Heights University Hospital

All Charges

Charge

Type

Setting

Price

HEMEPATH INTERPRETATION

Facility

$101.35

Service Code	HCPCS 80500
Hospital Charge Code	3030780
Hospital Revenue Code	310
Min. Negotiated Rate	$15.20
Max. Negotiated Rate	$15.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.20

HEMEPATH INTERPRETATION

Facility

$101.35

Service Code	HCPCS 80500
Hospital Charge Code	3030780
Hospital Revenue Code	310
Min. Negotiated Rate	$13.18
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.41
Rate for Payer: Aetna Medicare Advantage	$30.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.84
Rate for Payer: Cigna Commercial	$50.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.18
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.20
Rate for Payer: UnitedHealthcare Commercial	$114.00

HEMICAP MTP CE 1.5X3.5MM

Facility

$15,030.00

Service Code	HCPCS L8641
Hospital Charge Code	270699529
Hospital Revenue Code	278
Min. Negotiated Rate	$2,254.50
Max. Negotiated Rate	$3,637.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,006.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,637.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,254.50

HEMICAP MTP CE 1.5X3.5MM

Facility

$15,030.00

Service Code	HCPCS L8641
Hospital Charge Code	270699529
Hospital Revenue Code	278
Min. Negotiated Rate	$257.13
Max. Negotiated Rate	$4,509.00
Rate for Payer: Aetna Commercial	$4,509.00
Rate for Payer: Aetna Medicare Advantage	$4,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,832.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,832.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,006.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,832.65
Rate for Payer: Cigna Commercial	$428.55
Rate for Payer: Cigna Medicare Advantage	$257.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,637.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,254.50

HEMICAP TOE JT TAPER 9.5X18MM

Facility

$15,030.00

Service Code	HCPCS L8641
Hospital Charge Code	270696338
Hospital Revenue Code	278
Min. Negotiated Rate	$257.13
Max. Negotiated Rate	$4,509.00
Rate for Payer: Aetna Commercial	$4,509.00
Rate for Payer: Aetna Medicare Advantage	$4,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,832.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,832.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,006.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,832.65
Rate for Payer: Cigna Commercial	$428.55
Rate for Payer: Cigna Medicare Advantage	$257.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,637.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,254.50

HEMICAP TOE JT TAPER 9.5X18MM

Facility

$15,030.00

Service Code	HCPCS L8641
Hospital Charge Code	270696338
Hospital Revenue Code	278
Min. Negotiated Rate	$2,254.50
Max. Negotiated Rate	$3,637.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,006.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,637.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,254.50

HEMI DRILL BIT

Facility

$750.00

Hospital Charge Code	270681046
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

HEMI DRILL BIT

Facility

$750.00

Hospital Charge Code	270681046
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Oxford Commercial	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$375.00

HEMIN IV VIAL 313MG

Facility

$1,657.60

Hospital Charge Code	6010557
Hospital Revenue Code	250
Min. Negotiated Rate	$248.64
Max. Negotiated Rate	$248.64
Rate for Payer: Qualcare PPO/HMO/WC	$248.64

HEMIN IV VIAL 313MG

Facility

$1,657.60

Hospital Charge Code	6010557
Hospital Revenue Code	250
Min. Negotiated Rate	$215.49
Max. Negotiated Rate	$828.80
Rate for Payer: Aetna Commercial	$497.28
Rate for Payer: Aetna Medicare Advantage	$497.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$422.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$422.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$422.69
Rate for Payer: Cigna Commercial	$828.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.49
Rate for Payer: Oxford Commercial	$828.80
Rate for Payer: Qualcare PPO/HMO/WC	$248.64
Rate for Payer: UnitedHealthcare Commercial	$828.80

HEMISPH COATED SHELL 54MM OD

Facility

$30,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270703824
Hospital Revenue Code	278
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$15,000.00
Rate for Payer: Aetna Commercial	$9,000.00
Rate for Payer: Aetna Medicare Advantage	$9,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,650.00
Rate for Payer: Cigna Commercial	$15,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,260.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

HEMISPH COATED SHELL 54MM OD

Facility

$30,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270703824
Hospital Revenue Code	278
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,260.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

