Heights University Hospital

All Charges

Charge

Type

Setting

Price

HIV GENOTYPING,OTHER

Facility

$911.60

Service Code	HCPCS 87906
Hospital Charge Code	38477210
Hospital Revenue Code	306
Min. Negotiated Rate	$64.36
Max. Negotiated Rate	$471.67
Rate for Payer: Aetna Commercial	$417.09
Rate for Payer: Aetna Medicare Advantage	$128.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$128.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.67
Rate for Payer: Cigna Commercial	$128.73
Rate for Payer: Cigna Medicare Advantage	$64.36
Rate for Payer: Clover Medicare Advantage	$122.29
Rate for Payer: EmblemHealth Commercial	$386.19
Rate for Payer: Humana Medicare Advantage	$132.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.51
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$136.74
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$128.73
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$136.45
Rate for Payer: Wellcare Medicare Advantage	$128.73

HIVID/0.375MG/TAB

Facility

$6.00

Hospital Charge Code	60634928
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

HIVID/0.375MG/TAB

Facility

$6.00

Hospital Charge Code	60634928
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

HIVID/0.75MG

Facility

$8.00

Hospital Charge Code	60634903
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

HIVID/0.75MG

Facility

$8.00

Hospital Charge Code	60634903
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

HIV I DNA

Facility

$414.45

Service Code	HCPCS 87535
Hospital Charge Code	3032335
Hospital Revenue Code	306
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

HIV I DNA

Facility

$414.45

Service Code	HCPCS 87535
Hospital Charge Code	3032335
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	$53.88
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
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 I/II

Facility

$207.25

Service Code	HCPCS 86703
Hospital Charge Code	3032320
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	$26.94
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.09
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

HIV I/II

Facility

$207.25

Service Code	HCPCS 86703
Hospital Charge Code	3032320
Hospital Revenue Code	302
Min. Negotiated Rate	$31.09
Max. Negotiated Rate	$31.09
Rate for Payer: Qualcare PPO/HMO/WC	$31.09

HIV QUANT PCR WITH REFLEX

Facility

$638.45

Service Code	HCPCS 87536
Hospital Charge Code	3038147
Hospital Revenue Code	306
Min. Negotiated Rate	$42.55
Max. Negotiated Rate	$311.81
Rate for Payer: Aetna Commercial	$275.72
Rate for Payer: Aetna Medicare Advantage	$85.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$218.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.81
Rate for Payer: Cigna Commercial	$85.10
Rate for Payer: Cigna Medicare Advantage	$42.55
Rate for Payer: Clover Medicare Advantage	$80.84
Rate for Payer: EmblemHealth Commercial	$255.30
Rate for Payer: Humana Medicare Advantage	$87.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$95.77
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.10
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$90.21
Rate for Payer: Wellcare Medicare Advantage	$85.10

HIV QUANT PCR WITH REFLEX

Facility

$638.45

Service Code	HCPCS 87536
Hospital Charge Code	3038147
Hospital Revenue Code	306
Min. Negotiated Rate	$95.77
Max. Negotiated Rate	$95.77
Rate for Payer: Qualcare PPO/HMO/WC	$95.77

HIV RNA BY PCR - VIRAL LOAD

Facility

$638.45

Service Code	HCPCS 87536
Hospital Charge Code	3032257
Hospital Revenue Code	306
Min. Negotiated Rate	$95.77
Max. Negotiated Rate	$95.77
Rate for Payer: Qualcare PPO/HMO/WC	$95.77

HIV RNA BY PCR - VIRAL LOAD

Facility

$638.45

Service Code	HCPCS 87536
Hospital Charge Code	3032257
Hospital Revenue Code	306
Min. Negotiated Rate	$42.55
Max. Negotiated Rate	$311.81
Rate for Payer: Aetna Commercial	$275.72
Rate for Payer: Aetna Medicare Advantage	$85.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$218.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.81
Rate for Payer: Cigna Commercial	$85.10
Rate for Payer: Cigna Medicare Advantage	$42.55
Rate for Payer: Clover Medicare Advantage	$80.84
Rate for Payer: EmblemHealth Commercial	$255.30
Rate for Payer: Humana Medicare Advantage	$87.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$95.77
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.10
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$90.21
Rate for Payer: Wellcare Medicare Advantage	$85.10

HIV SOURCE PATIENT

Facility

$522.00

Service Code	HCPCS 86701
Hospital Charge Code	38479062
Hospital Revenue Code	302
Min. Negotiated Rate	$78.30
Max. Negotiated Rate	$78.30
Rate for Payer: Qualcare PPO/HMO/WC	$78.30

HIV SOURCE PATIENT

Facility

$522.00

Service Code	HCPCS 86701
Hospital Charge Code	38479062
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 WITH EXTENSIVE O.R. PROCEDURES WITH MCC

Facility

$206,409.50

Service Code	MSDRG 969
Min. Negotiated Rate	$60,007.54
Max. Negotiated Rate	$206,409.50
Rate for Payer: Aetna Commercial	$206,409.50
Rate for Payer: Aetna Medicare Advantage	$66,799.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189,385.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189,385.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$63,165.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189,385.29
Rate for Payer: Cigna Commercial	$131,736.50
Rate for Payer: Cigna Medicare Advantage	$63,165.83
Rate for Payer: Clover Medicare Advantage	$60,007.54
Rate for Payer: EmblemHealth Commercial	$189,497.49
Rate for Payer: Humana Medicare Advantage	$65,060.80
Rate for Payer: Oxford Commercial	$82,331.49
Rate for Payer: UnitedHealthcare Commercial	$93,453.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$63,165.83
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$66,955.78
Rate for Payer: Wellcare Medicare Advantage	$63,165.83

HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC

Facility

$88,932.83

Service Code	MSDRG 970
Min. Negotiated Rate	$27,985.33
Max. Negotiated Rate	$88,932.83
Rate for Payer: Aetna Commercial	$88,932.83
Rate for Payer: Aetna Medicare Advantage	$28,780.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76,636.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76,636.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29,458.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76,636.26
Rate for Payer: Cigna Commercial	$56,759.49
Rate for Payer: Cigna Medicare Advantage	$29,458.24
Rate for Payer: Clover Medicare Advantage	$27,985.33
Rate for Payer: EmblemHealth Commercial	$88,374.72
Rate for Payer: Humana Medicare Advantage	$30,341.99
Rate for Payer: Oxford Commercial	$35,473.03
Rate for Payer: UnitedHealthcare Commercial	$40,265.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$29,458.24
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$31,225.73
Rate for Payer: Wellcare Medicare Advantage	$29,458.24

HIV WITH MAJOR HIV RELATED CONDITION

Facility

$9,822.22

Service Code	APR-DRG 8921
Min. Negotiated Rate	$6,924.32
Max. Negotiated Rate	$9,822.22
Rate for Payer: Aetna Better Health Medicaid	$9,629.63
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,822.22
Rate for Payer: Wellpoint Medicaid Managed Care	$6,924.32

HIV WITH MAJOR HIV RELATED CONDITION

Facility

$14,185.62

Service Code	APR-DRG 8923
Min. Negotiated Rate	$11,999.82
Max. Negotiated Rate	$14,185.62
Rate for Payer: Aetna Better Health Medicaid	$13,907.47
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,185.62
Rate for Payer: Wellpoint Medicaid Managed Care	$11,999.82

HIV WITH MAJOR HIV RELATED CONDITION

Facility

$23,572.53

Service Code	APR-DRG 8924
Min. Negotiated Rate	$23,110.32
Max. Negotiated Rate	$23,572.53
Rate for Payer: Aetna Better Health Medicaid	$23,110.32
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,572.53
Rate for Payer: Wellpoint Medicaid Managed Care	$23,289.69

HIV WITH MAJOR HIV RELATED CONDITION

Facility

$10,339.08

Service Code	APR-DRG 8922
Min. Negotiated Rate	$9,157.98
Max. Negotiated Rate	$10,339.08
Rate for Payer: Aetna Better Health Medicaid	$10,136.35
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,339.08
Rate for Payer: Wellpoint Medicaid Managed Care	$9,157.98

HIV WITH MAJOR RELATED CONDITION WITH CC

Facility

$49,410.54

Service Code	MSDRG 975
Min. Negotiated Rate	$14,131.79
Max. Negotiated Rate	$49,410.54
Rate for Payer: Aetna Commercial	$43,667.23
Rate for Payer: Aetna Medicare Advantage	$14,131.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37,491.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37,491.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,470.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37,491.12
Rate for Payer: Cigna Commercial	$27,869.69
Rate for Payer: Cigna Medicare Advantage	$16,470.18
Rate for Payer: Clover Medicare Advantage	$15,646.67
Rate for Payer: EmblemHealth Commercial	$49,410.54
Rate for Payer: Humana Medicare Advantage	$16,964.29
Rate for Payer: Oxford Commercial	$17,417.75
Rate for Payer: UnitedHealthcare Commercial	$19,770.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,470.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17,458.39
Rate for Payer: Wellcare Medicare Advantage	$16,470.18

HIV WITH MAJOR RELATED CONDITION WITH MCC

Facility

$97,315.56

Service Code	MSDRG 974
Min. Negotiated Rate	$30,270.33
Max. Negotiated Rate	$97,315.56
Rate for Payer: Aetna Commercial	$97,315.56
Rate for Payer: Aetna Medicare Advantage	$31,493.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80,495.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80,495.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$31,863.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80,495.64
Rate for Payer: Cigna Commercial	$62,109.61
Rate for Payer: Cigna Medicare Advantage	$31,863.50
Rate for Payer: Clover Medicare Advantage	$30,270.33
Rate for Payer: EmblemHealth Commercial	$95,590.50
Rate for Payer: Humana Medicare Advantage	$32,819.40
Rate for Payer: Oxford Commercial	$38,816.70
Rate for Payer: UnitedHealthcare Commercial	$44,060.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$31,863.50
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$33,775.31
Rate for Payer: Wellcare Medicare Advantage	$31,863.50

HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC

Facility

$38,023.77

Service Code	MSDRG 976
Min. Negotiated Rate	$9,850.79
Max. Negotiated Rate	$38,023.77
Rate for Payer: Aetna Commercial	$30,438.94
Rate for Payer: Aetna Medicare Advantage	$9,850.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,431.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,431.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,674.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,431.95
Rate for Payer: Cigna Commercial	$19,250.53
Rate for Payer: Cigna Medicare Advantage	$12,674.59
Rate for Payer: Clover Medicare Advantage	$12,040.86
Rate for Payer: EmblemHealth Commercial	$38,023.77
Rate for Payer: Humana Medicare Advantage	$13,054.83
Rate for Payer: Oxford Commercial	$12,031.02
Rate for Payer: UnitedHealthcare Commercial	$13,656.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,674.59
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13,435.07
Rate for Payer: Wellcare Medicare Advantage	$12,674.59

HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS

Facility

$34,478.97

Service Code	APR-DRG 8904
Min. Negotiated Rate	$33,168.56
Max. Negotiated Rate	$34,478.97
Rate for Payer: Aetna Better Health Medicaid	$33,802.91
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$34,478.97
Rate for Payer: Wellpoint Medicaid Managed Care	$33,168.56

Know your out-of-pocket cost for care.

All Charges