Heights University Hospital

All Charges

Charge

Type

Setting

Price

CYTOPATH-CERV/VAG AUTO SCREEN

Facility

$181.49

Service Code	HCPCS 88175
Hospital Charge Code	38478092
Hospital Revenue Code	311
Min. Negotiated Rate	$27.22
Max. Negotiated Rate	$27.22
Rate for Payer: Qualcare PPO/HMO/WC	$27.22

CYTOPATH-CERV/VAG AUTO SCREEN

Facility

$181.49

Service Code	HCPCS 88175
Hospital Charge Code	38478092
Hospital Revenue Code	311
Min. Negotiated Rate	$13.30
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$86.22
Rate for Payer: Aetna Medicare Advantage	$26.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.50
Rate for Payer: Cigna Commercial	$26.61
Rate for Payer: Cigna Medicare Advantage	$13.30
Rate for Payer: Clover Medicare Advantage	$25.28
Rate for Payer: EmblemHealth Commercial	$79.83
Rate for Payer: Humana Medicare Advantage	$27.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.59
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.22
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.61
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28.21
Rate for Payer: Wellcare Medicare Advantage	$26.61

CYTOPATH,CERV/VAG. THIN PREP

Facility

$143.50

Service Code	HCPCS 88142
Hospital Charge Code	38470469
Hospital Revenue Code	311
Min. Negotiated Rate	$10.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$65.64
Rate for Payer: Aetna Medicare Advantage	$20.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.23
Rate for Payer: Cigna Commercial	$20.26
Rate for Payer: Cigna Medicare Advantage	$10.13
Rate for Payer: Clover Medicare Advantage	$19.25
Rate for Payer: EmblemHealth Commercial	$60.78
Rate for Payer: Humana Medicare Advantage	$20.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.52
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.26
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$21.48
Rate for Payer: Wellcare Medicare Advantage	$20.26

CYTOPATH,CERV/VAG. THIN PREP

Facility

$143.50

Service Code	HCPCS 88142
Hospital Charge Code	38470469
Hospital Revenue Code	311
Min. Negotiated Rate	$21.52
Max. Negotiated Rate	$21.52
Rate for Payer: Qualcare PPO/HMO/WC	$21.52

CYTOPATH,CERV/VAG THIN PREP,MD

Facility

$143.00

Service Code	HCPCS 88141
Hospital Charge Code	38470468
Hospital Revenue Code	311
Min. Negotiated Rate	$13.53
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.90
Rate for Payer: Aetna Medicare Advantage	$42.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.47
Rate for Payer: Cigna Commercial	$27.06
Rate for Payer: Cigna Medicare Advantage	$13.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.59
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.45
Rate for Payer: UnitedHealthcare Commercial	$114.00

CYTOPATH,CERV/VAG THIN PREP,MD

Facility

$143.00

Service Code	HCPCS 88141
Hospital Charge Code	38470468
Hospital Revenue Code	311
Min. Negotiated Rate	$21.45
Max. Negotiated Rate	$21.45
Rate for Payer: Qualcare PPO/HMO/WC	$21.45

CYTOPATH C/V AUTOFLID REDO

Facility

$390.00

Service Code	HCPCS 88175
Hospital Charge Code	39708053A
Hospital Revenue Code	311
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CYTOPATH C/V AUTOFLID REDO

Facility

$390.00

Service Code	HCPCS 88175
Hospital Charge Code	39708053A
Hospital Revenue Code	311
Min. Negotiated Rate	$13.30
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$86.22
Rate for Payer: Aetna Medicare Advantage	$26.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.50
Rate for Payer: Cigna Commercial	$26.61
Rate for Payer: Cigna Medicare Advantage	$13.30
Rate for Payer: Clover Medicare Advantage	$25.28
Rate for Payer: EmblemHealth Commercial	$79.83
Rate for Payer: Humana Medicare Advantage	$27.41
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	$26.61
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28.21
Rate for Payer: Wellcare Medicare Advantage	$26.61

CYTOPATH C/V THIN LAYER

Facility

$390.00

Service Code	HCPCS 88142
Hospital Charge Code	39990117B
Hospital Revenue Code	311
Min. Negotiated Rate	$10.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$65.64
Rate for Payer: Aetna Medicare Advantage	$20.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.23
Rate for Payer: Cigna Commercial	$20.26
Rate for Payer: Cigna Medicare Advantage	$10.13
Rate for Payer: Clover Medicare Advantage	$19.25
Rate for Payer: EmblemHealth Commercial	$60.78
Rate for Payer: Humana Medicare Advantage	$20.87
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	$20.26
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$21.48
Rate for Payer: Wellcare Medicare Advantage	$20.26

