Heights University Hospital

All Charges

Charge

Type

Setting

Price

HLA-B5701 TYPING

Facility

$424.85

Service Code	HCPCS 81381
Hospital Charge Code	39900321
Hospital Revenue Code	310
Min. Negotiated Rate	$55.23
Max. Negotiated Rate	$622.51
Rate for Payer: Aetna Commercial	$550.48
Rate for Payer: Aetna Medicare Advantage	$169.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$622.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$622.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$169.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$622.51
Rate for Payer: Cigna Commercial	$169.90
Rate for Payer: Cigna Medicare Advantage	$84.95
Rate for Payer: Clover Medicare Advantage	$161.41
Rate for Payer: EmblemHealth Commercial	$509.70
Rate for Payer: Humana Medicare Advantage	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.23
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.73
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$169.90
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$180.09
Rate for Payer: Wellcare Medicare Advantage	$169.90

HLA-B57 TYPING

Facility

$424.85

Service Code	HCPCS 81381
Hospital Charge Code	39900024
Hospital Revenue Code	310
Min. Negotiated Rate	$55.23
Max. Negotiated Rate	$622.51
Rate for Payer: Aetna Commercial	$550.48
Rate for Payer: Aetna Medicare Advantage	$169.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$622.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$622.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$169.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$622.51
Rate for Payer: Cigna Commercial	$169.90
Rate for Payer: Cigna Medicare Advantage	$84.95
Rate for Payer: Clover Medicare Advantage	$161.41
Rate for Payer: EmblemHealth Commercial	$509.70
Rate for Payer: Humana Medicare Advantage	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.23
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.73
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$169.90
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$180.09
Rate for Payer: Wellcare Medicare Advantage	$169.90

HLA-B57 TYPING

Facility

$424.85

Service Code	HCPCS 81381
Hospital Charge Code	39900024
Hospital Revenue Code	310
Min. Negotiated Rate	$63.73
Max. Negotiated Rate	$63.73
Rate for Payer: Qualcare PPO/HMO/WC	$63.73

HLA DQB1 LOW RES TYPING

Facility

$809.40

Service Code	HCPCS 81376
Hospital Charge Code	401081376
Hospital Revenue Code	310
Min. Negotiated Rate	$121.41
Max. Negotiated Rate	$121.41
Rate for Payer: Qualcare PPO/HMO/WC	$121.41

HLA DQB1 LOW RES TYPING

Facility

$809.40

Service Code	HCPCS 81376
Hospital Charge Code	401081376
Hospital Revenue Code	310
Min. Negotiated Rate	$61.11
Max. Negotiated Rate	$447.81
Rate for Payer: Aetna Commercial	$395.99
Rate for Payer: Aetna Medicare Advantage	$122.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$447.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$447.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$122.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$447.81
Rate for Payer: Cigna Commercial	$122.22
Rate for Payer: Cigna Medicare Advantage	$61.11
Rate for Payer: Clover Medicare Advantage	$116.11
Rate for Payer: EmblemHealth Commercial	$366.66
Rate for Payer: Humana Medicare Advantage	$125.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.22
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$121.41
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$122.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$129.55
Rate for Payer: Wellcare Medicare Advantage	$122.22

HLA - DR4

Facility

$197.29

Service Code	HCPCS 86816
Hospital Charge Code	38476301
Hospital Revenue Code	302
Min. Negotiated Rate	$29.59
Max. Negotiated Rate	$29.59
Rate for Payer: Qualcare PPO/HMO/WC	$29.59

HLA - DR4

Facility

$197.29

Service Code	HCPCS 86816
Hospital Charge Code	38476301
Hospital Revenue Code	302
Min. Negotiated Rate	$15.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$97.75
Rate for Payer: Aetna Medicare Advantage	$30.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$30.17
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	$110.54
Rate for Payer: Cigna Commercial	$30.17
Rate for Payer: Cigna Medicare Advantage	$15.09
Rate for Payer: Clover Medicare Advantage	$28.66
Rate for Payer: EmblemHealth Commercial	$90.51
Rate for Payer: Humana Medicare Advantage	$31.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.65
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.59
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$30.17
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$31.98
Rate for Payer: Wellcare Medicare Advantage	$30.17

