Heights University Hospital

All Charges

Charge

Type

Setting

Price

FACTOR INHIBITOR TEST

Facility

$91.00

Service Code	HCPCS 85335
Hospital Charge Code	38478077
Hospital Revenue Code	305
Min. Negotiated Rate	$6.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.70
Rate for Payer: Aetna Medicare Advantage	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.16
Rate for Payer: Cigna Commercial	$12.87
Rate for Payer: Cigna Medicare Advantage	$6.43
Rate for Payer: Clover Medicare Advantage	$12.23
Rate for Payer: EmblemHealth Commercial	$38.61
Rate for Payer: Humana Medicare Advantage	$13.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.87
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.64
Rate for Payer: Wellcare Medicare Advantage	$12.87

FACTOR INHIBITOR TEST

Facility

$91.00

Service Code	HCPCS 85335
Hospital Charge Code	38478077
Hospital Revenue Code	305
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

FACTOR IX

Facility

$503.00

Service Code	HCPCS 85250
Hospital Charge Code	38478041
Hospital Revenue Code	305
Min. Negotiated Rate	$75.45
Max. Negotiated Rate	$75.45
Rate for Payer: Qualcare PPO/HMO/WC	$75.45

FACTOR IX

Facility

$503.00

Service Code	HCPCS 85250
Hospital Charge Code	38478041
Hospital Revenue Code	305
Min. Negotiated Rate	$9.52
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$61.69
Rate for Payer: Aetna Medicare Advantage	$19.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.76
Rate for Payer: Cigna Commercial	$19.04
Rate for Payer: Cigna Medicare Advantage	$9.52
Rate for Payer: Clover Medicare Advantage	$18.09
Rate for Payer: EmblemHealth Commercial	$57.12
Rate for Payer: Humana Medicare Advantage	$19.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.39
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.04
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.18
Rate for Payer: Wellcare Medicare Advantage	$19.04

FACTOR IX ACTIVITY

Facility

$390.00

Service Code	HCPCS 85250
Hospital Charge Code	39900348
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FACTOR IX ACTIVITY

Facility

$390.00

Service Code	HCPCS 85250
Hospital Charge Code	39900348
Hospital Revenue Code	305
Min. Negotiated Rate	$9.52
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$61.69
Rate for Payer: Aetna Medicare Advantage	$19.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.76
Rate for Payer: Cigna Commercial	$19.04
Rate for Payer: Cigna Medicare Advantage	$9.52
Rate for Payer: Clover Medicare Advantage	$18.09
Rate for Payer: EmblemHealth Commercial	$57.12
Rate for Payer: Humana Medicare Advantage	$19.61
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	$19.04
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.18
Rate for Payer: Wellcare Medicare Advantage	$19.04

FACTOR IX ANTIGEN

Facility

$1,000.35

Service Code	HCPCS 85250
Hospital Charge Code	401085250
Hospital Revenue Code	305
Min. Negotiated Rate	$150.05
Max. Negotiated Rate	$150.05
Rate for Payer: Qualcare PPO/HMO/WC	$150.05

FACTOR IX ANTIGEN

Facility

$1,000.35

Service Code	HCPCS 85250
Hospital Charge Code	401085250
Hospital Revenue Code	305
Min. Negotiated Rate	$9.52
Max. Negotiated Rate	$150.05
Rate for Payer: Aetna Commercial	$61.69
Rate for Payer: Aetna Medicare Advantage	$19.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.76
Rate for Payer: Cigna Commercial	$19.04
Rate for Payer: Cigna Medicare Advantage	$9.52
Rate for Payer: Clover Medicare Advantage	$18.09
Rate for Payer: EmblemHealth Commercial	$57.12
Rate for Payer: Humana Medicare Advantage	$19.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.04
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.18
Rate for Payer: Wellcare Medicare Advantage	$19.04

FACTOR IX,FUNCTIONAL

Facility

$130.85

Service Code	HCPCS 85250
Hospital Charge Code	39900159
Hospital Revenue Code	305
Min. Negotiated Rate	$9.52
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$61.69
Rate for Payer: Aetna Medicare Advantage	$19.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.76
Rate for Payer: Cigna Commercial	$19.04
Rate for Payer: Cigna Medicare Advantage	$9.52
Rate for Payer: Clover Medicare Advantage	$18.09
Rate for Payer: EmblemHealth Commercial	$57.12
Rate for Payer: Humana Medicare Advantage	$19.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.63
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.04
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.18
Rate for Payer: Wellcare Medicare Advantage	$19.04

FACTOR IX,FUNCTIONAL

Facility

$130.85

Service Code	HCPCS 85250
Hospital Charge Code	39900159
Hospital Revenue Code	305
Min. Negotiated Rate	$19.63
Max. Negotiated Rate	$19.63
Rate for Payer: Qualcare PPO/HMO/WC	$19.63

FACTOR IX RECOMBINENT

Facility

$5.75

Hospital Charge Code	60629321
Hospital Revenue Code	636
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$2.88
Rate for Payer: Aetna Commercial	$1.73
Rate for Payer: Aetna Medicare Advantage	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.47
Rate for Payer: Cigna Commercial	$2.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.39
Rate for Payer: Qualcare PPO/HMO/WC	$0.86

