Heights University Hospital

All Charges

Charge

Type

Setting

Price

HISTO AB (HISTOPLASMA ANTIBODY

Facility

$144.85

Service Code	HCPCS 86698
Hospital Charge Code	3009537
Hospital Revenue Code	302
Min. Negotiated Rate	$21.73
Max. Negotiated Rate	$21.73
Rate for Payer: Qualcare PPO/HMO/WC	$21.73

HISTO BONE MARROW

Facility

$692.10

Service Code	HCPCS 88305
Hospital Charge Code	3004488
Hospital Revenue Code	310
Min. Negotiated Rate	$103.81
Max. Negotiated Rate	$103.81
Rate for Payer: Qualcare PPO/HMO/WC	$103.81

HISTO BONE MARROW

Facility

$692.10

Service Code	HCPCS 88305
Hospital Charge Code	3004488
Hospital Revenue Code	310
Min. Negotiated Rate	$39.47
Max. Negotiated Rate	$207.63
Rate for Payer: Aetna Commercial	$207.63
Rate for Payer: Aetna Medicare Advantage	$207.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.49
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$39.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$103.81
Rate for Payer: UnitedHealthcare Commercial	$114.00

HISTO BONE MARROW BILL

Facility

$692.10

Service Code	HCPCS 88305
Hospital Charge Code	3005212
Hospital Revenue Code	310
Min. Negotiated Rate	$39.47
Max. Negotiated Rate	$207.63
Rate for Payer: Aetna Commercial	$207.63
Rate for Payer: Aetna Medicare Advantage	$207.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.49
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$39.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$103.81
Rate for Payer: UnitedHealthcare Commercial	$114.00

HISTO BONE MARROW BILL

Facility

$692.10

Service Code	HCPCS 88305
Hospital Charge Code	3005213
Hospital Revenue Code	312
Min. Negotiated Rate	$39.47
Max. Negotiated Rate	$207.63
Rate for Payer: Aetna Commercial	$207.63
Rate for Payer: Aetna Medicare Advantage	$207.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.49
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$39.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$103.81
Rate for Payer: UnitedHealthcare Commercial	$114.00

HISTO BONE MARROW BILL

Facility

$692.10

Service Code	HCPCS 88305
Hospital Charge Code	3005212
Hospital Revenue Code	310
Min. Negotiated Rate	$103.81
Max. Negotiated Rate	$103.81
Rate for Payer: Qualcare PPO/HMO/WC	$103.81

HISTO BONE MARROW BILL

Facility

$692.10

Service Code	HCPCS 88305
Hospital Charge Code	3005213
Hospital Revenue Code	312
Min. Negotiated Rate	$103.81
Max. Negotiated Rate	$103.81
Rate for Payer: Qualcare PPO/HMO/WC	$103.81

HISTO GROSS

Facility

$465.00

Service Code	HCPCS 88300
Hospital Charge Code	3004967
Hospital Revenue Code	312
Min. Negotiated Rate	$9.33
Max. Negotiated Rate	$139.50
Rate for Payer: Aetna Commercial	$139.50
Rate for Payer: Aetna Medicare Advantage	$139.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.58
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: Cigna Medicare Advantage	$9.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

HISTO GROSS

Facility

$465.00

Service Code	HCPCS 88300
Hospital Charge Code	3004967
Hospital Revenue Code	312
Min. Negotiated Rate	$69.75
Max. Negotiated Rate	$69.75
Rate for Payer: Qualcare PPO/HMO/WC	$69.75

HISTO KIDNEY BIOPSY AST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	3005261
Hospital Revenue Code	310
Min. Negotiated Rate	$62.80
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$324.69
Rate for Payer: Aetna Medicare Advantage	$324.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.99
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$62.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.34
Rate for Payer: UnitedHealthcare Commercial	$114.00

HISTO KIDNEY BIOPSY AST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	3005261
Hospital Revenue Code	310
Min. Negotiated Rate	$162.34
Max. Negotiated Rate	$162.34
Rate for Payer: Qualcare PPO/HMO/WC	$162.34

HISTONE ANTIBODY

Facility

$390.00

Service Code	HCPCS 83516
Hospital Charge Code	39900457
Hospital Revenue Code	301
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	$16.83
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

HISTONE ANTIBODY

Facility

$390.00

Service Code	HCPCS 83516
Hospital Charge Code	39900457
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HISTOPLASMA AB,ID

Facility

$390.00

Service Code	HCPCS 86698
Hospital Charge Code	39900243
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HISTOPLASMA AB,ID

Facility

$390.00

Service Code	HCPCS 86698
Hospital Charge Code	39900243
Hospital Revenue Code	302
Min. Negotiated Rate	$6.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$44.68
Rate for Payer: Aetna Medicare Advantage	$13.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.79
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	$50.53
Rate for Payer: Cigna Commercial	$13.79
Rate for Payer: Cigna Medicare Advantage	$6.89
Rate for Payer: Clover Medicare Advantage	$13.10
Rate for Payer: EmblemHealth Commercial	$41.37
Rate for Payer: Humana Medicare Advantage	$14.20
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	$13.79
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.62
Rate for Payer: Wellcare Medicare Advantage	$13.79

