Heights University Hospital

All Charges

Charge

Type

Setting

Price

HEPATITIS BE ANTIBODY HBE AB

Facility

$559.00

Service Code	HCPCS 86707
Hospital Charge Code	38472359
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

HEPATITIS BE ANTIGEN

Facility

$390.00

Service Code	HCPCS 87350
Hospital Charge Code	39900392
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	$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	$11.53
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.22
Rate for Payer: Wellcare Medicare Advantage	$11.53

HEPATITIS BE ANTIGEN

Facility

$390.00

Service Code	HCPCS 87350
Hospital Charge Code	39900392
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEPATITIS BE ANTIGEN, HBE AG

Facility

$574.00

Service Code	HCPCS 86704
Hospital Charge Code	38479430
Hospital Revenue Code	302
Min. Negotiated Rate	$86.10
Max. Negotiated Rate	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$86.10

HEPATITIS BE ANTIGEN, HBE AG

Facility

$574.00

Service Code	HCPCS 86704
Hospital Charge Code	38479430
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
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	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

HEPATITIS BE ANTIGEN, HBE AG

Facility

$574.00

Service Code	HCPCS 86704
Hospital Charge Code	38472356
Hospital Revenue Code	302
Min. Negotiated Rate	$86.10
Max. Negotiated Rate	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$86.10

HEPATITIS BE ANTIGEN, HBE AG

Facility

$574.00

Service Code	HCPCS 86704
Hospital Charge Code	38472356
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
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	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

HEPATITIS B GENOTYPE

Facility

$1,769.40

Service Code	HCPCS 87912
Hospital Charge Code	39900309
Hospital Revenue Code	306
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$943.30
Rate for Payer: Aetna Commercial	$834.14
Rate for Payer: Aetna Medicare Advantage	$257.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$943.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$943.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$257.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$635.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$943.30
Rate for Payer: Cigna Commercial	$257.45
Rate for Payer: Cigna Medicare Advantage	$128.72
Rate for Payer: Clover Medicare Advantage	$244.58
Rate for Payer: EmblemHealth Commercial	$772.35
Rate for Payer: Humana Medicare Advantage	$265.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.02
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$265.41
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$257.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$272.90
Rate for Payer: Wellcare Medicare Advantage	$257.45

HEPATITIS B GENOTYPE

Facility

$1,769.40

Service Code	HCPCS 87912
Hospital Charge Code	39900309
Hospital Revenue Code	306
Min. Negotiated Rate	$265.41
Max. Negotiated Rate	$265.41
Rate for Payer: Qualcare PPO/HMO/WC	$265.41

HEPATITIS B-HEMOPHILUS INF B V

Facility

$95.00

Service Code	HCPCS 90748
Hospital Charge Code	83652341
Hospital Revenue Code	636
Min. Negotiated Rate	$14.25
Max. Negotiated Rate	$64.63
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$28.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.23
Rate for Payer: Cigna Commercial	$47.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.99
Rate for Payer: Qualcare PPO/HMO/WC	$14.25

HEPATITIS B-HEMOPHILUS INF B V

Facility

$95.00

Service Code	HCPCS 90748
Hospital Charge Code	83652341
Hospital Revenue Code	636
Min. Negotiated Rate	$14.25
Max. Negotiated Rate	$22.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.99
Rate for Payer: Qualcare PPO/HMO/WC	$14.25

HEPATITIS B IMMU GLOB INJ

Facility

$2,107.55

Hospital Charge Code	60628286
Hospital Revenue Code	259
Min. Negotiated Rate	$273.98
Max. Negotiated Rate	$1,053.78
Rate for Payer: Aetna Commercial	$632.26
Rate for Payer: Aetna Medicare Advantage	$632.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$537.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$537.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$537.43
Rate for Payer: Cigna Commercial	$1,053.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.98
Rate for Payer: Oxford Commercial	$1,053.78
Rate for Payer: Qualcare PPO/HMO/WC	$316.13
Rate for Payer: UnitedHealthcare Commercial	$1,053.78

HEPATITIS B IMMU GLOB INJ

Facility

$2,107.55

Hospital Charge Code	60628286
Hospital Revenue Code	259
Min. Negotiated Rate	$316.13
Max. Negotiated Rate	$316.13
Rate for Payer: Qualcare PPO/HMO/WC	$316.13

HEPATITIS B IMMU GLOB INJ 4 ML

Facility

$839.05

Service Code	HCPCS 90371
Hospital Charge Code	6002752
Hospital Revenue Code	636
Min. Negotiated Rate	$125.86
Max. Negotiated Rate	$203.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.05
Rate for Payer: Qualcare PPO/HMO/WC	$125.86

HEPATITIS B IMMU GLOB INJ 4 ML

Facility

$839.05

Service Code	HCPCS 90371
Hospital Charge Code	6002752
Hospital Revenue Code	636
Min. Negotiated Rate	$125.86
Max. Negotiated Rate	$251.72
Rate for Payer: Aetna Commercial	$251.72
Rate for Payer: Aetna Medicare Advantage	$251.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$213.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$213.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$213.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.05
Rate for Payer: Qualcare PPO/HMO/WC	$125.86

HEPATITISB IMMUNE GLOB 5ML INJ

Facility

$4,582.80

Service Code	HCPCS 90371
Hospital Charge Code	60629108
Hospital Revenue Code	636
Min. Negotiated Rate	$687.42
Max. Negotiated Rate	$1,374.84
Rate for Payer: Aetna Commercial	$1,374.84
Rate for Payer: Aetna Medicare Advantage	$1,374.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,168.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,168.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,168.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,109.04
Rate for Payer: Qualcare PPO/HMO/WC	$687.42

HEPATITISB IMMUNE GLOB 5ML INJ

Facility

$4,582.80

Service Code	HCPCS 90371
Hospital Charge Code	60629108
Hospital Revenue Code	636
Min. Negotiated Rate	$687.42
Max. Negotiated Rate	$1,109.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,109.04
Rate for Payer: Qualcare PPO/HMO/WC	$687.42

HEPATITIS B INJ 10MCG/ML

Facility

$472.35

Hospital Charge Code	60628303
Hospital Revenue Code	250
Min. Negotiated Rate	$70.85
Max. Negotiated Rate	$70.85
Rate for Payer: Qualcare PPO/HMO/WC	$70.85

HEPATITIS B INJ 10MCG/ML

Facility

$472.35

Hospital Charge Code	60628303
Hospital Revenue Code	250
Min. Negotiated Rate	$61.41
Max. Negotiated Rate	$236.18
Rate for Payer: Aetna Commercial	$141.71
Rate for Payer: Aetna Medicare Advantage	$141.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.45
Rate for Payer: Cigna Commercial	$236.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.41
Rate for Payer: Oxford Commercial	$236.18
Rate for Payer: Qualcare PPO/HMO/WC	$70.85
Rate for Payer: UnitedHealthcare Commercial	$236.18

HEPATITIS B S ANTIBODY

Facility

$15.12

Service Code	HCPCS 86706
Hospital Charge Code	8200342RS
Hospital Revenue Code	302
Min. Negotiated Rate	$1.97
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	$24.31
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	$1.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.27
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

HEPATITIS B S ANTIBODY

Facility

$139.25

Service Code	HCPCS 86706CF
Hospital Charge Code	8200343RS
Hospital Revenue Code	302
Min. Negotiated Rate	$18.10
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.77
Rate for Payer: Aetna Medicare Advantage	$41.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.51
Rate for Payer: Cigna Commercial	$69.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.89
Rate for Payer: UnitedHealthcare Commercial	$114.00

HEPATITIS B S ANTIBODY

Facility

$139.25

Service Code	HCPCS 86706CF
Hospital Charge Code	8200343RS
Hospital Revenue Code	302
Min. Negotiated Rate	$20.89
Max. Negotiated Rate	$20.89
Rate for Payer: Qualcare PPO/HMO/WC	$20.89

HEPATITIS B S ANTIBODY

Facility

$15.12

Service Code	HCPCS 86706
Hospital Charge Code	8200342RS
Hospital Revenue Code	302
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$2.27
Rate for Payer: Qualcare PPO/HMO/WC	$2.27

HEPATITIS B S ANTIGEN

Facility

$153.65

Service Code	HCPCS 87340
Hospital Charge Code	8200346RS
Hospital Revenue Code	306
Min. Negotiated Rate	$5.17
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$33.47
Rate for Payer: Aetna Medicare Advantage	$10.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.85
Rate for Payer: Cigna Commercial	$10.33
Rate for Payer: Cigna Medicare Advantage	$5.17
Rate for Payer: Clover Medicare Advantage	$9.81
Rate for Payer: EmblemHealth Commercial	$30.99
Rate for Payer: Humana Medicare Advantage	$10.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.33
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.95
Rate for Payer: Wellcare Medicare Advantage	$10.33

HEPATITIS B S ANTIGEN

Facility

$153.65

Service Code	HCPCS 87340CF
Hospital Charge Code	8200347RS
Hospital Revenue Code	306
Min. Negotiated Rate	$19.97
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.09
Rate for Payer: Aetna Medicare Advantage	$46.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.18
Rate for Payer: Cigna Commercial	$76.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Commercial	$114.00

Know your out-of-pocket cost for care.

All Charges