Heights University Hospital

All Charges

Charge

Type

Setting

Price

HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC

Facility

$114,887.00

Service Code	MSDRG 420
Min. Negotiated Rate	$35,060.01
Max. Negotiated Rate	$114,887.00
Rate for Payer: Aetna Commercial	$114,887.00
Rate for Payer: Aetna Medicare Advantage	$37,180.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88,214.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88,214.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$36,905.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88,214.40
Rate for Payer: Cigna Commercial	$73,324.20
Rate for Payer: Cigna Medicare Advantage	$36,905.27
Rate for Payer: Clover Medicare Advantage	$35,060.01
Rate for Payer: EmblemHealth Commercial	$110,715.81
Rate for Payer: Humana Medicare Advantage	$38,012.43
Rate for Payer: Oxford Commercial	$45,825.50
Rate for Payer: UnitedHealthcare Commercial	$52,016.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$36,905.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$39,119.59
Rate for Payer: Wellcare Medicare Advantage	$36,905.27

HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC

Facility

$52,443.75

Service Code	MSDRG 422
Min. Negotiated Rate	$15,272.16
Max. Negotiated Rate	$52,443.75
Rate for Payer: Aetna Commercial	$47,190.97
Rate for Payer: Aetna Medicare Advantage	$15,272.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38,869.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38,869.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,481.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38,869.47
Rate for Payer: Cigna Commercial	$30,118.64
Rate for Payer: Cigna Medicare Advantage	$17,481.25
Rate for Payer: Clover Medicare Advantage	$16,607.19
Rate for Payer: EmblemHealth Commercial	$52,443.75
Rate for Payer: Humana Medicare Advantage	$18,005.69
Rate for Payer: Oxford Commercial	$18,823.28
Rate for Payer: UnitedHealthcare Commercial	$21,366.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,481.25
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18,530.12
Rate for Payer: Wellcare Medicare Advantage	$17,481.25

HEPATOLITE

Facility

$62.75

Hospital Charge Code	270658220
Hospital Revenue Code	270
Min. Negotiated Rate	$8.16
Max. Negotiated Rate	$31.38
Rate for Payer: Aetna Commercial	$18.82
Rate for Payer: Aetna Medicare Advantage	$18.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.00
Rate for Payer: Cigna Commercial	$31.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.16
Rate for Payer: Oxford Commercial	$31.38
Rate for Payer: Qualcare PPO/HMO/WC	$9.41
Rate for Payer: UnitedHealthcare Commercial	$31.38

HEPATOLITE

Facility

$62.75

Hospital Charge Code	270658220
Hospital Revenue Code	270
Min. Negotiated Rate	$9.41
Max. Negotiated Rate	$9.41
Rate for Payer: Qualcare PPO/HMO/WC	$9.41

HEP A VIRUS ANT IGG

Facility

$426.00

Service Code	HCPCS 86708
Hospital Charge Code	38479435
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	$55.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.90
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

HEP A VIRUS ANT IGG

Facility

$426.00

Service Code	HCPCS 86708
Hospital Charge Code	38479435
Hospital Revenue Code	302
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$63.90
Rate for Payer: Qualcare PPO/HMO/WC	$63.90

HEP B CORE ANTIB

Facility

$559.00

Service Code	HCPCS 87350
Hospital Charge Code	38479493
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

HEP B CORE ANTIB

Facility

$559.00

Service Code	HCPCS 87350
Hospital Charge Code	38479493
Hospital Revenue Code	306
Min. Negotiated Rate	$83.85
Max. Negotiated Rate	$83.85
Rate for Payer: Qualcare PPO/HMO/WC	$83.85

HEP BE ANTIG

Facility

$559.00

Service Code	HCPCS 86707
Hospital Charge Code	38479486
Hospital Revenue Code	302
Min. Negotiated Rate	$83.85
Max. Negotiated Rate	$83.85
Rate for Payer: Qualcare PPO/HMO/WC	$83.85

HEP BE ANTIG

Facility

$559.00

Service Code	HCPCS 86707
Hospital Charge Code	38479486
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

HEP BE ANTIGENT

Facility

$574.00

Service Code	HCPCS 86704
Hospital Charge Code	38479487
Hospital Revenue Code	302
Min. Negotiated Rate	$86.10
Max. Negotiated Rate	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$86.10

HEP BE ANTIGENT

Facility

$574.00

Service Code	HCPCS 86704
Hospital Charge Code	38479487
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

