Heights University Hospital

All Charges

Charge

Type

Setting

Price

Cystic Fibrosis Intron Poly-T

Facility

$400.00

Service Code	HCPCS 81224
Hospital Charge Code	39708017
Hospital Revenue Code	310
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

Cystic Fibrosis Intron Poly-T

Facility

$400.00

Service Code	HCPCS 81224
Hospital Charge Code	39708017
Hospital Revenue Code	310
Min. Negotiated Rate	$52.00
Max. Negotiated Rate	$618.30
Rate for Payer: Aetna Commercial	$546.75
Rate for Payer: Aetna Medicare Advantage	$168.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$168.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.30
Rate for Payer: Cigna Commercial	$168.75
Rate for Payer: Cigna Medicare Advantage	$84.38
Rate for Payer: Clover Medicare Advantage	$160.31
Rate for Payer: EmblemHealth Commercial	$506.25
Rate for Payer: Humana Medicare Advantage	$173.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$168.75
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$178.88
Rate for Payer: Wellcare Medicare Advantage	$168.75

CYSTIC FIBROSIS PANEL

Facility

$390.00

Service Code	HCPCS 81220
Hospital Charge Code	3036006EX
Hospital Revenue Code	310
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$2,039.38
Rate for Payer: Aetna Commercial	$1,803.38
Rate for Payer: Aetna Medicare Advantage	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,039.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,039.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,039.38
Rate for Payer: Cigna Commercial	$556.60
Rate for Payer: Cigna Medicare Advantage	$278.30
Rate for Payer: Clover Medicare Advantage	$528.77
Rate for Payer: EmblemHealth Commercial	$1,669.80
Rate for Payer: Humana Medicare Advantage	$573.30
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	$556.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$590.00
Rate for Payer: Wellcare Medicare Advantage	$556.60

CYSTIC FIBROSIS PANEL

Facility

$390.00

Service Code	HCPCS 81220
Hospital Charge Code	3036006EX
Hospital Revenue Code	310
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CYSTIC FIBROSIS PROFILE.

Facility

$204.00

Service Code	HCPCS 81220
Hospital Charge Code	3009345
Hospital Revenue Code	310
Min. Negotiated Rate	$30.60
Max. Negotiated Rate	$30.60
Rate for Payer: Qualcare PPO/HMO/WC	$30.60

CYSTIC FIBROSIS PROFILE.

Facility

$204.00

Service Code	HCPCS 81220
Hospital Charge Code	3009345
Hospital Revenue Code	310
Min. Negotiated Rate	$26.52
Max. Negotiated Rate	$2,039.38
Rate for Payer: Aetna Commercial	$1,803.38
Rate for Payer: Aetna Medicare Advantage	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,039.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,039.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$556.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,039.38
Rate for Payer: Cigna Commercial	$556.60
Rate for Payer: Cigna Medicare Advantage	$278.30
Rate for Payer: Clover Medicare Advantage	$528.77
Rate for Payer: EmblemHealth Commercial	$1,669.80
Rate for Payer: Humana Medicare Advantage	$573.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.52
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$556.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$590.00
Rate for Payer: Wellcare Medicare Advantage	$556.60

CYSTIC FIBROSIS - PULMONARY DISEASE

Facility

$19,971.74

Service Code	APR-DRG 1312
Min. Negotiated Rate	$16,414.98
Max. Negotiated Rate	$19,971.74
Rate for Payer: Aetna Better Health Medicaid	$19,580.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$19,971.74
Rate for Payer: Wellpoint Medicaid Managed Care	$16,414.98

CYSTIC FIBROSIS - PULMONARY DISEASE

Facility

$35,133.41

Service Code	APR-DRG 1314
Min. Negotiated Rate	$27,396.79
Max. Negotiated Rate	$35,133.41
Rate for Payer: Aetna Better Health Medicaid	$34,444.52
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$35,133.41
Rate for Payer: Wellpoint Medicaid Managed Care	$27,396.79

CYSTIC FIBROSIS - PULMONARY DISEASE

Facility

$27,063.82

Service Code	APR-DRG 1313
Min. Negotiated Rate	$21,300.21
Max. Negotiated Rate	$27,063.82
Rate for Payer: Aetna Better Health Medicaid	$26,533.16
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27,063.82
Rate for Payer: Wellpoint Medicaid Managed Care	$21,300.21

CYSTIC FIBROSIS - PULMONARY DISEASE

Facility

$15,222.09

Service Code	APR-DRG 1311
Min. Negotiated Rate	$13,301.92
Max. Negotiated Rate	$15,222.09
Rate for Payer: Aetna Better Health Medicaid	$14,923.62
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,222.09
Rate for Payer: Wellpoint Medicaid Managed Care	$13,301.92

CYSTINE

Facility

$646.00

Service Code	HCPCS 82139
Hospital Charge Code	38473102
Hospital Revenue Code	301
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.66
Rate for Payer: Aetna Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.81
Rate for Payer: Cigna Commercial	$16.87
Rate for Payer: Cigna Medicare Advantage	$8.44
Rate for Payer: Clover Medicare Advantage	$16.03
Rate for Payer: EmblemHealth Commercial	$50.61
Rate for Payer: Humana Medicare Advantage	$17.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.87
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.88
Rate for Payer: Wellcare Medicare Advantage	$16.87

CYSTINE

Facility

$646.00

Service Code	HCPCS 82139
Hospital Charge Code	38473102
Hospital Revenue Code	301
Min. Negotiated Rate	$96.90
Max. Negotiated Rate	$96.90
Rate for Payer: Qualcare PPO/HMO/WC	$96.90

