Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH TRH (SPEC TUBE REQUIRED)

Facility

$900.00

Service Code	HCPCS 83519
Hospital Charge Code	397073658
Hospital Revenue Code	301
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

CH TRH (SPEC TUBE REQUIRED)

Facility

$900.00

Service Code	HCPCS 83519
Hospital Charge Code	397073658
Hospital Revenue Code	301
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$59.62
Rate for Payer: Aetna Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.42
Rate for Payer: Cigna Commercial	$18.40
Rate for Payer: Cigna Medicare Advantage	$9.20
Rate for Payer: Clover Medicare Advantage	$17.48
Rate for Payer: EmblemHealth Commercial	$55.20
Rate for Payer: Humana Medicare Advantage	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.40
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.50
Rate for Payer: Wellcare Medicare Advantage	$18.40

CH TRIAVIL

Facility

$254.00

Service Code	HCPCS 80335
Hospital Charge Code	397072132
Hospital Revenue Code	301
Min. Negotiated Rate	$38.10
Max. Negotiated Rate	$38.10
Rate for Payer: Qualcare PPO/HMO/WC	$38.10

CH TRIAVIL

Facility

$254.00

Service Code	HCPCS 80335
Hospital Charge Code	397072132
Hospital Revenue Code	301
Min. Negotiated Rate	$33.02
Max. Negotiated Rate	$127.00
Rate for Payer: Aetna Commercial	$76.20
Rate for Payer: Aetna Medicare Advantage	$76.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.77
Rate for Payer: Cigna Commercial	$127.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.02
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.10
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH TRICYCLIC LEVELS

Facility

$85.00

Service Code	HCPCS 80299
Hospital Charge Code	397073115
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

CH TRICYCLIC LEVELS

Facility

$85.00

Service Code	HCPCS 80299
Hospital Charge Code	397073115
Hospital Revenue Code	301
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

CH TRIFLUOROPERAZINE, SERUM

Facility

$386.00

Service Code	HCPCS 80342
Hospital Charge Code	397070017
Hospital Revenue Code	301
Min. Negotiated Rate	$50.18
Max. Negotiated Rate	$193.00
Rate for Payer: Aetna Commercial	$115.80
Rate for Payer: Aetna Medicare Advantage	$115.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.43
Rate for Payer: Cigna Commercial	$193.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.18
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.90
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH TRIFLUOROPERAZINE, SERUM

Facility

$386.00

Service Code	HCPCS 80342
Hospital Charge Code	397070017
Hospital Revenue Code	301
Min. Negotiated Rate	$57.90
Max. Negotiated Rate	$57.90
Rate for Payer: Qualcare PPO/HMO/WC	$57.90

CH TRIGLYCERIDE

Facility

$113.00

Service Code	HCPCS 84478
Hospital Charge Code	397071104
Hospital Revenue Code	301
Min. Negotiated Rate	$16.95
Max. Negotiated Rate	$16.95
Rate for Payer: Qualcare PPO/HMO/WC	$16.95

CH TRIGLYCERIDE

Facility

$113.00

Service Code	HCPCS 84478
Hospital Charge Code	397071104
Hospital Revenue Code	301
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.60
Rate for Payer: Aetna Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.03
Rate for Payer: Cigna Commercial	$5.74
Rate for Payer: Cigna Medicare Advantage	$2.87
Rate for Payer: Clover Medicare Advantage	$5.45
Rate for Payer: EmblemHealth Commercial	$17.22
Rate for Payer: Humana Medicare Advantage	$5.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.69
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.08
Rate for Payer: Wellcare Medicare Advantage	$5.74

CH TRILEPTAL(OXCARBAZEPINE)

Facility

$128.00

Service Code	HCPCS 84481
Hospital Charge Code	397073597
Hospital Revenue Code	301
Min. Negotiated Rate	$8.47
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.89
Rate for Payer: Aetna Medicare Advantage	$16.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.94
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	$62.07
Rate for Payer: Cigna Commercial	$16.94
Rate for Payer: Cigna Medicare Advantage	$8.47
Rate for Payer: Clover Medicare Advantage	$16.09
Rate for Payer: EmblemHealth Commercial	$50.82
Rate for Payer: Humana Medicare Advantage	$17.45
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	$16.94
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.96
Rate for Payer: Wellcare Medicare Advantage	$16.94

CH TRILEPTAL(OXCARBAZEPINE)

Facility

$128.00

Service Code	HCPCS 84481
Hospital Charge Code	397073597
Hospital Revenue Code	301
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

CH TROPONIN I

Facility

$123.44

Service Code	HCPCS 84484
Hospital Charge Code	397073188
Hospital Revenue Code	301
Min. Negotiated Rate	$18.52
Max. Negotiated Rate	$18.52
Rate for Payer: Qualcare PPO/HMO/WC	$18.52

CH TROPONIN I

Facility

$123.44

Service Code	HCPCS 84484
Hospital Charge Code	397073188
Hospital Revenue Code	301
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$40.40
Rate for Payer: Aetna Medicare Advantage	$12.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.69
Rate for Payer: Cigna Commercial	$12.47
Rate for Payer: Cigna Medicare Advantage	$6.24
Rate for Payer: Clover Medicare Advantage	$11.85
Rate for Payer: EmblemHealth Commercial	$37.41
Rate for Payer: Humana Medicare Advantage	$12.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.52
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.22
Rate for Payer: Wellcare Medicare Advantage	$12.47

CH TRYPANOSOMA DETECTION

Facility

$273.00

Service Code	HCPCS 86666
Hospital Charge Code	397071422
Hospital Revenue Code	302
Min. Negotiated Rate	$40.95
Max. Negotiated Rate	$40.95
Rate for Payer: Qualcare PPO/HMO/WC	$40.95

CH TRYPANOSOMA DETECTION

Facility

$273.00

Service Code	HCPCS 86666
Hospital Charge Code	397071422
Hospital Revenue Code	302
Min. Negotiated Rate	$5.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$32.98
Rate for Payer: Aetna Medicare Advantage	$10.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.30
Rate for Payer: Cigna Commercial	$10.18
Rate for Payer: Cigna Medicare Advantage	$5.09
Rate for Payer: Clover Medicare Advantage	$9.67
Rate for Payer: EmblemHealth Commercial	$30.54
Rate for Payer: Humana Medicare Advantage	$10.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.79
Rate for Payer: Wellcare Medicare Advantage	$10.18

CH TSH

Facility

$629.00

Service Code	HCPCS 84443
Hospital Charge Code	397071209
Hospital Revenue Code	301
Min. Negotiated Rate	$94.35
Max. Negotiated Rate	$94.35
Rate for Payer: Qualcare PPO/HMO/WC	$94.35

CH TSH

Facility

$629.00

Service Code	HCPCS 84443
Hospital Charge Code	397071209
Hospital Revenue Code	301
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.43
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.80
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	$61.56
Rate for Payer: Cigna Commercial	$16.80
Rate for Payer: Cigna Medicare Advantage	$8.40
Rate for Payer: Clover Medicare Advantage	$15.96
Rate for Payer: EmblemHealth Commercial	$50.40
Rate for Payer: Humana Medicare Advantage	$17.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.81
Rate for Payer: Wellcare Medicare Advantage	$16.80

CH TSH RECEPTOR AB

Facility

$457.00

Service Code	HCPCS 84235
Hospital Charge Code	397073159
Hospital Revenue Code	301
Min. Negotiated Rate	$68.55
Max. Negotiated Rate	$68.55
Rate for Payer: Qualcare PPO/HMO/WC	$68.55

CH TSH RECEPTOR AB

Facility

$457.00

Service Code	HCPCS 84235
Hospital Charge Code	397073159
Hospital Revenue Code	301
Min. Negotiated Rate	$35.62
Max. Negotiated Rate	$260.99
Rate for Payer: Aetna Commercial	$230.79
Rate for Payer: Aetna Medicare Advantage	$71.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$71.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.99
Rate for Payer: Cigna Commercial	$71.23
Rate for Payer: Cigna Medicare Advantage	$35.62
Rate for Payer: Clover Medicare Advantage	$67.67
Rate for Payer: EmblemHealth Commercial	$213.69
Rate for Payer: Humana Medicare Advantage	$73.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$71.23
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$75.50
Rate for Payer: Wellcare Medicare Advantage	$71.23

CH TYPE & SCREEN

Facility

$667.59

Service Code	HCPCS 86850
Hospital Charge Code	397031016
Hospital Revenue Code	300
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$124.10
Rate for Payer: Aetna Commercial	$31.65
Rate for Payer: Aetna Medicare Advantage	$9.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.80
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$4.88
Rate for Payer: Clover Medicare Advantage	$9.28
Rate for Payer: EmblemHealth Commercial	$29.31
Rate for Payer: Humana Medicare Advantage	$10.06
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	$9.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.36
Rate for Payer: Wellcare Medicare Advantage	$9.77

CH TYPE & SCREEN

Facility

$667.59

Service Code	HCPCS 86850
Hospital Charge Code	397031016
Hospital Revenue Code	300
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CH TYSABRI AB

Facility

$225.00

Service Code	HCPCS 86849
Hospital Charge Code	397073675
Hospital Revenue Code	302
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$67.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH TYSABRI AB

Facility

$225.00

Service Code	HCPCS 86849
Hospital Charge Code	397073675
Hospital Revenue Code	302
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

CH UCG POC

Facility

$210.00

Service Code	HCPCS 84703
Hospital Charge Code	397071552
Hospital Revenue Code	301
Min. Negotiated Rate	$3.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$24.36
Rate for Payer: Aetna Medicare Advantage	$7.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.55
Rate for Payer: Cigna Commercial	$7.52
Rate for Payer: Cigna Medicare Advantage	$3.76
Rate for Payer: Clover Medicare Advantage	$7.14
Rate for Payer: EmblemHealth Commercial	$22.56
Rate for Payer: Humana Medicare Advantage	$7.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.52
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.97
Rate for Payer: Wellcare Medicare Advantage	$7.52

Know your out-of-pocket cost for care.

All Charges