Heights University Hospital

All Charges

Charge

Type

Setting

Price

ALLERGY,MUGWORT

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479153
Hospital Revenue Code	305
Min. Negotiated Rate	$89.40
Max. Negotiated Rate	$89.40
Rate for Payer: Qualcare PPO/HMO/WC	$89.40

ALLERGY,MUGWORT

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479153
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	$77.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.40
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

ALLERGY PANEL (CMI) DERMAL INJ

Facility

$527.40

Hospital Charge Code	6007694
Hospital Revenue Code	250
Min. Negotiated Rate	$68.56
Max. Negotiated Rate	$263.70
Rate for Payer: Aetna Commercial	$158.22
Rate for Payer: Aetna Medicare Advantage	$158.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$134.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$134.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$134.49
Rate for Payer: Cigna Commercial	$263.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.56
Rate for Payer: Oxford Commercial	$263.70
Rate for Payer: Qualcare PPO/HMO/WC	$79.11
Rate for Payer: UnitedHealthcare Commercial	$263.70

ALLERGY PANEL (CMI) DERMAL INJ

Facility

$527.40

Hospital Charge Code	6007694
Hospital Revenue Code	250
Min. Negotiated Rate	$79.11
Max. Negotiated Rate	$79.11
Rate for Payer: Qualcare PPO/HMO/WC	$79.11

ALLERGY,PEANUT

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479138
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	$77.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.40
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

ALLERGY,PEANUT

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479138
Hospital Revenue Code	305
Min. Negotiated Rate	$89.40
Max. Negotiated Rate	$89.40
Rate for Payer: Qualcare PPO/HMO/WC	$89.40

ALLERGY,RAGWEED

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479152
Hospital Revenue Code	305
Min. Negotiated Rate	$89.40
Max. Negotiated Rate	$89.40
Rate for Payer: Qualcare PPO/HMO/WC	$89.40

ALLERGY,RAGWEED

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479152
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	$77.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.40
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

ALLERGY SCALLOP

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479145
Hospital Revenue Code	305
Min. Negotiated Rate	$89.40
Max. Negotiated Rate	$89.40
Rate for Payer: Qualcare PPO/HMO/WC	$89.40

ALLERGY SCALLOP

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479145
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	$77.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.40
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

ALLERGY,SESAME SEED

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479140
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	$77.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.40
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

ALLERGY,SESAME SEED

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479140
Hospital Revenue Code	305
Min. Negotiated Rate	$89.40
Max. Negotiated Rate	$89.40
Rate for Payer: Qualcare PPO/HMO/WC	$89.40

ALLERGY,SHRIMP

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479143
Hospital Revenue Code	305
Min. Negotiated Rate	$89.40
Max. Negotiated Rate	$89.40
Rate for Payer: Qualcare PPO/HMO/WC	$89.40

ALLERGY,SHRIMP

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479143
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	$77.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.40
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

ALLERGY, SOYBEAN

Facility

$596.00

Service Code	HCPCS 86001
Hospital Charge Code	38479136
Hospital Revenue Code	305
Min. Negotiated Rate	$89.40
Max. Negotiated Rate	$89.40
Rate for Payer: Qualcare PPO/HMO/WC	$89.40

ALLERGY, SOYBEAN

Facility

$596.00

Service Code	HCPCS 86001
Hospital Charge Code	38479136
Hospital Revenue Code	305
Min. Negotiated Rate	$3.91
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$25.34
Rate for Payer: Aetna Medicare Advantage	$7.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.65
Rate for Payer: Cigna Commercial	$7.82
Rate for Payer: Cigna Medicare Advantage	$3.91
Rate for Payer: Clover Medicare Advantage	$7.43
Rate for Payer: EmblemHealth Commercial	$23.46
Rate for Payer: Humana Medicare Advantage	$8.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.82
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.29
Rate for Payer: Wellcare Medicare Advantage	$7.82

ALLERGY,WALNUT

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479139
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	$77.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.40
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

ALLERGY,WALNUT

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479139
Hospital Revenue Code	305
Min. Negotiated Rate	$89.40
Max. Negotiated Rate	$89.40
Rate for Payer: Qualcare PPO/HMO/WC	$89.40

ALLERGY, WHEAT

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479137
Hospital Revenue Code	305
Min. Negotiated Rate	$89.40
Max. Negotiated Rate	$89.40
Rate for Payer: Qualcare PPO/HMO/WC	$89.40

ALLERGY, WHEAT

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479137
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	$77.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.40
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

ALLG SPEC IGE CRUDE XTRC EA

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	401086003
Hospital Revenue Code	302
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	$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	$5.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.53
Rate for Payer: Wellcare Medicare Advantage	$5.22

ALLG SPEC IGE CRUDE XTRC EA

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	401086003
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ALLODERM 4CM X 7 CM THINK

Facility

$5,215.00

Service Code	HCPCS Q4116
Hospital Charge Code	270682852
Hospital Revenue Code	636
Min. Negotiated Rate	$782.25
Max. Negotiated Rate	$1,262.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,262.03
Rate for Payer: Qualcare PPO/HMO/WC	$782.25

ALLODERM 4CM X 7 CM THINK

Facility

$5,215.00

Service Code	HCPCS Q4116
Hospital Charge Code	270682852
Hospital Revenue Code	636
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$1,564.50
Rate for Payer: Aetna Commercial	$1,564.50
Rate for Payer: Aetna Medicare Advantage	$1,564.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,329.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,329.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,329.83
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,262.03
Rate for Payer: Qualcare PPO/HMO/WC	$782.25

ALLODERM 6 CM x12 CM

Facility

$13,535.00

Service Code	HCPCS Q4116
Hospital Charge Code	270681284
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$4,060.50
Rate for Payer: Aetna Commercial	$4,060.50
Rate for Payer: Aetna Medicare Advantage	$4,060.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,451.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,451.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,707.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,451.43
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,275.47
Rate for Payer: Qualcare PPO/HMO/WC	$2,030.25

Know your out-of-pocket cost for care.

All Charges