Heights University Hospital

All Charges

Charge

Type

Setting

Price

HEPATIC AID

Facility

$71.00

Hospital Charge Code	60634848
Hospital Revenue Code	250
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$35.50
Rate for Payer: Aetna Commercial	$21.30
Rate for Payer: Aetna Medicare Advantage	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.11
Rate for Payer: Cigna Commercial	$35.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.23
Rate for Payer: Oxford Commercial	$35.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$35.50

HEPATIC AID

Facility

$71.00

Hospital Charge Code	60634848
Hospital Revenue Code	250
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS

Facility

$6,727.01

Service Code	APR-DRG 2791
Min. Negotiated Rate	$4,867.75
Max. Negotiated Rate	$6,727.01
Rate for Payer: Aetna Better Health Medicaid	$6,595.11
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,727.01
Rate for Payer: Wellpoint Medicaid Managed Care	$4,867.75

HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS

Facility

$12,951.22

Service Code	APR-DRG 2793
Min. Negotiated Rate	$10,214.03
Max. Negotiated Rate	$12,951.22
Rate for Payer: Aetna Better Health Medicaid	$12,697.27
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,951.22
Rate for Payer: Wellpoint Medicaid Managed Care	$10,214.03

HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS

Facility

$8,469.81

Service Code	APR-DRG 2792
Min. Negotiated Rate	$6,160.05
Max. Negotiated Rate	$8,469.81
Rate for Payer: Aetna Better Health Medicaid	$8,303.74
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,469.81
Rate for Payer: Wellpoint Medicaid Managed Care	$6,160.05

HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS

Facility

$27,186.05

Service Code	APR-DRG 2794
Min. Negotiated Rate	$25,758.86
Max. Negotiated Rate	$27,186.05
Rate for Payer: Aetna Better Health Medicaid	$26,652.99
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27,186.05
Rate for Payer: Wellpoint Medicaid Managed Care	$25,758.86

HEPATIC FUNCTION A

Facility

$653.80

Service Code	HCPCS 80076
Hospital Charge Code	38472002
Hospital Revenue Code	301
Min. Negotiated Rate	$98.07
Max. Negotiated Rate	$98.07
Rate for Payer: Qualcare PPO/HMO/WC	$98.07

HEPATIC FUNCTION A

Facility

$653.80

Service Code	HCPCS 80076
Hospital Charge Code	38472002
Hospital Revenue Code	301
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.47
Rate for Payer: Aetna Medicare Advantage	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.93
Rate for Payer: Cigna Commercial	$8.17
Rate for Payer: Cigna Medicare Advantage	$4.08
Rate for Payer: Clover Medicare Advantage	$7.76
Rate for Payer: EmblemHealth Commercial	$24.51
Rate for Payer: Humana Medicare Advantage	$8.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.99
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.07
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.17
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.66
Rate for Payer: Wellcare Medicare Advantage	$8.17

HEPATIC FUNCTION PROFILE

Facility

$1,189.30

Service Code	HCPCS 80076
Hospital Charge Code	3004844
Hospital Revenue Code	301
Min. Negotiated Rate	$178.40
Max. Negotiated Rate	$178.40
Rate for Payer: Qualcare PPO/HMO/WC	$178.40

HEPATIC FUNCTION PROFILE

Facility

$1,189.30

Service Code	HCPCS 80076
Hospital Charge Code	3004844
Hospital Revenue Code	301
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$178.40
Rate for Payer: Aetna Commercial	$26.47
Rate for Payer: Aetna Medicare Advantage	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.93
Rate for Payer: Cigna Commercial	$8.17
Rate for Payer: Cigna Medicare Advantage	$4.08
Rate for Payer: Clover Medicare Advantage	$7.76
Rate for Payer: EmblemHealth Commercial	$24.51
Rate for Payer: Humana Medicare Advantage	$8.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$178.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.17
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.66
Rate for Payer: Wellcare Medicare Advantage	$8.17

HEPATIT B INJ40MCG/ML DIALYSIS

Facility

$416.07

Service Code	NDC 58160082111
Hospital Charge Code	60628304
Hospital Revenue Code	636
Min. Negotiated Rate	$62.41
Max. Negotiated Rate	$208.03
Rate for Payer: Aetna Commercial	$124.82
Rate for Payer: Aetna Medicare Advantage	$124.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.10
Rate for Payer: Cigna Commercial	$208.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.69
Rate for Payer: Qualcare PPO/HMO/WC	$62.41

HEPATIT B INJ40MCG/ML DIALYSIS

Facility

$416.07

Service Code	NDC 58160082111
Hospital Charge Code	60628304
Hospital Revenue Code	636
Min. Negotiated Rate	$62.41
Max. Negotiated Rate	$100.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.69
Rate for Payer: Qualcare PPO/HMO/WC	$62.41

HEPATIT B INJ40MCG/ML DIALYSIS

Facility

$416.07

Service Code	HCPCS 90747
Hospital Charge Code	60628304P
Hospital Revenue Code	636
Min. Negotiated Rate	$62.41
Max. Negotiated Rate	$100.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.69
Rate for Payer: Qualcare PPO/HMO/WC	$62.41

HEPATIT B INJ40MCG/ML DIALYSIS

Facility

$416.07

Service Code	HCPCS 90747
Hospital Charge Code	60628304P
Hospital Revenue Code	636
Min. Negotiated Rate	$62.41
Max. Negotiated Rate	$164.42
Rate for Payer: Aetna Commercial	$124.82
Rate for Payer: Aetna Medicare Advantage	$124.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.10
Rate for Payer: Cigna Commercial	$164.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.69
Rate for Payer: Qualcare PPO/HMO/WC	$62.41

