Heights University Hospital

All Charges

Charge

Type

Setting

Price

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 8663191
Hospital Charge Code	39990089A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 86632
Hospital Charge Code	39990089C
Hospital Revenue Code	302
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.08
Rate for Payer: Aetna Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.68
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	$46.46
Rate for Payer: Cigna Commercial	$12.68
Rate for Payer: Cigna Medicare Advantage	$6.34
Rate for Payer: Clover Medicare Advantage	$12.05
Rate for Payer: EmblemHealth Commercial	$38.04
Rate for Payer: Humana Medicare Advantage	$13.06
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	$12.68
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.44
Rate for Payer: Wellcare Medicare Advantage	$12.68

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 8663191
Hospital Charge Code	39990089A
Hospital Revenue Code	302
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 8663191
Hospital Charge Code	39990089B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 86632
Hospital Charge Code	39990089C
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 8663191
Hospital Charge Code	39990089B
Hospital Revenue Code	302
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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

C. PNEUMONIAE IGM TITER

Facility

$153.65

Service Code	HCPCS 86632
Hospital Charge Code	3000940E
Hospital Revenue Code	302
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$23.05
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

C. PNEUMONIAE IGM TITER

Facility

$153.65

Service Code	HCPCS 86632
Hospital Charge Code	3000940E
Hospital Revenue Code	302
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.08
Rate for Payer: Aetna Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.68
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	$46.46
Rate for Payer: Cigna Commercial	$12.68
Rate for Payer: Cigna Medicare Advantage	$6.34
Rate for Payer: Clover Medicare Advantage	$12.05
Rate for Payer: EmblemHealth Commercial	$38.04
Rate for Payer: Humana Medicare Advantage	$13.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.68
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.44
Rate for Payer: Wellcare Medicare Advantage	$12.68

CPN SOFTWARE

Facility

$4,800.00

Hospital Charge Code	270658994
Hospital Revenue Code	272
Min. Negotiated Rate	$720.00
Max. Negotiated Rate	$720.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00

CPN SOFTWARE

Facility

$4,800.00

Hospital Charge Code	270658994
Hospital Revenue Code	272
Min. Negotiated Rate	$624.00
Max. Negotiated Rate	$2,400.00
Rate for Payer: Aetna Commercial	$1,440.00
Rate for Payer: Aetna Medicare Advantage	$1,440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,224.00
Rate for Payer: Cigna Commercial	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.00
Rate for Payer: Oxford Commercial	$2,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00
Rate for Payer: UnitedHealthcare Commercial	$2,400.00

CPR

Facility

$1,120.00

Service Code	HCPCS 92950
Hospital Charge Code	9500065
Hospital Revenue Code	480
Min. Negotiated Rate	$59.57
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$336.00
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.60
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

CPR

Facility

$1,120.00

Service Code	HCPCS 92950
Hospital Charge Code	9500065
Hospital Revenue Code	480
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$168.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

CPR

Facility

$1,000.00

Service Code	HCPCS 929507474
Hospital Charge Code	7411179
Hospital Revenue Code	480
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CPR

Facility

$1,000.00

Service Code	HCPCS 929507474
Hospital Charge Code	7411179
Hospital Revenue Code	480
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

CPR VIPER IMPLANT SYSTEM

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270676107
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

CPR VIPER IMPLANT SYSTEM

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270676107
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

CPS FIXED BEARING ARTICULAR SU

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704571
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

CPS FIXED BEARING ARTICULAR SU

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704571
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

C PSITTACI AB

Facility

$390.00

Service Code	HCPCS 86631
Hospital Charge Code	39708048A
Hospital Revenue Code	302
Min. Negotiated Rate	$5.91
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.30
Rate for Payer: Aetna Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.82
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	$43.31
Rate for Payer: Cigna Commercial	$11.82
Rate for Payer: Cigna Medicare Advantage	$5.91
Rate for Payer: Clover Medicare Advantage	$11.23
Rate for Payer: EmblemHealth Commercial	$35.46
Rate for Payer: Humana Medicare Advantage	$12.17
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	$11.82
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.53
Rate for Payer: Wellcare Medicare Advantage	$11.82

C PSITTACI AB

Facility

$390.00

Service Code	HCPCS 86631
Hospital Charge Code	39708048A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

C. PSITTACI IGG TITER

Facility

$124.00

Service Code	HCPCS 86631
Hospital Charge Code	3000940C
Hospital Revenue Code	302
Min. Negotiated Rate	$5.91
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.30
Rate for Payer: Aetna Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.82
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	$43.31
Rate for Payer: Cigna Commercial	$11.82
Rate for Payer: Cigna Medicare Advantage	$5.91
Rate for Payer: Clover Medicare Advantage	$11.23
Rate for Payer: EmblemHealth Commercial	$35.46
Rate for Payer: Humana Medicare Advantage	$12.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.82
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.53
Rate for Payer: Wellcare Medicare Advantage	$11.82

C. PSITTACI IGG TITER

Facility

$124.00

Service Code	HCPCS 86631
Hospital Charge Code	3000940C
Hospital Revenue Code	302
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

C PSITTACI IGM

Facility

$390.00

Service Code	HCPCS 86632
Hospital Charge Code	39708048B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

C PSITTACI IGM

Facility

$390.00

Service Code	HCPCS 86632
Hospital Charge Code	39708048B
Hospital Revenue Code	302
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.08
Rate for Payer: Aetna Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.68
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	$46.46
Rate for Payer: Cigna Commercial	$12.68
Rate for Payer: Cigna Medicare Advantage	$6.34
Rate for Payer: Clover Medicare Advantage	$12.05
Rate for Payer: EmblemHealth Commercial	$38.04
Rate for Payer: Humana Medicare Advantage	$13.06
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	$12.68
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.44
Rate for Payer: Wellcare Medicare Advantage	$12.68

C. PSITTACI IGM TITER

Facility

$153.65

Service Code	HCPCS 86632
Hospital Charge Code	3000940F
Hospital Revenue Code	302
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.08
Rate for Payer: Aetna Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.68
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	$46.46
Rate for Payer: Cigna Commercial	$12.68
Rate for Payer: Cigna Medicare Advantage	$6.34
Rate for Payer: Clover Medicare Advantage	$12.05
Rate for Payer: EmblemHealth Commercial	$38.04
Rate for Payer: Humana Medicare Advantage	$13.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.68
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.44
Rate for Payer: Wellcare Medicare Advantage	$12.68

Know your out-of-pocket cost for care.

All Charges