Heights University Hospital

All Charges

Charge

Type

Setting

Price

HCG QUANTTV

Facility

$886.20

Service Code	HCPCS 84702
Hospital Charge Code	38479481
Hospital Revenue Code	301
Min. Negotiated Rate	$132.93
Max. Negotiated Rate	$132.93
Rate for Payer: Qualcare PPO/HMO/WC	$132.93

HCG TOTAL

Facility

$520.00

Service Code	HCPCS 82677
Hospital Charge Code	38479484
Hospital Revenue Code	301
Min. Negotiated Rate	$12.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.34
Rate for Payer: Aetna Medicare Advantage	$24.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.60
Rate for Payer: Cigna Commercial	$24.18
Rate for Payer: Cigna Medicare Advantage	$12.09
Rate for Payer: Clover Medicare Advantage	$22.97
Rate for Payer: EmblemHealth Commercial	$72.54
Rate for Payer: Humana Medicare Advantage	$24.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.63
Rate for Payer: Wellcare Medicare Advantage	$24.18

HCG TOTAL

Facility

$520.00

Service Code	HCPCS 82677
Hospital Charge Code	38479484
Hospital Revenue Code	301
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$78.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.00

HCG,TUMOR MARKER

Facility

$390.00

Service Code	HCPCS 84702
Hospital Charge Code	3007243
Hospital Revenue Code	301
Min. Negotiated Rate	$7.53
Max. Negotiated Rate	$114.00
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	$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	$15.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.95
Rate for Payer: Wellcare Medicare Advantage	$15.05

HCG,TUMOR MARKER

Facility

$390.00

Service Code	HCPCS 84702
Hospital Charge Code	3007243
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HCL, FREE AND TOTAL

Facility

$63.00

Service Code	HCPCS 82926
Hospital Charge Code	38472377
Hospital Revenue Code	301
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.90
Rate for Payer: Aetna Medicare Advantage	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.07
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.19
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$114.00

HCL, FREE AND TOTAL

Facility

$63.00

Service Code	HCPCS 82926
Hospital Charge Code	38472377
Hospital Revenue Code	301
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

HC PEGGED GLENOID A-40

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686873
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

HC PEGGED GLENOID A-40

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686873
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,500.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

HCT

Facility

$22.45

Service Code	HCPCS 85014
Hospital Charge Code	8200337RS
Hospital Revenue Code	305
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

HCT

Facility

$22.45

Service Code	HCPCS 85014
Hospital Charge Code	8200337RS
Hospital Revenue Code	305
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.68
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.68
Rate for Payer: Cigna Commercial	$2.37
Rate for Payer: Cigna Medicare Advantage	$1.19
Rate for Payer: Clover Medicare Advantage	$2.25
Rate for Payer: EmblemHealth Commercial	$7.11
Rate for Payer: Humana Medicare Advantage	$2.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.51
Rate for Payer: Wellcare Medicare Advantage	$2.37

HCT (HEMATOCRIT)

Facility

$667.59

Service Code	HCPCS 85014
Hospital Charge Code	3002912
Hospital Revenue Code	305
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.68
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.68
Rate for Payer: Cigna Commercial	$2.37
Rate for Payer: Cigna Medicare Advantage	$1.19
Rate for Payer: Clover Medicare Advantage	$2.25
Rate for Payer: EmblemHealth Commercial	$7.11
Rate for Payer: Humana Medicare Advantage	$2.44
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	$2.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.51
Rate for Payer: Wellcare Medicare Advantage	$2.37

HCT (HEMATOCRIT)

Facility

$667.59

Service Code	HCPCS 85014
Hospital Charge Code	3002912
Hospital Revenue Code	305
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

HCV AB

Facility

$98.10

Service Code	HCPCS 86803
Hospital Charge Code	39900260
Hospital Revenue Code	302
Min. Negotiated Rate	$14.71
Max. Negotiated Rate	$14.71
Rate for Payer: Qualcare PPO/HMO/WC	$14.71

HCV AB

Facility

$98.10

Service Code	HCPCS 86803
Hospital Charge Code	39900260
Hospital Revenue Code	302
Min. Negotiated Rate	$7.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.23
Rate for Payer: Aetna Medicare Advantage	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.29
Rate for Payer: Cigna Commercial	$14.27
Rate for Payer: Cigna Medicare Advantage	$7.13
Rate for Payer: Clover Medicare Advantage	$13.56
Rate for Payer: EmblemHealth Commercial	$42.81
Rate for Payer: Humana Medicare Advantage	$14.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.71
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.13
Rate for Payer: Wellcare Medicare Advantage	$14.27