HLA DR/DQ,MULTIPLE ANTIGENS

Facility

$455.99

Service Code	HCPCS 86817
Hospital Charge Code	38476276
Hospital Revenue Code	302
Min. Negotiated Rate	$39.08
Max. Negotiated Rate	$388.90
Rate for Payer: Aetna Commercial	$343.89
Rate for Payer: Aetna Medicare Advantage	$106.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$106.14
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	$388.90
Rate for Payer: Cigna Commercial	$106.14
Rate for Payer: Cigna Medicare Advantage	$53.07
Rate for Payer: Clover Medicare Advantage	$100.83
Rate for Payer: EmblemHealth Commercial	$318.42
Rate for Payer: Humana Medicare Advantage	$109.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$106.14
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$112.51
Rate for Payer: Wellcare Medicare Advantage	$106.14

HLA DR/DQ,MULTIPLE ANTIGENS

Facility

$455.99

Service Code	HCPCS 86817
Hospital Charge Code	38476276
Hospital Revenue Code	302
Min. Negotiated Rate	$68.40
Max. Negotiated Rate	$68.40
Rate for Payer: Qualcare PPO/HMO/WC	$68.40

HLA-MATCH PLT PHERESIS LEUKO

Facility

$2,518.60

Hospital Charge Code	3100443
Hospital Revenue Code	390
Min. Negotiated Rate	$377.79
Max. Negotiated Rate	$377.79
Rate for Payer: Qualcare PPO/HMO/WC	$377.79

HLA-MATCH PLT PHERESIS LEUKO

Facility

$2,518.60

Hospital Charge Code	3100443
Hospital Revenue Code	390
Min. Negotiated Rate	$327.42
Max. Negotiated Rate	$1,259.30
Rate for Payer: Aetna Commercial	$755.58
Rate for Payer: Aetna Medicare Advantage	$755.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$642.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$642.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$642.24
Rate for Payer: Cigna Commercial	$1,259.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$327.42
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$377.79
Rate for Payer: UnitedHealthcare Commercial	$756.00

HLA TYPING; A,B,C SINGLE ANTG

Facility

$390.00

Service Code	HCPCS 86812
Hospital Charge Code	38473042
Hospital Revenue Code	302
Min. Negotiated Rate	$12.90
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$83.62
Rate for Payer: Aetna Medicare Advantage	$25.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.57
Rate for Payer: Cigna Commercial	$25.81
Rate for Payer: Cigna Medicare Advantage	$12.90
Rate for Payer: Clover Medicare Advantage	$24.52
Rate for Payer: EmblemHealth Commercial	$77.43
Rate for Payer: Humana Medicare Advantage	$26.58
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	$25.81
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$27.36
Rate for Payer: Wellcare Medicare Advantage	$25.81

HLA TYPING; A,B,C SINGLE ANTG

Facility

$390.00

Service Code	HCPCS 86812
Hospital Charge Code	38473042
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HLA TYPING CELIAC DISEASE I

Facility

$833.70

Service Code	HCPCS 81376
Hospital Charge Code	39990155A
Hospital Revenue Code	310
Min. Negotiated Rate	$125.06
Max. Negotiated Rate	$125.06
Rate for Payer: Qualcare PPO/HMO/WC	$125.06

HLA TYPING CELIAC DISEASE I

Facility

$833.70

Service Code	HCPCS 81376
Hospital Charge Code	39990155A
Hospital Revenue Code	310
Min. Negotiated Rate	$61.11
Max. Negotiated Rate	$447.81
Rate for Payer: Aetna Commercial	$395.99
Rate for Payer: Aetna Medicare Advantage	$122.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$447.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$447.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$122.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$447.81
Rate for Payer: Cigna Commercial	$122.22
Rate for Payer: Cigna Medicare Advantage	$61.11
Rate for Payer: Clover Medicare Advantage	$116.11
Rate for Payer: EmblemHealth Commercial	$366.66
Rate for Payer: Humana Medicare Advantage	$125.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$125.06
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$122.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$129.55
Rate for Payer: Wellcare Medicare Advantage	$122.22

