Heights University Hospital

All Charges

Charge

Type

Setting

Price

ELECTROLYTES

Facility

$251.00

Service Code	HCPCS 80051
Hospital Charge Code	38472008
Hospital Revenue Code	301
Min. Negotiated Rate	$37.65
Max. Negotiated Rate	$37.65
Rate for Payer: Qualcare PPO/HMO/WC	$37.65

ELECTROLYTES

Facility

$251.00

Service Code	HCPCS 80051
Hospital Charge Code	38472008
Hospital Revenue Code	301
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$22.71
Rate for Payer: Aetna Medicare Advantage	$7.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.68
Rate for Payer: Cigna Commercial	$7.01
Rate for Payer: Cigna Medicare Advantage	$3.50
Rate for Payer: Clover Medicare Advantage	$6.66
Rate for Payer: EmblemHealth Commercial	$21.03
Rate for Payer: Humana Medicare Advantage	$7.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.63
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.01
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.43
Rate for Payer: Wellcare Medicare Advantage	$7.01

ELECTROLYTES QN FECES

Facility

$77.65

Service Code	HCPCS 82438
Hospital Charge Code	3009993
Hospital Revenue Code	301
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$11.65
Rate for Payer: Qualcare PPO/HMO/WC	$11.65

ELECTROLYTES QN FECES

Facility

$77.65

Service Code	HCPCS 82438
Hospital Charge Code	3009993
Hospital Revenue Code	301
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.20
Rate for Payer: Aetna Medicare Advantage	$5.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.32
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: Cigna Medicare Advantage	$2.50
Rate for Payer: Clover Medicare Advantage	$4.75
Rate for Payer: EmblemHealth Commercial	$15.00
Rate for Payer: Humana Medicare Advantage	$5.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.30
Rate for Payer: Wellcare Medicare Advantage	$5.00

ELECTROLYTES, SERUM

Facility

$390.00

Service Code	HCPCS 80051
Hospital Charge Code	3001138
Hospital Revenue Code	301
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$22.71
Rate for Payer: Aetna Medicare Advantage	$7.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.68
Rate for Payer: Cigna Commercial	$7.01
Rate for Payer: Cigna Medicare Advantage	$3.50
Rate for Payer: Clover Medicare Advantage	$6.66
Rate for Payer: EmblemHealth Commercial	$21.03
Rate for Payer: Humana Medicare Advantage	$7.22
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	$7.01
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.43
Rate for Payer: Wellcare Medicare Advantage	$7.01

ELECTROLYTES, SERUM

Facility

$390.00

Service Code	HCPCS 80051
Hospital Charge Code	3001138
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ELECTROLYTES SERUM PANEL***

Facility

$17.00

Service Code	HCPCS 80051
Hospital Charge Code	3001138P
Hospital Revenue Code	301
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

ELECTROLYTES SERUM PANEL***

Facility

$17.00

Service Code	HCPCS 80051
Hospital Charge Code	3001138P
Hospital Revenue Code	301
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$22.71
Rate for Payer: Aetna Medicare Advantage	$7.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.68
Rate for Payer: Cigna Commercial	$7.01
Rate for Payer: Cigna Medicare Advantage	$3.50
Rate for Payer: Clover Medicare Advantage	$6.66
Rate for Payer: EmblemHealth Commercial	$21.03
Rate for Payer: Humana Medicare Advantage	$7.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.21
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.01
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.43
Rate for Payer: Wellcare Medicare Advantage	$7.01

ELECTROLYTES (STOOL)

Facility

$77.65

Service Code	HCPCS 82438
Hospital Charge Code	3009917
Hospital Revenue Code	301
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$11.65
Rate for Payer: Qualcare PPO/HMO/WC	$11.65

ELECTROLYTES (STOOL)

Facility

$77.65

Service Code	HCPCS 82438
Hospital Charge Code	3009917
Hospital Revenue Code	301
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.20
Rate for Payer: Aetna Medicare Advantage	$5.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.32
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: Cigna Medicare Advantage	$2.50
Rate for Payer: Clover Medicare Advantage	$4.75
Rate for Payer: EmblemHealth Commercial	$15.00
Rate for Payer: Humana Medicare Advantage	$5.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.30
Rate for Payer: Wellcare Medicare Advantage	$5.00

ELECTRONIC COMPATIBILITY EACH

Facility

$100.00

Service Code	HCPCS 86923
Hospital Charge Code	3100191
Hospital Revenue Code	300
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$30.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$114.00

ELECTRONIC COMPATIBILITY EACH

Facility

$100.00

Service Code	HCPCS 86923
Hospital Charge Code	3100191
Hospital Revenue Code	300
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

ELECTRON MICROSCOPY DIAGNOSTIC

Facility

$976.72

Service Code	HCPCS 88348
Hospital Charge Code	38477209
Hospital Revenue Code	312
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$1,918.64
Rate for Payer: Aetna Commercial	$293.02
Rate for Payer: Aetna Medicare Advantage	$293.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.06
Rate for Payer: Cigna Commercial	$1,918.64
Rate for Payer: Cigna Medicare Advantage	$274.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$146.51
Rate for Payer: UnitedHealthcare Commercial	$114.00

ELECTRON MICROSCOPY DIAGNOSTIC

Facility

$976.72

Service Code	HCPCS 88348
Hospital Charge Code	38477209
Hospital Revenue Code	312
Min. Negotiated Rate	$146.51
Max. Negotiated Rate	$146.51
Rate for Payer: Qualcare PPO/HMO/WC	$146.51

ELECTROPHORESIS, PROTEIN CSF**

Facility

$20.00

Service Code	HCPCS 84155
Hospital Charge Code	300222
Hospital Revenue Code	301
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

ELECTROPHORESIS, PROTEIN CSF**

Facility

$20.00

Service Code	HCPCS 84155
Hospital Charge Code	300222
Hospital Revenue Code	301
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$11.89
Rate for Payer: Aetna Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.45
Rate for Payer: Cigna Commercial	$3.67
Rate for Payer: Cigna Medicare Advantage	$1.83
Rate for Payer: Clover Medicare Advantage	$3.49
Rate for Payer: EmblemHealth Commercial	$11.01
Rate for Payer: Humana Medicare Advantage	$3.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.67
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.89
Rate for Payer: Wellcare Medicare Advantage	$3.67

ELECTROPHORETIC FRACT, EACH

Facility

$170.00

Service Code	HCPCS 84165
Hospital Charge Code	3002227B
Hospital Revenue Code	301
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$34.80
Rate for Payer: Aetna Medicare Advantage	$10.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.35
Rate for Payer: Cigna Commercial	$10.74
Rate for Payer: Cigna Medicare Advantage	$5.37
Rate for Payer: Clover Medicare Advantage	$10.20
Rate for Payer: EmblemHealth Commercial	$32.22
Rate for Payer: Humana Medicare Advantage	$11.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.38
Rate for Payer: Wellcare Medicare Advantage	$10.74

ELECTROPHORETIC FRACT, EACH

Facility

$170.00

Service Code	HCPCS 84165
Hospital Charge Code	3002227A
Hospital Revenue Code	301
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$34.80
Rate for Payer: Aetna Medicare Advantage	$10.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.35
Rate for Payer: Cigna Commercial	$10.74
Rate for Payer: Cigna Medicare Advantage	$5.37
Rate for Payer: Clover Medicare Advantage	$10.20
Rate for Payer: EmblemHealth Commercial	$32.22
Rate for Payer: Humana Medicare Advantage	$11.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.38
Rate for Payer: Wellcare Medicare Advantage	$10.74

ELECTROPHORETIC FRACT, EACH

Facility

$170.00

Service Code	HCPCS 84165
Hospital Charge Code	3002227B
Hospital Revenue Code	301
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

ELECTROPHORETIC FRACT, EACH

Facility

$170.00

Service Code	HCPCS 84165
Hospital Charge Code	3002227A
Hospital Revenue Code	301
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

ELECTRO RESUSCITATION ONESTEP

Facility

$335.75

Hospital Charge Code	270675199
Hospital Revenue Code	270
Min. Negotiated Rate	$50.36
Max. Negotiated Rate	$50.36
Rate for Payer: Qualcare PPO/HMO/WC	$50.36

ELECTRO RESUSCITATION ONESTEP

Facility

$344.13

Hospital Charge Code	270675199N
Hospital Revenue Code	270
Min. Negotiated Rate	$51.62
Max. Negotiated Rate	$51.62
Rate for Payer: Qualcare PPO/HMO/WC	$51.62

ELECTRO RESUSCITATION ONESTEP

Facility

$344.13

Hospital Charge Code	270675199N
Hospital Revenue Code	270
Min. Negotiated Rate	$44.74
Max. Negotiated Rate	$172.06
Rate for Payer: Aetna Commercial	$103.24
Rate for Payer: Aetna Medicare Advantage	$103.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.75
Rate for Payer: Cigna Commercial	$172.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.74
Rate for Payer: Oxford Commercial	$172.06
Rate for Payer: Qualcare PPO/HMO/WC	$51.62
Rate for Payer: UnitedHealthcare Commercial	$172.06

ELECTRO RESUSCITATION ONESTEP

Facility

$335.75

Hospital Charge Code	270675199
Hospital Revenue Code	270
Min. Negotiated Rate	$43.65
Max. Negotiated Rate	$167.88
Rate for Payer: Aetna Commercial	$100.72
Rate for Payer: Aetna Medicare Advantage	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.62
Rate for Payer: Cigna Commercial	$167.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.65
Rate for Payer: Oxford Commercial	$167.88
Rate for Payer: Qualcare PPO/HMO/WC	$50.36
Rate for Payer: UnitedHealthcare Commercial	$167.88

ELECTROSURCICAL PROBE W/HNDL**

Facility

$86.00

Hospital Charge Code	1607027
Hospital Revenue Code	272
Min. Negotiated Rate	$12.90
Max. Negotiated Rate	$12.90
Rate for Payer: Qualcare PPO/HMO/WC	$12.90

Know your out-of-pocket cost for care.

All Charges