Heights University Hospital

All Charges

Charge

Type

Setting

Price

FIB LAS 550 MIC HOL DHBFSF550D

Facility

$1,310.00

Hospital Charge Code	270640373
Hospital Revenue Code	272
Min. Negotiated Rate	$170.30
Max. Negotiated Rate	$655.00
Rate for Payer: Aetna Commercial	$393.00
Rate for Payer: Aetna Medicare Advantage	$393.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$334.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$334.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$334.05
Rate for Payer: Cigna Commercial	$655.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.30
Rate for Payer: Oxford Commercial	$655.00
Rate for Payer: Qualcare PPO/HMO/WC	$196.50
Rate for Payer: UnitedHealthcare Commercial	$655.00

FIBRINET (MMRB0004)

Facility

$8,975.00

Hospital Charge Code	270693823
Hospital Revenue Code	272
Min. Negotiated Rate	$1,346.25
Max. Negotiated Rate	$1,346.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25

FIBRINET (MMRB0004)

Facility

$8,975.00

Hospital Charge Code	270693823
Hospital Revenue Code	272
Min. Negotiated Rate	$1,166.75
Max. Negotiated Rate	$4,487.50
Rate for Payer: Aetna Commercial	$2,692.50
Rate for Payer: Aetna Medicare Advantage	$2,692.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,288.62
Rate for Payer: Cigna Commercial	$4,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,166.75
Rate for Payer: Oxford Commercial	$4,487.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25
Rate for Payer: UnitedHealthcare Commercial	$4,487.50

FIBRINET PLATELETRICHPLASMAKIT

Facility

$17,500.00

Hospital Charge Code	270686056
Hospital Revenue Code	270
Min. Negotiated Rate	$2,275.00
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$5,250.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,275.00
Rate for Payer: Oxford Commercial	$8,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Commercial	$8,750.00

FIBRINET PLATELETRICHPLASMAKIT

Facility

$17,500.00

Hospital Charge Code	270686056
Hospital Revenue Code	270
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$2,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

FIBRINET PRP

Facility

$8,975.00

Hospital Charge Code	270693149
Hospital Revenue Code	272
Min. Negotiated Rate	$1,346.25
Max. Negotiated Rate	$1,346.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25

FIBRINET PRP

Facility

$8,975.00

Hospital Charge Code	270693149
Hospital Revenue Code	272
Min. Negotiated Rate	$1,166.75
Max. Negotiated Rate	$4,487.50
Rate for Payer: Aetna Commercial	$2,692.50
Rate for Payer: Aetna Medicare Advantage	$2,692.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,288.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,288.62
Rate for Payer: Cigna Commercial	$4,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,166.75
Rate for Payer: Oxford Commercial	$4,487.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25
Rate for Payer: UnitedHealthcare Commercial	$4,487.50

FIBRINOGEN

Facility

$118.00

Service Code	HCPCS 85384
Hospital Charge Code	38478014
Hospital Revenue Code	305
Min. Negotiated Rate	$17.70
Max. Negotiated Rate	$17.70
Rate for Payer: Qualcare PPO/HMO/WC	$17.70

FIBRINOGEN

Facility

$58.40

Service Code	HCPCS 85384
Hospital Charge Code	39900171
Hospital Revenue Code	305
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.49
Rate for Payer: Aetna Medicare Advantage	$9.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.61
Rate for Payer: Cigna Commercial	$9.72
Rate for Payer: Cigna Medicare Advantage	$4.86
Rate for Payer: Clover Medicare Advantage	$9.23
Rate for Payer: EmblemHealth Commercial	$29.16
Rate for Payer: Humana Medicare Advantage	$10.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.59
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.76
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.72
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.30
Rate for Payer: Wellcare Medicare Advantage	$9.72

FIBRINOGEN

Facility

$118.00

Service Code	HCPCS 85384
Hospital Charge Code	38478014
Hospital Revenue Code	305
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.49
Rate for Payer: Aetna Medicare Advantage	$9.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.61
Rate for Payer: Cigna Commercial	$9.72
Rate for Payer: Cigna Medicare Advantage	$4.86
Rate for Payer: Clover Medicare Advantage	$9.23
Rate for Payer: EmblemHealth Commercial	$29.16
Rate for Payer: Humana Medicare Advantage	$10.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.72
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.30
Rate for Payer: Wellcare Medicare Advantage	$9.72

FIBRINOGEN

Facility

$58.40

Service Code	HCPCS 85384
Hospital Charge Code	39900171
Hospital Revenue Code	305
Min. Negotiated Rate	$8.76
Max. Negotiated Rate	$8.76
Rate for Payer: Qualcare PPO/HMO/WC	$8.76

FIBRINOGEN DEGRADATION PRODUCT

Facility

$105.18

Service Code	HCPCS 85362
Hospital Charge Code	38478020
Hospital Revenue Code	305
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$22.32
Rate for Payer: Aetna Medicare Advantage	$6.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.24
Rate for Payer: Cigna Commercial	$6.89
Rate for Payer: Cigna Medicare Advantage	$3.44
Rate for Payer: Clover Medicare Advantage	$6.55
Rate for Payer: EmblemHealth Commercial	$20.67
Rate for Payer: Humana Medicare Advantage	$7.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.78
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.89
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.30
Rate for Payer: Wellcare Medicare Advantage	$6.89