CYSTINE BLOOD****

Facility

$70.00

Service Code	HCPCS 82131
Hospital Charge Code	3001039
Hospital Revenue Code	301
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.50

CYSTINE BLOOD****

Facility

$70.00

Service Code	HCPCS 82131
Hospital Charge Code	3001039
Hospital Revenue Code	301
Min. Negotiated Rate	$9.10
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$74.46
Rate for Payer: Aetna Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.20
Rate for Payer: Cigna Commercial	$22.98
Rate for Payer: Cigna Medicare Advantage	$11.49
Rate for Payer: Clover Medicare Advantage	$21.83
Rate for Payer: EmblemHealth Commercial	$68.94
Rate for Payer: Humana Medicare Advantage	$23.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.36
Rate for Payer: Wellcare Medicare Advantage	$22.98

CYSTINE/HOMOCYSTINE (URINE)

Facility

$39.25

Service Code	HCPCS 82615
Hospital Charge Code	3030442
Hospital Revenue Code	301
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$5.89
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

CYSTINE/HOMOCYSTINE (URINE)

Facility

$39.25

Service Code	HCPCS 82615
Hospital Charge Code	3030442
Hospital Revenue Code	301
Min. Negotiated Rate	$4.78
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.94
Rate for Payer: Aetna Medicare Advantage	$9.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.99
Rate for Payer: Cigna Commercial	$9.55
Rate for Payer: Cigna Medicare Advantage	$4.78
Rate for Payer: Clover Medicare Advantage	$9.07
Rate for Payer: EmblemHealth Commercial	$28.65
Rate for Payer: Humana Medicare Advantage	$9.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.55
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.12
Rate for Payer: Wellcare Medicare Advantage	$9.55

CYSTINE PLASMA

Facility

$153.65

Service Code	HCPCS 82131
Hospital Charge Code	3009340
Hospital Revenue Code	301
Min. Negotiated Rate	$11.49
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$74.46
Rate for Payer: Aetna Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.20
Rate for Payer: Cigna Commercial	$22.98
Rate for Payer: Cigna Medicare Advantage	$11.49
Rate for Payer: Clover Medicare Advantage	$21.83
Rate for Payer: EmblemHealth Commercial	$68.94
Rate for Payer: Humana Medicare Advantage	$23.67
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	$22.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.36
Rate for Payer: Wellcare Medicare Advantage	$22.98

CYSTINE PLASMA

Facility

$153.65

Service Code	HCPCS 82131
Hospital Charge Code	3009340
Hospital Revenue Code	301
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$23.05
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

CYSTINE,QUALITATIVE URINE

Facility

$390.00

Service Code	HCPCS 82131
Hospital Charge Code	3009342
Hospital Revenue Code	301
Min. Negotiated Rate	$11.49
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$74.46
Rate for Payer: Aetna Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.20
Rate for Payer: Cigna Commercial	$22.98
Rate for Payer: Cigna Medicare Advantage	$11.49
Rate for Payer: Clover Medicare Advantage	$21.83
Rate for Payer: EmblemHealth Commercial	$68.94
Rate for Payer: Humana Medicare Advantage	$23.67
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	$22.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.36
Rate for Payer: Wellcare Medicare Advantage	$22.98

CYSTINE,QUALITATIVE URINE

Facility

$390.00

Service Code	HCPCS 82131
Hospital Charge Code	3009342
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CYSTINE,URINE

Facility

$646.00

Service Code	HCPCS 82131
Hospital Charge Code	38473103
Hospital Revenue Code	301
Min. Negotiated Rate	$96.90
Max. Negotiated Rate	$96.90
Rate for Payer: Qualcare PPO/HMO/WC	$96.90

CYSTINE,URINE

Facility

$646.00

Service Code	HCPCS 82131
Hospital Charge Code	38473103
Hospital Revenue Code	301
Min. Negotiated Rate	$11.49
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$74.46
Rate for Payer: Aetna Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.20
Rate for Payer: Cigna Commercial	$22.98
Rate for Payer: Cigna Medicare Advantage	$11.49
Rate for Payer: Clover Medicare Advantage	$21.83
Rate for Payer: EmblemHealth Commercial	$68.94
Rate for Payer: Humana Medicare Advantage	$23.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.36
Rate for Payer: Wellcare Medicare Advantage	$22.98

CYSTLITHTMY W REM STNE WVN RES

Facility

$23,841.70

Service Code	HCPCS 51050
Hospital Charge Code	1600000509
Hospital Revenue Code	360
Min. Negotiated Rate	$3,576.26
Max. Negotiated Rate	$3,576.26
Rate for Payer: Qualcare PPO/HMO/WC	$3,576.26

CYSTLITHTMY W REM STNE WVN RES

Facility

$23,841.70

Service Code	HCPCS 51050
Hospital Charge Code	1600000509
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$12,768.54
Rate for Payer: Cigna Commercial	$12,768.54
Rate for Payer: Aetna Commercial	$7,152.51
Rate for Payer: Aetna Medicare Advantage	$7,152.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,079.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,079.63
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	$6,079.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,099.42
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,576.26
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

CYSTOCATH 8FR *******

Facility

$166.00

Hospital Charge Code	8000424
Hospital Revenue Code	279
Min. Negotiated Rate	$21.58
Max. Negotiated Rate	$83.00
Rate for Payer: Aetna Commercial	$49.80
Rate for Payer: Aetna Medicare Advantage	$49.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.33
Rate for Payer: Cigna Commercial	$83.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.58
Rate for Payer: Oxford Commercial	$83.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.90
Rate for Payer: UnitedHealthcare Commercial	$83.00

Know your out-of-pocket cost for care.

All Charges