Heights University Hospital

All Charges

Charge

Type

Setting

Price

ALO VERA GEL SPRAY 16OZ

Facility

$32.65

Hospital Charge Code	60628806
Hospital Revenue Code	250
Min. Negotiated Rate	$4.24
Max. Negotiated Rate	$16.32
Rate for Payer: Aetna Commercial	$9.79
Rate for Payer: Aetna Medicare Advantage	$9.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.33
Rate for Payer: Cigna Commercial	$16.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.24
Rate for Payer: Oxford Commercial	$16.32
Rate for Payer: Qualcare PPO/HMO/WC	$4.90
Rate for Payer: UnitedHealthcare Commercial	$16.32

ALPHA-1 ACID GLYCOPROTEIN

Facility

$150.00

Service Code	HCPCS 83883
Hospital Charge Code	3038103
Hospital Revenue Code	301
Min. Negotiated Rate	$6.80
Max. Negotiated Rate	$165.64
Rate for Payer: Aetna Commercial	$44.06
Rate for Payer: Aetna Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.83
Rate for Payer: Cigna Commercial	$13.60
Rate for Payer: Cigna Medicare Advantage	$6.80
Rate for Payer: Clover Medicare Advantage	$12.92
Rate for Payer: EmblemHealth Commercial	$40.80
Rate for Payer: Humana Medicare Advantage	$14.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.42
Rate for Payer: Wellcare Medicare Advantage	$13.60

ALPHA-1 ACID GLYCOPROTEIN

Facility

$150.00

Service Code	HCPCS 83883
Hospital Charge Code	3038103
Hospital Revenue Code	301
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

ALPHA 1 ANTITRYPSIN

Facility

$530.00

Service Code	HCPCS 82104
Hospital Charge Code	38472056
Hospital Revenue Code	301
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.85
Rate for Payer: Aetna Medicare Advantage	$14.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.98
Rate for Payer: Cigna Commercial	$14.46
Rate for Payer: Cigna Medicare Advantage	$7.23
Rate for Payer: Clover Medicare Advantage	$13.74
Rate for Payer: EmblemHealth Commercial	$43.38
Rate for Payer: Humana Medicare Advantage	$14.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$79.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.46
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.33
Rate for Payer: Wellcare Medicare Advantage	$14.46

ALPHA 1 ANTITRYPSIN

Facility

$116.85

Service Code	HCPCS 82103
Hospital Charge Code	3000221
Hospital Revenue Code	301
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$17.53
Rate for Payer: Qualcare PPO/HMO/WC	$17.53

ALPHA 1 ANTITRYPSIN

Facility

$530.00

Service Code	HCPCS 82104
Hospital Charge Code	38472056
Hospital Revenue Code	301
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$79.50
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

ALPHA 1 ANTITRYPSIN

Facility

$116.85

Service Code	HCPCS 82103
Hospital Charge Code	3000221
Hospital Revenue Code	301
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.55
Rate for Payer: Aetna Medicare Advantage	$13.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.24
Rate for Payer: Cigna Commercial	$13.44
Rate for Payer: Cigna Medicare Advantage	$6.72
Rate for Payer: Clover Medicare Advantage	$12.77
Rate for Payer: EmblemHealth Commercial	$40.32
Rate for Payer: Humana Medicare Advantage	$13.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.19
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.53
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.44
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.25
Rate for Payer: Wellcare Medicare Advantage	$13.44

ALPHA 1 ANTITRYPSIN**

Facility

$56.00

Hospital Charge Code	3010220
Hospital Revenue Code	309
Min. Negotiated Rate	$7.28
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.80
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.28
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$114.00

ALPHA 1 ANTITRYPSIN**

Facility

$56.00

Hospital Charge Code	3010220
Hospital Revenue Code	309
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

ALPHA-1-ANTITRYPSIN

Facility

$667.59

Service Code	HCPCS 82103
Hospital Charge Code	39900038
Hospital Revenue Code	301
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.55
Rate for Payer: Aetna Medicare Advantage	$13.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.24
Rate for Payer: Cigna Commercial	$13.44
Rate for Payer: Cigna Medicare Advantage	$6.72
Rate for Payer: Clover Medicare Advantage	$12.77
Rate for Payer: EmblemHealth Commercial	$40.32
Rate for Payer: Humana Medicare Advantage	$13.84
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	$13.44
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.25
Rate for Payer: Wellcare Medicare Advantage	$13.44

ALPHA-1-ANTITRYPSIN

Facility

$667.59

Service Code	HCPCS 82103
Hospital Charge Code	39900038
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

ALPHA-1 ANTITRYPSIN/MUTAT I

Facility

$390.00

Service Code	HCPCS 82103
Hospital Charge Code	39990061A
Hospital Revenue Code	301
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.55
Rate for Payer: Aetna Medicare Advantage	$13.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.24
Rate for Payer: Cigna Commercial	$13.44
Rate for Payer: Cigna Medicare Advantage	$6.72
Rate for Payer: Clover Medicare Advantage	$12.77
Rate for Payer: EmblemHealth Commercial	$40.32
Rate for Payer: Humana Medicare Advantage	$13.84
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	$13.44
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.25
Rate for Payer: Wellcare Medicare Advantage	$13.44

ALPHA-1 ANTITRYPSIN/MUTAT I

Facility

$390.00

Service Code	HCPCS 82103
Hospital Charge Code	39990061A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ALPHA-1 ANTITRYPSIN/MUTAT II