HCV AB,RIBA

Facility

$106.50

Service Code	HCPCS 86804
Hospital Charge Code	39900261
Hospital Revenue Code	302
Min. Negotiated Rate	$15.97
Max. Negotiated Rate	$15.97
Rate for Payer: Qualcare PPO/HMO/WC	$15.97

HCV AB,RIBA

Facility

$106.50

Service Code	HCPCS 86804
Hospital Charge Code	39900261
Hospital Revenue Code	302
Min. Negotiated Rate	$7.75
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$50.19
Rate for Payer: Aetna Medicare Advantage	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.76
Rate for Payer: Cigna Commercial	$15.49
Rate for Payer: Cigna Medicare Advantage	$7.75
Rate for Payer: Clover Medicare Advantage	$14.72
Rate for Payer: EmblemHealth Commercial	$46.47
Rate for Payer: Humana Medicare Advantage	$15.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.85
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.97
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.49
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.42
Rate for Payer: Wellcare Medicare Advantage	$15.49

HCV Antibody

Facility

$98.10

Service Code	HCPCS 86803
Hospital Charge Code	39888008
Hospital Revenue Code	302
Min. Negotiated Rate	$7.13
Max. Negotiated Rate	$114.00
Rate for Payer: Cigna Commercial	$14.27
Rate for Payer: Aetna Commercial	$46.23
Rate for Payer: Aetna Medicare Advantage	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.29
Rate for Payer: Cigna Medicare Advantage	$7.13
Rate for Payer: Clover Medicare Advantage	$13.56
Rate for Payer: EmblemHealth Commercial	$42.81
Rate for Payer: Humana Medicare Advantage	$14.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.71
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.13
Rate for Payer: Wellcare Medicare Advantage	$14.27

HCV Antibody

Facility

$98.10

Service Code	HCPCS 86803
Hospital Charge Code	39888008
Hospital Revenue Code	302
Min. Negotiated Rate	$14.71
Max. Negotiated Rate	$14.71
Rate for Payer: Qualcare PPO/HMO/WC	$14.71

HCV FIBROSURE I

Facility

$150.00

Service Code	HCPCS 83883
Hospital Charge Code	3036014A
Hospital Revenue Code	301
Min. Negotiated Rate	$6.80
Max. Negotiated Rate	$165.64
Rate for Payer: Aetna Commercial	$44.06
Rate for Payer: Aetna Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.83
Rate for Payer: Cigna Commercial	$13.60
Rate for Payer: Cigna Medicare Advantage	$6.80
Rate for Payer: Clover Medicare Advantage	$12.92
Rate for Payer: EmblemHealth Commercial	$40.80
Rate for Payer: Humana Medicare Advantage	$14.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.42
Rate for Payer: Wellcare Medicare Advantage	$13.60

HCV FIBROSURE I

Facility

$150.00

Service Code	HCPCS 83883
Hospital Charge Code	3036014A
Hospital Revenue Code	301
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

HCV FIBROSURE II

Facility

$47.25

Service Code	HCPCS 84460
Hospital Charge Code	3036014B
Hospital Revenue Code	301
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.17
Rate for Payer: Aetna Medicare Advantage	$5.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.30
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	$19.42
Rate for Payer: Cigna Commercial	$5.30
Rate for Payer: Cigna Medicare Advantage	$2.65
Rate for Payer: Clover Medicare Advantage	$5.04
Rate for Payer: EmblemHealth Commercial	$15.90
Rate for Payer: Humana Medicare Advantage	$5.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.09
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.30
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.62
Rate for Payer: Wellcare Medicare Advantage	$5.30

HCV FIBROSURE II

Facility

$47.25

Service Code	HCPCS 84460
Hospital Charge Code	3036014B
Hospital Revenue Code	301
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Qualcare PPO/HMO/WC	$7.09

HCV FIBROSURE III

Facility

$205.65

Service Code	HCPCS 82172
Hospital Charge Code	3036014C
Hospital Revenue Code	301
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

HCV FIBROSURE III

Facility

$205.65

Service Code	HCPCS 82172
Hospital Charge Code	3036014C
Hospital Revenue Code	301
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$68.33
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.27
Rate for Payer: Cigna Commercial	$21.09
Rate for Payer: Cigna Medicare Advantage	$10.54
Rate for Payer: Clover Medicare Advantage	$20.04
Rate for Payer: EmblemHealth Commercial	$63.27
Rate for Payer: Humana Medicare Advantage	$21.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.36
Rate for Payer: Wellcare Medicare Advantage	$21.09

Know your out-of-pocket cost for care.

All Charges