HEP B IMMUNE GLOB. 5 ML

Facility

$3,089.00

Service Code	HCPCS 90371
Hospital Charge Code	60635745
Hospital Revenue Code	636
Min. Negotiated Rate	$463.35
Max. Negotiated Rate	$926.70
Rate for Payer: Aetna Commercial	$926.70
Rate for Payer: Aetna Medicare Advantage	$926.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$787.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$787.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$787.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$747.54
Rate for Payer: Qualcare PPO/HMO/WC	$463.35

HEP B IMMUNE GLOB. 5 ML

Facility

$3,089.00

Service Code	HCPCS 90371
Hospital Charge Code	60635745
Hospital Revenue Code	636
Min. Negotiated Rate	$463.35
Max. Negotiated Rate	$747.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$747.54
Rate for Payer: Qualcare PPO/HMO/WC	$463.35

HEP B IMMUNE GLOB. .5ML

Facility

$367.60

Service Code	HCPCS 90371
Hospital Charge Code	60635746
Hospital Revenue Code	636
Min. Negotiated Rate	$55.14
Max. Negotiated Rate	$88.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.96
Rate for Payer: Qualcare PPO/HMO/WC	$55.14

HEP B IMMUNE GLOB. .5ML

Facility

$367.60

Service Code	HCPCS 90371
Hospital Charge Code	60635746
Hospital Revenue Code	636
Min. Negotiated Rate	$55.14
Max. Negotiated Rate	$110.28
Rate for Payer: Aetna Commercial	$110.28
Rate for Payer: Aetna Medicare Advantage	$110.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.96
Rate for Payer: Qualcare PPO/HMO/WC	$55.14

HEP B SURF

Facility

$559.00

Service Code	HCPCS 86706
Hospital Charge Code	38479485
Hospital Revenue Code	302
Min. Negotiated Rate	$5.37
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	$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	$10.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.38
Rate for Payer: Wellcare Medicare Advantage	$10.74

HEP B SURF

Facility

$559.00

Service Code	HCPCS 86706
Hospital Charge Code	38479485
Hospital Revenue Code	302
Min. Negotiated Rate	$83.85
Max. Negotiated Rate	$83.85
Rate for Payer: Qualcare PPO/HMO/WC	$83.85

HEP B SURF AB QNT

Facility

$559.00

Service Code	HCPCS 86706
Hospital Charge Code	38479494
Hospital Revenue Code	302
Min. Negotiated Rate	$83.85
Max. Negotiated Rate	$83.85
Rate for Payer: Qualcare PPO/HMO/WC	$83.85

HEP B SURF AB QNT

Facility

$559.00

Service Code	HCPCS 86706
Hospital Charge Code	38479494
Hospital Revenue Code	302
Min. Negotiated Rate	$5.37
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	$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	$10.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.38
Rate for Payer: Wellcare Medicare Advantage	$10.74

HEP B SURFACE AB QN

Facility

$559.00

Service Code	HCPCS 86706
Hospital Charge Code	38479104
Hospital Revenue Code	302
Min. Negotiated Rate	$83.85
Max. Negotiated Rate	$83.85
Rate for Payer: Qualcare PPO/HMO/WC	$83.85

HEP B SURFACE AB QN

Facility

$559.00

Service Code	HCPCS 86706
Hospital Charge Code	38479104
Hospital Revenue Code	302
Min. Negotiated Rate	$5.37
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	$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	$10.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.38
Rate for Payer: Wellcare Medicare Advantage	$10.74

HEP B SURFACE ANTIBODY

Facility

$559.00

Service Code	HCPCS 86706
Hospital Charge Code	38479489
Hospital Revenue Code	302
Min. Negotiated Rate	$5.37
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	$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	$10.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.38
Rate for Payer: Wellcare Medicare Advantage	$10.74

HEP B SURFACE ANTIBODY

Facility

$559.00

Service Code	HCPCS 86706
Hospital Charge Code	38479489
Hospital Revenue Code	302
Min. Negotiated Rate	$83.85
Max. Negotiated Rate	$83.85
Rate for Payer: Qualcare PPO/HMO/WC	$83.85

HEP B SURF ANTIBODY

Facility

$311.00

Service Code	HCPCS 86706
Hospital Charge Code	38479492
Hospital Revenue Code	302
Min. Negotiated Rate	$46.65
Max. Negotiated Rate	$46.65
Rate for Payer: Qualcare PPO/HMO/WC	$46.65

Know your out-of-pocket cost for care.

All Charges