Facility

$390.00

Service Code	HCPCS 81332
Hospital Charge Code	39990061B
Hospital Revenue Code	310
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ALPHA-1 ANTITRYPSIN/MUTAT II

Facility

$390.00

Service Code	HCPCS 81332
Hospital Charge Code	39990061B
Hospital Revenue Code	310
Min. Negotiated Rate	$21.82
Max. Negotiated Rate	$159.93
Rate for Payer: Aetna Commercial	$141.43
Rate for Payer: Aetna Medicare Advantage	$43.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$43.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.93
Rate for Payer: Cigna Commercial	$43.65
Rate for Payer: Cigna Medicare Advantage	$21.82
Rate for Payer: Clover Medicare Advantage	$41.47
Rate for Payer: EmblemHealth Commercial	$130.95
Rate for Payer: Humana Medicare Advantage	$44.96
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	$43.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$46.27
Rate for Payer: Wellcare Medicare Advantage	$43.65

ALPHA-1-ANTITRYPSIN/PHENO I

Facility

$390.00

Service Code	HCPCS 82104
Hospital Charge Code	39990060B
Hospital Revenue Code	301
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.85
Rate for Payer: Aetna Medicare Advantage	$14.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.98
Rate for Payer: Cigna Commercial	$14.46
Rate for Payer: Cigna Medicare Advantage	$7.23
Rate for Payer: Clover Medicare Advantage	$13.74
Rate for Payer: EmblemHealth Commercial	$43.38
Rate for Payer: Humana Medicare Advantage	$14.89
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	$14.46
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.33
Rate for Payer: Wellcare Medicare Advantage	$14.46

ALPHA-1-ANTITRYPSIN/PHENO I

Facility

$390.00

Service Code	HCPCS 82104
Hospital Charge Code	39990060B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ALPHA-1-ANTITRYPSIN/PHENO II

Facility

$390.00

Service Code	HCPCS 82103
Hospital Charge Code	39990060A
Hospital Revenue Code	301
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$114.00
Rate for Payer: EmblemHealth Commercial	$40.32
Rate for Payer: Humana Medicare Advantage	$13.84
Rate for Payer: Aetna Commercial	$43.55
Rate for Payer: Aetna Medicare Advantage	$13.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.24
Rate for Payer: Cigna Commercial	$13.44
Rate for Payer: Cigna Medicare Advantage	$6.72
Rate for Payer: Clover Medicare Advantage	$12.77
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	$13.44
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.25
Rate for Payer: Wellcare Medicare Advantage	$13.44

ALPHA-1-ANTITRYPSIN/PHENO II

Facility

$390.00

Service Code	HCPCS 82103
Hospital Charge Code	39990060A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ALPHA-1-ANTRYPSIN

Facility

$530.00

Service Code	HCPCS 82104
Hospital Charge Code	38479074
Hospital Revenue Code	301
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.85
Rate for Payer: Aetna Medicare Advantage	$14.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.98
Rate for Payer: Cigna Commercial	$14.46
Rate for Payer: Cigna Medicare Advantage	$7.23
Rate for Payer: Clover Medicare Advantage	$13.74
Rate for Payer: EmblemHealth Commercial	$43.38
Rate for Payer: Humana Medicare Advantage	$14.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$79.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.46
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.33
Rate for Payer: Wellcare Medicare Advantage	$14.46

ALPHA-1-ANTRYPSIN

Facility

$530.00

Service Code	HCPCS 82104
Hospital Charge Code	38479074
Hospital Revenue Code	301
Min. Negotiated Rate	$79.50
Max. Negotiated Rate	$79.50
Rate for Payer: Qualcare PPO/HMO/WC	$79.50

ALPHA 2 MA

Facility

$150.00

Service Code	HCPCS 83883
Hospital Charge Code	3035091
Hospital Revenue Code	301
Min. Negotiated Rate	$6.80
Max. Negotiated Rate	$165.64
Rate for Payer: Cigna Medicare Advantage	$6.80
Rate for Payer: Aetna Commercial	$44.06
Rate for Payer: Aetna Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.83
Rate for Payer: Cigna Commercial	$13.60
Rate for Payer: Clover Medicare Advantage	$12.92
Rate for Payer: EmblemHealth Commercial	$40.80
Rate for Payer: Humana Medicare Advantage	$14.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.42
Rate for Payer: Wellcare Medicare Advantage	$13.60

ALPHA 2 MA

Facility

$150.00

Service Code	HCPCS 83883
Hospital Charge Code	3035091
Hospital Revenue Code	301
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

ALPHA 2 MACROGLOBULIN

Facility

$445.00

Service Code	HCPCS 86329
Hospital Charge Code	38472059
Hospital Revenue Code	302
Min. Negotiated Rate	$7.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$45.52
Rate for Payer: Aetna Medicare Advantage	$14.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.48
Rate for Payer: Cigna Commercial	$14.05
Rate for Payer: Cigna Medicare Advantage	$7.03
Rate for Payer: Clover Medicare Advantage	$13.35
Rate for Payer: EmblemHealth Commercial	$42.15
Rate for Payer: Humana Medicare Advantage	$14.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.85
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.89
Rate for Payer: Wellcare Medicare Advantage	$14.05

ALPHA 2 MACROGLOBULIN

Facility

$445.00

Service Code	HCPCS 86329
Hospital Charge Code	38472059
Hospital Revenue Code	302
Min. Negotiated Rate	$66.75
Max. Negotiated Rate	$66.75
Rate for Payer: Qualcare PPO/HMO/WC	$66.75

Know your out-of-pocket cost for care.

All Charges