Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH UCG POC

Facility

$210.00

Service Code	HCPCS 84703
Hospital Charge Code	397071552
Hospital Revenue Code	301
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

CHUCK KEY LARGE 1/4

Facility

$104.70

Hospital Charge Code	270645829
Hospital Revenue Code	271
Min. Negotiated Rate	$13.61
Max. Negotiated Rate	$52.35
Rate for Payer: Aetna Commercial	$31.41
Rate for Payer: Aetna Medicare Advantage	$31.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.70
Rate for Payer: Cigna Commercial	$52.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.61
Rate for Payer: Oxford Commercial	$52.35
Rate for Payer: Qualcare PPO/HMO/WC	$15.71
Rate for Payer: UnitedHealthcare Commercial	$52.35

CHUCK KEY LARGE 1/4

Facility

$104.70

Hospital Charge Code	270645829
Hospital Revenue Code	271
Min. Negotiated Rate	$15.71
Max. Negotiated Rate	$15.71
Rate for Payer: Qualcare PPO/HMO/WC	$15.71

CHUCK KEY SMALL 5/32

Facility

$104.70

Hospital Charge Code	270645830
Hospital Revenue Code	271
Min. Negotiated Rate	$13.61
Max. Negotiated Rate	$52.35
Rate for Payer: Aetna Commercial	$31.41
Rate for Payer: Aetna Medicare Advantage	$31.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.70
Rate for Payer: Cigna Commercial	$52.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.61
Rate for Payer: Oxford Commercial	$52.35
Rate for Payer: Qualcare PPO/HMO/WC	$15.71
Rate for Payer: UnitedHealthcare Commercial	$52.35

CHUCK KEY SMALL 5/32

Facility

$104.70

Hospital Charge Code	270645830
Hospital Revenue Code	271
Min. Negotiated Rate	$15.71
Max. Negotiated Rate	$15.71
Rate for Payer: Qualcare PPO/HMO/WC	$15.71

CH UREA NITROGEN

Facility

$40.00

Service Code	HCPCS 84520
Hospital Charge Code	397071038
Hospital Revenue Code	301
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CH UREA NITROGEN

Facility

$40.00

Service Code	HCPCS 84520
Hospital Charge Code	397071038
Hospital Revenue Code	301
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$12.80
Rate for Payer: Aetna Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.95
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	$14.47
Rate for Payer: Cigna Commercial	$3.95
Rate for Payer: Cigna Medicare Advantage	$1.98
Rate for Payer: Clover Medicare Advantage	$3.75
Rate for Payer: EmblemHealth Commercial	$11.85
Rate for Payer: Humana Medicare Advantage	$4.07
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	$3.95
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.19
Rate for Payer: Wellcare Medicare Advantage	$3.95

CH UREA NITROGEN (RANDOM)

Facility

$390.00

Service Code	HCPCS 84540
Hospital Charge Code	397073108
Hospital Revenue Code	301
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.01
Rate for Payer: Aetna Medicare Advantage	$5.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.56
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	$20.37
Rate for Payer: Cigna Commercial	$5.56
Rate for Payer: Cigna Medicare Advantage	$2.78
Rate for Payer: Clover Medicare Advantage	$5.28
Rate for Payer: EmblemHealth Commercial	$16.68
Rate for Payer: Humana Medicare Advantage	$5.73
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	$5.56
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.89
Rate for Payer: Wellcare Medicare Advantage	$5.56

CH UREA NITROGEN (RANDOM)

Facility

$390.00

Service Code	HCPCS 84540
Hospital Charge Code	397073108
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH UREA NITROGEN UR 24 HR

Facility

$127.00

Service Code	HCPCS 84540
Hospital Charge Code	397071012
Hospital Revenue Code	301
Min. Negotiated Rate	$19.05
Max. Negotiated Rate	$19.05
Rate for Payer: Qualcare PPO/HMO/WC	$19.05

CH UREA NITROGEN UR 24 HR

Facility

$127.00

Service Code	HCPCS 84540
Hospital Charge Code	397071012
Hospital Revenue Code	301
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.01
Rate for Payer: Aetna Medicare Advantage	$5.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.56
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	$20.37
Rate for Payer: Cigna Commercial	$5.56
Rate for Payer: Cigna Medicare Advantage	$2.78
Rate for Payer: Clover Medicare Advantage	$5.28
Rate for Payer: EmblemHealth Commercial	$16.68
Rate for Payer: Humana Medicare Advantage	$5.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.51
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.56
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.89
Rate for Payer: Wellcare Medicare Advantage	$5.56

CH URIC ACID

Facility

$82.00

Service Code	HCPCS 84550
Hospital Charge Code	397071040
Hospital Revenue Code	301
Min. Negotiated Rate	$2.26
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.64
Rate for Payer: Aetna Medicare Advantage	$4.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.52
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	$16.56
Rate for Payer: Cigna Commercial	$4.52
Rate for Payer: Cigna Medicare Advantage	$2.26
Rate for Payer: Clover Medicare Advantage	$4.29
Rate for Payer: EmblemHealth Commercial	$13.56
Rate for Payer: Humana Medicare Advantage	$4.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.52
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.79
Rate for Payer: Wellcare Medicare Advantage	$4.52

CH URIC ACID

Facility

$82.00

Service Code	HCPCS 84550
Hospital Charge Code	397071040
Hospital Revenue Code	301
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$12.30
Rate for Payer: Qualcare PPO/HMO/WC	$12.30

CH URIC ACID FLUID

Facility

$63.25

Service Code	HCPCS 84560
Hospital Charge Code	397073046
Hospital Revenue Code	301
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$9.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

