Heights University Hospital

All Charges

Charge

Type

Setting

Price

FROZEN SECTION

Facility

$390.00

Service Code	HCPCS 88332
Hospital Charge Code	3004935
Hospital Revenue Code	312
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FROZEN SECTION

Facility

$390.00

Service Code	HCPCS 88332
Hospital Charge Code	3004935
Hospital Revenue Code	312
Min. Negotiated Rate	$30.02
Max. Negotiated Rate	$117.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$60.05
Rate for Payer: Cigna Medicare Advantage	$30.02
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

FROZEN SECTION*****

Facility

$161.00

Service Code	HCPCS 8833159
Hospital Charge Code	3004934A
Hospital Revenue Code	312
Min. Negotiated Rate	$20.93
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.30
Rate for Payer: Aetna Medicare Advantage	$48.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.05
Rate for Payer: Cigna Commercial	$80.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.15
Rate for Payer: UnitedHealthcare Commercial	$114.00

FROZEN SECTION*****

Facility

$161.00

Service Code	HCPCS 8833159
Hospital Charge Code	3004934A
Hospital Revenue Code	312
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$24.15
Rate for Payer: Qualcare PPO/HMO/WC	$24.15

FROZEN SECTION ADD BLOCK

Facility

$300.85

Service Code	HCPCS 88332
Hospital Charge Code	3004943
Hospital Revenue Code	312
Min. Negotiated Rate	$45.13
Max. Negotiated Rate	$45.13
Rate for Payer: Qualcare PPO/HMO/WC	$45.13

FROZEN SECTION ADD BLOCK

Facility

$390.00

Service Code	HCPCS 88332
Hospital Charge Code	3004942
Hospital Revenue Code	310
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FROZEN SECTION ADD BLOCK

Facility

$390.00

Service Code	HCPCS 88332
Hospital Charge Code	3004942
Hospital Revenue Code	310
Min. Negotiated Rate	$30.02
Max. Negotiated Rate	$117.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$60.05
Rate for Payer: Cigna Medicare Advantage	$30.02
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

FROZEN SECTION ADD BLOCK

Facility

$300.85

Service Code	HCPCS 88332
Hospital Charge Code	3004943
Hospital Revenue Code	312
Min. Negotiated Rate	$30.02
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$90.25
Rate for Payer: Aetna Medicare Advantage	$90.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.72
Rate for Payer: Cigna Commercial	$60.05
Rate for Payer: Cigna Medicare Advantage	$30.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.13
Rate for Payer: UnitedHealthcare Commercial	$114.00

FROZEN SECTION ADDTIONAL SURGE

Facility

$186.00

Service Code	HCPCS 88332
Hospital Charge Code	38474034
Hospital Revenue Code	310
Min. Negotiated Rate	$27.90
Max. Negotiated Rate	$27.90
Rate for Payer: Qualcare PPO/HMO/WC	$27.90

FROZEN SECTION ADDTIONAL SURGE

Facility

$186.00

Service Code	HCPCS 88332
Hospital Charge Code	38474034
Hospital Revenue Code	310
Min. Negotiated Rate	$24.18
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.80
Rate for Payer: Aetna Medicare Advantage	$55.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.43
Rate for Payer: Cigna Commercial	$60.05
Rate for Payer: Cigna Medicare Advantage	$30.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.18
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.90
Rate for Payer: UnitedHealthcare Commercial	$114.00

FROZEN SECTION CYTOLOGY

Facility

$211.25

Service Code	HCPCS 88333
Hospital Charge Code	3005395
Hospital Revenue Code	311
Min. Negotiated Rate	$31.69
Max. Negotiated Rate	$31.69
Rate for Payer: Qualcare PPO/HMO/WC	$31.69

FROZEN SECTION CYTOLOGY

Facility

$211.25

Service Code	HCPCS 88333
Hospital Charge Code	3005395
Hospital Revenue Code	311
Min. Negotiated Rate	$27.46
Max. Negotiated Rate	$1,918.64
Rate for Payer: Aetna Commercial	$63.38
Rate for Payer: Aetna Medicare Advantage	$63.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.87
Rate for Payer: Cigna Commercial	$1,918.64
Rate for Payer: Cigna Medicare Advantage	$49.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.69
Rate for Payer: UnitedHealthcare Commercial	$114.00

FROZEN SECTION DURING SURGERY

Facility

$401.00

Service Code	HCPCS 88331
Hospital Charge Code	38474031
Hospital Revenue Code	310
Min. Negotiated Rate	$52.13
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$120.30
Rate for Payer: Aetna Medicare Advantage	$120.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.25
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$54.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.15
Rate for Payer: UnitedHealthcare Commercial	$114.00

