Heights University Hospital

All Charges

Charge

Type

Setting

Price

ALANINE AMINOTRANSFERASE (ALT/

Facility

$345.00

Service Code	HCPCS 84460
Hospital Charge Code	38472038
Hospital Revenue Code	301
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.17
Rate for Payer: Aetna Medicare Advantage	$5.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.30
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	$19.42
Rate for Payer: Cigna Commercial	$5.30
Rate for Payer: Cigna Medicare Advantage	$2.65
Rate for Payer: Clover Medicare Advantage	$5.04
Rate for Payer: EmblemHealth Commercial	$15.90
Rate for Payer: Humana Medicare Advantage	$5.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.85
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.30
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.62
Rate for Payer: Wellcare Medicare Advantage	$5.30

ALANINE AMINOTRANSFERASE (ALT/

Facility

$345.00

Service Code	HCPCS 84460
Hospital Charge Code	38472038
Hospital Revenue Code	301
Min. Negotiated Rate	$51.75
Max. Negotiated Rate	$51.75
Rate for Payer: Qualcare PPO/HMO/WC	$51.75

ALANINE QUANT SERUM

Facility

$47.25

Service Code	HCPCS 84460
Hospital Charge Code	3006913
Hospital Revenue Code	301
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Qualcare PPO/HMO/WC	$7.09

ALANINE QUANT SERUM

Facility

$47.25

Service Code	HCPCS 84460
Hospital Charge Code	3006913
Hospital Revenue Code	301
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.17
Rate for Payer: Aetna Medicare Advantage	$5.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.30
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	$19.42
Rate for Payer: Cigna Commercial	$5.30
Rate for Payer: Cigna Medicare Advantage	$2.65
Rate for Payer: Clover Medicare Advantage	$5.04
Rate for Payer: EmblemHealth Commercial	$15.90
Rate for Payer: Humana Medicare Advantage	$5.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.09
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.30
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.62
Rate for Payer: Wellcare Medicare Advantage	$5.30

ALBALON 0.1% LIQUIFILM OP

Facility

$71.00

Hospital Charge Code	60632408
Hospital Revenue Code	250
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$35.50
Rate for Payer: Aetna Commercial	$21.30
Rate for Payer: Aetna Medicare Advantage	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.11
Rate for Payer: Cigna Commercial	$35.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.23
Rate for Payer: Oxford Commercial	$35.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$35.50

ALBALON 0.1% LIQUIFILM OP

Facility

$71.00

Hospital Charge Code	60632408
Hospital Revenue Code	250
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

ALBALON A

Facility

$71.00

Hospital Charge Code	60634514
Hospital Revenue Code	250
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

ALBALON A

Facility

$71.00

Hospital Charge Code	60634514
Hospital Revenue Code	250
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$35.50
Rate for Payer: Aetna Commercial	$21.30
Rate for Payer: Aetna Medicare Advantage	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.11
Rate for Payer: Cigna Commercial	$35.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.23
Rate for Payer: Oxford Commercial	$35.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$35.50

ALBENDAZOLE 200 MG TAB

Facility

$1,177.99

Service Code	NDC 52054055028
Hospital Charge Code	60629233
Hospital Revenue Code	250
Min. Negotiated Rate	$153.14
Max. Negotiated Rate	$589.00
Rate for Payer: Aetna Commercial	$353.40
Rate for Payer: Aetna Medicare Advantage	$353.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$300.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$300.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$300.39
Rate for Payer: Cigna Commercial	$589.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.14
Rate for Payer: Oxford Commercial	$589.00
Rate for Payer: Qualcare PPO/HMO/WC	$176.70
Rate for Payer: UnitedHealthcare Commercial	$589.00

ALBENDAZOLE 200 MG TAB

Facility

$1,177.99

Service Code	NDC 52054055028
Hospital Charge Code	60629233
Hospital Revenue Code	250
Min. Negotiated Rate	$176.70
Max. Negotiated Rate	$176.70
Rate for Payer: Qualcare PPO/HMO/WC	$176.70

ALBENZA, 200MG, TAB

Facility

$4.00

Hospital Charge Code	60635446
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ALBENZA, 200MG, TAB

Facility

$4.00

Hospital Charge Code	60635446
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

ALBUMIN

Facility

$137.50

Service Code	HCPCS 82040
Hospital Charge Code	8200300RS
Hospital Revenue Code	307
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.04
Rate for Payer: Aetna Medicare Advantage	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.14
Rate for Payer: Cigna Commercial	$4.95
Rate for Payer: Cigna Medicare Advantage	$2.48
Rate for Payer: Clover Medicare Advantage	$4.70
Rate for Payer: EmblemHealth Commercial	$14.85
Rate for Payer: Humana Medicare Advantage	$5.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.88
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.62
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.95
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.25
Rate for Payer: Wellcare Medicare Advantage	$4.95

