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

CH THYROGLOBULIN

Facility

$382.00

Service Code	HCPCS 84432
Hospital Charge Code	397072129
Hospital Revenue Code	301
Min. Negotiated Rate	$57.30
Max. Negotiated Rate	$57.30
Rate for Payer: Qualcare PPO/HMO/WC	$57.30

CH THYROGLOBULIN

Facility

$382.00

Service Code	HCPCS 84432
Hospital Charge Code	397072129
Hospital Revenue Code	301
Min. Negotiated Rate	$8.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.03
Rate for Payer: Aetna Medicare Advantage	$16.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.06
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	$58.84
Rate for Payer: Cigna Commercial	$16.06
Rate for Payer: Cigna Medicare Advantage	$8.03
Rate for Payer: Clover Medicare Advantage	$15.26
Rate for Payer: EmblemHealth Commercial	$48.18
Rate for Payer: Humana Medicare Advantage	$16.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.06
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.02
Rate for Payer: Wellcare Medicare Advantage	$16.06

Know your out-of-pocket cost for care.

All Charges