FACTOR IX RECOMBINENT

Facility

$5.75

Hospital Charge Code	60629321
Hospital Revenue Code	636
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$1.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.39
Rate for Payer: Qualcare PPO/HMO/WC	$0.86

FACTOR V

Facility

$448.00

Hospital Charge Code	3004167
Hospital Revenue Code	301
Min. Negotiated Rate	$58.24
Max. Negotiated Rate	$224.00
Rate for Payer: Aetna Commercial	$134.40
Rate for Payer: Aetna Medicare Advantage	$134.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.24
Rate for Payer: Cigna Commercial	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.24
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.20
Rate for Payer: UnitedHealthcare Commercial	$114.00

FACTOR V

Facility

$448.00

Hospital Charge Code	3004167
Hospital Revenue Code	301
Min. Negotiated Rate	$67.20
Max. Negotiated Rate	$67.20
Rate for Payer: Qualcare PPO/HMO/WC	$67.20

FACTOR V

Facility

$384.00

Service Code	HCPCS 85220
Hospital Charge Code	38478035
Hospital Revenue Code	305
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.19
Rate for Payer: Aetna Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.67
Rate for Payer: Cigna Commercial	$17.65
Rate for Payer: Cigna Medicare Advantage	$8.82
Rate for Payer: Clover Medicare Advantage	$16.77
Rate for Payer: EmblemHealth Commercial	$52.95
Rate for Payer: Humana Medicare Advantage	$18.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.71
Rate for Payer: Wellcare Medicare Advantage	$17.65

FACTOR V

Facility

$384.00

Service Code	HCPCS 85220
Hospital Charge Code	38478035
Hospital Revenue Code	305
Min. Negotiated Rate	$57.60
Max. Negotiated Rate	$57.60
Rate for Payer: Qualcare PPO/HMO/WC	$57.60

FACTOR V ACTIVITY

Facility

$390.00

Service Code	HCPCS 85220
Hospital Charge Code	39900345
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FACTOR V ACTIVITY

Facility

$390.00

Service Code	HCPCS 85220
Hospital Charge Code	39900345
Hospital Revenue Code	305
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.19
Rate for Payer: Aetna Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.67
Rate for Payer: Cigna Commercial	$17.65
Rate for Payer: Cigna Medicare Advantage	$8.82
Rate for Payer: Clover Medicare Advantage	$16.77
Rate for Payer: EmblemHealth Commercial	$52.95
Rate for Payer: Humana Medicare Advantage	$18.18
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	$17.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.71
Rate for Payer: Wellcare Medicare Advantage	$17.65

FACTOR V ASSAY

Facility

$167.25

Service Code	HCPCS 85220
Hospital Charge Code	3004173
Hospital Revenue Code	305
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.19
Rate for Payer: Aetna Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.67
Rate for Payer: Cigna Commercial	$17.65
Rate for Payer: Cigna Medicare Advantage	$8.82
Rate for Payer: Clover Medicare Advantage	$16.77
Rate for Payer: EmblemHealth Commercial	$52.95
Rate for Payer: Humana Medicare Advantage	$18.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.09
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.71
Rate for Payer: Wellcare Medicare Advantage	$17.65

FACTOR V ASSAY

Facility

$167.25

Service Code	HCPCS 85220
Hospital Charge Code	3004173
Hospital Revenue Code	305
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$25.09
Rate for Payer: Qualcare PPO/HMO/WC	$25.09

FACTOR V,FUNCTIONAL

Facility

$121.30

Service Code	HCPCS 85220
Hospital Charge Code	39900156
Hospital Revenue Code	305
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.19
Rate for Payer: Aetna Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.67
Rate for Payer: Cigna Commercial	$17.65
Rate for Payer: Cigna Medicare Advantage	$8.82
Rate for Payer: Clover Medicare Advantage	$16.77
Rate for Payer: EmblemHealth Commercial	$52.95
Rate for Payer: Humana Medicare Advantage	$18.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.71
Rate for Payer: Wellcare Medicare Advantage	$17.65

FACTOR V,FUNCTIONAL

Facility

$121.30

Service Code	HCPCS 85220
Hospital Charge Code	39900156
Hospital Revenue Code	305
Min. Negotiated Rate	$18.20
Max. Negotiated Rate	$18.20
Rate for Payer: Qualcare PPO/HMO/WC	$18.20

FACTOR VII

Facility

$167.25

Service Code	HCPCS 85230
Hospital Charge Code	3004181
Hospital Revenue Code	305
Min. Negotiated Rate	$8.95
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.00
Rate for Payer: Aetna Medicare Advantage	$17.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.59
Rate for Payer: Cigna Commercial	$17.90
Rate for Payer: Cigna Medicare Advantage	$8.95
Rate for Payer: Clover Medicare Advantage	$17.00
Rate for Payer: EmblemHealth Commercial	$53.70
Rate for Payer: Humana Medicare Advantage	$18.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.09
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.90
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.97
Rate for Payer: Wellcare Medicare Advantage	$17.90

FACTOR VII

Facility

$167.25

Service Code	HCPCS 85230
Hospital Charge Code	3004181
Hospital Revenue Code	305
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$25.09
Rate for Payer: Qualcare PPO/HMO/WC	$25.09

FACTOR VII ACTIVITY

Facility

$390.00

Service Code	HCPCS 85230
Hospital Charge Code	39900346
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges