Heights University Hospital

All Charges

Charge

Type

Setting

Price

ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY

Facility

$26,207.16

Service Code	APR-DRG 7724
Min. Negotiated Rate	$24,243.44
Max. Negotiated Rate	$26,207.16
Rate for Payer: Aetna Better Health Medicaid	$25,693.29
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,207.16
Rate for Payer: Wellpoint Medicaid Managed Care	$24,243.44

ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY

Facility

$7,762.03

Service Code	APR-DRG 7722
Min. Negotiated Rate	$6,648.63
Max. Negotiated Rate	$7,762.03
Rate for Payer: Aetna Better Health Medicaid	$7,609.83
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,762.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6,648.63

ALCOHOL BLOOD, (COC)***

Facility

$123.00

Service Code	HCPCS 82055
Hospital Charge Code	3032323
Hospital Revenue Code	301
Min. Negotiated Rate	$15.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$36.90
Rate for Payer: Aetna Medicare Advantage	$36.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.36
Rate for Payer: Cigna Commercial	$61.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.99
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.45
Rate for Payer: UnitedHealthcare Commercial	$114.00

ALCOHOL BLOOD, (COC)***

Facility

$123.00

Service Code	HCPCS 82055
Hospital Charge Code	3032323
Hospital Revenue Code	301
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$18.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

ALCOHOL DEHYD 98% AMP 5ML

Facility

$163.00

Hospital Charge Code	60635581
Hospital Revenue Code	250
Min. Negotiated Rate	$24.45
Max. Negotiated Rate	$24.45
Rate for Payer: Qualcare PPO/HMO/WC	$24.45

ALCOHOL DEHYD 98% AMP 5ML

Facility

$163.00

Hospital Charge Code	60635581
Hospital Revenue Code	250
Min. Negotiated Rate	$21.19
Max. Negotiated Rate	$81.50
Rate for Payer: Aetna Commercial	$48.90
Rate for Payer: Aetna Medicare Advantage	$48.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.56
Rate for Payer: Cigna Commercial	$81.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.19
Rate for Payer: Oxford Commercial	$81.50
Rate for Payer: Qualcare PPO/HMO/WC	$24.45
Rate for Payer: UnitedHealthcare Commercial	$81.50

ALCOHOL DEHYDRATED 98% INJ

Facility

$1,406.40

Hospital Charge Code	6063943053
Hospital Revenue Code	250
Min. Negotiated Rate	$182.83
Max. Negotiated Rate	$703.20
Rate for Payer: Aetna Commercial	$421.92
Rate for Payer: Aetna Medicare Advantage	$421.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.63
Rate for Payer: Cigna Commercial	$703.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.83
Rate for Payer: Oxford Commercial	$703.20
Rate for Payer: Qualcare PPO/HMO/WC	$210.96
Rate for Payer: UnitedHealthcare Commercial	$703.20

ALCOHOL DEHYDRATED 98% INJ

Facility

$1,406.40

Hospital Charge Code	6063943053
Hospital Revenue Code	250
Min. Negotiated Rate	$210.96
Max. Negotiated Rate	$210.96
Rate for Payer: Qualcare PPO/HMO/WC	$210.96

ALCOHOL DEXTROSE (GLASS) *****

Facility

$39.00

Hospital Charge Code	7000276
Hospital Revenue Code	258
Min. Negotiated Rate	$5.07
Max. Negotiated Rate	$19.50
Rate for Payer: Aetna Commercial	$11.70
Rate for Payer: Aetna Medicare Advantage	$11.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.95
Rate for Payer: Cigna Commercial	$19.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.07
Rate for Payer: Oxford Commercial	$19.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.85
Rate for Payer: UnitedHealthcare Commercial	$19.50

ALCOHOL DEXTROSE (GLASS) *****

Facility

$39.00

Hospital Charge Code	7000276
Hospital Revenue Code	258
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$5.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.85

ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA

Facility

$29,728.20

Service Code	MSDRG 894
Min. Negotiated Rate	$6,731.97
Max. Negotiated Rate	$29,728.20
Rate for Payer: Aetna Commercial	$20,801.79
Rate for Payer: Aetna Medicare Advantage	$6,731.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,713.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,713.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,909.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,713.19
Rate for Payer: Cigna Commercial	$13,276.30
Rate for Payer: Cigna Medicare Advantage	$9,909.40
Rate for Payer: Clover Medicare Advantage	$9,413.93
Rate for Payer: EmblemHealth Commercial	$29,728.20
Rate for Payer: Humana Medicare Advantage	$10,206.68
Rate for Payer: Oxford Commercial	$8,297.31
Rate for Payer: UnitedHealthcare Commercial	$9,418.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,909.40
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10,503.96
Rate for Payer: Wellcare Medicare Advantage	$9,909.40

ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC

Facility

$62,475.03

Service Code	MSDRG 896
Min. Negotiated Rate	$19,043.55
Max. Negotiated Rate	$62,475.03
Rate for Payer: Aetna Commercial	$58,844.57
Rate for Payer: Aetna Medicare Advantage	$19,043.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,069.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,069.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,825.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49,069.26
Rate for Payer: Cigna Commercial	$37,556.30
Rate for Payer: Cigna Medicare Advantage	$20,825.01
Rate for Payer: Clover Medicare Advantage	$19,783.76
Rate for Payer: EmblemHealth Commercial	$62,475.03
Rate for Payer: Humana Medicare Advantage	$21,449.76
Rate for Payer: Oxford Commercial	$23,471.60
Rate for Payer: UnitedHealthcare Commercial	$26,642.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,825.01
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22,074.51
Rate for Payer: Wellcare Medicare Advantage	$20,825.01

ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC

Facility

$37,446.15

Service Code	MSDRG 897
Min. Negotiated Rate	$9,633.63
Max. Negotiated Rate	$37,446.15
Rate for Payer: Aetna Commercial	$29,767.92
Rate for Payer: Aetna Medicare Advantage	$9,633.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,707.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,707.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,482.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,707.62
Rate for Payer: Cigna Commercial	$18,998.74
Rate for Payer: Cigna Medicare Advantage	$12,482.05
Rate for Payer: Clover Medicare Advantage	$11,857.95
Rate for Payer: EmblemHealth Commercial	$37,446.15
Rate for Payer: Humana Medicare Advantage	$12,856.51
Rate for Payer: Oxford Commercial	$11,873.66
Rate for Payer: UnitedHealthcare Commercial	$13,477.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,482.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13,230.97
Rate for Payer: Wellcare Medicare Advantage	$12,482.05

ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY

Facility

$52,911.06

Service Code	MSDRG 895
Min. Negotiated Rate	$15,447.85
Max. Negotiated Rate	$52,911.06
Rate for Payer: Aetna Commercial	$47,733.86
Rate for Payer: Aetna Medicare Advantage	$15,447.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44,382.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44,382.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,637.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44,382.87
Rate for Payer: Cigna Commercial	$30,465.13
Rate for Payer: Cigna Medicare Advantage	$17,637.02
Rate for Payer: Clover Medicare Advantage	$16,755.17
Rate for Payer: EmblemHealth Commercial	$52,911.06
Rate for Payer: Humana Medicare Advantage	$18,166.13
Rate for Payer: Oxford Commercial	$19,039.82
Rate for Payer: UnitedHealthcare Commercial	$21,611.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,637.02
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18,695.24
Rate for Payer: Wellcare Medicare Advantage	$17,637.02

ALCOHOL,ETHYL

Facility

$583.80

Service Code	HCPCS 80320
Hospital Charge Code	38472033
Hospital Revenue Code	301
Min. Negotiated Rate	$75.89
Max. Negotiated Rate	$291.90
Rate for Payer: Aetna Commercial	$175.14
Rate for Payer: Aetna Medicare Advantage	$175.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.87
Rate for Payer: Cigna Commercial	$291.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.89
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.57
Rate for Payer: UnitedHealthcare Commercial	$114.00

ALCOHOL,ETHYL

Facility

$583.80

Service Code	HCPCS 80320
Hospital Charge Code	38472033
Hospital Revenue Code	301
Min. Negotiated Rate	$87.57
Max. Negotiated Rate	$87.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.57

ALCOHOL,ETHYL,QL,URINE

Facility

$499.75

Service Code	HCPCS 80320
Hospital Charge Code	39900407
Hospital Revenue Code	301
Min. Negotiated Rate	$74.96
Max. Negotiated Rate	$74.96
Rate for Payer: Qualcare PPO/HMO/WC	$74.96

ALCOHOL,ETHYL,QL,URINE

Facility

$499.75

Service Code	HCPCS 80320
Hospital Charge Code	39900407
Hospital Revenue Code	301
Min. Negotiated Rate	$64.97
Max. Negotiated Rate	$249.88
Rate for Payer: Aetna Commercial	$149.93
Rate for Payer: Aetna Medicare Advantage	$149.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.44
Rate for Payer: Cigna Commercial	$249.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.96
Rate for Payer: UnitedHealthcare Commercial	$114.00

ALCOHOL, ETHYL, QN

Facility

$390.00

Service Code	HCPCS 80320
Hospital Charge Code	39900035
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ALCOHOL, ETHYL, QN

Facility

$390.00

Service Code	HCPCS 80320
Hospital Charge Code	39900035
Hospital Revenue Code	301
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

ALCOHOL, ETHYL, QUANT,URINE***

Facility

$92.00

Service Code	HCPCS 80320
Hospital Charge Code	3031127
Hospital Revenue Code	301
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.80

ALCOHOL, ETHYL, QUANT,URINE***

Facility

$92.00

Service Code	HCPCS 80320
Hospital Charge Code	3031127
Hospital Revenue Code	301
Min. Negotiated Rate	$11.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$27.60
Rate for Payer: Aetna Medicare Advantage	$27.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.46
Rate for Payer: Cigna Commercial	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.96
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.80
Rate for Payer: UnitedHealthcare Commercial	$114.00

ALCOHOL ETHYL SOL 100% GAL

Facility

$41.60

Hospital Charge Code	6009377
Hospital Revenue Code	250
Min. Negotiated Rate	$5.41
Max. Negotiated Rate	$20.80
Rate for Payer: Aetna Commercial	$12.48
Rate for Payer: Aetna Medicare Advantage	$12.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.61
Rate for Payer: Cigna Commercial	$20.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.41
Rate for Payer: Oxford Commercial	$20.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.24
Rate for Payer: UnitedHealthcare Commercial	$20.80

ALCOHOL ETHYL SOL 100% GAL

Facility

$41.60

Hospital Charge Code	6009377
Hospital Revenue Code	250
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$6.24
Rate for Payer: Qualcare PPO/HMO/WC	$6.24

ALCOHOL ETHYL SOL 95% GAL

Facility

$37.80

Hospital Charge Code	6009369
Hospital Revenue Code	250
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$18.90
Rate for Payer: Aetna Commercial	$11.34
Rate for Payer: Aetna Medicare Advantage	$11.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.64
Rate for Payer: Cigna Commercial	$18.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.91
Rate for Payer: Oxford Commercial	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$5.67
Rate for Payer: UnitedHealthcare Commercial	$18.90

Know your out-of-pocket cost for care.

All Charges