Heights University Hospital

All Charges

Charge

Type

Setting

Price

HEMOGLOBINOPATHY EVALUATION I

Facility

$390.00

Service Code	HCPCS 83021
Hospital Charge Code	39990070A
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	$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	$18.06
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.14
Rate for Payer: Wellcare Medicare Advantage	$18.06

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

HEMOGLOBINOPATHY EVALUATION I

Facility

$390.00

Service Code	HCPCS 85041
Hospital Charge Code	39990070D
Hospital Revenue Code	301
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$9.78
Rate for Payer: Aetna Medicare Advantage	$3.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.02
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	$11.07
Rate for Payer: Cigna Commercial	$3.02
Rate for Payer: Cigna Medicare Advantage	$1.51
Rate for Payer: Clover Medicare Advantage	$2.87
Rate for Payer: EmblemHealth Commercial	$9.06
Rate for Payer: Humana Medicare Advantage	$3.11
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	$3.02
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.20
Rate for Payer: Wellcare Medicare Advantage	$3.02

HEMOGLOBINOPATHY EVALUATION I

Facility

$390.00

Service Code	HCPCS 85014
Hospital Charge Code	39990070B
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEMOGLOBINOPATHY EVALUATION I

Facility

$390.00

Service Code	HCPCS 85041
Hospital Charge Code	39990070D
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEMOGLOBINOPATHY EVALUATION I

Facility

$390.00

Service Code	HCPCS 83021
Hospital Charge Code	39990070A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEMOGLOBINOPATHY EVALUATION I

Facility

$390.00

Service Code	HCPCS 85014
Hospital Charge Code	39990070B
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	$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	$2.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.51
Rate for Payer: Wellcare Medicare Advantage	$2.37

HEMOGLOBIN (PLASMA)

Facility

$67.25

Service Code	HCPCS 83051
Hospital Charge Code	3030277
Hospital Revenue Code	301
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$23.68
Rate for Payer: Aetna Medicare Advantage	$7.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.31
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	$26.78
Rate for Payer: Cigna Commercial	$7.31
Rate for Payer: Cigna Medicare Advantage	$3.65
Rate for Payer: Clover Medicare Advantage	$6.94
Rate for Payer: EmblemHealth Commercial	$21.93
Rate for Payer: Humana Medicare Advantage	$7.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.09
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.31
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.75
Rate for Payer: Wellcare Medicare Advantage	$7.31

HEMOGLOBIN (PLASMA)

Facility

$67.25

Service Code	HCPCS 83051
Hospital Charge Code	3030277
Hospital Revenue Code	301
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$10.09
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

HEMOGLOBIN,URINARY FREE

Facility

$268.50

Service Code	HCPCS 81003
Hospital Charge Code	3031699
Hospital Revenue Code	307
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.29
Rate for Payer: Aetna Medicare Advantage	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.25
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	$8.24
Rate for Payer: Cigna Commercial	$2.25
Rate for Payer: Cigna Medicare Advantage	$1.12
Rate for Payer: Clover Medicare Advantage	$2.14
Rate for Payer: EmblemHealth Commercial	$6.75
Rate for Payer: Humana Medicare Advantage	$2.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.27
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.25
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.38
Rate for Payer: Wellcare Medicare Advantage	$2.25

HEMOGLOBIN,URINARY FREE

Facility

$268.50

Service Code	HCPCS 81003
Hospital Charge Code	3031699
Hospital Revenue Code	307
Min. Negotiated Rate	$40.27
Max. Negotiated Rate	$40.27
Rate for Payer: Qualcare PPO/HMO/WC	$40.27

HEMOGLOBIN URINE

Facility

$390.00

Service Code	HCPCS 83069
Hospital Charge Code	38477022
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEMOGLOBIN URINE

Facility

$390.00

Service Code	HCPCS 83069
Hospital Charge Code	38477022
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	$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	$3.95
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.19
Rate for Payer: Wellcare Medicare Advantage	$3.95

HEMOGLOBIN WHC****

Facility

$2.20

Service Code	HCPCS Q0116
Hospital Charge Code	9600030
Hospital Revenue Code	309
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.33
Rate for Payer: Qualcare PPO/HMO/WC	$0.33

HEMOGLOBIN WHC****

Facility

$2.20

Service Code	HCPCS Q0116
Hospital Charge Code	9600030
Hospital Revenue Code	309
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$0.66
Rate for Payer: Aetna Medicare Advantage	$0.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.56
Rate for Payer: Cigna Commercial	$1.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.29
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.33
Rate for Payer: UnitedHealthcare Commercial	$114.00

HEMOPAD (8CM-10CM)/EACH

Facility

$757.00

Hospital Charge Code	60633080
Hospital Revenue Code	250
Min. Negotiated Rate	$98.41
Max. Negotiated Rate	$378.50
Rate for Payer: Aetna Commercial	$227.10
Rate for Payer: Aetna Medicare Advantage	$227.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$193.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$193.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$193.03
Rate for Payer: Cigna Commercial	$378.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.41
Rate for Payer: Oxford Commercial	$378.50
Rate for Payer: Qualcare PPO/HMO/WC	$113.55
Rate for Payer: UnitedHealthcare Commercial	$378.50

HEMOPAD (8CM-10CM)/EACH

Facility

$757.00

Hospital Charge Code	60633080
Hospital Revenue Code	250
Min. Negotiated Rate	$113.55
Max. Negotiated Rate	$113.55
Rate for Payer: Qualcare PPO/HMO/WC	$113.55

HEMOPLOBIN A2 QN

Facility

$127.84

Service Code	HCPCS 83021
Hospital Charge Code	38478096
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	$16.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.18
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

HEMOPLOBIN A2 QN

Facility

$127.84

Service Code	HCPCS 83021
Hospital Charge Code	38478096
Hospital Revenue Code	301
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$19.18
Rate for Payer: Qualcare PPO/HMO/WC	$19.18

HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility

$8,606.02

Service Code	APR-DRG 8102
Min. Negotiated Rate	$8,437.27
Max. Negotiated Rate	$8,606.02
Rate for Payer: Aetna Better Health Medicaid	$8,437.27
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,606.02

HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility

$6,257.91

Service Code	APR-DRG 8101
Min. Negotiated Rate	$6,135.21
Max. Negotiated Rate	$6,257.91
Rate for Payer: Aetna Better Health Medicaid	$6,135.21
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,257.91

HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility

$13,531.18

Service Code	APR-DRG 8103
Min. Negotiated Rate	$13,265.86
Max. Negotiated Rate	$13,531.18
Rate for Payer: Aetna Better Health Medicaid	$13,265.86
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,531.18

HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION

Facility

$27,251.99

Service Code	APR-DRG 8104
Min. Negotiated Rate	$26,717.64
Max. Negotiated Rate	$27,251.99
Rate for Payer: Aetna Better Health Medicaid	$26,717.64
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27,251.99

HEMORRHOIDAL SUPP

Facility

$4.00

Service Code	NDC 536138912
Hospital Charge Code	6063943317
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

HEMORRHOIDAL SUPP

Facility

$4.00

Service Code	NDC 536138912
Hospital Charge Code	6063943317
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

Know your out-of-pocket cost for care.

All Charges