Heights University Hospital

All Charges

Charge

Type

Setting

Price

GIARDIA AG,EIA,STOOL, I

Facility

$75.65

Service Code	HCPCS 87328
Hospital Charge Code	39990054A
Hospital Revenue Code	306
Min. Negotiated Rate	$11.35
Max. Negotiated Rate	$11.35
Rate for Payer: Qualcare PPO/HMO/WC	$11.35

GIARDIA AG,EIA,STOOL, I

Facility

$75.65

Service Code	HCPCS 87328
Hospital Charge Code	39990054A
Hospital Revenue Code	306
Min. Negotiated Rate	$6.91
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$44.78
Rate for Payer: Aetna Medicare Advantage	$13.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.64
Rate for Payer: Cigna Commercial	$13.82
Rate for Payer: Cigna Medicare Advantage	$6.91
Rate for Payer: Clover Medicare Advantage	$13.13
Rate for Payer: EmblemHealth Commercial	$41.46
Rate for Payer: Humana Medicare Advantage	$14.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.82
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.65
Rate for Payer: Wellcare Medicare Advantage	$13.82

GIARDIA AG,EIA,STOOL, II

Facility

$75.65

Service Code	HCPCS 87329
Hospital Charge Code	39990054B
Hospital Revenue Code	306
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.82
Rate for Payer: Aetna Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.89
Rate for Payer: Cigna Commercial	$11.98
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.70
Rate for Payer: Wellcare Medicare Advantage	$11.98

GIARDIA AG,EIA,STOOL, II

Facility

$75.65

Service Code	HCPCS 87329
Hospital Charge Code	39990054B
Hospital Revenue Code	306
Min. Negotiated Rate	$11.35
Max. Negotiated Rate	$11.35
Rate for Payer: Qualcare PPO/HMO/WC	$11.35

GIARDIA ANTIGEN

Facility

$181.65

Service Code	HCPCS 87329
Hospital Charge Code	3009743
Hospital Revenue Code	306
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

GIARDIA ANTIGEN

Facility

$181.65

Service Code	HCPCS 87329
Hospital Charge Code	3009743
Hospital Revenue Code	306
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.82
Rate for Payer: Aetna Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.89
Rate for Payer: Cigna Commercial	$11.98
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.70
Rate for Payer: Wellcare Medicare Advantage	$11.98

GIEMSA STAIN

Facility

$390.00

Service Code	HCPCS 88312
Hospital Charge Code	3005267
Hospital Revenue Code	310
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$124.10
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	$124.10
Rate for Payer: Cigna Medicare Advantage	$62.63
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

GIEMSA STAIN

Facility

$390.00

Service Code	HCPCS 88312
Hospital Charge Code	3005267
Hospital Revenue Code	310
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

GI PATHOGEN PANEL RT-PCR STOOL

Facility

$495.82

Service Code	HCPCS 87506
Hospital Charge Code	401387506
Hospital Revenue Code	306
Min. Negotiated Rate	$64.46
Max. Negotiated Rate	$963.60
Rate for Payer: Aetna Commercial	$852.09
Rate for Payer: Aetna Medicare Advantage	$262.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$963.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$963.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$262.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$217.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$963.60
Rate for Payer: Cigna Commercial	$262.99
Rate for Payer: Cigna Medicare Advantage	$131.50
Rate for Payer: Clover Medicare Advantage	$249.84
Rate for Payer: EmblemHealth Commercial	$788.97
Rate for Payer: Humana Medicare Advantage	$270.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.37
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$262.99
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$278.77
Rate for Payer: Wellcare Medicare Advantage	$262.99

GI PATHOGEN PANEL RT-PCR STOOL

Facility

$495.82

Service Code	HCPCS 87506
Hospital Charge Code	401387506
Hospital Revenue Code	306
Min. Negotiated Rate	$74.37
Max. Negotiated Rate	$74.37
Rate for Payer: Qualcare PPO/HMO/WC	$74.37

GIRDLE MID-THIGH SZ LG 110663

Facility

$351.70

Hospital Charge Code	270622256
Hospital Revenue Code	272
Min. Negotiated Rate	$45.72
Max. Negotiated Rate	$175.85
Rate for Payer: Aetna Commercial	$105.51
Rate for Payer: Aetna Medicare Advantage	$105.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.68
Rate for Payer: Cigna Commercial	$175.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.72
Rate for Payer: Oxford Commercial	$175.85
Rate for Payer: Qualcare PPO/HMO/WC	$52.76
Rate for Payer: UnitedHealthcare Commercial	$175.85

