Heights University Hospital

All Charges

Charge

Type

Setting

Price

HEPATITIS B VACCINE 1ML

Facility

$349.45

Hospital Charge Code	6007025
Hospital Revenue Code	250
Min. Negotiated Rate	$52.42
Max. Negotiated Rate	$52.42
Rate for Payer: Qualcare PPO/HMO/WC	$52.42

HEPATITIS B VACCINE 20MCG/ML

Facility

$128.00

Service Code	HCPCS 90744
Hospital Charge Code	60631545
Hospital Revenue Code	636
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$30.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.98
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

HEPATITIS B VACCINE 20MCG/ML

Facility

$128.00

Service Code	HCPCS 90744
Hospital Charge Code	60631545
Hospital Revenue Code	636
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$38.40
Rate for Payer: Aetna Commercial	$38.40
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$33.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.98
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

HEPATITIS B VACCINE PED 0.5ML

Facility

$270.75

Service Code	HCPCS 90744
Hospital Charge Code	6017875
Hospital Revenue Code	636
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$65.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.52
Rate for Payer: Qualcare PPO/HMO/WC	$40.61

HEPATITIS B VACCINE PED 0.5ML

Facility

$270.75

Service Code	HCPCS 90744
Hospital Charge Code	6017875
Hospital Revenue Code	636
Min. Negotiated Rate	$33.20
Max. Negotiated Rate	$81.22
Rate for Payer: Aetna Commercial	$81.22
Rate for Payer: Aetna Medicare Advantage	$81.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.04
Rate for Payer: Cigna Commercial	$33.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.52
Rate for Payer: Qualcare PPO/HMO/WC	$40.61

HEPATITIS B VACCINE PED 5MCG

Facility

$373.12

Service Code	HCPCS 90744
Hospital Charge Code	60628646
Hospital Revenue Code	636
Min. Negotiated Rate	$33.20
Max. Negotiated Rate	$111.94
Rate for Payer: Aetna Commercial	$111.94
Rate for Payer: Aetna Medicare Advantage	$111.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.15
Rate for Payer: Cigna Commercial	$33.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.30
Rate for Payer: Qualcare PPO/HMO/WC	$55.97

HEPATITIS B VACCINE PED 5MCG

Facility

$373.12

Service Code	HCPCS 90744
Hospital Charge Code	60628646
Hospital Revenue Code	636
Min. Negotiated Rate	$55.97
Max. Negotiated Rate	$90.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.30
Rate for Payer: Qualcare PPO/HMO/WC	$55.97

HEPATITIS B VIRAL DNA AMP PRB

Facility

$383.25

Service Code	HCPCS 87516
Hospital Charge Code	3000866
Hospital Revenue Code	306
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$128.57
Rate for Payer: Aetna Commercial	$113.69
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.57
Rate for Payer: Cigna Commercial	$35.09
Rate for Payer: Cigna Medicare Advantage	$17.55
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.49
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

HEPATITIS B VIRAL DNA AMP PRB

Facility

$383.25

Service Code	HCPCS 87516
Hospital Charge Code	3000866
Hospital Revenue Code	306
Min. Negotiated Rate	$57.49
Max. Negotiated Rate	$57.49
Rate for Payer: Qualcare PPO/HMO/WC	$57.49

HEPATITIS B VIRAL PCR

Facility

$390.00

Service Code	HCPCS 87517
Hospital Charge Code	39900298
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	$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	$42.84
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$45.41
Rate for Payer: Wellcare Medicare Advantage	$42.84

HEPATITIS B VIRAL PCR

Facility

$390.00

Service Code	HCPCS 87517
Hospital Charge Code	39900298
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEPATITIS C AB

Facility

$141.65

Service Code	HCPCS 86803
Hospital Charge Code	8200344RS
Hospital Revenue Code	302
Min. Negotiated Rate	$7.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.23
Rate for Payer: Aetna Medicare Advantage	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.29
Rate for Payer: Cigna Commercial	$14.27
Rate for Payer: Cigna Medicare Advantage	$7.13
Rate for Payer: Clover Medicare Advantage	$13.56
Rate for Payer: EmblemHealth Commercial	$42.81
Rate for Payer: Humana Medicare Advantage	$14.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.13
Rate for Payer: Wellcare Medicare Advantage	$14.27

HEPATITIS C AB

Facility

$141.65

Service Code	HCPCS 86803CF
Hospital Charge Code	8200345RS
Hospital Revenue Code	302
Min. Negotiated Rate	$18.41
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.49
Rate for Payer: Aetna Medicare Advantage	$42.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.12
Rate for Payer: Cigna Commercial	$70.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$114.00

HEPATITIS C AB

Facility

$141.65

Service Code	HCPCS 86803CF
Hospital Charge Code	8200345RS
Hospital Revenue Code	302
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

HEPATITIS C AB

Facility

$141.65

Service Code	HCPCS 86803
Hospital Charge Code	8200344RS
Hospital Revenue Code	302
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

HEPATITIS C AB (HCV)

Facility

$141.65

Service Code	HCPCS 86803
Hospital Charge Code	3006442E
Hospital Revenue Code	302
Min. Negotiated Rate	$7.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.23
Rate for Payer: Aetna Medicare Advantage	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.29
Rate for Payer: Cigna Commercial	$14.27
Rate for Payer: Cigna Medicare Advantage	$7.13
Rate for Payer: Clover Medicare Advantage	$13.56
Rate for Payer: EmblemHealth Commercial	$42.81
Rate for Payer: Humana Medicare Advantage	$14.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.13
Rate for Payer: Wellcare Medicare Advantage	$14.27

HEPATITIS C AB (HCV)

Facility

$141.65

Service Code	HCPCS 86803
Hospital Charge Code	3006442E
Hospital Revenue Code	302
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

HEPATITIS C AB (HCV)

Facility

$141.65

Service Code	HCPCS 86803
Hospital Charge Code	3007481
Hospital Revenue Code	302
Min. Negotiated Rate	$7.13
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.23
Rate for Payer: Aetna Medicare Advantage	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.29
Rate for Payer: Cigna Commercial	$14.27
Rate for Payer: Cigna Medicare Advantage	$7.13
Rate for Payer: Clover Medicare Advantage	$13.56
Rate for Payer: EmblemHealth Commercial	$42.81
Rate for Payer: Humana Medicare Advantage	$14.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.13
Rate for Payer: Wellcare Medicare Advantage	$14.27

HEPATITIS C AB (HCV)

Facility

$141.65

Service Code	HCPCS 86803
Hospital Charge Code	3007481
Hospital Revenue Code	302
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

HEPATITIS C AB (RIBA)

Facility

$873.00

Service Code	HCPCS 86804
Hospital Charge Code	38476254
Hospital Revenue Code	302
Min. Negotiated Rate	$130.95
Max. Negotiated Rate	$130.95
Rate for Payer: Qualcare PPO/HMO/WC	$130.95

HEPATITIS C AB (RIBA)

Facility

$873.00

Service Code	HCPCS 86804
Hospital Charge Code	38476254
Hospital Revenue Code	302
Min. Negotiated Rate	$7.75
Max. Negotiated Rate	$130.95
Rate for Payer: Aetna Commercial	$50.19
Rate for Payer: Aetna Medicare Advantage	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.76
Rate for Payer: Cigna Commercial	$15.49
Rate for Payer: Cigna Medicare Advantage	$7.75
Rate for Payer: Clover Medicare Advantage	$14.72
Rate for Payer: EmblemHealth Commercial	$46.47
Rate for Payer: Humana Medicare Advantage	$15.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$130.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.49
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.42
Rate for Payer: Wellcare Medicare Advantage	$15.49

HEPATITIS C AB W RFLX TO HCV

Facility

$3,410.19

Service Code	HCPCS 86803
Hospital Charge Code	401086803
Hospital Revenue Code	302
Min. Negotiated Rate	$7.13
Max. Negotiated Rate	$511.53
Rate for Payer: Aetna Commercial	$46.23
Rate for Payer: Aetna Medicare Advantage	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.29
Rate for Payer: Cigna Commercial	$14.27
Rate for Payer: Cigna Medicare Advantage	$7.13
Rate for Payer: Clover Medicare Advantage	$13.56
Rate for Payer: EmblemHealth Commercial	$42.81
Rate for Payer: Humana Medicare Advantage	$14.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$443.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$511.53
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.13
Rate for Payer: Wellcare Medicare Advantage	$14.27

HEPATITIS C AB W RFLX TO HCV

Facility

$3,410.19

Service Code	HCPCS 86803
Hospital Charge Code	401086803
Hospital Revenue Code	302
Min. Negotiated Rate	$511.53
Max. Negotiated Rate	$511.53
Rate for Payer: Qualcare PPO/HMO/WC	$511.53

HEPATITIS C ANTIBODY

Facility

$871.00

Service Code	HCPCS 86803
Hospital Charge Code	38472332
Hospital Revenue Code	302
Min. Negotiated Rate	$130.65
Max. Negotiated Rate	$130.65
Rate for Payer: Qualcare PPO/HMO/WC	$130.65

HEPATITIS C ANTIBODY

Facility

$871.00

Service Code	HCPCS 86803
Hospital Charge Code	38472332
Hospital Revenue Code	302
Min. Negotiated Rate	$7.13
Max. Negotiated Rate	$130.65
Rate for Payer: Aetna Commercial	$46.23
Rate for Payer: Aetna Medicare Advantage	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.29
Rate for Payer: Cigna Commercial	$14.27
Rate for Payer: Cigna Medicare Advantage	$7.13
Rate for Payer: Clover Medicare Advantage	$13.56
Rate for Payer: EmblemHealth Commercial	$42.81
Rate for Payer: Humana Medicare Advantage	$14.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.23
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$130.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.13
Rate for Payer: Wellcare Medicare Advantage	$14.27

Know your out-of-pocket cost for care.

All Charges