CYTOPATH C/V THIN LAYER

Facility

$390.00

Service Code	HCPCS 88142
Hospital Charge Code	39990117B
Hospital Revenue Code	311
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CYTOPATH, FLD, BRSH & WASH

Facility

$166.00

Service Code	HCPCS 88104
Hospital Charge Code	1600000649
Hospital Revenue Code	360
Min. Negotiated Rate	$24.90
Max. Negotiated Rate	$24.90
Rate for Payer: Qualcare PPO/HMO/WC	$24.90

CYTOPATH, FLD, BRSH & WASH

Facility

$166.00

Service Code	HCPCS 88104
Hospital Charge Code	1600000649
Hospital Revenue Code	360
Min. Negotiated Rate	$21.58
Max. Negotiated Rate	$1,864.00
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) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.33
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.58
Rate for Payer: Qualcare PPO/HMO/WC	$24.90

CYTOPATHOLOGY SMEAR W/INTERPRE

Facility

$425.00

Service Code	HCPCS 88104
Hospital Charge Code	3005347
Hospital Revenue Code	311
Min. Negotiated Rate	$47.88
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$47.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

CYTOPATHOLOGY SMEAR W/INTERPRE

Facility

$425.00

Service Code	HCPCS 88104
Hospital Charge Code	3005347
Hospital Revenue Code	311
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

CYTOPATHOLOGY THIN PREP

Facility

$390.00

Service Code	HCPCS 88112
Hospital Charge Code	3005365
Hospital Revenue Code	310
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$124.10
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	$124.10
Rate for Payer: Cigna Medicare Advantage	$37.05
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

CYTOPATHOLOGY THIN PREP

Facility

$390.00

Service Code	HCPCS 88112
Hospital Charge Code	3005365
Hospital Revenue Code	310
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CYTOPATH SELCT CELL ENHANCE EX

Facility

$218.74

Service Code	HCPCS 88112
Hospital Charge Code	38477183
Hospital Revenue Code	311
Min. Negotiated Rate	$28.44
Max. Negotiated Rate	$124.10
Rate for Payer: Aetna Commercial	$65.62
Rate for Payer: Aetna Medicare Advantage	$65.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.78
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$37.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.44
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.81
Rate for Payer: UnitedHealthcare Commercial	$114.00

CYTOPATH SELCT CELL ENHANCE EX

Facility

$218.74

Service Code	HCPCS 88112
Hospital Charge Code	38477183
Hospital Revenue Code	311
Min. Negotiated Rate	$32.81
Max. Negotiated Rate	$32.81
Rate for Payer: Qualcare PPO/HMO/WC	$32.81

CYTOPATH SLIDES CERV/VAG HORM

Facility

$42.00

Service Code	HCPCS 88155
Hospital Charge Code	38477046
Hospital Revenue Code	311
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

CYTOPATH SLIDES CERV/VAG HORM

Facility

$42.00

Service Code	HCPCS 88155
Hospital Charge Code	38477046
Hospital Revenue Code	311
Min. Negotiated Rate	$5.46
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.47
Rate for Payer: Aetna Medicare Advantage	$14.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.68
Rate for Payer: Cigna Commercial	$14.65
Rate for Payer: Cigna Medicare Advantage	$7.33
Rate for Payer: Clover Medicare Advantage	$13.92
Rate for Payer: EmblemHealth Commercial	$43.95
Rate for Payer: Humana Medicare Advantage	$15.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.53
Rate for Payer: Wellcare Medicare Advantage	$14.65

CYTOSAR 100 MG

Facility

$75.00

Hospital Charge Code	60635306
Hospital Revenue Code	636
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$18.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

CYTOSAR 100 MG

Facility

$75.00

Hospital Charge Code	60635306
Hospital Revenue Code	636
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

CYTOSAR-U/1GM

Facility

$321.00

Hospital Charge Code	60632767
Hospital Revenue Code	636
Min. Negotiated Rate	$48.15
Max. Negotiated Rate	$160.50
Rate for Payer: Aetna Commercial	$96.30
Rate for Payer: Aetna Medicare Advantage	$96.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.86
Rate for Payer: Cigna Commercial	$160.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.68
Rate for Payer: Qualcare PPO/HMO/WC	$48.15

CYTOSAR-U/1GM

Facility

$321.00

Hospital Charge Code	60632767
Hospital Revenue Code	636
Min. Negotiated Rate	$48.15
Max. Negotiated Rate	$77.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.68
Rate for Payer: Qualcare PPO/HMO/WC	$48.15

CYTO SPUTUM

Facility

$390.00

Service Code	HCPCS 88108
Hospital Charge Code	3001336
Hospital Revenue Code	311
Min. Negotiated Rate	$39.18
Max. Negotiated Rate	$117.00
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	$88.94
Rate for Payer: Cigna Medicare Advantage	$39.18
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

Know your out-of-pocket cost for care.

All Charges