HEPATITIS A ADLT VAC50U/ML INJ

Facility

$510.61

Service Code	NDC 6484100
Hospital Charge Code	60628864
Hospital Revenue Code	250
Min. Negotiated Rate	$66.38
Max. Negotiated Rate	$255.31
Rate for Payer: Aetna Commercial	$153.18
Rate for Payer: Aetna Medicare Advantage	$153.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.21
Rate for Payer: Cigna Commercial	$255.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.38
Rate for Payer: Oxford Commercial	$255.31
Rate for Payer: Qualcare PPO/HMO/WC	$76.59
Rate for Payer: UnitedHealthcare Commercial	$255.31

HEPATITIS A ADLT VAC50U/ML INJ

Facility

$510.61

Service Code	NDC 6484100
Hospital Charge Code	60628864
Hospital Revenue Code	250
Min. Negotiated Rate	$76.59
Max. Negotiated Rate	$76.59
Rate for Payer: Qualcare PPO/HMO/WC	$76.59

HEPATITIS A (ADULT)

Facility

$171.79

Service Code	HCPCS 90632
Hospital Charge Code	93950065
Hospital Revenue Code	636
Min. Negotiated Rate	$25.77
Max. Negotiated Rate	$41.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.57
Rate for Payer: Qualcare PPO/HMO/WC	$25.77

HEPATITIS A (ADULT)

Facility

$171.79

Service Code	HCPCS 90632
Hospital Charge Code	93950065
Hospital Revenue Code	636
Min. Negotiated Rate	$25.77
Max. Negotiated Rate	$91.24
Rate for Payer: Aetna Commercial	$51.54
Rate for Payer: Aetna Medicare Advantage	$51.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$91.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.81
Rate for Payer: Cigna Commercial	$73.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.57
Rate for Payer: Qualcare PPO/HMO/WC	$25.77

Hepatitis A Antibody, IgM

Facility

$76.80

Service Code	HCPCS 86709
Hospital Charge Code	39888022
Hospital Revenue Code	302
Min. Negotiated Rate	$5.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$36.48
Rate for Payer: Aetna Medicare Advantage	$11.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.26
Rate for Payer: Cigna Commercial	$11.26
Rate for Payer: Cigna Medicare Advantage	$5.63
Rate for Payer: Clover Medicare Advantage	$10.70
Rate for Payer: EmblemHealth Commercial	$33.78
Rate for Payer: Humana Medicare Advantage	$11.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.52
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.26
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.94
Rate for Payer: Wellcare Medicare Advantage	$11.26

Hepatitis A Antibody, IgM

Facility

$76.80

Service Code	HCPCS 86709
Hospital Charge Code	39888022
Hospital Revenue Code	302
Min. Negotiated Rate	$11.52
Max. Negotiated Rate	$11.52
Rate for Payer: Qualcare PPO/HMO/WC	$11.52

HEPATITIS A ANTIBODY IGM

Facility

$54.45

Service Code	HCPCS 86709
Hospital Charge Code	3007456
Hospital Revenue Code	302
Min. Negotiated Rate	$5.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$36.48
Rate for Payer: Aetna Medicare Advantage	$11.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.26
Rate for Payer: Cigna Commercial	$11.26
Rate for Payer: Cigna Medicare Advantage	$5.63
Rate for Payer: Clover Medicare Advantage	$10.70
Rate for Payer: EmblemHealth Commercial	$33.78
Rate for Payer: Humana Medicare Advantage	$11.60
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	$11.26
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.94
Rate for Payer: Wellcare Medicare Advantage	$11.26

HEPATITIS A ANTIBODY IGM

Facility

$54.45

Service Code	HCPCS 86709
Hospital Charge Code	3007456
Hospital Revenue Code	302
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$8.17

HEPATITIS A ANTIBODY TOTAL

Facility

$116.00

Service Code	HCPCS 86708
Hospital Charge Code	3006442A
Hospital Revenue Code	302
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

HEPATITIS A ANTIBODY TOTAL

Facility

$116.00

Service Code	HCPCS 86708
Hospital Charge Code	3007457
Hospital Revenue Code	302
Min. Negotiated Rate	$6.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$40.14
Rate for Payer: Aetna Medicare Advantage	$12.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.40
Rate for Payer: Cigna Commercial	$12.39
Rate for Payer: Cigna Medicare Advantage	$6.20
Rate for Payer: Clover Medicare Advantage	$11.77
Rate for Payer: EmblemHealth Commercial	$37.17
Rate for Payer: Humana Medicare Advantage	$12.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.13
Rate for Payer: Wellcare Medicare Advantage	$12.39

HEPATITIS A ANTIBODY TOTAL

Facility

$116.00

Service Code	HCPCS 86708
Hospital Charge Code	3006442A
Hospital Revenue Code	302
Min. Negotiated Rate	$6.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$40.14
Rate for Payer: Aetna Medicare Advantage	$12.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.40
Rate for Payer: Cigna Commercial	$12.39
Rate for Payer: Cigna Medicare Advantage	$6.20
Rate for Payer: Clover Medicare Advantage	$11.77
Rate for Payer: EmblemHealth Commercial	$37.17
Rate for Payer: Humana Medicare Advantage	$12.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.13
Rate for Payer: Wellcare Medicare Advantage	$12.39

Know your out-of-pocket cost for care.

All Charges