Heights University Hospital

All Charges

Charge

Type

Setting

Price

FP SMKNG&TOBACCO CESS COUNSLG

Facility

$123.00

Service Code	HCPCS 99406
Hospital Charge Code	83652505
Hospital Revenue Code	942
Min. Negotiated Rate	$15.99
Max. Negotiated Rate	$779.00
Rate for Payer: Aetna Commercial	$36.90
Rate for Payer: Aetna Medicare Advantage	$36.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.36
Rate for Payer: Cigna Commercial	$89.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.99
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.45
Rate for Payer: UnitedHealthcare Commercial	$779.00

FP SMK&TOBACCO CESS COUNSELING

Facility

$123.00

Service Code	HCPCS 99407
Hospital Charge Code	83652507
Hospital Revenue Code	942
Min. Negotiated Rate	$15.99
Max. Negotiated Rate	$779.00
Rate for Payer: Aetna Commercial	$36.90
Rate for Payer: Aetna Medicare Advantage	$36.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.36
Rate for Payer: Cigna Commercial	$89.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.99
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.45
Rate for Payer: UnitedHealthcare Commercial	$779.00

FP SMK&TOBACCO CESS COUNSELING

Facility

$123.00

Service Code	HCPCS 99407
Hospital Charge Code	83652507
Hospital Revenue Code	942
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$18.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

FP SMOKE & TOBAC CESS COU 3-10

Facility

$123.00

Service Code	HCPCS 99406
Hospital Charge Code	87502380
Hospital Revenue Code	510
Min. Negotiated Rate	$15.99
Max. Negotiated Rate	$89.22
Rate for Payer: Aetna Commercial	$36.90
Rate for Payer: Aetna Medicare Advantage	$36.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.36
Rate for Payer: Cigna Commercial	$89.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.99
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

FP SMOKE & TOBAC CESS COU 3-10

Facility

$123.00

Service Code	HCPCS 99406
Hospital Charge Code	87502380
Hospital Revenue Code	510
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$18.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

FP SMOKE&TOB CESS COUNSL>10MIN

Facility

$123.00

Service Code	HCPCS 99407
Hospital Charge Code	87502385
Hospital Revenue Code	510
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$18.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

FP SMOKE&TOB CESS COUNSL>10MIN

Facility

$123.00

Service Code	HCPCS 99407
Hospital Charge Code	87502385
Hospital Revenue Code	510
Min. Negotiated Rate	$15.99
Max. Negotiated Rate	$89.22
Rate for Payer: Aetna Commercial	$36.90
Rate for Payer: Aetna Medicare Advantage	$36.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.36
Rate for Payer: Cigna Commercial	$89.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.99
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

FP SP ENGERIX HEP B PED 10MCG

Facility

$50.00

Service Code	HCPCS 90744
Hospital Charge Code	83652599
Hospital Revenue Code	636
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$12.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.10
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

FP SP ENGERIX HEP B PED 10MCG

Facility

$50.00

Service Code	HCPCS 90744
Hospital Charge Code	83652599
Hospital Revenue Code	636
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$37.90
Rate for Payer: Aetna Commercial	$15.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$33.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.10
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

FP SP TD TOX>7 YRS& OLDER-N P

Facility

$130.18

Service Code	HCPCS 90714
Hospital Charge Code	83652601
Hospital Revenue Code	636
Min. Negotiated Rate	$19.53
Max. Negotiated Rate	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.53

FP SP TD TOX>7 YRS& OLDER-N P

Facility

$130.18

Service Code	HCPCS 90714
Hospital Charge Code	83652601
Hospital Revenue Code	636
Min. Negotiated Rate	$19.53
Max. Negotiated Rate	$39.05
Rate for Payer: Aetna Commercial	$39.05
Rate for Payer: Aetna Medicare Advantage	$39.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.20
Rate for Payer: Cigna Commercial	$38.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.53

FP SUBUNGUAL HEMATOMA EVACUAT

Facility

$696.50

Service Code	HCPCS 11740
Hospital Charge Code	87502490
Hospital Revenue Code	761
Min. Negotiated Rate	$18.66
Max. Negotiated Rate	$348.25
Rate for Payer: Aetna Better Health Medicaid	$193.50
Rate for Payer: Aetna Commercial	$208.95
Rate for Payer: Aetna Medicare Advantage	$208.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.61
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.55
Rate for Payer: Oxford Commercial	$348.25
Rate for Payer: Qualcare PPO/HMO/WC	$104.47
Rate for Payer: UnitedHealthcare Commercial	$348.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37

