Heights University Hospital

All Charges

Charge

Type

Setting

Price

Hawk One M 6F 2.2 135

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683844N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$4,410.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

Hawk One M 6F 2.2 135

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683844N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$9,112.50
Rate for Payer: Aetna Commercial	$5,467.50
Rate for Payer: Aetna Medicare Advantage	$5,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,647.38
Rate for Payer: Cigna Commercial	$9,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

Hawk One M 6F 2.2 135

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683844
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$4,410.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

HAWK ONE M 6F 2.2 135

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683844S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$9,112.50
Rate for Payer: Aetna Commercial	$5,467.50
Rate for Payer: Aetna Medicare Advantage	$5,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,647.38
Rate for Payer: Cigna Commercial	$9,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

HAWK ONE M 6F 2.2 135

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683844S
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$4,410.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

Hawk One S

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683845N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$4,410.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

Hawk One S

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683845
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$9,112.50
Rate for Payer: Aetna Commercial	$5,467.50
Rate for Payer: Aetna Medicare Advantage	$5,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,647.38
Rate for Payer: Cigna Commercial	$9,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

Hawk One S

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683845
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$4,410.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

Hawk One S

Facility

$18,225.00

Service Code	HCPCS C1714
Hospital Charge Code	270683845N
Hospital Revenue Code	278
Min. Negotiated Rate	$2,733.75
Max. Negotiated Rate	$9,112.50
Rate for Payer: Aetna Commercial	$5,467.50
Rate for Payer: Aetna Medicare Advantage	$5,467.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,647.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,645.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,647.38
Rate for Payer: Cigna Commercial	$9,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,410.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,733.75

HB CORE AB (IGM)

Facility

$192.85

Service Code	HCPCS 86705
Hospital Charge Code	3035119
Hospital Revenue Code	300
Min. Negotiated Rate	$5.88
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.13
Rate for Payer: Aetna Medicare Advantage	$11.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.13
Rate for Payer: Cigna Commercial	$11.77
Rate for Payer: Cigna Medicare Advantage	$5.88
Rate for Payer: Clover Medicare Advantage	$11.18
Rate for Payer: EmblemHealth Commercial	$35.31
Rate for Payer: Humana Medicare Advantage	$12.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.93
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.48
Rate for Payer: Wellcare Medicare Advantage	$11.77

HB CORE AB (IGM)

Facility

$80.90

Service Code	HCPCS 86705
Hospital Charge Code	39900245
Hospital Revenue Code	302
Min. Negotiated Rate	$5.88
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.13
Rate for Payer: Aetna Medicare Advantage	$11.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.13
Rate for Payer: Cigna Commercial	$11.77
Rate for Payer: Cigna Medicare Advantage	$5.88
Rate for Payer: Clover Medicare Advantage	$11.18
Rate for Payer: EmblemHealth Commercial	$35.31
Rate for Payer: Humana Medicare Advantage	$12.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.52
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.13
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.48
Rate for Payer: Wellcare Medicare Advantage	$11.77

HB CORE AB (IGM)

Facility

$192.85

Service Code	HCPCS 86705
Hospital Charge Code	3035119
Hospital Revenue Code	300
Min. Negotiated Rate	$28.93
Max. Negotiated Rate	$28.93
Rate for Payer: Qualcare PPO/HMO/WC	$28.93

HB CORE AB (IGM)

Facility

$80.90

Service Code	HCPCS 86705
Hospital Charge Code	39900245
Hospital Revenue Code	302
Min. Negotiated Rate	$12.13
Max. Negotiated Rate	$12.13
Rate for Payer: Qualcare PPO/HMO/WC	$12.13

HB CORE AB,TOTAL

Facility

$82.85

Service Code	HCPCS 86704
Hospital Charge Code	39900244
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.43
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

HB CORE AB,TOTAL

Facility

$82.85

Service Code	HCPCS 86704
Hospital Charge Code	39900244
Hospital Revenue Code	302
Min. Negotiated Rate	$12.43
Max. Negotiated Rate	$12.43
Rate for Payer: Qualcare PPO/HMO/WC	$12.43

