Heights University Hospital

All Charges

Charge

Type

Setting

Price

ALPHA 2 MACROGLOBULIN

Facility

$150.00

Service Code	HCPCS 83883
Hospital Charge Code	3006954
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 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 BSM 5.0 STERL 1980902050

Facility

$3,100.00

Hospital Charge Code	270632505
Hospital Revenue Code	272
Min. Negotiated Rate	$403.00
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$930.00
Rate for Payer: Aetna Medicare Advantage	$930.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$790.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$790.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$790.50
Rate for Payer: Cigna Commercial	$1,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.00
Rate for Payer: Oxford Commercial	$1,550.00
Rate for Payer: Qualcare PPO/HMO/WC	$465.00
Rate for Payer: UnitedHealthcare Commercial	$1,550.00

ALPHA BSM 5.0 STERL 1980902050

Facility

$3,100.00

Hospital Charge Code	270632505
Hospital Revenue Code	272
Min. Negotiated Rate	$465.00
Max. Negotiated Rate	$465.00
Rate for Payer: Qualcare PPO/HMO/WC	$465.00

ALPHACAN 0.2% OPHT SOL

Facility

$89.00

Hospital Charge Code	60635276
Hospital Revenue Code	250
Min. Negotiated Rate	$11.57
Max. Negotiated Rate	$44.50
Rate for Payer: Aetna Commercial	$26.70
Rate for Payer: Aetna Medicare Advantage	$26.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.70
Rate for Payer: Cigna Commercial	$44.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.57
Rate for Payer: Oxford Commercial	$44.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.35
Rate for Payer: UnitedHealthcare Commercial	$44.50

ALPHACAN 0.2% OPHT SOL

Facility

$89.00

Hospital Charge Code	60635276
Hospital Revenue Code	250
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$13.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.35

ALPHA-CHYMOTRYPSIN VL OPH 750U

Facility

$254.75

Hospital Charge Code	6005920
Hospital Revenue Code	252
Min. Negotiated Rate	$38.21
Max. Negotiated Rate	$38.21
Rate for Payer: Qualcare PPO/HMO/WC	$38.21

ALPHA-CHYMOTRYPSIN VL OPH 750U

Facility

$254.75

Hospital Charge Code	6005920
Hospital Revenue Code	252
Min. Negotiated Rate	$33.12
Max. Negotiated Rate	$127.38
Rate for Payer: Aetna Commercial	$76.42
Rate for Payer: Aetna Medicare Advantage	$76.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.96
Rate for Payer: Cigna Commercial	$127.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.12
Rate for Payer: Oxford Commercial	$127.38
Rate for Payer: Qualcare PPO/HMO/WC	$38.21
Rate for Payer: UnitedHealthcare Commercial	$127.38

ALPHA FETL PROTEIN

Facility

$550.00

Service Code	HCPCS 82105
Hospital Charge Code	38479482
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.33
Rate for Payer: Aetna Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$16.77
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.78
Rate for Payer: Wellcare Medicare Advantage	$16.77

ALPHA FETL PROTEIN

Facility

$550.00

Service Code	HCPCS 82105
Hospital Charge Code	38479482
Hospital Revenue Code	301
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

ALPHA FETOPROTEIN (AFP)

Facility

$550.00

Service Code	HCPCS 82105
Hospital Charge Code	38472062
Hospital Revenue Code	301
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

ALPHA FETOPROTEIN (AFP)

Facility

$550.00

Service Code	HCPCS 82105
Hospital Charge Code	38472062
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.33
Rate for Payer: Aetna Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$16.77
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.78
Rate for Payer: Wellcare Medicare Advantage	$16.77

ALPHAFETOPROTEIN,AFP

Facility

$550.00

Service Code	HCPCS 82105
Hospital Charge Code	38479404
Hospital Revenue Code	301
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

ALPHAFETOPROTEIN,AFP

Facility

$550.00

Service Code	HCPCS 82105
Hospital Charge Code	38479404
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.33
Rate for Payer: Aetna Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$16.77
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.78
Rate for Payer: Wellcare Medicare Advantage	$16.77

ALPHA FETOPROTEIN, AMNIOTIC FL

Facility

$350.00

Service Code	HCPCS 82106
Hospital Charge Code	38472068
Hospital Revenue Code	301
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

ALPHA FETOPROTEIN, AMNIOTIC FL

Facility

$350.00

Service Code	HCPCS 82106
Hospital Charge Code	38472068
Hospital Revenue Code	301
Min. Negotiated Rate	$8.50
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.08
Rate for Payer: Aetna Medicare Advantage	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.29
Rate for Payer: Cigna Commercial	$17.00
Rate for Payer: Cigna Medicare Advantage	$8.50
Rate for Payer: Clover Medicare Advantage	$16.15
Rate for Payer: EmblemHealth Commercial	$51.00
Rate for Payer: Humana Medicare Advantage	$17.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.02
Rate for Payer: Wellcare Medicare Advantage	$17.00