CH URIC ACID FLUID

Facility

$63.25

Service Code	HCPCS 84560
Hospital Charge Code	397073046
Hospital Revenue Code	301
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.46
Rate for Payer: Aetna Medicare Advantage	$5.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.08
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	$18.61
Rate for Payer: Cigna Commercial	$5.08
Rate for Payer: Cigna Medicare Advantage	$2.54
Rate for Payer: Clover Medicare Advantage	$4.83
Rate for Payer: EmblemHealth Commercial	$15.24
Rate for Payer: Humana Medicare Advantage	$5.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.22
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.49
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.08
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.38
Rate for Payer: Wellcare Medicare Advantage	$5.08

CH URIC ACID (RANDOM)

Facility

$158.00

Service Code	HCPCS 84560
Hospital Charge Code	397073109
Hospital Revenue Code	301
Min. Negotiated Rate	$23.70
Max. Negotiated Rate	$23.70
Rate for Payer: Qualcare PPO/HMO/WC	$23.70

CH URIC ACID (RANDOM)

Facility

$158.00

Service Code	HCPCS 84560
Hospital Charge Code	397073109
Hospital Revenue Code	301
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.46
Rate for Payer: Aetna Medicare Advantage	$5.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.08
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	$18.61
Rate for Payer: Cigna Commercial	$5.08
Rate for Payer: Cigna Medicare Advantage	$2.54
Rate for Payer: Clover Medicare Advantage	$4.83
Rate for Payer: EmblemHealth Commercial	$15.24
Rate for Payer: Humana Medicare Advantage	$5.23
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	$5.08
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.38
Rate for Payer: Wellcare Medicare Advantage	$5.08

CH URIC ACID URINE 24HR

Facility

$259.00

Service Code	HCPCS 84560
Hospital Charge Code	397071314
Hospital Revenue Code	301
Min. Negotiated Rate	$38.85
Max. Negotiated Rate	$38.85
Rate for Payer: Qualcare PPO/HMO/WC	$38.85

CH URIC ACID URINE 24HR

Facility

$259.00

Service Code	HCPCS 84560
Hospital Charge Code	397071314
Hospital Revenue Code	301
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.46
Rate for Payer: Aetna Medicare Advantage	$5.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.08
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	$18.61
Rate for Payer: Cigna Commercial	$5.08
Rate for Payer: Cigna Medicare Advantage	$2.54
Rate for Payer: Clover Medicare Advantage	$4.83
Rate for Payer: EmblemHealth Commercial	$15.24
Rate for Payer: Humana Medicare Advantage	$5.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.08
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.38
Rate for Payer: Wellcare Medicare Advantage	$5.08

CH URINALYSIS ROUTINE

Facility

$790.84

Service Code	HCPCS 81001
Hospital Charge Code	397071008
Hospital Revenue Code	307
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$118.63
Rate for Payer: Aetna Commercial	$10.27
Rate for Payer: Aetna Medicare Advantage	$3.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.61
Rate for Payer: Cigna Commercial	$3.17
Rate for Payer: Cigna Medicare Advantage	$1.58
Rate for Payer: Clover Medicare Advantage	$3.01
Rate for Payer: EmblemHealth Commercial	$9.51
Rate for Payer: Humana Medicare Advantage	$3.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.81
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.63
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.17
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.36
Rate for Payer: Wellcare Medicare Advantage	$3.17

CH URINALYSIS ROUTINE

Facility

$790.84

Service Code	HCPCS 81001
Hospital Charge Code	397071008
Hospital Revenue Code	307
Min. Negotiated Rate	$118.63
Max. Negotiated Rate	$118.63
Rate for Payer: Qualcare PPO/HMO/WC	$118.63

CH URINE MICROSCOPIC

Facility

$20.75

Service Code	HCPCS 81015
Hospital Charge Code	397073025
Hospital Revenue Code	307
Min. Negotiated Rate	$3.11
Max. Negotiated Rate	$3.11
Rate for Payer: Qualcare PPO/HMO/WC	$3.11

CH URINE MICROSCOPIC

Facility

$20.75

Service Code	HCPCS 81015
Hospital Charge Code	397073025
Hospital Revenue Code	307
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$9.88
Rate for Payer: Aetna Medicare Advantage	$3.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.18
Rate for Payer: Cigna Commercial	$3.05
Rate for Payer: Cigna Medicare Advantage	$1.52
Rate for Payer: Clover Medicare Advantage	$2.90
Rate for Payer: EmblemHealth Commercial	$9.15
Rate for Payer: Humana Medicare Advantage	$3.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.11
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.23
Rate for Payer: Wellcare Medicare Advantage	$3.05

CH UROBILINOGEN

Facility

$42.00

Service Code	HCPCS 84578
Hospital Charge Code	397071189
Hospital Revenue Code	301
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

CH UROBILINOGEN

Facility

$42.00

Service Code	HCPCS 84578
Hospital Charge Code	397071189
Hospital Revenue Code	301
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.48
Rate for Payer: Aetna Medicare Advantage	$4.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.38
Rate for Payer: Cigna Commercial	$4.47
Rate for Payer: Cigna Medicare Advantage	$2.23
Rate for Payer: Clover Medicare Advantage	$4.25
Rate for Payer: EmblemHealth Commercial	$13.41
Rate for Payer: Humana Medicare Advantage	$4.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.74
Rate for Payer: Wellcare Medicare Advantage	$4.47

Know your out-of-pocket cost for care.

All Charges