GIRDLE MID-THIGH SZ LG 110663

Facility

$351.70

Hospital Charge Code	270622256
Hospital Revenue Code	272
Min. Negotiated Rate	$52.76
Max. Negotiated Rate	$52.76
Rate for Payer: Qualcare PPO/HMO/WC	$52.76

GIRDLE MID THIGH SZ SM 110661

Facility

$348.95

Hospital Charge Code	270625188
Hospital Revenue Code	272
Min. Negotiated Rate	$45.36
Max. Negotiated Rate	$174.47
Rate for Payer: Aetna Commercial	$104.69
Rate for Payer: Aetna Medicare Advantage	$104.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.98
Rate for Payer: Cigna Commercial	$174.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.36
Rate for Payer: Oxford Commercial	$174.47
Rate for Payer: Qualcare PPO/HMO/WC	$52.34
Rate for Payer: UnitedHealthcare Commercial	$174.47

GIRDLE MID THIGH SZ SM 110661

Facility

$348.95

Hospital Charge Code	270625188
Hospital Revenue Code	272
Min. Negotiated Rate	$52.34
Max. Negotiated Rate	$52.34
Rate for Payer: Qualcare PPO/HMO/WC	$52.34

GI STOOL PCR PANEL 22TARGETS

Facility

$780.00

Service Code	HCPCS 0097U
Hospital Charge Code	40130097U
Hospital Revenue Code	306
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$117.00
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

GI STOOL PCR PANEL 22TARGETS

Facility

$780.00

Service Code	HCPCS 0097U
Hospital Charge Code	40130097U
Hospital Revenue Code	306
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$234.00
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$117.00
Rate for Payer: UnitedHealthcare Commercial	$114.00

GLACIAL ACETIC ACID

Facility

$3.00

Hospital Charge Code	60634471
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

GLACIAL ACETIC ACID

Facility

$3.00

Hospital Charge Code	60634471
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

GLASSES, CUSTOM ENGRAVING ON F

Facility

$10.00

Hospital Charge Code	270667070
Hospital Revenue Code	270
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

GLASSES, CUSTOM ENGRAVING ON F

Facility

$10.00

Hospital Charge Code	270667070
Hospital Revenue Code	270
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$3.00
Rate for Payer: Aetna Medicare Advantage	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.55
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$5.00

GLASSES, FITOVER TORTOISE

Facility

$1,245.00

Hospital Charge Code	270660852
Hospital Revenue Code	270
Min. Negotiated Rate	$161.85
Max. Negotiated Rate	$622.50
Rate for Payer: Aetna Commercial	$373.50
Rate for Payer: Aetna Medicare Advantage	$373.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.48
Rate for Payer: Cigna Commercial	$622.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.85
Rate for Payer: Oxford Commercial	$622.50
Rate for Payer: Qualcare PPO/HMO/WC	$186.75
Rate for Payer: UnitedHealthcare Commercial	$622.50

GLASSES, FITOVER TORTOISE

Facility

$1,245.00

Hospital Charge Code	270660852
Hospital Revenue Code	270
Min. Negotiated Rate	$186.75
Max. Negotiated Rate	$186.75
Rate for Payer: Qualcare PPO/HMO/WC	$186.75

GLATIRAMER 20 MG/ML INJ

Facility

$1,180.00

Hospital Charge Code	60628810
Hospital Revenue Code	636
Min. Negotiated Rate	$177.00
Max. Negotiated Rate	$590.00
Rate for Payer: Aetna Commercial	$354.00
Rate for Payer: Aetna Medicare Advantage	$354.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$300.90
Rate for Payer: Cigna Commercial	$590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.56
Rate for Payer: Qualcare PPO/HMO/WC	$177.00

GLATIRAMER 20 MG/ML INJ

Facility

$1,180.00

Hospital Charge Code	60628810
Hospital Revenue Code	636
Min. Negotiated Rate	$177.00
Max. Negotiated Rate	$285.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.56
Rate for Payer: Qualcare PPO/HMO/WC	$177.00

GLATIRAMER ACETATE INJ 20MG

Facility

$7,325.45

Hospital Charge Code	60629269
Hospital Revenue Code	636
Min. Negotiated Rate	$1,098.82
Max. Negotiated Rate	$1,772.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,772.76
Rate for Payer: Qualcare PPO/HMO/WC	$1,098.82

Know your out-of-pocket cost for care.

All Charges