Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

ALCOHOL ETHYL URINE QUANT***

Facility

$146.00

Service Code	HCPCS 80320
Hospital Charge Code	3009891
Hospital Revenue Code	301
Min. Negotiated Rate	$18.98
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.80
Rate for Payer: Aetna Medicare Advantage	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.23
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$114.00

ALCOHOL ETHYL URINE QUANT***

Facility

$146.00

Service Code	HCPCS 80320
Hospital Charge Code	3009891
Hospital Revenue Code	301
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

ALCOHOL GASTRIC

Facility

$111.25

Service Code	HCPCS 84600
Hospital Charge Code	3000412
Hospital Revenue Code	301
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$16.69
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

ALCOHOL GASTRIC

Facility

$111.25

Service Code	HCPCS 84600
Hospital Charge Code	3000412
Hospital Revenue Code	301
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.44
Rate for Payer: Aetna Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.69
Rate for Payer: Cigna Commercial	$17.11
Rate for Payer: Cigna Medicare Advantage	$8.55
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.14
Rate for Payer: Wellcare Medicare Advantage	$17.11

ALCOHOLIC LIVER DISEASE

Facility

$29,108.59

Service Code	APR-DRG 2804
Min. Negotiated Rate	$22,412.41
Max. Negotiated Rate	$29,108.59
Rate for Payer: Aetna Better Health Medicaid	$28,537.83
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$29,108.59
Rate for Payer: Wellpoint Medicaid Managed Care	$22,412.41

ALCOHOLIC LIVER DISEASE

Facility

$9,136.93

Service Code	APR-DRG 2802
Min. Negotiated Rate	$6,233.37
Max. Negotiated Rate	$9,136.93
Rate for Payer: Aetna Better Health Medicaid	$8,957.77
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,136.93
Rate for Payer: Wellpoint Medicaid Managed Care	$6,233.37

ALCOHOLIC LIVER DISEASE

Facility

$13,915.98

Service Code	APR-DRG 2803
Min. Negotiated Rate	$9,932.17
Max. Negotiated Rate	$13,915.98
Rate for Payer: Aetna Better Health Medicaid	$13,643.12
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,915.98
Rate for Payer: Wellpoint Medicaid Managed Care	$9,932.17

ALCOHOLIC LIVER DISEASE

Facility

$7,075.26

Service Code	APR-DRG 2801
Min. Negotiated Rate	$4,974.71
Max. Negotiated Rate	$7,075.26
Rate for Payer: Aetna Better Health Medicaid	$6,936.53
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,075.26
Rate for Payer: Wellpoint Medicaid Managed Care	$4,974.71

ALCOHOL ISOPROPYL

Facility

$111.25

Service Code	HCPCS 84600
Hospital Charge Code	3000413
Hospital Revenue Code	301
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.44
Rate for Payer: Aetna Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.69
Rate for Payer: Cigna Commercial	$17.11
Rate for Payer: Cigna Medicare Advantage	$8.55
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.14
Rate for Payer: Wellcare Medicare Advantage	$17.11

ALCOHOL ISOPROPYL

Facility

$111.25

Service Code	HCPCS 84600
Hospital Charge Code	3000413
Hospital Revenue Code	301
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$16.69
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

ALCOHOL,ISOPROPYL

Facility

$572.00

Service Code	HCPCS 84600
Hospital Charge Code	38473088
Hospital Revenue Code	301
Min. Negotiated Rate	$85.80
Max. Negotiated Rate	$85.80
Rate for Payer: Qualcare PPO/HMO/WC	$85.80

ALCOHOL,ISOPROPYL

Facility

$572.00

Service Code	HCPCS 84600
Hospital Charge Code	38473088
Hospital Revenue Code	301
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.44
Rate for Payer: Aetna Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.69
Rate for Payer: Cigna Commercial	$17.11
Rate for Payer: Cigna Medicare Advantage	$8.55
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.14
Rate for Payer: Wellcare Medicare Advantage	$17.11

ALCOHOL LEVEL***

Facility

$71.00

Hospital Charge Code	3010410
Hospital Revenue Code	309
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

ALCOHOL LEVEL***

Facility

$71.00

Hospital Charge Code	3010410
Hospital Revenue Code	309
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$114.00
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	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$114.00

ALCOHOL METHYL

Facility

$111.25

Service Code	HCPCS 84600
Hospital Charge Code	3000414
Hospital Revenue Code	301
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$114.00
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: Aetna Commercial	$55.44
Rate for Payer: Aetna Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.69
Rate for Payer: Cigna Commercial	$17.11
Rate for Payer: Cigna Medicare Advantage	$8.55
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.14
Rate for Payer: Wellcare Medicare Advantage	$17.11

ALCOHOL METHYL

Facility

$111.25

Service Code	HCPCS 84600
Hospital Charge Code	3000414
Hospital Revenue Code	301
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$16.69
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

ALCOHOL,METHYL

Facility

$572.00

Service Code	HCPCS 84600
Hospital Charge Code	38473089
Hospital Revenue Code	301
Min. Negotiated Rate	$85.80
Max. Negotiated Rate	$85.80
Rate for Payer: Qualcare PPO/HMO/WC	$85.80

ALCOHOL,METHYL

Facility

$572.00

Service Code	HCPCS 84600
Hospital Charge Code	38473089
Hospital Revenue Code	301
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.44
Rate for Payer: Aetna Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.69
Rate for Payer: Cigna Commercial	$17.11
Rate for Payer: Cigna Medicare Advantage	$8.55
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.14
Rate for Payer: Wellcare Medicare Advantage	$17.11

ALCOHOL,METHYL,BLOOD

Facility

$110.50

Service Code	HCPCS 84600
Hospital Charge Code	39900152
Hospital Revenue Code	301
Min. Negotiated Rate	$16.57
Max. Negotiated Rate	$16.57
Rate for Payer: Qualcare PPO/HMO/WC	$16.57

ALCOHOL,METHYL,BLOOD

Facility

$110.50

Service Code	HCPCS 84600
Hospital Charge Code	39900152
Hospital Revenue Code	301
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.44
Rate for Payer: Aetna Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.69
Rate for Payer: Cigna Commercial	$17.11
Rate for Payer: Cigna Medicare Advantage	$8.55
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.37
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.57
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.14
Rate for Payer: Wellcare Medicare Advantage	$17.11

ALCOHOL PREP PAD STERILE 2-PLY

Facility

$0.03

Hospital Charge Code	270300045
Hospital Revenue Code	272
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

ALCOHOL PREP PAD STERILE 2-PLY

Facility

$0.03

Hospital Charge Code	270300045
Hospital Revenue Code	272
Max. Negotiated Rate	$0.02
Rate for Payer: Aetna Commercial	$0.01
Rate for Payer: Aetna Medicare Advantage	$0.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.01
Rate for Payer: Cigna Commercial	$0.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$0.02
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$0.02

ALCOHOL PREP PAD WEBCOL 2 PLY

Facility

$0.03

Hospital Charge Code	270624065
Hospital Revenue Code	272
Max. Negotiated Rate	$0.02
Rate for Payer: Aetna Commercial	$0.01
Rate for Payer: Aetna Medicare Advantage	$0.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.01
Rate for Payer: Cigna Commercial	$0.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$0.02
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$0.02

ALCOHOL PREP PAD WEBCOL 2 PLY

Facility

$0.03

Hospital Charge Code	270624065
Hospital Revenue Code	272
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Know your out-of-pocket cost for care.

All Charges