Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH TOCAINIDE

Facility

$85.00

Service Code	HCPCS 80299
Hospital Charge Code	397073118
Hospital Revenue Code	301
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

CH TOLUENE BLOOD

Facility

$309.00

Service Code	HCPCS 84600
Hospital Charge Code	397073661
Hospital Revenue Code	301
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.44
Rate for Payer: Aetna Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.69
Rate for Payer: Cigna Commercial	$17.11
Rate for Payer: Cigna Medicare Advantage	$8.55
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.14
Rate for Payer: Wellcare Medicare Advantage	$17.11

CH TOLUENE BLOOD

Facility

$309.00

Service Code	HCPCS 84600
Hospital Charge Code	397073661
Hospital Revenue Code	301
Min. Negotiated Rate	$46.35
Max. Negotiated Rate	$46.35
Rate for Payer: Qualcare PPO/HMO/WC	$46.35

CH TOPIRAMATE (TOPAMAX)

Facility

$119.00

Service Code	HCPCS 80201
Hospital Charge Code	397073555
Hospital Revenue Code	301
Min. Negotiated Rate	$17.85
Max. Negotiated Rate	$17.85
Rate for Payer: Qualcare PPO/HMO/WC	$17.85

CH TOPIRAMATE (TOPAMAX)

Facility

$119.00

Service Code	HCPCS 80201
Hospital Charge Code	397073555
Hospital Revenue Code	301
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.62
Rate for Payer: Aetna Medicare Advantage	$11.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.67
Rate for Payer: Cigna Commercial	$11.92
Rate for Payer: Cigna Medicare Advantage	$5.96
Rate for Payer: Clover Medicare Advantage	$11.32
Rate for Payer: EmblemHealth Commercial	$35.76
Rate for Payer: Humana Medicare Advantage	$12.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.47
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.92
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.64
Rate for Payer: Wellcare Medicare Advantage	$11.92

CH TOTAL AMYLASE

Facility

$114.00

Service Code	HCPCS 82150
Hospital Charge Code	397073257
Hospital Revenue Code	301
Min. Negotiated Rate	$3.24
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$21.00
Rate for Payer: Aetna Medicare Advantage	$6.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.74
Rate for Payer: Cigna Commercial	$6.48
Rate for Payer: Cigna Medicare Advantage	$3.24
Rate for Payer: Clover Medicare Advantage	$6.16
Rate for Payer: EmblemHealth Commercial	$19.44
Rate for Payer: Humana Medicare Advantage	$6.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.87
Rate for Payer: Wellcare Medicare Advantage	$6.48

CH TOTAL AMYLASE

Facility

$114.00

Service Code	HCPCS 82150
Hospital Charge Code	397073257
Hospital Revenue Code	301
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$17.10
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

CH TOTAL CK

Facility

$385.26

Service Code	HCPCS 82550
Hospital Charge Code	397073254
Hospital Revenue Code	301
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$21.09
Rate for Payer: Aetna Medicare Advantage	$6.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.85
Rate for Payer: Cigna Commercial	$6.51
Rate for Payer: Cigna Medicare Advantage	$3.25
Rate for Payer: Clover Medicare Advantage	$6.18
Rate for Payer: EmblemHealth Commercial	$19.53
Rate for Payer: Humana Medicare Advantage	$6.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.79
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.51
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.90
Rate for Payer: Wellcare Medicare Advantage	$6.51

CH TOTAL CK

Facility

$385.26

Service Code	HCPCS 82550
Hospital Charge Code	397073254
Hospital Revenue Code	301
Min. Negotiated Rate	$57.79
Max. Negotiated Rate	$57.79
Rate for Payer: Qualcare PPO/HMO/WC	$57.79

CH TOTAL LIPIDS, FL

Facility

$390.00

Service Code	HCPCS 84311
Hospital Charge Code	397073054
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH TOTAL LIPIDS, FL

Facility

$390.00

Service Code	HCPCS 84311
Hospital Charge Code	397073054
Hospital Revenue Code	301
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.24
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.68
Rate for Payer: Cigna Commercial	$8.10
Rate for Payer: Cigna Medicare Advantage	$4.05
Rate for Payer: Clover Medicare Advantage	$7.70
Rate for Payer: EmblemHealth Commercial	$24.30
Rate for Payer: Humana Medicare Advantage	$8.34
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	$8.10
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.59
Rate for Payer: Wellcare Medicare Advantage	$8.10

CH TOTAL PROTEIN (RANDOM)

