Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH VOLTGE GATED CALCIUM CHAB

Facility

$420.00

Service Code	HCPCS 83519
Hospital Charge Code	397073344
Hospital Revenue Code	301
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Medicare Advantage	$18.40
Rate for Payer: Aetna Commercial	$59.62
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	$54.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.00
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 VOLUME MEAS FOR TIMED COL

Facility

$19.00

Service Code	HCPCS 81050
Hospital Charge Code	397073588
Hospital Revenue Code	307
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$11.79
Rate for Payer: Aetna Medicare Advantage	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.34
Rate for Payer: Cigna Commercial	$3.64
Rate for Payer: Cigna Medicare Advantage	$1.82
Rate for Payer: Clover Medicare Advantage	$3.46
Rate for Payer: EmblemHealth Commercial	$10.92
Rate for Payer: Humana Medicare Advantage	$3.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.47
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.86
Rate for Payer: Wellcare Medicare Advantage	$3.64

CH VOLUME MEAS FOR TIMED COL

Facility

$19.00

Service Code	HCPCS 81050
Hospital Charge Code	397073588
Hospital Revenue Code	307
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$2.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.85

CH VOLUME MEASUREMENT

Facility

$20.00

Service Code	HCPCS 81050
Hospital Charge Code	397073578
Hospital Revenue Code	307
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

CH VOLUME MEASUREMENT

Facility

$20.00

Service Code	HCPCS 81050
Hospital Charge Code	397073578
Hospital Revenue Code	307
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$11.79
Rate for Payer: Aetna Medicare Advantage	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.34
Rate for Payer: Cigna Commercial	$3.64
Rate for Payer: Cigna Medicare Advantage	$1.82
Rate for Payer: Clover Medicare Advantage	$3.46
Rate for Payer: EmblemHealth Commercial	$10.92
Rate for Payer: Humana Medicare Advantage	$3.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.86
Rate for Payer: Wellcare Medicare Advantage	$3.64

CH VON WILLEBRAND ANTIGEN

Facility

$218.00

Service Code	HCPCS 85246
Hospital Charge Code	397073318
Hospital Revenue Code	305
Min. Negotiated Rate	$32.70
Max. Negotiated Rate	$32.70
Rate for Payer: Qualcare PPO/HMO/WC	$32.70

CH VON WILLEBRAND ANTIGEN

Facility

$218.00

Service Code	HCPCS 85246
Hospital Charge Code	397073318
Hospital Revenue Code	305
Min. Negotiated Rate	$11.47
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$74.33
Rate for Payer: Aetna Medicare Advantage	$22.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.05
Rate for Payer: Cigna Commercial	$22.94
Rate for Payer: Cigna Medicare Advantage	$11.47
Rate for Payer: Clover Medicare Advantage	$21.79
Rate for Payer: EmblemHealth Commercial	$68.82
Rate for Payer: Humana Medicare Advantage	$23.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.94
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.32
Rate for Payer: Wellcare Medicare Advantage	$22.94

CH VON WILLEBRAND MULTIMERS

Facility

$142.00

Service Code	HCPCS 85247
Hospital Charge Code	397073319
Hospital Revenue Code	305
Min. Negotiated Rate	$21.30
Max. Negotiated Rate	$21.30
Rate for Payer: Qualcare PPO/HMO/WC	$21.30

CH VON WILLEBRAND MULTIMERS

Facility

$142.00

Service Code	HCPCS 85247
Hospital Charge Code	397073319
Hospital Revenue Code	305
Min. Negotiated Rate	$11.47
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$74.33
Rate for Payer: Aetna Medicare Advantage	$22.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.05
Rate for Payer: Cigna Commercial	$22.94
Rate for Payer: Cigna Medicare Advantage	$11.47
Rate for Payer: Clover Medicare Advantage	$21.79
Rate for Payer: EmblemHealth Commercial	$68.82
Rate for Payer: Humana Medicare Advantage	$23.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.94
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.32
Rate for Payer: Wellcare Medicare Advantage	$22.94

CH VON WILLEBRAND PROFILE

Facility

$494.00

Service Code	HCPCS 85240
Hospital Charge Code	397072141
Hospital Revenue Code	305
Min. Negotiated Rate	$74.10
Max. Negotiated Rate	$74.10
Rate for Payer: Qualcare PPO/HMO/WC	$74.10

CH VON WILLEBRAND PROFILE

Facility

$494.00

Service Code	HCPCS 85240
Hospital Charge Code	397072141
Hospital Revenue Code	305
Min. Negotiated Rate	$8.95
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.00
Rate for Payer: Aetna Medicare Advantage	$17.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.59
Rate for Payer: Cigna Commercial	$17.90
Rate for Payer: Cigna Medicare Advantage	$8.95
Rate for Payer: Clover Medicare Advantage	$17.00
Rate for Payer: EmblemHealth Commercial	$53.70
Rate for Payer: Humana Medicare Advantage	$18.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.22
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.90
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.97
Rate for Payer: Wellcare Medicare Advantage	$17.90

CH VON WILLEBRAND RISTOCETIN

Facility

$198.00

Service Code	HCPCS 85245
Hospital Charge Code	397073210
Hospital Revenue Code	305
Min. Negotiated Rate	$29.70
Max. Negotiated Rate	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$29.70

CH VON WILLEBRAND RISTOCETIN

Facility

$198.00

Service Code	HCPCS 85245
Hospital Charge Code	397073210
Hospital Revenue Code	305
Min. Negotiated Rate	$11.47
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$74.33
Rate for Payer: Aetna Medicare Advantage	$22.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.05
Rate for Payer: Cigna Commercial	$22.94
Rate for Payer: Cigna Medicare Advantage	$11.47
Rate for Payer: Clover Medicare Advantage	$21.79
Rate for Payer: EmblemHealth Commercial	$68.82
Rate for Payer: Humana Medicare Advantage	$23.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.94
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.32
Rate for Payer: Wellcare Medicare Advantage	$22.94

CH VWF PROTEASE ACT W/RF INT

Facility

$710.00

Service Code	HCPCS 85397
Hospital Charge Code	397071513
Hospital Revenue Code	305
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$106.50
Rate for Payer: Qualcare PPO/HMO/WC	$106.50

CH VWF PROTEASE ACT W/RF INT

Facility

$710.00

Service Code	HCPCS 85397
Hospital Charge Code	397071513
Hospital Revenue Code	305
Min. Negotiated Rate	$15.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$99.99
Rate for Payer: Aetna Medicare Advantage	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$30.86
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	$113.07
Rate for Payer: Cigna Commercial	$30.86
Rate for Payer: Cigna Medicare Advantage	$15.43
Rate for Payer: Clover Medicare Advantage	$29.32
Rate for Payer: EmblemHealth Commercial	$92.58
Rate for Payer: Humana Medicare Advantage	$31.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$106.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$30.86
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$32.71
Rate for Payer: Wellcare Medicare Advantage	$30.86

CH WASHED RBC

Facility

$944.00

Service Code	HCPCS P9022
Hospital Charge Code	397031049
Hospital Revenue Code	390
Min. Negotiated Rate	$141.60
Max. Negotiated Rate	$141.60
Rate for Payer: Qualcare PPO/HMO/WC	$141.60

CH WASHED RBC

Facility

$944.00

Service Code	HCPCS P9022
Hospital Charge Code	397031049
Hospital Revenue Code	390
Min. Negotiated Rate	$122.72
Max. Negotiated Rate	$859.12
Rate for Payer: Aetna Commercial	$283.20
Rate for Payer: Aetna Medicare Advantage	$283.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.72
Rate for Payer: Cigna Commercial	$859.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.72
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$141.60
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH WBC COUNT

Facility

$17.00

Service Code	HCPCS 8504891
Hospital Charge Code	397021289
Hospital Revenue Code	301
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

CH WBC COUNT

Facility

$59.00

Service Code	HCPCS 85048
Hospital Charge Code	397021022
Hospital Revenue Code	301
Min. Negotiated Rate	$8.85
Max. Negotiated Rate	$8.85
Rate for Payer: Qualcare PPO/HMO/WC	$8.85

CH WBC COUNT

Facility

$17.00

Service Code	HCPCS 8504891
Hospital Charge Code	397021289
Hospital Revenue Code	301
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$5.10
Rate for Payer: Aetna Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.33
Rate for Payer: Cigna Commercial	$8.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.21
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH WBC COUNT

Facility

$59.00

Service Code	HCPCS 85048
Hospital Charge Code	397021022
Hospital Revenue Code	301
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$8.23
Rate for Payer: Aetna Medicare Advantage	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.31
Rate for Payer: Cigna Commercial	$2.54
Rate for Payer: Cigna Medicare Advantage	$1.27
Rate for Payer: Clover Medicare Advantage	$2.41
Rate for Payer: EmblemHealth Commercial	$7.62
Rate for Payer: Humana Medicare Advantage	$2.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.54
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.69
Rate for Payer: Wellcare Medicare Advantage	$2.54

CH WBC & DIFFERENTIAL

Facility

$390.00

Service Code	HCPCS 85048
Hospital Charge Code	397021061
Hospital Revenue Code	301
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$8.23
Rate for Payer: Aetna Medicare Advantage	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.31
Rate for Payer: Cigna Commercial	$2.54
Rate for Payer: Cigna Medicare Advantage	$1.27
Rate for Payer: Clover Medicare Advantage	$2.41
Rate for Payer: EmblemHealth Commercial	$7.62
Rate for Payer: Humana Medicare Advantage	$2.62
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	$2.54
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.69
Rate for Payer: Wellcare Medicare Advantage	$2.54

CH WBC & DIFFERENTIAL

Facility

$390.00

Service Code	HCPCS 85048
Hospital Charge Code	397021061
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH WELBUTRIM

Facility

$292.00

Service Code	HCPCS 80299
Hospital Charge Code	397071357
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	$37.96
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.80
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 WELBUTRIM

Facility

$292.00

Service Code	HCPCS 80299
Hospital Charge Code	397071357
Hospital Revenue Code	301
Min. Negotiated Rate	$43.80
Max. Negotiated Rate	$43.80
Rate for Payer: Qualcare PPO/HMO/WC	$43.80

Know your out-of-pocket cost for care.

All Charges