HEMI W/SHAPED BONE BLOCKS 10MM

Facility

$16,715.00

Service Code	HCPCS C1776
Hospital Charge Code	270673449
Hospital Revenue Code	278
Min. Negotiated Rate	$2,507.25
Max. Negotiated Rate	$8,357.50
Rate for Payer: Aetna Commercial	$5,014.50
Rate for Payer: Aetna Medicare Advantage	$5,014.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,262.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,262.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,343.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,262.32
Rate for Payer: Cigna Commercial	$8,357.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,045.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,507.25

HEMI W/SHAPED BONE BLOCKS 10MM

Facility

$16,715.00

Service Code	HCPCS C1776
Hospital Charge Code	270673449
Hospital Revenue Code	278
Min. Negotiated Rate	$2,507.25
Max. Negotiated Rate	$4,045.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,343.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,045.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,507.25

HEMOCLIP LIGATION TA MEDIUM

Facility

$210.00

Hospital Charge Code	270695604
Hospital Revenue Code	272
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$63.00
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$105.00

HEMOCLIP LIGATION TA MEDIUM

Facility

$210.00

Hospital Charge Code	270695604
Hospital Revenue Code	272
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

HEMOCRIT (WAIVED TEST)WHC***

Facility

$1.50

Service Code	HCPCS 85013WF
Hospital Charge Code	9600029
Hospital Revenue Code	309
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.23
Rate for Payer: Qualcare PPO/HMO/WC	$0.23

HEMOCRIT (WAIVED TEST)WHC***

Facility

$1.50

Service Code	HCPCS 85013WF
Hospital Charge Code	9600029
Hospital Revenue Code	309
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$0.45
Rate for Payer: Aetna Medicare Advantage	$0.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.38
Rate for Payer: Cigna Commercial	$0.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.23
Rate for Payer: UnitedHealthcare Commercial	$114.00

HEMODIALYSIS IP

Facility

$2,800.00

Hospital Charge Code	8200024
Hospital Revenue Code	801
Min. Negotiated Rate	$364.00
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$840.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.00
Rate for Payer: Oxford Commercial	$1,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$1,400.00

HEMODIALYSIS IP

Facility

$2,800.00

Hospital Charge Code	8200024
Hospital Revenue Code	801
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

HEMODIALYSIS OP ESRD

Facility

$2,800.00

Service Code	HCPCS 90999
Hospital Charge Code	8200040
Hospital Revenue Code	821
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

HEMODIALYSIS OP ESRD

Facility

$2,800.00

Service Code	HCPCS 90999
Hospital Charge Code	8200040
Hospital Revenue Code	821
Min. Negotiated Rate	$364.00
Max. Negotiated Rate	$2,892.00
Rate for Payer: Aetna Commercial	$840.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$447.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.00
Rate for Payer: Oxford Commercial	$2,546.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$2,892.00

HEMODIALYSIS OP NONPAT/ER

Facility

$2,800.00

Service Code	HCPCS 90935
Hospital Charge Code	8200521
Hospital Revenue Code	829
Min. Negotiated Rate	$364.00
Max. Negotiated Rate	$2,892.00
Rate for Payer: Aetna Commercial	$840.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,634.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.00
Rate for Payer: Oxford Commercial	$2,546.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$2,892.00

HEMODIALYSIS OP NONPAT/ER

Facility

$2,800.00

Service Code	HCPCS 90935
Hospital Charge Code	8200521
Hospital Revenue Code	829
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

HEMOGLOB ELECTROPHORESIS

Facility

$406.00

Service Code	HCPCS 83020
Hospital Charge Code	38479437
Hospital Revenue Code	301
Min. Negotiated Rate	$6.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.70
Rate for Payer: Aetna Medicare Advantage	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.87
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	$47.16
Rate for Payer: Cigna Commercial	$12.87
Rate for Payer: Cigna Medicare Advantage	$6.43
Rate for Payer: Clover Medicare Advantage	$12.23
Rate for Payer: EmblemHealth Commercial	$38.61
Rate for Payer: Humana Medicare Advantage	$13.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.78
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.87
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.64
Rate for Payer: Wellcare Medicare Advantage	$12.87

Know your out-of-pocket cost for care.

All Charges