Heights University Hospital

All Charges

Charge

Type

Setting

Price

HEPATITIS B CORE ANTIBODY

Facility

$574.00

Service Code	HCPCS 87350
Hospital Charge Code	38479436
Hospital Revenue Code	306
Min. Negotiated Rate	$86.10
Max. Negotiated Rate	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$86.10

HEPATITIS B CORE ANTIBODY

Facility

$574.00

Service Code	HCPCS 87350
Hospital Charge Code	38479436
Hospital Revenue Code	306
Min. Negotiated Rate	$5.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.36
Rate for Payer: Aetna Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.25
Rate for Payer: Cigna Commercial	$11.53
Rate for Payer: Cigna Medicare Advantage	$5.76
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.22
Rate for Payer: Wellcare Medicare Advantage	$11.53

HEPATITIS B CORE ANTIBODY HBCA

Facility

$574.00

Service Code	HCPCS 87350
Hospital Charge Code	38472350
Hospital Revenue Code	306
Min. Negotiated Rate	$86.10
Max. Negotiated Rate	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$86.10

HEPATITIS B CORE ANTIBODY HBCA

Facility

$559.00

Service Code	HCPCS 87350
Hospital Charge Code	38479432
Hospital Revenue Code	306
Min. Negotiated Rate	$5.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.36
Rate for Payer: Aetna Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.25
Rate for Payer: Cigna Commercial	$11.53
Rate for Payer: Cigna Medicare Advantage	$5.76
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$83.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.22
Rate for Payer: Wellcare Medicare Advantage	$11.53

HEPATITIS B CORE ANTIBODY HBCA

Facility

$559.00

Service Code	HCPCS 87350
Hospital Charge Code	38479432
Hospital Revenue Code	306
Min. Negotiated Rate	$83.85
Max. Negotiated Rate	$83.85
Rate for Payer: Qualcare PPO/HMO/WC	$83.85

HEPATITIS B CORE ANTIBODY HBCA

Facility

$574.00

Service Code	HCPCS 87350
Hospital Charge Code	38472350
Hospital Revenue Code	306
Min. Negotiated Rate	$5.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.36
Rate for Payer: Aetna Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.25
Rate for Payer: Cigna Commercial	$11.53
Rate for Payer: Cigna Medicare Advantage	$5.76
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.22
Rate for Payer: Wellcare Medicare Advantage	$11.53

HEPATITIS B CORE ANTIBODY, IGM

Facility

$763.00

Service Code	HCPCS 86705
Hospital Charge Code	38472353
Hospital Revenue Code	302
Min. Negotiated Rate	$114.45
Max. Negotiated Rate	$114.45
Rate for Payer: Qualcare PPO/HMO/WC	$114.45

HEPATITIS B CORE ANTIBODY, IGM

Facility

$763.00

Service Code	HCPCS 86705
Hospital Charge Code	38472353
Hospital Revenue Code	302
Min. Negotiated Rate	$5.88
Max. Negotiated Rate	$114.45
Rate for Payer: Aetna Commercial	$38.13
Rate for Payer: Aetna Medicare Advantage	$11.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.13
Rate for Payer: Cigna Commercial	$11.77
Rate for Payer: Cigna Medicare Advantage	$5.88
Rate for Payer: Clover Medicare Advantage	$11.18
Rate for Payer: EmblemHealth Commercial	$35.31
Rate for Payer: Humana Medicare Advantage	$12.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.19
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$114.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.48
Rate for Payer: Wellcare Medicare Advantage	$11.77

HEPATITIS B CORE ANTIBODY,IGM

Facility

$763.00

Service Code	HCPCS 86705
Hospital Charge Code	38479433
Hospital Revenue Code	302
Min. Negotiated Rate	$5.88
Max. Negotiated Rate	$114.45
Rate for Payer: Aetna Commercial	$38.13
Rate for Payer: Aetna Medicare Advantage	$11.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.13
Rate for Payer: Cigna Commercial	$11.77
Rate for Payer: Cigna Medicare Advantage	$5.88
Rate for Payer: Clover Medicare Advantage	$11.18
Rate for Payer: EmblemHealth Commercial	$35.31
Rate for Payer: Humana Medicare Advantage	$12.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.19
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$114.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.48
Rate for Payer: Wellcare Medicare Advantage	$11.77

HEPATITIS B CORE ANTIBODY,IGM

Facility

$763.00

Service Code	HCPCS 86705
Hospital Charge Code	38479433
Hospital Revenue Code	302
Min. Negotiated Rate	$114.45
Max. Negotiated Rate	$114.45
Rate for Payer: Qualcare PPO/HMO/WC	$114.45

HEPATITIS B CORE IGM

Facility

$80.90

Service Code	HCPCS 86705
Hospital Charge Code	39900522
Hospital Revenue Code	302
Min. Negotiated Rate	$12.13
Max. Negotiated Rate	$12.13
Rate for Payer: Qualcare PPO/HMO/WC	$12.13

HEPATITIS B CORE IGM

Facility

$80.90

Service Code	HCPCS 86705
Hospital Charge Code	39900522
Hospital Revenue Code	302
Min. Negotiated Rate	$5.88
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.13
Rate for Payer: Aetna Medicare Advantage	$11.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.13
Rate for Payer: Cigna Commercial	$11.77
Rate for Payer: Cigna Medicare Advantage	$5.88
Rate for Payer: Clover Medicare Advantage	$11.18
Rate for Payer: EmblemHealth Commercial	$35.31
Rate for Payer: Humana Medicare Advantage	$12.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.52
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.13
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.48
Rate for Payer: Wellcare Medicare Advantage	$11.77