FIBRINOGEN DEGRADATION PRODUCT

Facility

$105.18

Service Code	HCPCS 85362
Hospital Charge Code	38478020
Hospital Revenue Code	305
Min. Negotiated Rate	$15.78
Max. Negotiated Rate	$15.78
Rate for Payer: Qualcare PPO/HMO/WC	$15.78

FIBRINOGEN IGA AGGREGATE

Facility

$844.00

Service Code	HCPCS 85366
Hospital Charge Code	3008893
Hospital Revenue Code	305
Min. Negotiated Rate	$126.60
Max. Negotiated Rate	$126.60
Rate for Payer: Qualcare PPO/HMO/WC	$126.60

FIBRINOGEN IGA AGGREGATE

Facility

$844.00

Service Code	HCPCS 85366
Hospital Charge Code	3008893
Hospital Revenue Code	305
Min. Negotiated Rate	$14.96
Max. Negotiated Rate	$294.81
Rate for Payer: Aetna Commercial	$260.69
Rate for Payer: Aetna Medicare Advantage	$80.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$294.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$294.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$80.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$294.81
Rate for Payer: Cigna Commercial	$80.46
Rate for Payer: Cigna Medicare Advantage	$40.23
Rate for Payer: Clover Medicare Advantage	$76.44
Rate for Payer: EmblemHealth Commercial	$241.38
Rate for Payer: Humana Medicare Advantage	$82.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.72
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$80.46
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$85.29
Rate for Payer: Wellcare Medicare Advantage	$80.46

FIBRINOGEN, QUANT

Facility

$667.59

Service Code	HCPCS 85384
Hospital Charge Code	3001302
Hospital Revenue Code	305
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

FIBRINOGEN, QUANT

Facility

$667.59

Service Code	HCPCS 85384
Hospital Charge Code	3001302
Hospital Revenue Code	305
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.49
Rate for Payer: Aetna Medicare Advantage	$9.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.61
Rate for Payer: Cigna Commercial	$9.72
Rate for Payer: Cigna Medicare Advantage	$4.86
Rate for Payer: Clover Medicare Advantage	$9.23
Rate for Payer: EmblemHealth Commercial	$29.16
Rate for Payer: Humana Medicare Advantage	$10.01
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	$9.72
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.30
Rate for Payer: Wellcare Medicare Advantage	$9.72

FIBRINOLYS/DNA-ASE OINT 28GM

Facility

$11.25

Hospital Charge Code	6002398
Hospital Revenue Code	250
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$3.38
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$5.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$5.62

FIBRINOLYS/DNA-ASE OINT 28GM

Facility

$11.25

Hospital Charge Code	6002398
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

FIBRINOLYSIN 30U/CLORCL 300MG

Facility

$352.65

Hospital Charge Code	6009419
Hospital Revenue Code	250
Min. Negotiated Rate	$52.90
Max. Negotiated Rate	$52.90
Rate for Payer: Qualcare PPO/HMO/WC	$52.90

FIBRINOLYSIN 30U/CLORCL 300MG

Facility

$352.65

Hospital Charge Code	6009419
Hospital Revenue Code	250
Min. Negotiated Rate	$45.84
Max. Negotiated Rate	$176.32
Rate for Payer: Aetna Commercial	$105.80
Rate for Payer: Aetna Medicare Advantage	$105.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.93
Rate for Payer: Cigna Commercial	$176.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.84
Rate for Payer: Oxford Commercial	$176.32
Rate for Payer: Qualcare PPO/HMO/WC	$52.90
Rate for Payer: UnitedHealthcare Commercial	$176.32

FIBRINOLYTIC FACTRS/INHIB PLAS

Facility

$121.75

Service Code	HCPCS 85415
Hospital Charge Code	38477145
Hospital Revenue Code	305
Min. Negotiated Rate	$18.26
Max. Negotiated Rate	$18.26
Rate for Payer: Qualcare PPO/HMO/WC	$18.26

FIBRINOLYTIC FACTRS/INHIB PLAS

Facility

$121.75

Service Code	HCPCS 85415
Hospital Charge Code	38477145
Hospital Revenue Code	305
Min. Negotiated Rate	$8.60
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.70
Rate for Payer: Aetna Medicare Advantage	$17.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.19
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	$62.98
Rate for Payer: Cigna Commercial	$17.19
Rate for Payer: Cigna Medicare Advantage	$8.60
Rate for Payer: Clover Medicare Advantage	$16.33
Rate for Payer: EmblemHealth Commercial	$51.57
Rate for Payer: Humana Medicare Advantage	$17.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.26
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.19
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.22
Rate for Payer: Wellcare Medicare Advantage	$17.19

FIBRINOLYTIC PLASMINOGEN

Facility

$390.00

Service Code	HCPCS 85420
Hospital Charge Code	401485420
Hospital Revenue Code	305
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$21.16
Rate for Payer: Aetna Medicare Advantage	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.93
Rate for Payer: Cigna Commercial	$6.53
Rate for Payer: Cigna Medicare Advantage	$3.27
Rate for Payer: Clover Medicare Advantage	$6.20
Rate for Payer: EmblemHealth Commercial	$19.59
Rate for Payer: Humana Medicare Advantage	$6.73
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	$6.53
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.92
Rate for Payer: Wellcare Medicare Advantage	$6.53

FIBRINOLYTIC PLASMINOGEN

Facility

$390.00

Service Code	HCPCS 85420
Hospital Charge Code	401485420
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