Heights University Hospital

All Charges

Charge

Type

Setting

Price

HISTOPLASMA ANTIGEN

Facility

$125.00

Service Code	HCPCS 87385
Hospital Charge Code	3035050
Hospital Revenue Code	306
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

HISTOPLASMA ANTIGEN

Facility

$390.00

Service Code	HCPCS 87385
Hospital Charge Code	39900288
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	$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	$13.25
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.04
Rate for Payer: Wellcare Medicare Advantage	$13.25

HISTO PLASMA ANTIGEN URINE

Facility

$125.00

Service Code	HCPCS 87385
Hospital Charge Code	3009991
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

HISTO PLASMA ANTIGEN URINE

Facility

$125.00

Service Code	HCPCS 87385
Hospital Charge Code	3009991
Hospital Revenue Code	306
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

HISTOPLASMOSIS, URINE***

Facility

$147.00

Service Code	HCPCS 83520
Hospital Charge Code	3031606
Hospital Revenue Code	309
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.95
Rate for Payer: Aetna Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.28
Rate for Payer: Cigna Commercial	$17.27
Rate for Payer: Cigna Medicare Advantage	$8.63
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.31
Rate for Payer: Wellcare Medicare Advantage	$17.27

HISTOPLASMOSIS, URINE***

Facility

$147.00

Service Code	HCPCS 83520
Hospital Charge Code	3031606
Hospital Revenue Code	309
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$22.05
Rate for Payer: Qualcare PPO/HMO/WC	$22.05

HIV 1/2 AB

Facility

$390.00

Service Code	HCPCS 86703
Hospital Charge Code	39900432
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HIV 1/2 AB

Facility

$390.00

Service Code	HCPCS 86703
Hospital Charge Code	39900432
Hospital Revenue Code	302
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$44.42
Rate for Payer: Aetna Medicare Advantage	$13.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.23
Rate for Payer: Cigna Commercial	$13.71
Rate for Payer: Cigna Medicare Advantage	$6.86
Rate for Payer: Clover Medicare Advantage	$13.02
Rate for Payer: EmblemHealth Commercial	$41.13
Rate for Payer: Humana Medicare Advantage	$14.12
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	$13.71
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.53
Rate for Payer: Wellcare Medicare Advantage	$13.71

HIV1/2 AG&AB 4TH GEN W REFL-SO

Facility

$118.90

Service Code	HCPCS 87389
Hospital Charge Code	401387389
Hospital Revenue Code	306
Min. Negotiated Rate	$17.84
Max. Negotiated Rate	$17.84
Rate for Payer: Qualcare PPO/HMO/WC	$17.84

HIV1/2 AG&AB 4TH GEN W REFL-SO

Facility

$118.90

Service Code	HCPCS 87389
Hospital Charge Code	401387389
Hospital Revenue Code	306
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.02
Rate for Payer: Aetna Medicare Advantage	$24.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.23
Rate for Payer: Cigna Commercial	$24.08
Rate for Payer: Cigna Medicare Advantage	$12.04
Rate for Payer: Clover Medicare Advantage	$22.88
Rate for Payer: EmblemHealth Commercial	$72.24
Rate for Payer: Humana Medicare Advantage	$24.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.84
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.08
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.52
Rate for Payer: Wellcare Medicare Advantage	$24.08

HIV1/2 AG & AB 4TH GEN W REFLX

Facility

$390.00

Service Code	HCPCS 87389
Hospital Charge Code	38479743
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HIV1/2 AG & AB 4TH GEN W REFLX

Facility

$390.00

Service Code	HCPCS 87389
Hospital Charge Code	38479743
Hospital Revenue Code	306
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.02
Rate for Payer: Aetna Medicare Advantage	$24.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.23
Rate for Payer: Cigna Commercial	$24.08
Rate for Payer: Cigna Medicare Advantage	$12.04
Rate for Payer: Clover Medicare Advantage	$22.88
Rate for Payer: EmblemHealth Commercial	$72.24
Rate for Payer: Humana Medicare Advantage	$24.80
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	$24.08
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.52
Rate for Payer: Wellcare Medicare Advantage	$24.08

HIV-172 RAPID SCREEN

Facility

$522.00

Service Code	HCPCS 86701
Hospital Charge Code	38479060
Hospital Revenue Code	302
Min. Negotiated Rate	$78.30
Max. Negotiated Rate	$78.30
Rate for Payer: Qualcare PPO/HMO/WC	$78.30

