Heights University Hospital

All Charges

Charge

Type

Setting

Price

FECAL LEUKOCYTE

Facility

$150.00

Service Code	HCPCS 89055
Hospital Charge Code	38475094
Hospital Revenue Code	309
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

FECAL LEUKOCYTE

Facility

$150.00

Service Code	HCPCS 89055
Hospital Charge Code	38475094
Hospital Revenue Code	309
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.83
Rate for Payer: Aetna Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.65
Rate for Payer: Cigna Commercial	$4.27
Rate for Payer: Cigna Medicare Advantage	$2.13
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
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	$4.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.53
Rate for Payer: Wellcare Medicare Advantage	$4.27

FECAL LEUKOCYTES

Facility

$390.00

Service Code	HCPCS 87205
Hospital Charge Code	3004652
Hospital Revenue Code	309
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.83
Rate for Payer: Aetna Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.65
Rate for Payer: Cigna Commercial	$4.27
Rate for Payer: Cigna Medicare Advantage	$2.13
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
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	$4.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.53
Rate for Payer: Wellcare Medicare Advantage	$4.27

FECAL LEUKOCYTES

Facility

$390.00

Service Code	HCPCS 87205
Hospital Charge Code	3004652
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FECAL LIPIDS,TOTAL

Facility

$390.00

Service Code	HCPCS 82710
Hospital Charge Code	39900078
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FECAL LIPIDS,TOTAL

Facility

$390.00

Service Code	HCPCS 82710
Hospital Charge Code	39900078
Hospital Revenue Code	301
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.43
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.80
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	$61.56
Rate for Payer: Cigna Commercial	$16.80
Rate for Payer: Cigna Medicare Advantage	$8.40
Rate for Payer: Clover Medicare Advantage	$15.96
Rate for Payer: EmblemHealth Commercial	$50.40
Rate for Payer: Humana Medicare Advantage	$17.30
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	$16.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.81
Rate for Payer: Wellcare Medicare Advantage	$16.80

FECAL, STARCH

Facility

$116.00

Service Code	HCPCS 82710
Hospital Charge Code	3004653
Hospital Revenue Code	301
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

FECAL, STARCH

Facility

$116.00

Service Code	HCPCS 82710
Hospital Charge Code	3004653
Hospital Revenue Code	301
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.43
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.80
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	$61.56
Rate for Payer: Cigna Commercial	$16.80
Rate for Payer: Cigna Medicare Advantage	$8.40
Rate for Payer: Clover Medicare Advantage	$15.96
Rate for Payer: EmblemHealth Commercial	$50.40
Rate for Payer: Humana Medicare Advantage	$17.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.81
Rate for Payer: Wellcare Medicare Advantage	$16.80

FEC. PANCREATIC ELASTASE-1

Facility

$951.00

Service Code	HCPCS 82656
Hospital Charge Code	397071379
Hospital Revenue Code	301
Min. Negotiated Rate	$142.65
Max. Negotiated Rate	$142.65
Rate for Payer: Qualcare PPO/HMO/WC	$142.65

FEC. PANCREATIC ELASTASE-1

Facility

$951.00

Service Code	HCPCS 82656
Hospital Charge Code	397071379
Hospital Revenue Code	301
Min. Negotiated Rate	$5.76
Max. Negotiated Rate	$142.65
Rate for Payer: Aetna Commercial	$37.36
Rate for Payer: Aetna Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.25
Rate for Payer: Cigna Commercial	$11.53
Rate for Payer: Cigna Medicare Advantage	$5.76
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.63
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.22
Rate for Payer: Wellcare Medicare Advantage	$11.53

FEE CANCEL AT PROCEDURE ATS400

Facility

$1,455.00

Hospital Charge Code	270613407
Hospital Revenue Code	272
Min. Negotiated Rate	$218.25
Max. Negotiated Rate	$218.25
Rate for Payer: Qualcare PPO/HMO/WC	$218.25