FROZEN SECTION DURING SURGERY

Facility

$401.00

Service Code	HCPCS 88331
Hospital Charge Code	38474031
Hospital Revenue Code	310
Min. Negotiated Rate	$60.15
Max. Negotiated Rate	$60.15
Rate for Payer: Qualcare PPO/HMO/WC	$60.15

FROZEN THAWED RBC,DEGLYCEROLYZ

Facility

$2,167.00

Hospital Charge Code	38471034
Hospital Revenue Code	390
Min. Negotiated Rate	$281.71
Max. Negotiated Rate	$1,083.50
Rate for Payer: Aetna Commercial	$650.10
Rate for Payer: Aetna Medicare Advantage	$650.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$552.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$552.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$552.59
Rate for Payer: Cigna Commercial	$1,083.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.71
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$325.05
Rate for Payer: UnitedHealthcare Commercial	$756.00

FROZEN THAWED RBC,DEGLYCEROLYZ

Facility

$2,167.00

Hospital Charge Code	38471034
Hospital Revenue Code	390
Min. Negotiated Rate	$325.05
Max. Negotiated Rate	$325.05
Rate for Payer: Qualcare PPO/HMO/WC	$325.05

FRUCTOSAMINE

Facility

$667.59

Service Code	HCPCS 82985
Hospital Charge Code	39900088
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.30
Rate for Payer: Aetna Medicare Advantage	$16.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.41
Rate for Payer: Cigna Commercial	$16.76
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.92
Rate for Payer: EmblemHealth Commercial	$50.28
Rate for Payer: Humana Medicare Advantage	$17.26
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	$16.76
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.77
Rate for Payer: Wellcare Medicare Advantage	$16.76

FRUCTOSAMINE

Facility

$141.65

Service Code	HCPCS 82985
Hospital Charge Code	3007408
Hospital Revenue Code	301
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

FRUCTOSAMINE

Facility

$141.65

Service Code	HCPCS 82985
Hospital Charge Code	3007408
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.30
Rate for Payer: Aetna Medicare Advantage	$16.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.41
Rate for Payer: Cigna Commercial	$16.76
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.92
Rate for Payer: EmblemHealth Commercial	$50.28
Rate for Payer: Humana Medicare Advantage	$17.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.76
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.77
Rate for Payer: Wellcare Medicare Advantage	$16.76

FRUCTOSAMINE

Facility

$667.59

Service Code	HCPCS 82985
Hospital Charge Code	39900088
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

FRUCTOSAMINE, SERUM

Facility

$446.00

Service Code	HCPCS 82985
Hospital Charge Code	38474105
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.30
Rate for Payer: Aetna Medicare Advantage	$16.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.41
Rate for Payer: Cigna Commercial	$16.76
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.92
Rate for Payer: EmblemHealth Commercial	$50.28
Rate for Payer: Humana Medicare Advantage	$17.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.76
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.77
Rate for Payer: Wellcare Medicare Advantage	$16.76

FRUCTOSAMINE, SERUM

Facility

$446.00

Service Code	HCPCS 82985
Hospital Charge Code	38474105
Hospital Revenue Code	301
Min. Negotiated Rate	$66.90
Max. Negotiated Rate	$66.90
Rate for Payer: Qualcare PPO/HMO/WC	$66.90

FRUCTOSE,SEMEN,QN

Facility

$390.00

Service Code	HCPCS 82757
Hospital Charge Code	39900081
Hospital Revenue Code	301
Min. Negotiated Rate	$8.67
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$56.18
Rate for Payer: Aetna Medicare Advantage	$17.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.53
Rate for Payer: Cigna Commercial	$17.34
Rate for Payer: Cigna Medicare Advantage	$8.67
Rate for Payer: Clover Medicare Advantage	$16.47
Rate for Payer: EmblemHealth Commercial	$52.02
Rate for Payer: Humana Medicare Advantage	$17.86
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	$17.34
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.38
Rate for Payer: Wellcare Medicare Advantage	$17.34

FRUCTOSE,SEMEN,QN

Facility

$390.00

Service Code	HCPCS 82757
Hospital Charge Code	39900081
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

F-SERIES CANN SCREW 2.0X40MM

Facility

$1,550.00

Service Code	HCPCS C1713
Hospital Charge Code	270681049
Hospital Revenue Code	278
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$375.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.10
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

Know your out-of-pocket cost for care.

All Charges