HB DNA PCR

Facility

$296.95

Service Code	HCPCS 87517
Hospital Charge Code	3035101
Hospital Revenue Code	306
Min. Negotiated Rate	$21.42
Max. Negotiated Rate	$156.97
Rate for Payer: Aetna Commercial	$138.80
Rate for Payer: Aetna Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.97
Rate for Payer: Cigna Commercial	$42.84
Rate for Payer: Cigna Medicare Advantage	$21.42
Rate for Payer: Clover Medicare Advantage	$40.70
Rate for Payer: EmblemHealth Commercial	$128.52
Rate for Payer: Humana Medicare Advantage	$44.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.54
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$45.41
Rate for Payer: Wellcare Medicare Advantage	$42.84

HB DNA PCR

Facility

$296.95

Service Code	HCPCS 87517
Hospital Charge Code	3035101
Hospital Revenue Code	306
Min. Negotiated Rate	$44.54
Max. Negotiated Rate	$44.54
Rate for Payer: Qualcare PPO/HMO/WC	$44.54

HB E AB

Facility

$79.50

Service Code	HCPCS 86707
Hospital Charge Code	39900246
Hospital Revenue Code	302
Min. Negotiated Rate	$5.79
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.49
Rate for Payer: Aetna Medicare Advantage	$11.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.39
Rate for Payer: Cigna Commercial	$11.57
Rate for Payer: Cigna Medicare Advantage	$5.79
Rate for Payer: Clover Medicare Advantage	$10.99
Rate for Payer: EmblemHealth Commercial	$34.71
Rate for Payer: Humana Medicare Advantage	$11.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.93
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.57
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.26
Rate for Payer: Wellcare Medicare Advantage	$11.57

HB E AB

Facility

$79.50

Service Code	HCPCS 86707
Hospital Charge Code	39900246
Hospital Revenue Code	302
Min. Negotiated Rate	$11.93
Max. Negotiated Rate	$11.93
Rate for Payer: Qualcare PPO/HMO/WC	$11.93

HB E AG

Facility

$79.20

Service Code	HCPCS 87350
Hospital Charge Code	39900287
Hospital Revenue Code	306
Min. Negotiated Rate	$11.88
Max. Negotiated Rate	$11.88
Rate for Payer: Qualcare PPO/HMO/WC	$11.88

HB E AG

Facility

$79.20

Service Code	HCPCS 87350
Hospital Charge Code	39900287
Hospital Revenue Code	306
Min. Negotiated Rate	$5.76
Max. Negotiated Rate	$114.00
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	$12.21
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	$10.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.88
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

HBIG (HEPAT B IMM GLOB)

Facility

$774.00

Hospital Charge Code	60634536
Hospital Revenue Code	250
Min. Negotiated Rate	$100.62
Max. Negotiated Rate	$387.00
Rate for Payer: Aetna Commercial	$232.20
Rate for Payer: Aetna Medicare Advantage	$232.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.37
Rate for Payer: Cigna Commercial	$387.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.62
Rate for Payer: Oxford Commercial	$387.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.10
Rate for Payer: UnitedHealthcare Commercial	$387.00

HBIG (HEPAT B IMM GLOB)

Facility

$774.00

Hospital Charge Code	60634536
Hospital Revenue Code	250
Min. Negotiated Rate	$116.10
Max. Negotiated Rate	$116.10
Rate for Payer: Qualcare PPO/HMO/WC	$116.10

HB S AB, I

Facility

$103.05

Service Code	HCPCS 86317
Hospital Charge Code	39990031A
Hospital Revenue Code	302
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.57
Rate for Payer: Aetna Medicare Advantage	$14.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.99
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	$54.92
Rate for Payer: Cigna Commercial	$14.99
Rate for Payer: Cigna Medicare Advantage	$7.50
Rate for Payer: Clover Medicare Advantage	$14.24
Rate for Payer: EmblemHealth Commercial	$44.97
Rate for Payer: Humana Medicare Advantage	$15.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.46
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.99
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.89
Rate for Payer: Wellcare Medicare Advantage	$14.99

HB S AB, I

Facility

$103.05

Service Code	HCPCS 86317
Hospital Charge Code	39990031A
Hospital Revenue Code	302
Min. Negotiated Rate	$15.46
Max. Negotiated Rate	$15.46
Rate for Payer: Qualcare PPO/HMO/WC	$15.46

Know your out-of-pocket cost for care.

All Charges