FEE CANCEL AT PROCEDURE ATS400

Facility

$1,455.00

Hospital Charge Code	270613407
Hospital Revenue Code	272
Min. Negotiated Rate	$189.15
Max. Negotiated Rate	$727.50
Rate for Payer: Aetna Commercial	$436.50
Rate for Payer: Aetna Medicare Advantage	$436.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$371.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$371.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$371.02
Rate for Payer: Cigna Commercial	$727.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.15
Rate for Payer: Oxford Commercial	$727.50
Rate for Payer: Qualcare PPO/HMO/WC	$218.25
Rate for Payer: UnitedHealthcare Commercial	$727.50

FEEDING TUBE CHANGE****

Facility

$225.00

Service Code	HCPCS 43760
Hospital Charge Code	1001120
Hospital Revenue Code	361
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

FEEDING TUBE CHANGE****

Facility

$225.00

Service Code	HCPCS 43760
Hospital Charge Code	1001120
Hospital Revenue Code	361
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Better Health Medicaid	$766.34
Rate for Payer: Aetna Commercial	$67.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.25
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$781.67
Rate for Payer: Wellpoint Medicaid Managed Care	$766.34

FEEDING TUBE INFANT 6FR

Facility

$7.70

Hospital Charge Code	270659380
Hospital Revenue Code	272
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

FEEDING TUBE INFANT 6FR

Facility

$7.70

Hospital Charge Code	270659380
Hospital Revenue Code	272
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$3.85
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.96
Rate for Payer: Cigna Commercial	$3.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.00
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$3.85

FEEDING TUBE JUJUNAL

Facility

$195.20

Hospital Charge Code	270687764
Hospital Revenue Code	272
Min. Negotiated Rate	$25.38
Max. Negotiated Rate	$97.60
Rate for Payer: Aetna Commercial	$58.56
Rate for Payer: Aetna Medicare Advantage	$58.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.78
Rate for Payer: Cigna Commercial	$97.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.38
Rate for Payer: Oxford Commercial	$97.60
Rate for Payer: Qualcare PPO/HMO/WC	$29.28
Rate for Payer: UnitedHealthcare Commercial	$97.60

FEEDING TUBE JUJUNAL

Facility

$195.20

Hospital Charge Code	270687764
Hospital Revenue Code	272
Min. Negotiated Rate	$29.28
Max. Negotiated Rate	$29.28
Rate for Payer: Qualcare PPO/HMO/WC	$29.28

FEE SHIPPING/DEVICE PAT CHAR

Facility

$750.00

Hospital Charge Code	270608796
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$375.00

FEE SHIPPING/DEVICE PAT CHAR

Facility

$750.00

Hospital Charge Code	270608796
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

FEE SHOULDER BASKET FEE

Facility

$496.00

Hospital Charge Code	270636218
Hospital Revenue Code	272
Min. Negotiated Rate	$64.48
Max. Negotiated Rate	$248.00
Rate for Payer: Aetna Commercial	$148.80
Rate for Payer: Aetna Medicare Advantage	$148.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.48
Rate for Payer: Cigna Commercial	$248.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.48
Rate for Payer: Oxford Commercial	$248.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.40
Rate for Payer: UnitedHealthcare Commercial	$248.00

FEE SHOULDER BASKET FEE

Facility

$496.00

Hospital Charge Code	270636218
Hospital Revenue Code	272
Min. Negotiated Rate	$74.40
Max. Negotiated Rate	$74.40
Rate for Payer: Qualcare PPO/HMO/WC	$74.40

FELBAMATE

Facility

$324.00

Service Code	HCPCS 80299
Hospital Charge Code	38476778
Hospital Revenue Code	301
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

FELBAMATE

Facility

$256.00

Service Code	HCPCS 82542
Hospital Charge Code	3009909
Hospital Revenue Code	301
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

FELBAMATE

Facility

$256.00

Service Code	HCPCS 82542
Hospital Charge Code	3009909
Hospital Revenue Code	301
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.05
Rate for Payer: Aetna Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.27
Rate for Payer: Cigna Commercial	$24.09
Rate for Payer: Cigna Medicare Advantage	$12.04
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.54
Rate for Payer: Wellcare Medicare Advantage	$24.09

Know your out-of-pocket cost for care.

All Charges