HEPATITIS B,DNA,BDNA

Facility

$481.00

Service Code	HCPCS 87517
Hospital Charge Code	38475109
Hospital Revenue Code	306
Min. Negotiated Rate	$72.15
Max. Negotiated Rate	$72.15
Rate for Payer: Qualcare PPO/HMO/WC	$72.15

HEPATITIS B,DNA,BDNA

Facility

$481.00

Service Code	HCPCS 87517
Hospital Charge Code	38475109
Hospital Revenue Code	306
Min. Negotiated Rate	$21.42
Max. Negotiated Rate	$156.97
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	$45.38
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	$62.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.15
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

HEPATITIS B DNA PCR

Facility

$303.34

Service Code	HCPCS 87517
Hospital Charge Code	38478094
Hospital Revenue Code	306
Min. Negotiated Rate	$45.50
Max. Negotiated Rate	$45.50
Rate for Payer: Qualcare PPO/HMO/WC	$45.50

HEPATITIS B DNA PCR

Facility

$303.34

Service Code	HCPCS 87517
Hospital Charge Code	38478094
Hospital Revenue Code	306
Min. Negotiated Rate	$21.42
Max. Negotiated Rate	$156.97
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	$45.38
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	$39.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.50
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

HEPATITIS Be AB HBeAb

Facility

$124.85

Service Code	HCPCS 86707
Hospital Charge Code	3008026
Hospital Revenue Code	302
Min. Negotiated Rate	$18.73
Max. Negotiated Rate	$18.73
Rate for Payer: Qualcare PPO/HMO/WC	$18.73

HEPATITIS Be AB HBeAb

Facility

$124.85

Service Code	HCPCS 86707
Hospital Charge Code	3008026
Hospital Revenue Code	302
Min. Negotiated Rate	$5.79
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.49
Rate for Payer: Aetna Medicare Advantage	$11.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.39
Rate for Payer: Cigna Commercial	$11.57
Rate for Payer: Cigna Medicare Advantage	$5.79
Rate for Payer: Clover Medicare Advantage	$10.99
Rate for Payer: EmblemHealth Commercial	$34.71
Rate for Payer: Humana Medicare Advantage	$11.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.23
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.73
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.57
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.26
Rate for Payer: Wellcare Medicare Advantage	$11.57

HEPATITIS Be AG HBeAg

Facility

$65.65

Service Code	HCPCS 87350
Hospital Charge Code	3008018
Hospital Revenue Code	306
Min. Negotiated Rate	$5.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.36
Rate for Payer: Aetna Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.25
Rate for Payer: Cigna Commercial	$11.53
Rate for Payer: Cigna Medicare Advantage	$5.76
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
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	$11.53
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.22
Rate for Payer: Wellcare Medicare Advantage	$11.53

HEPATITIS Be AG HBeAg

Facility

$65.65

Service Code	HCPCS 87350
Hospital Charge Code	3008018
Hospital Revenue Code	306
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

HEPATITIS BE ANTIBODY

Facility

$390.00

Service Code	HCPCS 86707
Hospital Charge Code	39900383
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEPATITIS BE ANTIBODY

Facility

$390.00

Service Code	HCPCS 86707
Hospital Charge Code	39900383
Hospital Revenue Code	302
Min. Negotiated Rate	$5.79
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.49
Rate for Payer: Aetna Medicare Advantage	$11.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.39
Rate for Payer: Cigna Commercial	$11.57
Rate for Payer: Cigna Medicare Advantage	$5.79
Rate for Payer: Clover Medicare Advantage	$10.99
Rate for Payer: EmblemHealth Commercial	$34.71
Rate for Payer: Humana Medicare Advantage	$11.92
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	$11.57
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.26
Rate for Payer: Wellcare Medicare Advantage	$11.57

HEPATITIS BE ANTIBODY HBE AB

Facility

$559.00

Service Code	HCPCS 86707
Hospital Charge Code	38472359
Hospital Revenue Code	302
Min. Negotiated Rate	$83.85
Max. Negotiated Rate	$83.85
Rate for Payer: Qualcare PPO/HMO/WC	$83.85

HEPATITIS BE ANTIBODY HBE AB

Facility

$559.00

Service Code	HCPCS 86707
Hospital Charge Code	38479431
Hospital Revenue Code	302
Min. Negotiated Rate	$83.85
Max. Negotiated Rate	$83.85
Rate for Payer: Qualcare PPO/HMO/WC	$83.85

HEPATITIS BE ANTIBODY HBE AB

Facility

$559.00

Service Code	HCPCS 86707
Hospital Charge Code	38479431
Hospital Revenue Code	302
Min. Negotiated Rate	$5.79
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.49
Rate for Payer: Aetna Medicare Advantage	$11.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.39
Rate for Payer: Cigna Commercial	$11.57
Rate for Payer: Cigna Medicare Advantage	$5.79
Rate for Payer: Clover Medicare Advantage	$10.99
Rate for Payer: EmblemHealth Commercial	$34.71
Rate for Payer: Humana Medicare Advantage	$11.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$83.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.57
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.26
Rate for Payer: Wellcare Medicare Advantage	$11.57

Know your out-of-pocket cost for care.

All Charges