HIV-172 RAPID SCREEN

Facility

$522.00

Service Code	HCPCS 86701
Hospital Charge Code	38479060
Hospital Revenue Code	302
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$28.80
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.89
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	$32.57
Rate for Payer: Cigna Commercial	$8.89
Rate for Payer: Cigna Medicare Advantage	$4.45
Rate for Payer: Clover Medicare Advantage	$8.45
Rate for Payer: EmblemHealth Commercial	$26.67
Rate for Payer: Humana Medicare Advantage	$9.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.89
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.42
Rate for Payer: Wellcare Medicare Advantage	$8.89

HIV-1AB,WB

Facility

$522.00

Service Code	HCPCS 86701
Hospital Charge Code	38479090
Hospital Revenue Code	302
Min. Negotiated Rate	$78.30
Max. Negotiated Rate	$78.30
Rate for Payer: Qualcare PPO/HMO/WC	$78.30

HIV-1AB,WB

Facility

$522.00

Service Code	HCPCS 86701
Hospital Charge Code	38479090
Hospital Revenue Code	302
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$28.80
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.89
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	$32.57
Rate for Payer: Cigna Commercial	$8.89
Rate for Payer: Cigna Medicare Advantage	$4.45
Rate for Payer: Clover Medicare Advantage	$8.45
Rate for Payer: EmblemHealth Commercial	$26.67
Rate for Payer: Humana Medicare Advantage	$9.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.89
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.42
Rate for Payer: Wellcare Medicare Advantage	$8.89

HIV 1 AB WESTERN BLOT

Facility

$133.00

Service Code	HCPCS 86689
Hospital Charge Code	39900379
Hospital Revenue Code	302
Min. Negotiated Rate	$9.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$62.69
Rate for Payer: Aetna Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.90
Rate for Payer: Cigna Commercial	$19.35
Rate for Payer: Cigna Medicare Advantage	$9.68
Rate for Payer: Clover Medicare Advantage	$18.38
Rate for Payer: EmblemHealth Commercial	$58.05
Rate for Payer: Humana Medicare Advantage	$19.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.29
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.51
Rate for Payer: Wellcare Medicare Advantage	$19.35

HIV 1 AB WESTERN BLOT

Facility

$133.00

Service Code	HCPCS 86689
Hospital Charge Code	39900379
Hospital Revenue Code	302
Min. Negotiated Rate	$19.95
Max. Negotiated Rate	$19.95
Rate for Payer: Qualcare PPO/HMO/WC	$19.95

HIV-1 AB W/FX

Facility

$522.00

Service Code	HCPCS 86701
Hospital Charge Code	38479089
Hospital Revenue Code	302
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$28.80
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.89
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	$32.57
Rate for Payer: Cigna Commercial	$8.89
Rate for Payer: Cigna Medicare Advantage	$4.45
Rate for Payer: Clover Medicare Advantage	$8.45
Rate for Payer: EmblemHealth Commercial	$26.67
Rate for Payer: Humana Medicare Advantage	$9.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.89
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.42
Rate for Payer: Wellcare Medicare Advantage	$8.89

HIV-1 AB W/FX

Facility

$522.00

Service Code	HCPCS 86701
Hospital Charge Code	38479089
Hospital Revenue Code	302
Min. Negotiated Rate	$78.30
Max. Negotiated Rate	$78.30
Rate for Payer: Qualcare PPO/HMO/WC	$78.30

HIV-1 DNA,PCR

Facility

$501.00

Service Code	HCPCS 87535
Hospital Charge Code	38476238
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	$65.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.15
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

HIV-1 DNA,PCR

Facility

$501.00

Service Code	HCPCS 87535
Hospital Charge Code	38476238
Hospital Revenue Code	306
Min. Negotiated Rate	$75.15
Max. Negotiated Rate	$75.15
Rate for Payer: Qualcare PPO/HMO/WC	$75.15

HIV-1 DNA Qualitative PCR

Facility

$2,309.05

Service Code	HCPCS 87535
Hospital Charge Code	401187535
Hospital Revenue Code	306
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$346.36
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	$300.18
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$346.36
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

HIV-1 DNA Qualitative PCR

Facility

$2,309.05

Service Code	HCPCS 87535
Hospital Charge Code	401187535
Hospital Revenue Code	306
Min. Negotiated Rate	$346.36
Max. Negotiated Rate	$346.36
Rate for Payer: Qualcare PPO/HMO/WC	$346.36

HIV-1 GENOTYPE

Facility

$1,769.40

Service Code	HCPCS 87901
Hospital Charge Code	39900406
Hospital Revenue Code	306
Min. Negotiated Rate	$265.41
Max. Negotiated Rate	$265.41
Rate for Payer: Qualcare PPO/HMO/WC	$265.41

Know your out-of-pocket cost for care.

All Charges