Heights University Hospital

All Charges

Charge

Type

Setting

Price

HCV FIBROSURE IV

Facility

$54.45

Service Code	HCPCS 82247
Hospital Charge Code	3036014D
Hospital Revenue Code	301
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.26
Rate for Payer: Aetna Medicare Advantage	$5.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.39
Rate for Payer: Cigna Commercial	$5.02
Rate for Payer: Cigna Medicare Advantage	$2.51
Rate for Payer: Clover Medicare Advantage	$4.77
Rate for Payer: EmblemHealth Commercial	$15.06
Rate for Payer: Humana Medicare Advantage	$5.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.17
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.02
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.32
Rate for Payer: Wellcare Medicare Advantage	$5.02

HCV FIBROSURE IV

Facility

$54.45

Service Code	HCPCS 82247
Hospital Charge Code	3036014D
Hospital Revenue Code	301
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$8.17

HCV FIBROSURE V

Facility

$65.65

Service Code	HCPCS 82977
Hospital Charge Code	3036014E
Hospital Revenue Code	301
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

HCV FIBROSURE V

Facility

$65.65

Service Code	HCPCS 82977
Hospital Charge Code	3036014E
Hospital Revenue Code	301
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$23.33
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.38
Rate for Payer: Cigna Commercial	$7.20
Rate for Payer: Cigna Medicare Advantage	$3.60
Rate for Payer: Clover Medicare Advantage	$6.84
Rate for Payer: EmblemHealth Commercial	$21.60
Rate for Payer: Humana Medicare Advantage	$7.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.20
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.63
Rate for Payer: Wellcare Medicare Advantage	$7.20

HCV FIBROSURE VI

Facility

$119.25

Service Code	HCPCS 83010
Hospital Charge Code	3036014F
Hospital Revenue Code	301
Min. Negotiated Rate	$6.29
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$40.76
Rate for Payer: Aetna Medicare Advantage	$12.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.58
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	$46.09
Rate for Payer: Cigna Commercial	$12.58
Rate for Payer: Cigna Medicare Advantage	$6.29
Rate for Payer: Clover Medicare Advantage	$11.95
Rate for Payer: EmblemHealth Commercial	$37.74
Rate for Payer: Humana Medicare Advantage	$12.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.89
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.58
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.33
Rate for Payer: Wellcare Medicare Advantage	$12.58

HCV FIBROSURE VI

Facility

$119.25

Service Code	HCPCS 83010
Hospital Charge Code	3036014F
Hospital Revenue Code	301
Min. Negotiated Rate	$17.89
Max. Negotiated Rate	$17.89
Rate for Payer: Qualcare PPO/HMO/WC	$17.89

HCV GENOTYPE, LIPA

Facility

$1,769.40

Service Code	HCPCS 87902
Hospital Charge Code	39900308
Hospital Revenue Code	306
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$943.30
Rate for Payer: Aetna Commercial	$834.14
Rate for Payer: Aetna Medicare Advantage	$257.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$943.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$943.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$257.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$943.30
Rate for Payer: Cigna Commercial	$257.45
Rate for Payer: Cigna Medicare Advantage	$128.72
Rate for Payer: Clover Medicare Advantage	$244.58
Rate for Payer: EmblemHealth Commercial	$772.35
Rate for Payer: Humana Medicare Advantage	$265.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.02
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$265.41
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$257.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$272.90
Rate for Payer: Wellcare Medicare Advantage	$257.45

HCV GENOTYPE, LIPA

Facility

$1,769.40

Service Code	HCPCS 87902
Hospital Charge Code	39900308
Hospital Revenue Code	306
Min. Negotiated Rate	$265.41
Max. Negotiated Rate	$265.41
Rate for Payer: Qualcare PPO/HMO/WC	$265.41

HCV RNA GENOTYPE

Facility

$1,823.20

Service Code	HCPCS 87902
Hospital Charge Code	38473153
Hospital Revenue Code	306
Min. Negotiated Rate	$273.48
Max. Negotiated Rate	$273.48
Rate for Payer: Qualcare PPO/HMO/WC	$273.48

HCV RNA GENOTYPE

Facility

$1,823.20

Service Code	HCPCS 87902
Hospital Charge Code	38473153
Hospital Revenue Code	306
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$943.30
Rate for Payer: Aetna Commercial	$834.14
Rate for Payer: Aetna Medicare Advantage	$257.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$943.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$943.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$257.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$943.30
Rate for Payer: Cigna Commercial	$257.45
Rate for Payer: Cigna Medicare Advantage	$128.72
Rate for Payer: Clover Medicare Advantage	$244.58
Rate for Payer: EmblemHealth Commercial	$772.35
Rate for Payer: Humana Medicare Advantage	$265.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.02
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$273.48
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$257.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$272.90
Rate for Payer: Wellcare Medicare Advantage	$257.45