HLA TYPING CELIAC DISEASE II

Facility

$843.65

Service Code	HCPCS 81382
Hospital Charge Code	39990155B
Hospital Revenue Code	310
Min. Negotiated Rate	$61.84
Max. Negotiated Rate	$453.16
Rate for Payer: EmblemHealth Commercial	$371.04
Rate for Payer: Humana Medicare Advantage	$127.39
Rate for Payer: Aetna Commercial	$400.72
Rate for Payer: Aetna Medicare Advantage	$123.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$453.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$453.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$123.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$453.16
Rate for Payer: Cigna Commercial	$123.68
Rate for Payer: Cigna Medicare Advantage	$61.84
Rate for Payer: Clover Medicare Advantage	$117.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$123.68
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$131.10
Rate for Payer: Wellcare Medicare Advantage	$123.68

HLA TYPING CELIAC DISEASE II

Facility

$843.65

Service Code	HCPCS 81382
Hospital Charge Code	39990155B
Hospital Revenue Code	310
Min. Negotiated Rate	$126.55
Max. Negotiated Rate	$126.55
Rate for Payer: Qualcare PPO/HMO/WC	$126.55

HLTHSHAKE-NO SUGAR ADDED

Facility

$4.00

Hospital Charge Code	60635156
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

HLTHSHAKE-NO SUGAR ADDED

Facility

$4.00

Hospital Charge Code	60635156
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

HME BALLARD FLEX

Facility

$18.45

Hospital Charge Code	270600633
Hospital Revenue Code	272
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$9.22
Rate for Payer: Aetna Commercial	$5.54
Rate for Payer: Aetna Medicare Advantage	$5.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.70
Rate for Payer: Cigna Commercial	$9.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$9.22
Rate for Payer: Qualcare PPO/HMO/WC	$2.77
Rate for Payer: UnitedHealthcare Commercial	$9.22

HME BALLARD FLEX

Facility

$18.45

Hospital Charge Code	270600633
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$2.77
Rate for Payer: Qualcare PPO/HMO/WC	$2.77

HMMF LOCKSCREW AXS SD 2.0X6MM

Facility

$978.20

Service Code	HCPCS C1713
Hospital Charge Code	270705879
Hospital Revenue Code	278
Min. Negotiated Rate	$146.73
Max. Negotiated Rate	$236.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.72
Rate for Payer: Qualcare PPO/HMO/WC	$146.73

HMMF LOCKSCREW AXS SD 2.0X6MM

Facility

$978.20

Service Code	HCPCS C1713
Hospital Charge Code	270705879
Hospital Revenue Code	278
Min. Negotiated Rate	$146.73
Max. Negotiated Rate	$489.10
Rate for Payer: Aetna Commercial	$293.46
Rate for Payer: Aetna Medicare Advantage	$293.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.44
Rate for Payer: Cigna Commercial	$489.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.72
Rate for Payer: Qualcare PPO/HMO/WC	$146.73

HMMF LOCKSCREW AXS SD 2.0X8MM

Facility

$978.20

Service Code	HCPCS C1713
Hospital Charge Code	270705880
Hospital Revenue Code	278
Min. Negotiated Rate	$146.73
Max. Negotiated Rate	$236.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.72
Rate for Payer: Qualcare PPO/HMO/WC	$146.73

HMMF LOCKSCREW AXS SD 2.0X8MM

Facility

$978.20

Service Code	HCPCS C1713
Hospital Charge Code	270705880
Hospital Revenue Code	278
Min. Negotiated Rate	$146.73
Max. Negotiated Rate	$489.10
Rate for Payer: Aetna Commercial	$293.46
Rate for Payer: Aetna Medicare Advantage	$293.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.44
Rate for Payer: Cigna Commercial	$489.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.72
Rate for Payer: Qualcare PPO/HMO/WC	$146.73

Know your out-of-pocket cost for care.

All Charges