Facility

$390.00

Service Code	HCPCS 84155
Hospital Charge Code	397073114
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH TOTAL PROTEIN (RANDOM)

Facility

$390.00

Service Code	HCPCS 84155
Hospital Charge Code	397073114
Hospital Revenue Code	301
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$11.89
Rate for Payer: Aetna Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.45
Rate for Payer: Cigna Commercial	$3.67
Rate for Payer: Cigna Medicare Advantage	$1.83
Rate for Payer: Clover Medicare Advantage	$3.49
Rate for Payer: EmblemHealth Commercial	$11.01
Rate for Payer: Humana Medicare Advantage	$3.78
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	$3.67
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.89
Rate for Payer: Wellcare Medicare Advantage	$3.67

CH TOXOPLASMA GONDII IGM CSF

Facility

$86.00

Service Code	HCPCS 86778
Hospital Charge Code	397071540
Hospital Revenue Code	302
Min. Negotiated Rate	$12.90
Max. Negotiated Rate	$12.90
Rate for Payer: Qualcare PPO/HMO/WC	$12.90

CH TOXOPLASMA GONDII IGM CSF

Facility

$86.00

Service Code	HCPCS 86778
Hospital Charge Code	397071540
Hospital Revenue Code	302
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.69
Rate for Payer: Aetna Medicare Advantage	$14.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.41
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	$52.80
Rate for Payer: Cigna Commercial	$14.41
Rate for Payer: Cigna Medicare Advantage	$7.21
Rate for Payer: Clover Medicare Advantage	$13.69
Rate for Payer: EmblemHealth Commercial	$43.23
Rate for Payer: Humana Medicare Advantage	$14.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.18
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.41
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.27
Rate for Payer: Wellcare Medicare Advantage	$14.41

CH TOXOPLASMA IGG/IGM

Facility

$390.00

Service Code	HCPCS 86777
Hospital Charge Code	397043215
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	$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	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

CH TOXOPLASMA IGG/IGM

Facility

$390.00

Service Code	HCPCS 86777
Hospital Charge Code	397043215
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH TRAMADOL-SERUM

Facility

$430.00

Service Code	HCPCS 80373
Hospital Charge Code	397071476
Hospital Revenue Code	301
Min. Negotiated Rate	$64.50
Max. Negotiated Rate	$64.50
Rate for Payer: Qualcare PPO/HMO/WC	$64.50

CH TRAMADOL-SERUM

Facility

$430.00

Service Code	HCPCS 80373
Hospital Charge Code	397071476
Hospital Revenue Code	301
Min. Negotiated Rate	$55.90
Max. Negotiated Rate	$215.00
Rate for Payer: Aetna Commercial	$129.00
Rate for Payer: Aetna Medicare Advantage	$129.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.65
Rate for Payer: Cigna Commercial	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$64.50
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH TRANSFERRIN

Facility

$164.00

Service Code	HCPCS 84466
Hospital Charge Code	397071211
Hospital Revenue Code	301
Min. Negotiated Rate	$6.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.34
Rate for Payer: Aetna Medicare Advantage	$12.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.75
Rate for Payer: Cigna Commercial	$12.76
Rate for Payer: Cigna Medicare Advantage	$6.38
Rate for Payer: Clover Medicare Advantage	$12.12
Rate for Payer: EmblemHealth Commercial	$38.28
Rate for Payer: Humana Medicare Advantage	$13.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.76
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.53
Rate for Payer: Wellcare Medicare Advantage	$12.76

CH TRANSFERRIN

Facility

$164.00

Service Code	HCPCS 84466
Hospital Charge Code	397071211
Hospital Revenue Code	301
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$24.60
Rate for Payer: Qualcare PPO/HMO/WC	$24.60

CH TRANSGLUTAMINASE ANTIBODY

Facility

$81.00

Service Code	HCPCS 83520
Hospital Charge Code	397073596
Hospital Revenue Code	301
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$12.15
Rate for Payer: Qualcare PPO/HMO/WC	$12.15

CH TRANSGLUTAMINASE ANTIBODY

Facility

$81.00

Service Code	HCPCS 83520
Hospital Charge Code	397073596
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	$10.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.15
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 TRAZODONE

Facility

$85.00

Service Code	HCPCS 80299
Hospital Charge Code	397072131
Hospital Revenue Code	301
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

CH TRAZODONE

Facility

$85.00

Service Code	HCPCS 80299
Hospital Charge Code	397072131
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	$11.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
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

Know your out-of-pocket cost for care.

All Charges