Heights University Hospital

All Charges

Charge

Type

Setting

Price

HEMOGLOBIN F

Facility

$515.00

Service Code	HCPCS 83021
Hospital Charge Code	38472401
Hospital Revenue Code	301
Min. Negotiated Rate	$77.25
Max. Negotiated Rate	$77.25
Rate for Payer: Qualcare PPO/HMO/WC	$77.25

HEMOGLOBIN F

Facility

$515.00

Service Code	HCPCS 83021
Hospital Charge Code	38472401
Hospital Revenue Code	301
Min. Negotiated Rate	$9.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.51
Rate for Payer: Aetna Medicare Advantage	$18.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.17
Rate for Payer: Cigna Commercial	$18.06
Rate for Payer: Cigna Medicare Advantage	$9.03
Rate for Payer: Clover Medicare Advantage	$17.16
Rate for Payer: EmblemHealth Commercial	$54.18
Rate for Payer: Humana Medicare Advantage	$18.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.95
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$77.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.06
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.14
Rate for Payer: Wellcare Medicare Advantage	$18.06

HEMOGLOBIN F CHEMICAL

Facility

$58.55

Service Code	HCPCS 83030
Hospital Charge Code	38477054
Hospital Revenue Code	301
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	$22.44
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	$7.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.78
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

HEMOGLOBIN F CHEMICAL

Facility

$58.55

Service Code	HCPCS 83030
Hospital Charge Code	38477054
Hospital Revenue Code	301
Min. Negotiated Rate	$8.78
Max. Negotiated Rate	$8.78
Rate for Payer: Qualcare PPO/HMO/WC	$8.78

HEMOGLOBIN, FETAL

Facility

$218.45

Service Code	HCPCS 83021
Hospital Charge Code	3001517
Hospital Revenue Code	301
Min. Negotiated Rate	$9.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.51
Rate for Payer: Aetna Medicare Advantage	$18.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.17
Rate for Payer: Cigna Commercial	$18.06
Rate for Payer: Cigna Medicare Advantage	$9.03
Rate for Payer: Clover Medicare Advantage	$17.16
Rate for Payer: EmblemHealth Commercial	$54.18
Rate for Payer: Humana Medicare Advantage	$18.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.77
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.06
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.14
Rate for Payer: Wellcare Medicare Advantage	$18.06

HEMOGLOBIN, FETAL

Facility

$218.45

Service Code	HCPCS 83021
Hospital Charge Code	3001517
Hospital Revenue Code	301
Min. Negotiated Rate	$32.77
Max. Negotiated Rate	$32.77
Rate for Payer: Qualcare PPO/HMO/WC	$32.77

HEMOGLOBIN,FETAL

Facility

$218.45

Service Code	HCPCS 83021
Hospital Charge Code	3030279
Hospital Revenue Code	301
Min. Negotiated Rate	$9.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.51
Rate for Payer: Aetna Medicare Advantage	$18.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.17
Rate for Payer: Cigna Commercial	$18.06
Rate for Payer: Cigna Medicare Advantage	$9.03
Rate for Payer: Clover Medicare Advantage	$17.16
Rate for Payer: EmblemHealth Commercial	$54.18
Rate for Payer: Humana Medicare Advantage	$18.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.77
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.06
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.14
Rate for Payer: Wellcare Medicare Advantage	$18.06

HEMOGLOBIN,FETAL

Facility

$218.45

Service Code	HCPCS 83021
Hospital Charge Code	3030279
Hospital Revenue Code	301
Min. Negotiated Rate	$32.77
Max. Negotiated Rate	$32.77
Rate for Payer: Qualcare PPO/HMO/WC	$32.77

HEMOGLOBIN FETAL KB STAIN

Facility

$390.00

Service Code	HCPCS 85460
Hospital Charge Code	3001278
Hospital Revenue Code	305
Min. Negotiated Rate	$3.87
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$25.05
Rate for Payer: Aetna Medicare Advantage	$7.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.32
Rate for Payer: Cigna Commercial	$7.73
Rate for Payer: Cigna Medicare Advantage	$3.87
Rate for Payer: Clover Medicare Advantage	$7.34
Rate for Payer: EmblemHealth Commercial	$23.19
Rate for Payer: Humana Medicare Advantage	$7.96
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	$7.73
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.19
Rate for Payer: Wellcare Medicare Advantage	$7.73

HEMOGLOBIN FETAL KB STAIN

Facility

$390.00

Service Code	HCPCS 85460
Hospital Charge Code	3001278
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEMOGLOBIN F QUALITATIVE

Facility

$50.00

Service Code	HCPCS 83033
Hospital Charge Code	3100190
Hospital Revenue Code	300
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

HEMOGLOBIN F QUALITATIVE

Facility

$42.00

Service Code	HCPCS 83033
Hospital Charge Code	38477045
Hospital Revenue Code	301
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