HISTOPLASMA ANTIBODIES

Facility

$88.54

Service Code	HCPCS 86698
Hospital Charge Code	38476040
Hospital Revenue Code	302
Min. Negotiated Rate	$13.28
Max. Negotiated Rate	$13.28
Rate for Payer: Qualcare PPO/HMO/WC	$13.28

HISTOPLASMA ANTIBODIES

Facility

$88.54

Service Code	HCPCS 86698
Hospital Charge Code	38476040
Hospital Revenue Code	302
Min. Negotiated Rate	$6.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$44.68
Rate for Payer: Aetna Medicare Advantage	$13.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.79
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	$50.53
Rate for Payer: Cigna Commercial	$13.79
Rate for Payer: Cigna Medicare Advantage	$6.89
Rate for Payer: Clover Medicare Advantage	$13.10
Rate for Payer: EmblemHealth Commercial	$41.37
Rate for Payer: Humana Medicare Advantage	$14.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.51
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.28
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.79
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.62
Rate for Payer: Wellcare Medicare Advantage	$13.79

HISTOPLASMA ANTIBODY PROFILE 1

Facility

$144.85

Service Code	HCPCS 86698
Hospital Charge Code	3009628A
Hospital Revenue Code	302
Min. Negotiated Rate	$21.73
Max. Negotiated Rate	$21.73
Rate for Payer: Qualcare PPO/HMO/WC	$21.73

HISTOPLASMA ANTIBODY PROFILE 1

Facility

$144.85

Service Code	HCPCS 86698
Hospital Charge Code	3009628A
Hospital Revenue Code	302
Min. Negotiated Rate	$6.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$44.68
Rate for Payer: Aetna Medicare Advantage	$13.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.79
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	$50.53
Rate for Payer: Cigna Commercial	$13.79
Rate for Payer: Cigna Medicare Advantage	$6.89
Rate for Payer: Clover Medicare Advantage	$13.10
Rate for Payer: EmblemHealth Commercial	$41.37
Rate for Payer: Humana Medicare Advantage	$14.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.73
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.79
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.62
Rate for Payer: Wellcare Medicare Advantage	$13.79

HISTOPLASMA ANTIBODY PROFILE 2

Facility

$144.85

Service Code	HCPCS 86698
Hospital Charge Code	3009628B
Hospital Revenue Code	302
Min. Negotiated Rate	$21.73
Max. Negotiated Rate	$21.73
Rate for Payer: Qualcare PPO/HMO/WC	$21.73

HISTOPLASMA ANTIBODY PROFILE 2

Facility

$144.85

Service Code	HCPCS 86698
Hospital Charge Code	3009628B
Hospital Revenue Code	302
Min. Negotiated Rate	$6.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$44.68
Rate for Payer: Aetna Medicare Advantage	$13.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.79
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	$50.53
Rate for Payer: Cigna Commercial	$13.79
Rate for Payer: Cigna Medicare Advantage	$6.89
Rate for Payer: Clover Medicare Advantage	$13.10
Rate for Payer: EmblemHealth Commercial	$41.37
Rate for Payer: Humana Medicare Advantage	$14.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.73
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.79
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.62
Rate for Payer: Wellcare Medicare Advantage	$13.79

HISTOPLASMA ANTIGEN

Facility

$157.00

Service Code	HCPCS 87449
Hospital Charge Code	38476250
Hospital Revenue Code	306
Min. Negotiated Rate	$23.55
Max. Negotiated Rate	$23.55
Rate for Payer: Qualcare PPO/HMO/WC	$23.55

HISTOPLASMA ANTIGEN

Facility

$157.00

Service Code	HCPCS 87449
Hospital Charge Code	38476250
Hospital Revenue Code	306
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.82
Rate for Payer: Aetna Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.89
Rate for Payer: Cigna Commercial	$11.98
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.70
Rate for Payer: Wellcare Medicare Advantage	$11.98

HISTOPLASMA ANTIGEN

Facility

$125.00

Service Code	HCPCS 87385
Hospital Charge Code	3035050
Hospital Revenue Code	306
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.93
Rate for Payer: Aetna Medicare Advantage	$13.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.55
Rate for Payer: Cigna Commercial	$13.25
Rate for Payer: Cigna Medicare Advantage	$6.62
Rate for Payer: Clover Medicare Advantage	$12.59
Rate for Payer: EmblemHealth Commercial	$39.75
Rate for Payer: Humana Medicare Advantage	$13.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.25
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.04
Rate for Payer: Wellcare Medicare Advantage	$13.25

HISTOPLASMA ANTIGEN

Facility

$390.00

Service Code	HCPCS 87385
Hospital Charge Code	39900288
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges