Heights University Hospital

All Charges

Charge

Type

Setting

Price

HB S AB, II

Facility

$73.80

Service Code	HCPCS 86706
Hospital Charge Code	39990031B
Hospital Revenue Code	302
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$34.80
Rate for Payer: Aetna Medicare Advantage	$10.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.74
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	$39.35
Rate for Payer: Cigna Commercial	$10.74
Rate for Payer: Cigna Medicare Advantage	$5.37
Rate for Payer: Clover Medicare Advantage	$10.20
Rate for Payer: EmblemHealth Commercial	$32.22
Rate for Payer: Humana Medicare Advantage	$11.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.59
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.07
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.38
Rate for Payer: Wellcare Medicare Advantage	$10.74

HB S AB, II

Facility

$73.80

Service Code	HCPCS 86706
Hospital Charge Code	39990031B
Hospital Revenue Code	302
Min. Negotiated Rate	$11.07
Max. Negotiated Rate	$11.07
Rate for Payer: Qualcare PPO/HMO/WC	$11.07

HB S AG W/REFLEX CONF

Facility

$71.00

Service Code	HCPCS 87340
Hospital Charge Code	39900286
Hospital Revenue Code	306
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

HB S AG W/REFLEX CONF

Facility

$71.00

Service Code	HCPCS 87340
Hospital Charge Code	39900286
Hospital Revenue Code	306
Min. Negotiated Rate	$5.17
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$33.47
Rate for Payer: Aetna Medicare Advantage	$10.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.85
Rate for Payer: Cigna Commercial	$10.33
Rate for Payer: Cigna Medicare Advantage	$5.17
Rate for Payer: Clover Medicare Advantage	$9.81
Rate for Payer: EmblemHealth Commercial	$30.99
Rate for Payer: Humana Medicare Advantage	$10.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.23
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.33
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.95
Rate for Payer: Wellcare Medicare Advantage	$10.33

HBV1

Facility

$390.00

Service Code	HCPCS 86704
Hospital Charge Code	39708025A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HBV1

Facility

$390.00

Service Code	HCPCS 86704
Hospital Charge Code	39708025A
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	$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	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

HBV2

Facility

$390.00

Service Code	HCPCS 86705
Hospital Charge Code	39708025B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HBV2

Facility

$390.00

Service Code	HCPCS 86705
Hospital Charge Code	39708025B
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	$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	$11.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.48
Rate for Payer: Wellcare Medicare Advantage	$11.77

HBV3

Facility

$390.00

Service Code	HCPCS 86706
Hospital Charge Code	39708025C
Hospital Revenue Code	302
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$34.80
Rate for Payer: Aetna Medicare Advantage	$10.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.74
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	$39.35
Rate for Payer: Cigna Commercial	$10.74
Rate for Payer: Cigna Medicare Advantage	$5.37
Rate for Payer: Clover Medicare Advantage	$10.20
Rate for Payer: EmblemHealth Commercial	$32.22
Rate for Payer: Humana Medicare Advantage	$11.06
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	$10.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.38
Rate for Payer: Wellcare Medicare Advantage	$10.74

HBV3

Facility

$390.00

Service Code	HCPCS 86706
Hospital Charge Code	39708025C
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HBV4

Facility

$390.00

Service Code	HCPCS 86707
Hospital Charge Code	39708025D
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HBV4

Facility

$390.00

Service Code	HCPCS 86707
Hospital Charge Code	39708025D
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	$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	$11.57
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.26
Rate for Payer: Wellcare Medicare Advantage	$11.57

HBV5

Facility

$390.00

Service Code	HCPCS 87340
Hospital Charge Code	39708025E
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HBV5

Facility

$390.00

Service Code	HCPCS 87340
Hospital Charge Code	39708025E
Hospital Revenue Code	306
Min. Negotiated Rate	$5.17
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$33.47
Rate for Payer: Aetna Medicare Advantage	$10.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.85
Rate for Payer: Cigna Commercial	$10.33
Rate for Payer: Cigna Medicare Advantage	$5.17
Rate for Payer: Clover Medicare Advantage	$9.81
Rate for Payer: EmblemHealth Commercial	$30.99
Rate for Payer: Humana Medicare Advantage	$10.64
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	$10.33
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.95
Rate for Payer: Wellcare Medicare Advantage	$10.33

HBV6

Facility

$390.00

Service Code	HCPCS 87350
Hospital Charge Code	39708025F
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HBV6

Facility

$390.00

Service Code	HCPCS 87350
Hospital Charge Code	39708025F
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	$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	$11.53
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.22
Rate for Payer: Wellcare Medicare Advantage	$11.53

HBV DNA***

Facility

$324.00

Hospital Charge Code	3010865
Hospital Revenue Code	301
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

HBV DNA***

Facility

$324.00

Hospital Charge Code	3010865
Hospital Revenue Code	301
Min. Negotiated Rate	$42.12
Max. Negotiated Rate	$162.00
Rate for Payer: Aetna Commercial	$97.20
Rate for Payer: Aetna Medicare Advantage	$97.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.62
Rate for Payer: Cigna Commercial	$162.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.60
Rate for Payer: UnitedHealthcare Commercial	$114.00

HCG PREG TEST,SERUM,QUAL

Facility

$296.00

Service Code	HCPCS 84703
Hospital Charge Code	38477017
Hospital Revenue Code	301
Min. Negotiated Rate	$44.40
Max. Negotiated Rate	$44.40
Rate for Payer: Qualcare PPO/HMO/WC	$44.40

HCG PREG TEST,SERUM,QUAL

Facility

$296.00

Service Code	HCPCS 84703
Hospital Charge Code	38477017
Hospital Revenue Code	301
Min. Negotiated Rate	$3.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$24.36
Rate for Payer: Aetna Medicare Advantage	$7.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.52
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	$27.55
Rate for Payer: Cigna Commercial	$7.52
Rate for Payer: Cigna Medicare Advantage	$3.76
Rate for Payer: Clover Medicare Advantage	$7.14
Rate for Payer: EmblemHealth Commercial	$22.56
Rate for Payer: Humana Medicare Advantage	$7.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.52
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.97
Rate for Payer: Wellcare Medicare Advantage	$7.52

HCG,QUANT

Facility

$886.20

Service Code	HCPCS 84702
Hospital Charge Code	38479096
Hospital Revenue Code	301
Min. Negotiated Rate	$7.53
Max. Negotiated Rate	$132.93
Rate for Payer: Aetna Commercial	$48.76
Rate for Payer: Aetna Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.14
Rate for Payer: Cigna Commercial	$15.05
Rate for Payer: Cigna Medicare Advantage	$7.53
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.21
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.93
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.95
Rate for Payer: Wellcare Medicare Advantage	$15.05

HCG,QUANT

Facility

$886.20

Service Code	HCPCS 84702
Hospital Charge Code	38479096
Hospital Revenue Code	301
Min. Negotiated Rate	$132.93
Max. Negotiated Rate	$132.93
Rate for Payer: Qualcare PPO/HMO/WC	$132.93

HCG,QUANT

Facility

$886.20

Service Code	HCPCS 84702
Hospital Charge Code	38472203
Hospital Revenue Code	301
Min. Negotiated Rate	$7.53
Max. Negotiated Rate	$132.93
Rate for Payer: Aetna Commercial	$48.76
Rate for Payer: Aetna Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.14
Rate for Payer: Cigna Commercial	$15.05
Rate for Payer: Cigna Medicare Advantage	$7.53
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.21
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.93
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.95
Rate for Payer: Wellcare Medicare Advantage	$15.05

HCG,QUANT

Facility

$886.20

Service Code	HCPCS 84702
Hospital Charge Code	38472203
Hospital Revenue Code	301
Min. Negotiated Rate	$132.93
Max. Negotiated Rate	$132.93
Rate for Payer: Qualcare PPO/HMO/WC	$132.93

HCG QUANTTV

Facility

$886.20

Service Code	HCPCS 84702
Hospital Charge Code	38479481
Hospital Revenue Code	301
Min. Negotiated Rate	$7.53
Max. Negotiated Rate	$132.93
Rate for Payer: Aetna Commercial	$48.76
Rate for Payer: Aetna Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.14
Rate for Payer: Cigna Commercial	$15.05
Rate for Payer: Cigna Medicare Advantage	$7.53
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.21
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$132.93
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.95
Rate for Payer: Wellcare Medicare Advantage	$15.05

Know your out-of-pocket cost for care.

All Charges