ALBUMIN

Facility

$76.00

Service Code	HCPCS 82040
Hospital Charge Code	38472041
Hospital Revenue Code	307
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.04
Rate for Payer: Aetna Medicare Advantage	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.14
Rate for Payer: Cigna Commercial	$4.95
Rate for Payer: Cigna Medicare Advantage	$2.48
Rate for Payer: Clover Medicare Advantage	$4.70
Rate for Payer: EmblemHealth Commercial	$14.85
Rate for Payer: Humana Medicare Advantage	$5.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.88
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.95
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.25
Rate for Payer: Wellcare Medicare Advantage	$4.95

ALBUMIN

Facility

$137.50

Service Code	HCPCS 82040
Hospital Charge Code	8200300RS
Hospital Revenue Code	307
Min. Negotiated Rate	$20.62
Max. Negotiated Rate	$20.62
Rate for Payer: Qualcare PPO/HMO/WC	$20.62

ALBUMIN

Facility

$76.00

Service Code	HCPCS 82040
Hospital Charge Code	38472041
Hospital Revenue Code	307
Min. Negotiated Rate	$11.40
Max. Negotiated Rate	$11.40
Rate for Payer: Qualcare PPO/HMO/WC	$11.40

ALBUMIN 25% - 25G/100ML

Facility

$864.30

Service Code	HCPCS P9047
Hospital Charge Code	60630107
Hospital Revenue Code	636
Min. Negotiated Rate	$129.65
Max. Negotiated Rate	$209.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.16
Rate for Payer: Qualcare PPO/HMO/WC	$129.65

ALBUMIN 25% - 25G/100ML

Facility

$864.30

Service Code	HCPCS P9047
Hospital Charge Code	60630107
Hospital Revenue Code	636
Min. Negotiated Rate	$129.65
Max. Negotiated Rate	$259.29
Rate for Payer: Aetna Commercial	$259.29
Rate for Payer: Aetna Medicare Advantage	$259.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$220.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$220.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$220.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.16
Rate for Payer: Qualcare PPO/HMO/WC	$129.65

ALBUMIN 25%/50ML

Facility

$482.00

Hospital Charge Code	60634506
Hospital Revenue Code	636
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$241.00
Rate for Payer: Aetna Commercial	$144.60
Rate for Payer: Aetna Medicare Advantage	$144.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.91
Rate for Payer: Cigna Commercial	$241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.64
Rate for Payer: Qualcare PPO/HMO/WC	$72.30

ALBUMIN 25%/50ML

Facility

$482.00

Hospital Charge Code	60634506
Hospital Revenue Code	636
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$116.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$116.64
Rate for Payer: Qualcare PPO/HMO/WC	$72.30

ALBUMIN 5%/250ML

Facility

$322.00

Hospital Charge Code	60634827
Hospital Revenue Code	636
Min. Negotiated Rate	$48.30
Max. Negotiated Rate	$161.00
Rate for Payer: Aetna Commercial	$96.60
Rate for Payer: Aetna Medicare Advantage	$96.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.11
Rate for Payer: Cigna Commercial	$161.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.92
Rate for Payer: Qualcare PPO/HMO/WC	$48.30

ALBUMIN 5%/250ML

Facility

$322.00

Hospital Charge Code	60634827
Hospital Revenue Code	636
Min. Negotiated Rate	$48.30
Max. Negotiated Rate	$77.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.92
Rate for Payer: Qualcare PPO/HMO/WC	$48.30

ALBUMIN, BODY FLUID

Facility

$47.50

Service Code	HCPCS 82042
Hospital Charge Code	3002848
Hospital Revenue Code	307
Min. Negotiated Rate	$3.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$25.21
Rate for Payer: Aetna Medicare Advantage	$7.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.51
Rate for Payer: Cigna Commercial	$7.78
Rate for Payer: Cigna Medicare Advantage	$3.89
Rate for Payer: Clover Medicare Advantage	$7.39
Rate for Payer: EmblemHealth Commercial	$23.34
Rate for Payer: Humana Medicare Advantage	$8.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.12
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.25
Rate for Payer: Wellcare Medicare Advantage	$7.78

ALBUMIN, BODY FLUID

Facility

$47.50

Service Code	HCPCS 82042
Hospital Charge Code	3002848
Hospital Revenue Code	307
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.12

ALBUMIN CSF PROTEIN ELECT

Facility

$88.00

Service Code	HCPCS 84165
Hospital Charge Code	3006947
Hospital Revenue Code	301
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$34.80
Rate for Payer: Aetna Medicare Advantage	$10.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.74
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	$39.35
Rate for Payer: Cigna Commercial	$10.74
Rate for Payer: Cigna Medicare Advantage	$5.37
Rate for Payer: Clover Medicare Advantage	$10.20
Rate for Payer: EmblemHealth Commercial	$32.22
Rate for Payer: Humana Medicare Advantage	$11.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.44
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.38
Rate for Payer: Wellcare Medicare Advantage	$10.74

Know your out-of-pocket cost for care.

All Charges