FP SUBUNGUAL HEMATOMA EVACUAT

Facility

$696.50

Service Code	HCPCS 11740
Hospital Charge Code	87502490
Hospital Revenue Code	761
Min. Negotiated Rate	$104.47
Max. Negotiated Rate	$104.47
Rate for Payer: Qualcare PPO/HMO/WC	$104.47

FP SUBUNGUAL HEMATOMA EVACUAT

Facility

$177.00

Service Code	HCPCS 11740
Hospital Charge Code	83652055
Hospital Revenue Code	761
Min. Negotiated Rate	$26.55
Max. Negotiated Rate	$26.55
Rate for Payer: Qualcare PPO/HMO/WC	$26.55

FP SUBUNGUAL HEMATOMA EVACUAT

Facility

$177.00

Service Code	HCPCS 11740
Hospital Charge Code	83652055
Hospital Revenue Code	761
Min. Negotiated Rate	$18.66
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Better Health Medicaid	$193.50
Rate for Payer: Aetna Commercial	$53.10
Rate for Payer: Aetna Medicare Advantage	$53.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.13
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.01
Rate for Payer: Oxford Commercial	$88.50
Rate for Payer: Qualcare PPO/HMO/WC	$26.55
Rate for Payer: UnitedHealthcare Commercial	$88.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37

FP TYMPANOMETER

Facility

$203.70

Service Code	HCPCS 92567
Hospital Charge Code	87502710
Hospital Revenue Code	471
Min. Negotiated Rate	$26.48
Max. Negotiated Rate	$1,180.00
Rate for Payer: Aetna Commercial	$61.11
Rate for Payer: Aetna Medicare Advantage	$61.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.94
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.48
Rate for Payer: Oxford Commercial	$1,040.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.55
Rate for Payer: UnitedHealthcare Commercial	$1,180.00

FP TYMPANOMETER

Facility

$203.70

Service Code	HCPCS 92567
Hospital Charge Code	87502710
Hospital Revenue Code	471
Min. Negotiated Rate	$30.55
Max. Negotiated Rate	$30.55
Rate for Payer: Qualcare PPO/HMO/WC	$30.55

FP VACC ADM

Facility

$156.00

Service Code	HCPCS 90471
Hospital Charge Code	83652518
Hospital Revenue Code	771
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$23.40
Rate for Payer: Qualcare PPO/HMO/WC	$23.40

FP VACC ADM

Facility

$156.00

Service Code	HCPCS 90471
Hospital Charge Code	83652518
Hospital Revenue Code	771
Min. Negotiated Rate	$20.28
Max. Negotiated Rate	$171.47
Rate for Payer: Aetna Commercial	$46.80
Rate for Payer: Aetna Medicare Advantage	$46.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.78
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.28
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.40
Rate for Payer: UnitedHealthcare Commercial	$103.00

FRACTIONATED PORPHYRINS I

Facility

$231.25

Service Code	HCPCS 82542
Hospital Charge Code	3038538A
Hospital Revenue Code	301
Min. Negotiated Rate	$34.69
Max. Negotiated Rate	$34.69
Rate for Payer: Qualcare PPO/HMO/WC	$34.69

FRACTIONATED PORPHYRINS I

Facility

$231.25

Service Code	HCPCS 82542
Hospital Charge Code	3038538A
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	$30.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.69
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

FRACTIONATED PORPHYRINS II

Facility

$231.25

Service Code	HCPCS 82542
Hospital Charge Code	3038538B
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	$30.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.69
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

FRACTIONATED PORPHYRINS II

Facility

$231.25

Service Code	HCPCS 82542
Hospital Charge Code	3038538B
Hospital Revenue Code	301
Min. Negotiated Rate	$34.69
Max. Negotiated Rate	$34.69
Rate for Payer: Qualcare PPO/HMO/WC	$34.69

FRACTIONATED PORPHYRINS III

Facility

$231.25

Service Code	HCPCS 82542
Hospital Charge Code	3038538C
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	$30.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.69
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

FRACTIONATED PORPHYRINS III

Facility

$231.25

Service Code	HCPCS 82542
Hospital Charge Code	3038538C
Hospital Revenue Code	301
Min. Negotiated Rate	$34.69
Max. Negotiated Rate	$34.69
Rate for Payer: Qualcare PPO/HMO/WC	$34.69

Know your out-of-pocket cost for care.

All Charges