Heights University Hospital

All Charges

Charge

Type

Setting

Price

CULT SKIN GRAFT F/N/HF/G

Facility

$17,020.00

Service Code	HCPCS 15155
Hospital Charge Code	1600000338
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,439.01
Rate for Payer: Aetna Commercial	$5,106.00
Rate for Payer: Aetna Medicare Advantage	$5,106.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,340.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,340.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,340.10
Rate for Payer: Cigna Commercial	$8,439.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,212.60
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,553.00
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

CULT SKIN GRAFT F/N/HF/G

Facility

$17,020.00

Service Code	HCPCS 15155
Hospital Charge Code	1600000338
Hospital Revenue Code	360
Min. Negotiated Rate	$2,553.00
Max. Negotiated Rate	$2,553.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,553.00

CULT SKINGRFT T/ARM/LEG

Facility

$10,771.05

Service Code	HCPCS 15150
Hospital Charge Code	1600000277
Hospital Revenue Code	360
Min. Negotiated Rate	$1,400.24
Max. Negotiated Rate	$4,913.48
Rate for Payer: Aetna Commercial	$3,231.32
Rate for Payer: Aetna Medicare Advantage	$3,231.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,746.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,746.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,746.62
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,400.24
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,615.66
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

CULT SKINGRFT T/ARM/LEG

Facility

$10,771.05

Service Code	HCPCS 15150
Hospital Charge Code	1600000277
Hospital Revenue Code	360
Min. Negotiated Rate	$1,615.66
Max. Negotiated Rate	$1,615.66
Rate for Payer: Qualcare PPO/HMO/WC	$1,615.66

CULTUE, GENITAL****

Facility

$32.00

Hospital Charge Code	3010022
Hospital Revenue Code	306
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$9.60
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$114.00

CULTUE, GENITAL****

Facility

$32.00

Hospital Charge Code	3010022
Hospital Revenue Code	306
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

CULTURE ACID FAST (INC SMEAR**

Facility

$67.00

Hospital Charge Code	3010063
Hospital Revenue Code	306
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

CULTURE ACID FAST (INC SMEAR**

Facility

$67.00

Hospital Charge Code	3010063
Hospital Revenue Code	306
Min. Negotiated Rate	$8.71
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$20.10
Rate for Payer: Aetna Medicare Advantage	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.09
Rate for Payer: Cigna Commercial	$33.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.71
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.05
Rate for Payer: UnitedHealthcare Commercial	$114.00

CULTURE ACID FAST, STOOL

Facility

$295.25

Service Code	HCPCS 87116
Hospital Charge Code	3009396
Hospital Revenue Code	309
Min. Negotiated Rate	$44.29
Max. Negotiated Rate	$44.29
Rate for Payer: Qualcare PPO/HMO/WC	$44.29

CULTURE ACID FAST, STOOL

Facility

$295.25

Service Code	HCPCS 87116
Hospital Charge Code	3009396
Hospital Revenue Code	309
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$34.99
Rate for Payer: Aetna Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.57
Rate for Payer: Cigna Commercial	$10.80
Rate for Payer: Cigna Medicare Advantage	$5.40
Rate for Payer: Clover Medicare Advantage	$10.26
Rate for Payer: EmblemHealth Commercial	$32.40
Rate for Payer: Humana Medicare Advantage	$11.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.29
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.45
Rate for Payer: Wellcare Medicare Advantage	$10.80

CULTURE ADENOVIRUS

Facility

$287.25

Service Code	HCPCS 87252
Hospital Charge Code	3009560
Hospital Revenue Code	309
Min. Negotiated Rate	$13.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$84.47
Rate for Payer: Aetna Medicare Advantage	$26.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.52
Rate for Payer: Cigna Commercial	$26.07
Rate for Payer: Cigna Medicare Advantage	$13.04
Rate for Payer: Clover Medicare Advantage	$24.77
Rate for Payer: EmblemHealth Commercial	$78.21
Rate for Payer: Humana Medicare Advantage	$26.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.09
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.07
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$27.63
Rate for Payer: Wellcare Medicare Advantage	$26.07

CULTURE ADENOVIRUS

Facility

$287.25

Service Code	HCPCS 87252
Hospital Charge Code	3009560
Hospital Revenue Code	309
Min. Negotiated Rate	$43.09
Max. Negotiated Rate	$43.09
Rate for Payer: Qualcare PPO/HMO/WC	$43.09

CULTURE,AEROBIC

Facility

$59.20

Service Code	HCPCS 87070
Hospital Charge Code	39900264
Hospital Revenue Code	306
Min. Negotiated Rate	$4.31
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$27.93
Rate for Payer: Aetna Medicare Advantage	$8.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.58
Rate for Payer: Cigna Commercial	$8.62
Rate for Payer: Cigna Medicare Advantage	$4.31
Rate for Payer: Clover Medicare Advantage	$8.19
Rate for Payer: EmblemHealth Commercial	$25.86
Rate for Payer: Humana Medicare Advantage	$8.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.88
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.62
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.14
Rate for Payer: Wellcare Medicare Advantage	$8.62

CULTURE,AEROBIC

Facility

$59.20

Service Code	HCPCS 87070
Hospital Charge Code	39900264
Hospital Revenue Code	306
Min. Negotiated Rate	$8.88
Max. Negotiated Rate	$8.88
Rate for Payer: Qualcare PPO/HMO/WC	$8.88

