Heights University Hospital

All Charges

Charge

Type

Setting

Price

AFP TETRA MATERNAL SERUM SCRN

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3009988
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$114.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: Aetna Commercial	$54.33
Rate for Payer: Aetna Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$16.77
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.78
Rate for Payer: Wellcare Medicare Advantage	$16.77

AFP TETRA MATERNAL SERUM SCRN

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3009988
Hospital Revenue Code	301
Min. Negotiated Rate	$18.19
Max. Negotiated Rate	$18.19
Rate for Payer: Qualcare PPO/HMO/WC	$18.19

AFP TRIPLE SCREEN (SERUM)

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3001287
Hospital Revenue Code	301
Min. Negotiated Rate	$18.19
Max. Negotiated Rate	$18.19
Rate for Payer: Qualcare PPO/HMO/WC	$18.19

AFP TRIPLE SCREEN (SERUM)

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3001287
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.33
Rate for Payer: Aetna Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$16.77
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.19
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.78
Rate for Payer: Wellcare Medicare Advantage	$16.77

AFP TUMOR MARKER

Facility

$115.30

Service Code	HCPCS 82105
Hospital Charge Code	39900422
Hospital Revenue Code	301
Min. Negotiated Rate	$17.30
Max. Negotiated Rate	$17.30
Rate for Payer: Qualcare PPO/HMO/WC	$17.30

AFP TUMOR MARKER

Facility

$115.30

Service Code	HCPCS 82105
Hospital Charge Code	39900422
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.33
Rate for Payer: Aetna Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$16.77
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.99
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.78
Rate for Payer: Wellcare Medicare Advantage	$16.77

AFP TUMOR MARKER CSF***

Facility

$26.00

Service Code	HCPCS 82105
Hospital Charge Code	3001286
Hospital Revenue Code	300
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.90

AFP TUMOR MARKER CSF***

Facility

$26.00

Service Code	HCPCS 82105
Hospital Charge Code	3001286
Hospital Revenue Code	300
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.33
Rate for Payer: Aetna Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$16.77
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.78
Rate for Payer: Wellcare Medicare Advantage	$16.77

AFP TUMOR MARKER, CSF

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3031755
Hospital Revenue Code	301
Min. Negotiated Rate	$18.19
Max. Negotiated Rate	$18.19
Rate for Payer: Qualcare PPO/HMO/WC	$18.19

AFP TUMOR MARKER, CSF

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3031755
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.33
Rate for Payer: Aetna Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$16.77
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.19
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.78
Rate for Payer: Wellcare Medicare Advantage	$16.77

AFP TUMOR MARKER, SERUM

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3031754
Hospital Revenue Code	301
Min. Negotiated Rate	$18.19
Max. Negotiated Rate	$18.19
Rate for Payer: Qualcare PPO/HMO/WC	$18.19

AFP TUMOR MARKER, SERUM

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3031754
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.33
Rate for Payer: Aetna Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$16.77
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.19
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.78
Rate for Payer: Wellcare Medicare Advantage	$16.77

AFP WITH AFP-L3%

Facility

$442.70

Service Code	HCPCS 82107
Hospital Charge Code	3038102
Hospital Revenue Code	300
Min. Negotiated Rate	$32.20
Max. Negotiated Rate	$236.00
Rate for Payer: Aetna Commercial	$208.69
Rate for Payer: Aetna Medicare Advantage	$64.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$64.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$168.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$236.00
Rate for Payer: Cigna Commercial	$64.41
Rate for Payer: Cigna Medicare Advantage	$32.20
Rate for Payer: Clover Medicare Advantage	$61.19
Rate for Payer: EmblemHealth Commercial	$193.23
Rate for Payer: Humana Medicare Advantage	$66.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.55
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.41
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$64.41
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$68.27
Rate for Payer: Wellcare Medicare Advantage	$64.41

AFP WITH AFP-L3%

Facility

$442.70

Service Code	HCPCS 82107
Hospital Charge Code	3038102
Hospital Revenue Code	300
Min. Negotiated Rate	$66.41
Max. Negotiated Rate	$66.41
Rate for Payer: Qualcare PPO/HMO/WC	$66.41

AFRIN 0.05% NASAL SPRAY 15ML

Facility

$13.74

Service Code	NDC 904571135
Hospital Charge Code	6063943288
Hospital Revenue Code	250
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$2.06
Rate for Payer: Qualcare PPO/HMO/WC	$2.06

AFRIN 0.05% NASAL SPRAY 15ML

Facility

$13.74

Service Code	NDC 904571135
Hospital Charge Code	6063943288
Hospital Revenue Code	250
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$6.87
Rate for Payer: Aetna Commercial	$4.12
Rate for Payer: Aetna Medicare Advantage	$4.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.50
Rate for Payer: Cigna Commercial	$6.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.79
Rate for Payer: Oxford Commercial	$6.87
Rate for Payer: Qualcare PPO/HMO/WC	$2.06
Rate for Payer: UnitedHealthcare Commercial	$6.87

AFRIN NASAL SPRAY 3ML

Facility

$34.60

Hospital Charge Code	6006720
Hospital Revenue Code	251
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$17.30
Rate for Payer: Aetna Commercial	$10.38
Rate for Payer: Aetna Medicare Advantage	$10.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.82
Rate for Payer: Cigna Commercial	$17.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$17.30
Rate for Payer: Qualcare PPO/HMO/WC	$5.19
Rate for Payer: UnitedHealthcare Commercial	$17.30

AFRIN NASAL SPRAY 3ML

Facility

$34.60

Hospital Charge Code	6006720
Hospital Revenue Code	251
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$5.19
Rate for Payer: Qualcare PPO/HMO/WC	$5.19

AFRIN PEDIATRIC 0.025% NA

Facility

$17.00

Hospital Charge Code	60632406
Hospital Revenue Code	250
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

AFRIN PEDIATRIC 0.025% NA

Facility

$17.00

Hospital Charge Code	60632406
Hospital Revenue Code	250
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$8.50
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	$8.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$8.50

AFRIN SPRAY 1%

Facility

$8.00

Hospital Charge Code	60634650
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

AFRIN SPRAY 1%

Facility

$8.00

Hospital Charge Code	60634650
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

AFRIN SPRAY 1/2%

Facility

$17.00

Hospital Charge Code	60634651
Hospital Revenue Code	250
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

AFRIN SPRAY 1/2%

Facility

$17.00

Hospital Charge Code	60634651
Hospital Revenue Code	250
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$8.50
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	$8.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$8.50

AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC

Facility

$44,508.12

Service Code	MSDRG 560
Min. Negotiated Rate	$12,288.66
Max. Negotiated Rate	$44,508.12
Rate for Payer: Aetna Commercial	$37,971.96
Rate for Payer: Aetna Medicare Advantage	$12,288.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,150.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,150.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,836.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,150.71
Rate for Payer: Cigna Commercial	$24,234.80
Rate for Payer: Cigna Medicare Advantage	$14,836.04
Rate for Payer: Clover Medicare Advantage	$14,094.24
Rate for Payer: EmblemHealth Commercial	$44,508.12
Rate for Payer: Humana Medicare Advantage	$15,281.12
Rate for Payer: Oxford Commercial	$15,146.05
Rate for Payer: UnitedHealthcare Commercial	$17,192.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,836.04
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15,726.20
Rate for Payer: Wellcare Medicare Advantage	$14,836.04

Know your out-of-pocket cost for care.

All Charges