HCV RNA,PCR

Facility

$390.00

Service Code	HCPCS 87522
Hospital Charge Code	39900300
Hospital Revenue Code	306
Min. Negotiated Rate	$21.42
Max. Negotiated Rate	$228.14
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	$228.14
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	$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	$42.84
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$45.41
Rate for Payer: Wellcare Medicare Advantage	$42.84

HCV RNA,PCR

Facility

$390.00

Service Code	HCPCS 87522
Hospital Charge Code	39900300
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HCV RNA,QL,PCR

Facility

$383.25

Service Code	HCPCS 87521
Hospital Charge Code	3009390
Hospital Revenue Code	306
Min. Negotiated Rate	$57.49
Max. Negotiated Rate	$57.49
Rate for Payer: Qualcare PPO/HMO/WC	$57.49

HCV RNA,QL,PCR

Facility

$383.25

Service Code	HCPCS 87521
Hospital Charge Code	3009390
Hospital Revenue Code	306
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$128.57
Rate for Payer: Aetna Commercial	$113.69
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.57
Rate for Payer: Cigna Commercial	$35.09
Rate for Payer: Cigna Medicare Advantage	$17.55
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.49
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

HCV RNA,QL,PCR,PLASMA

Facility

$241.20

Service Code	HCPCS 87521
Hospital Charge Code	39900299
Hospital Revenue Code	306
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$128.57
Rate for Payer: Aetna Commercial	$113.69
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.57
Rate for Payer: Cigna Commercial	$35.09
Rate for Payer: Cigna Medicare Advantage	$17.55
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.18
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

HCV RNA,QL,PCR,PLASMA

Facility

$241.20

Service Code	HCPCS 87521
Hospital Charge Code	39900299
Hospital Revenue Code	306
Min. Negotiated Rate	$36.18
Max. Negotiated Rate	$36.18
Rate for Payer: Qualcare PPO/HMO/WC	$36.18

HCV RNA,QN,REAL TIME PCR

Facility

$383.25

Service Code	HCPCS 87522
Hospital Charge Code	3009389
Hospital Revenue Code	306
Min. Negotiated Rate	$57.49
Max. Negotiated Rate	$57.49
Rate for Payer: Qualcare PPO/HMO/WC	$57.49

HCV RNA,QN,REAL TIME PCR

Facility

$383.25

Service Code	HCPCS 87522
Hospital Charge Code	3009389
Hospital Revenue Code	306
Min. Negotiated Rate	$21.42
Max. Negotiated Rate	$228.14
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	$228.14
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	$49.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.49
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

HCV VRNA GENOTYP 1NS5bRXRESIST

Facility

$776.05

Service Code	HCPCS 87902
Hospital Charge Code	401187902
Hospital Revenue Code	306
Min. Negotiated Rate	$116.41
Max. Negotiated Rate	$116.41
Rate for Payer: Qualcare PPO/HMO/WC	$116.41

HCV VRNA GENOTYP 1NS5bRXRESIST

Facility

$776.05

Service Code	HCPCS 87902
Hospital Charge Code	401187902
Hospital Revenue Code	306
Min. Negotiated Rate	$100.89
Max. Negotiated Rate	$943.30
Rate for Payer: Aetna Commercial	$834.14
Rate for Payer: Aetna Medicare Advantage	$257.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$943.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$943.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$257.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$943.30
Rate for Payer: Cigna Commercial	$257.45
Rate for Payer: Cigna Medicare Advantage	$128.72
Rate for Payer: Clover Medicare Advantage	$244.58
Rate for Payer: EmblemHealth Commercial	$772.35
Rate for Payer: Humana Medicare Advantage	$265.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.89
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.41
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$257.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$272.90
Rate for Payer: Wellcare Medicare Advantage	$257.45

HD 5 US BAGLESS

Facility

$0.01

Hospital Charge Code	270703400
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

HD 5 US BAGLESS

Facility

$0.01

Hospital Charge Code	270703400
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

HD FEM BIOLOX DELTA OPT 40MM

Facility

$11,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270699207
Hospital Revenue Code	278
Min. Negotiated Rate	$1,710.00
Max. Negotiated Rate	$5,700.00
Rate for Payer: Aetna Commercial	$3,420.00
Rate for Payer: Aetna Medicare Advantage	$3,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,907.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,907.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,907.00
Rate for Payer: Cigna Commercial	$5,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,758.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,710.00

HD FEM BIOLOX DELTA OPT 40MM

Facility

$11,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270699207
Hospital Revenue Code	278
Min. Negotiated Rate	$1,710.00
Max. Negotiated Rate	$2,758.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,758.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,710.00

HD FEM BIOLOX D OPT 28MM OD

Facility

$8,286.00

Service Code	HCPCS C1776
Hospital Charge Code	270697542
Hospital Revenue Code	278
Min. Negotiated Rate	$1,242.90
Max. Negotiated Rate	$2,005.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,657.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,005.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,242.90

Know your out-of-pocket cost for care.

All Charges