CULTURE AEROBIC BACTERIA-SO

Facility

$98.99

Service Code	HCPCS 87070
Hospital Charge Code	401387070
Hospital Revenue Code	306
Min. Negotiated Rate	$4.31
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$27.93
Rate for Payer: Aetna Medicare Advantage	$8.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.58
Rate for Payer: Cigna Commercial	$8.62
Rate for Payer: Cigna Medicare Advantage	$4.31
Rate for Payer: Clover Medicare Advantage	$8.19
Rate for Payer: EmblemHealth Commercial	$25.86
Rate for Payer: Humana Medicare Advantage	$8.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.87
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.62
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.14
Rate for Payer: Wellcare Medicare Advantage	$8.62

CULTURE AEROBIC BACTERIA-SO

Facility

$98.99

Service Code	HCPCS 87070
Hospital Charge Code	401387070
Hospital Revenue Code	306
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$14.85
Rate for Payer: Qualcare PPO/HMO/WC	$14.85

CULTURE AEROBIC IDENTIFY

Facility

$138.14

Service Code	HCPCS 87077
Hospital Charge Code	401387077
Hospital Revenue Code	306
Min. Negotiated Rate	$20.72
Max. Negotiated Rate	$20.72
Rate for Payer: Qualcare PPO/HMO/WC	$20.72

CULTURE AEROBIC IDENTIFY

Facility

$138.14

Service Code	HCPCS 87077
Hospital Charge Code	401387077
Hospital Revenue Code	306
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.18
Rate for Payer: Aetna Medicare Advantage	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.61
Rate for Payer: Cigna Commercial	$8.08
Rate for Payer: Cigna Medicare Advantage	$4.04
Rate for Payer: Clover Medicare Advantage	$7.68
Rate for Payer: EmblemHealth Commercial	$24.24
Rate for Payer: Humana Medicare Advantage	$8.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.96
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.72
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.08
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.56
Rate for Payer: Wellcare Medicare Advantage	$8.08

CULTURE AFB

Facility

$295.25

Service Code	HCPCS 87116
Hospital Charge Code	3000064
Hospital Revenue Code	309
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$34.99
Rate for Payer: Aetna Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.57
Rate for Payer: Cigna Commercial	$10.80
Rate for Payer: Cigna Medicare Advantage	$5.40
Rate for Payer: Clover Medicare Advantage	$10.26
Rate for Payer: EmblemHealth Commercial	$32.40
Rate for Payer: Humana Medicare Advantage	$11.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.29
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.45
Rate for Payer: Wellcare Medicare Advantage	$10.80

CULTURE AFB

Facility

$295.25

Service Code	HCPCS 87116
Hospital Charge Code	3000064
Hospital Revenue Code	309
Min. Negotiated Rate	$44.29
Max. Negotiated Rate	$44.29
Rate for Payer: Qualcare PPO/HMO/WC	$44.29

CULTURE ANAEROBIC

Facility

$390.00

Service Code	HCPCS 87075
Hospital Charge Code	3009511
Hospital Revenue Code	309
Min. Negotiated Rate	$4.74
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.68
Rate for Payer: Aetna Medicare Advantage	$9.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.70
Rate for Payer: Cigna Commercial	$9.47
Rate for Payer: Cigna Medicare Advantage	$4.74
Rate for Payer: Clover Medicare Advantage	$9.00
Rate for Payer: EmblemHealth Commercial	$28.41
Rate for Payer: Humana Medicare Advantage	$9.75
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	$9.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.04
Rate for Payer: Wellcare Medicare Advantage	$9.47

CULTURE ANAEROBIC

Facility

$390.00

Service Code	HCPCS 87075
Hospital Charge Code	3009511
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CULTURE BACTERIA XCPT BLOOD-SO

Facility

$63.93

Service Code	HCPCS 87075
Hospital Charge Code	40134446B
Hospital Revenue Code	306
Min. Negotiated Rate	$9.59
Max. Negotiated Rate	$9.59
Rate for Payer: Qualcare PPO/HMO/WC	$9.59

CULTURE BACTERIA XCPT BLOOD-SO

Facility

$63.93

Service Code	HCPCS 87075
Hospital Charge Code	40134446B
Hospital Revenue Code	306
Min. Negotiated Rate	$4.74
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.68
Rate for Payer: Aetna Medicare Advantage	$9.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.70
Rate for Payer: Cigna Commercial	$9.47
Rate for Payer: Cigna Medicare Advantage	$4.74
Rate for Payer: Clover Medicare Advantage	$9.00
Rate for Payer: EmblemHealth Commercial	$28.41
Rate for Payer: Humana Medicare Advantage	$9.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.31
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.59
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.04
Rate for Payer: Wellcare Medicare Advantage	$9.47

CULTURE BACTERIA XCPT BLOOD-SO

Facility

$103.94

Service Code	HCPCS 87075
Hospital Charge Code	40134469A
Hospital Revenue Code	306
Min. Negotiated Rate	$15.59
Max. Negotiated Rate	$15.59
Rate for Payer: Qualcare PPO/HMO/WC	$15.59

Know your out-of-pocket cost for care.

All Charges