HEMOGLOBIN F QUALITATIVE

Facility

$42.00

Service Code	HCPCS 83033
Hospital Charge Code	38477045
Hospital Revenue Code	301
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$25.92
Rate for Payer: Aetna Medicare Advantage	$8.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.31
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: Cigna Medicare Advantage	$4.00
Rate for Payer: Clover Medicare Advantage	$7.60
Rate for Payer: EmblemHealth Commercial	$24.00
Rate for Payer: Humana Medicare Advantage	$8.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.48
Rate for Payer: Wellcare Medicare Advantage	$8.00

HEMOGLOBIN F QUALITATIVE

Facility

$50.00

Service Code	HCPCS 83033
Hospital Charge Code	3100190
Hospital Revenue Code	300
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$25.92
Rate for Payer: Aetna Medicare Advantage	$8.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.31
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: Cigna Medicare Advantage	$4.00
Rate for Payer: Clover Medicare Advantage	$7.60
Rate for Payer: EmblemHealth Commercial	$24.00
Rate for Payer: Humana Medicare Advantage	$8.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.48
Rate for Payer: Wellcare Medicare Advantage	$8.00

HEMOGLOBIN FRACTIONATION I

Facility

$218.45

Service Code	HCPCS 83021
Hospital Charge Code	3038532A
Hospital Revenue Code	301
Min. Negotiated Rate	$32.77
Max. Negotiated Rate	$32.77
Rate for Payer: Qualcare PPO/HMO/WC	$32.77

HEMOGLOBIN FRACTIONATION I

Facility

$218.45

Service Code	HCPCS 83021
Hospital Charge Code	3038532A
Hospital Revenue Code	301
Min. Negotiated Rate	$9.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.51
Rate for Payer: Aetna Medicare Advantage	$18.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.17
Rate for Payer: Cigna Commercial	$18.06
Rate for Payer: Cigna Medicare Advantage	$9.03
Rate for Payer: Clover Medicare Advantage	$17.16
Rate for Payer: EmblemHealth Commercial	$54.18
Rate for Payer: Humana Medicare Advantage	$18.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.77
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.06
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.14
Rate for Payer: Wellcare Medicare Advantage	$18.06

HEMOGLOBIN FRACTIONATION II

Facility

$109.25

Service Code	HCPCS 85660
Hospital Charge Code	3038532B
Hospital Revenue Code	305
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.85
Rate for Payer: Aetna Medicare Advantage	$5.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.51
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	$20.19
Rate for Payer: Cigna Commercial	$5.51
Rate for Payer: Cigna Medicare Advantage	$2.75
Rate for Payer: Clover Medicare Advantage	$5.23
Rate for Payer: EmblemHealth Commercial	$16.53
Rate for Payer: Humana Medicare Advantage	$5.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.39
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.51
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.84
Rate for Payer: Wellcare Medicare Advantage	$5.51

HEMOGLOBIN FRACTIONATION II

Facility

$109.25

Service Code	HCPCS 85660
Hospital Charge Code	3038532B
Hospital Revenue Code	305
Min. Negotiated Rate	$16.39
Max. Negotiated Rate	$16.39
Rate for Payer: Qualcare PPO/HMO/WC	$16.39

HEMOGLOBIN, FREE URINE

Facility

$43.25

Service Code	HCPCS 83069
Hospital Charge Code	3031698
Hospital Revenue Code	301
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$12.80
Rate for Payer: Aetna Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.95
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	$14.47
Rate for Payer: Cigna Commercial	$3.95
Rate for Payer: Cigna Medicare Advantage	$1.98
Rate for Payer: Clover Medicare Advantage	$3.75
Rate for Payer: EmblemHealth Commercial	$11.85
Rate for Payer: Humana Medicare Advantage	$4.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.95
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.19
Rate for Payer: Wellcare Medicare Advantage	$3.95

HEMOGLOBIN, FREE URINE

Facility

$43.25

Service Code	HCPCS 83069
Hospital Charge Code	3031698
Hospital Revenue Code	301
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

HEMOGLOBIN HGB

Facility

$667.59

Service Code	HCPCS 85018
Hospital Charge Code	3031697
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	$2.24
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

HEMOGLOBIN HGB

Facility

$667.59

Service Code	HCPCS 85018
Hospital Charge Code	3031697
Hospital Revenue Code	305
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

HEMOGLOBIN (HGB) A1C

Facility

$48.00

Service Code	HCPCS 83036
Hospital Charge Code	3035006
Hospital Revenue Code	301
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.46
Rate for Payer: Aetna Medicare Advantage	$9.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.58
Rate for Payer: Cigna Commercial	$9.71
Rate for Payer: Cigna Medicare Advantage	$4.86
Rate for Payer: Clover Medicare Advantage	$9.22
Rate for Payer: EmblemHealth Commercial	$29.13
Rate for Payer: Humana Medicare Advantage	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.24
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.71
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.29
Rate for Payer: Wellcare Medicare Advantage	$9.71

HEMOGLOBIN (HGB) A1C

Facility

$48.00

Service Code	HCPCS 83036
Hospital Charge Code	3035006
Hospital Revenue Code	301
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

HEMOGLOBINOPATHY EVALUATION I

Facility

$390.00

Service Code	HCPCS 85018
Hospital Charge Code	39990070C
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges