Heights University Hospital

All Charges

Charge

Type

Setting

Price

ALKALINE PHOSPHATASE ISOENZYME

Facility

$442.00

Service Code	HCPCS 84080
Hospital Charge Code	3006103A
Hospital Revenue Code	301
Min. Negotiated Rate	$66.30
Max. Negotiated Rate	$66.30
Rate for Payer: Qualcare PPO/HMO/WC	$66.30

ALKALINE PHOSPHATASE SERUM

Facility

$667.59

Service Code	HCPCS 84075
Hospital Charge Code	3000197
Hospital Revenue Code	301
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.78
Rate for Payer: Aetna Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.98
Rate for Payer: Cigna Commercial	$5.18
Rate for Payer: Cigna Medicare Advantage	$2.59
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.49
Rate for Payer: Wellcare Medicare Advantage	$5.18

ALKALINE PHOSPHATASE SERUM

Facility

$667.59

Service Code	HCPCS 84075
Hospital Charge Code	3000197
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

ALKALOIDS NOS

Facility

$190.45

Service Code	HCPCS 80323
Hospital Charge Code	397043300
Hospital Revenue Code	301
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.13
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$114.00

ALKALOIDS NOS

Facility

$190.45

Service Code	HCPCS 80323
Hospital Charge Code	397043300
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ALK PHOSPHATASE, BONE

Facility

$54.45

Service Code	HCPCS 84075
Hospital Charge Code	3009995
Hospital Revenue Code	301
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$8.17

ALK PHOSPHATASE, BONE

Facility

$54.45

Service Code	HCPCS 84075
Hospital Charge Code	3009995
Hospital Revenue Code	301
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.78
Rate for Payer: Aetna Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.98
Rate for Payer: Cigna Commercial	$5.18
Rate for Payer: Cigna Medicare Advantage	$2.59
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.17
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.49
Rate for Payer: Wellcare Medicare Advantage	$5.18

ALK PHOSPHATASE,BONE

Facility

$35.55

Service Code	HCPCS 84075
Hospital Charge Code	39900119
Hospital Revenue Code	301
Min. Negotiated Rate	$5.33
Max. Negotiated Rate	$5.33
Rate for Payer: Qualcare PPO/HMO/WC	$5.33

ALK PHOSPHATASE,BONE

Facility

$35.55

Service Code	HCPCS 84075
Hospital Charge Code	39900119
Hospital Revenue Code	301
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.78
Rate for Payer: Aetna Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.98
Rate for Payer: Cigna Commercial	$5.18
Rate for Payer: Cigna Medicare Advantage	$2.59
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.33
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.49
Rate for Payer: Wellcare Medicare Advantage	$5.18

ALK PHOSPHATASE ISOENZYME I

Facility

$390.00

Service Code	HCPCS 84075
Hospital Charge Code	39990073A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ALK PHOSPHATASE ISOENZYME I

Facility

$390.00

Service Code	HCPCS 84075
Hospital Charge Code	39990073A
Hospital Revenue Code	301
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.78
Rate for Payer: Aetna Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.98
Rate for Payer: Cigna Commercial	$5.18
Rate for Payer: Cigna Medicare Advantage	$2.59
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
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	$5.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.49
Rate for Payer: Wellcare Medicare Advantage	$5.18

ALK PHOSPHATASE ISOENZYME II

Facility

$390.00

Service Code	HCPCS 84080
Hospital Charge Code	39990073B
Hospital Revenue Code	301
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.89
Rate for Payer: Aetna Medicare Advantage	$14.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.15
Rate for Payer: Cigna Commercial	$14.78
Rate for Payer: Cigna Medicare Advantage	$7.39
Rate for Payer: Clover Medicare Advantage	$14.04
Rate for Payer: EmblemHealth Commercial	$44.34
Rate for Payer: Humana Medicare Advantage	$15.22
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	$14.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.67
Rate for Payer: Wellcare Medicare Advantage	$14.78

ALK PHOSPHATASE ISOENZYME II

Facility

$390.00

Service Code	HCPCS 84080
Hospital Charge Code	39990073B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ALLBEE W/ VITAMIN C/TAB

Facility

$3.00

Hospital Charge Code	60634303
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ALLBEE W/ VITAMIN C/TAB

Facility

$3.00

Hospital Charge Code	60634303
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

Allegra

Facility

$16.28

Service Code	NDC 378078205
Hospital Charge Code	6063943300
Hospital Revenue Code	250
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$8.14
Rate for Payer: Aetna Commercial	$4.88
Rate for Payer: Aetna Medicare Advantage	$4.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.15
Rate for Payer: Cigna Commercial	$8.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.12
Rate for Payer: Oxford Commercial	$8.14
Rate for Payer: Qualcare PPO/HMO/WC	$2.44
Rate for Payer: UnitedHealthcare Commercial	$8.14

Allegra

Facility

$16.28

Service Code	NDC 378078205
Hospital Charge Code	6063943300
Hospital Revenue Code	250
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$2.44
Rate for Payer: Qualcare PPO/HMO/WC	$2.44

ALLEN TOTAL KNEE STABILIZER

Facility

$1,565.00

Hospital Charge Code	270656097
Hospital Revenue Code	272
Min. Negotiated Rate	$203.45
Max. Negotiated Rate	$782.50
Rate for Payer: Aetna Commercial	$469.50
Rate for Payer: Aetna Medicare Advantage	$469.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$399.07
Rate for Payer: Cigna Commercial	$782.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.45
Rate for Payer: Oxford Commercial	$782.50
Rate for Payer: Qualcare PPO/HMO/WC	$234.75
Rate for Payer: UnitedHealthcare Commercial	$782.50

ALLEN TOTAL KNEE STABILIZER

Facility

$1,565.00

Hospital Charge Code	270656097
Hospital Revenue Code	272
Min. Negotiated Rate	$234.75
Max. Negotiated Rate	$234.75
Rate for Payer: Qualcare PPO/HMO/WC	$234.75

ALLERGAN EAR DROPS 15ML

Facility

$9.00

Hospital Charge Code	6016117
Hospital Revenue Code	251
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

ALLERGAN EAR DROPS 15ML

Facility

$9.00

Hospital Charge Code	6016117
Hospital Revenue Code	251
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

ALLERGEN ALMOND

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3031241
Hospital Revenue Code	305
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

ALLERGEN ALMOND

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3031241
Hospital Revenue Code	305
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.91
Rate for Payer: Aetna Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.13
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: Cigna Medicare Advantage	$2.61
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.53
Rate for Payer: Wellcare Medicare Advantage	$5.22

ALLERGEN AMERICAN ELM

Facility

$52.00

Service Code	HCPCS 8600391
Hospital Charge Code	3031298
Hospital Revenue Code	305
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

ALLERGEN AMERICAN ELM

Facility

$52.00

Service Code	HCPCS 8600391
Hospital Charge Code	3031298
Hospital Revenue Code	305
Min. Negotiated Rate	$6.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.60
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$114.00

Know your out-of-pocket cost for care.

All Charges