ALPHA-FETOPROTEIN L3

Facility

$290.78

Service Code	HCPCS 82107
Hospital Charge Code	401182107
Hospital Revenue Code	301
Min. Negotiated Rate	$43.62
Max. Negotiated Rate	$43.62
Rate for Payer: Qualcare PPO/HMO/WC	$43.62

ALPHA-FETOPROTEIN L3

Facility

$290.78

Service Code	HCPCS 82107
Hospital Charge Code	401182107
Hospital Revenue Code	301
Min. Negotiated Rate	$32.20
Max. Negotiated Rate	$236.00
Rate for Payer: Aetna Commercial	$208.69
Rate for Payer: Aetna Medicare Advantage	$64.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$64.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$168.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$236.00
Rate for Payer: Cigna Commercial	$64.41
Rate for Payer: Cigna Medicare Advantage	$32.20
Rate for Payer: Clover Medicare Advantage	$61.19
Rate for Payer: EmblemHealth Commercial	$193.23
Rate for Payer: Humana Medicare Advantage	$66.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.62
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$64.41
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$68.27
Rate for Payer: Wellcare Medicare Advantage	$64.41

ALPHA FETOPROTEIN,MATERNAL SER

Facility

$550.00

Service Code	HCPCS 82105
Hospital Charge Code	38472065
Hospital Revenue Code	301
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

ALPHA FETOPROTEIN,MATERNAL SER

Facility

$550.00

Service Code	HCPCS 82105
Hospital Charge Code	38472065
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.33
Rate for Payer: Aetna Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.45
Rate for Payer: Cigna Commercial	$16.77
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.78
Rate for Payer: Wellcare Medicare Advantage	$16.77

ALPHAGAN, 0.2%, 5ML

Facility

$121.47

Service Code	NDC 24208041105
Hospital Charge Code	60635466
Hospital Revenue Code	250
Min. Negotiated Rate	$15.79
Max. Negotiated Rate	$60.73
Rate for Payer: Aetna Commercial	$36.44
Rate for Payer: Aetna Medicare Advantage	$36.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.97
Rate for Payer: Cigna Commercial	$60.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.79
Rate for Payer: Oxford Commercial	$60.73
Rate for Payer: Qualcare PPO/HMO/WC	$18.22
Rate for Payer: UnitedHealthcare Commercial	$60.73

ALPHAGAN, 0.2%, 5ML

Facility

$121.47

Service Code	NDC 24208041105
Hospital Charge Code	60635466
Hospital Revenue Code	250
Min. Negotiated Rate	$18.22
Max. Negotiated Rate	$18.22
Rate for Payer: Qualcare PPO/HMO/WC	$18.22

ALPHA-GLOBIN COMMON MUTAT

Facility

$2,323.00

Service Code	HCPCS 81257
Hospital Charge Code	39900320
Hospital Revenue Code	310
Min. Negotiated Rate	$51.13
Max. Negotiated Rate	$374.68
Rate for Payer: Aetna Commercial	$331.32
Rate for Payer: Aetna Medicare Advantage	$102.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$374.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$374.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$102.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$374.68
Rate for Payer: Cigna Commercial	$102.26
Rate for Payer: Cigna Medicare Advantage	$51.13
Rate for Payer: Clover Medicare Advantage	$97.15
Rate for Payer: EmblemHealth Commercial	$306.78
Rate for Payer: Humana Medicare Advantage	$105.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.99
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$348.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$102.26
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$108.40
Rate for Payer: Wellcare Medicare Advantage	$102.26

ALPHA-GLOBIN COMMON MUTAT

Facility

$2,323.00

Service Code	HCPCS 81257
Hospital Charge Code	39900320
Hospital Revenue Code	310
Min. Negotiated Rate	$348.45
Max. Negotiated Rate	$348.45
Rate for Payer: Qualcare PPO/HMO/WC	$348.45

ALPHA-GLOBIN COMPLETE

Facility

$2,375.00

Service Code	HCPCS 81405
Hospital Charge Code	39900030
Hospital Revenue Code	310
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$1,104.15
Rate for Payer: Aetna Commercial	$976.37
Rate for Payer: Aetna Medicare Advantage	$301.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,104.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,104.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$301.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,104.15
Rate for Payer: Cigna Commercial	$301.35
Rate for Payer: Cigna Medicare Advantage	$150.68
Rate for Payer: Clover Medicare Advantage	$286.28
Rate for Payer: EmblemHealth Commercial	$904.05
Rate for Payer: Humana Medicare Advantage	$310.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$308.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$356.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$301.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$319.43
Rate for Payer: Wellcare Medicare Advantage	$301.35

Know your out-of-pocket cost for care.

All Charges