Heights University Hospital

All Charges

Charge

Type

Setting

Price

HOMATROPINE 5% OPHTH/5ML

Facility

$60.00

Hospital Charge Code	60633095
Hospital Revenue Code	250
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$18.00
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$30.00

HOMATROPINE 5% OPHTH SOLN

Facility

$168.30

Hospital Charge Code	60628066
Hospital Revenue Code	250
Min. Negotiated Rate	$21.88
Max. Negotiated Rate	$84.15
Rate for Payer: Aetna Commercial	$50.49
Rate for Payer: Aetna Medicare Advantage	$50.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.92
Rate for Payer: Cigna Commercial	$84.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.88
Rate for Payer: Oxford Commercial	$84.15
Rate for Payer: Qualcare PPO/HMO/WC	$25.25
Rate for Payer: UnitedHealthcare Commercial	$84.15

HOMATROPINE 5% OPHTH SOLN

Facility

$168.30

Hospital Charge Code	60628066
Hospital Revenue Code	250
Min. Negotiated Rate	$25.25
Max. Negotiated Rate	$25.25
Rate for Payer: Qualcare PPO/HMO/WC	$25.25

HOMATROPINE HBR 2% OPHTH

Facility

$4.00

Hospital Charge Code	60633093
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

HOMATROPINE HBR 2% OPHTH

Facility

$4.00

Hospital Charge Code	60633093
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

HOMATROPINE HBR SOL OPH 2%

Facility

$61.45

Hospital Charge Code	6002786
Hospital Revenue Code	251
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$9.22
Rate for Payer: Qualcare PPO/HMO/WC	$9.22

HOMATROPINE HBR SOL OPH 2%

Facility

$61.45

Hospital Charge Code	6002786
Hospital Revenue Code	251
Min. Negotiated Rate	$7.99
Max. Negotiated Rate	$30.73
Rate for Payer: Aetna Commercial	$18.43
Rate for Payer: Aetna Medicare Advantage	$18.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.67
Rate for Payer: Cigna Commercial	$30.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.99
Rate for Payer: Oxford Commercial	$30.73
Rate for Payer: Qualcare PPO/HMO/WC	$9.22
Rate for Payer: UnitedHealthcare Commercial	$30.73

HOMATROPINE HBR SOL OPH 5%

Facility

$70.40

Hospital Charge Code	6002794
Hospital Revenue Code	251
Min. Negotiated Rate	$10.56
Max. Negotiated Rate	$10.56
Rate for Payer: Qualcare PPO/HMO/WC	$10.56

HOMATROPINE HBR SOL OPH 5%

Facility

$70.40

Hospital Charge Code	6002794
Hospital Revenue Code	251
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$35.20
Rate for Payer: Aetna Commercial	$21.12
Rate for Payer: Aetna Medicare Advantage	$21.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.95
Rate for Payer: Cigna Commercial	$35.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.15
Rate for Payer: Oxford Commercial	$35.20
Rate for Payer: Qualcare PPO/HMO/WC	$10.56
Rate for Payer: UnitedHealthcare Commercial	$35.20

HOMATROPINE SOL OPH 2%/5ML

Facility

$36.60

Hospital Charge Code	6062789
Hospital Revenue Code	251
Min. Negotiated Rate	$4.76
Max. Negotiated Rate	$18.30
Rate for Payer: Aetna Commercial	$10.98
Rate for Payer: Aetna Medicare Advantage	$10.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.33
Rate for Payer: Cigna Commercial	$18.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.76
Rate for Payer: Oxford Commercial	$18.30
Rate for Payer: Qualcare PPO/HMO/WC	$5.49
Rate for Payer: UnitedHealthcare Commercial	$18.30

HOMATROPINE SOL OPH 2%/5ML

Facility

$36.60

Hospital Charge Code	6062789
Hospital Revenue Code	251
Min. Negotiated Rate	$5.49
Max. Negotiated Rate	$5.49
Rate for Payer: Qualcare PPO/HMO/WC	$5.49

HOME SLEEP TEST/TYPE 3 PORATAB

Facility

$30,000.00

Service Code	HCPCS G0399
Hospital Charge Code	90000055
Hospital Revenue Code	920
Min. Negotiated Rate	$514.20
Max. Negotiated Rate	$9,000.00
Rate for Payer: Aetna Commercial	$9,000.00
Rate for Payer: Aetna Medicare Advantage	$9,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,650.00
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,900.00
Rate for Payer: Oxford Commercial	$7,719.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00
Rate for Payer: UnitedHealthcare Commercial	$8,761.00

HOME SLEEP TEST/TYPE 3 PORATAB

Facility

$30,000.00

Service Code	HCPCS G0399
Hospital Charge Code	90000055
Hospital Revenue Code	920
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$4,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

HOMOCYSTEINE

Facility

$1,243.00

Service Code	HCPCS 82131
Hospital Charge Code	38473072
Hospital Revenue Code	301
Min. Negotiated Rate	$186.45
Max. Negotiated Rate	$186.45
Rate for Payer: Qualcare PPO/HMO/WC	$186.45

HOMOCYSTEINE

Facility

$986.00

Service Code	HCPCS 82131
Hospital Charge Code	38472013
Hospital Revenue Code	301
Min. Negotiated Rate	$147.90
Max. Negotiated Rate	$147.90
Rate for Payer: Qualcare PPO/HMO/WC	$147.90

HOMOCYSTEINE

Facility

$1,243.00

Service Code	HCPCS 82131
Hospital Charge Code	38473072
Hospital Revenue Code	301
Min. Negotiated Rate	$11.49
Max. Negotiated Rate	$186.45
Rate for Payer: Aetna Commercial	$74.46
Rate for Payer: Aetna Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.20
Rate for Payer: Cigna Commercial	$22.98
Rate for Payer: Cigna Medicare Advantage	$11.49
Rate for Payer: Clover Medicare Advantage	$21.83
Rate for Payer: EmblemHealth Commercial	$68.94
Rate for Payer: Humana Medicare Advantage	$23.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.59
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$186.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.36
Rate for Payer: Wellcare Medicare Advantage	$22.98

HOMOCYSTEINE

Facility

$986.00

Service Code	HCPCS 82131
Hospital Charge Code	38472013
Hospital Revenue Code	301
Min. Negotiated Rate	$11.49
Max. Negotiated Rate	$147.90
Rate for Payer: Aetna Commercial	$74.46
Rate for Payer: Aetna Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.20
Rate for Payer: Cigna Commercial	$22.98
Rate for Payer: Cigna Medicare Advantage	$11.49
Rate for Payer: Clover Medicare Advantage	$21.83
Rate for Payer: EmblemHealth Commercial	$68.94
Rate for Payer: Humana Medicare Advantage	$23.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.18
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.36
Rate for Payer: Wellcare Medicare Advantage	$22.98

HOMOCYSTEINE,CARD

Facility

$1,243.00

Service Code	HCPCS 82131
Hospital Charge Code	38479100
Hospital Revenue Code	301
Min. Negotiated Rate	$186.45
Max. Negotiated Rate	$186.45
Rate for Payer: Qualcare PPO/HMO/WC	$186.45

HOMOCYSTEINE,CARD

Facility

$1,243.00

Service Code	HCPCS 82131
Hospital Charge Code	38479100
Hospital Revenue Code	301
Min. Negotiated Rate	$11.49
Max. Negotiated Rate	$186.45
Rate for Payer: Aetna Commercial	$74.46
Rate for Payer: Aetna Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.20
Rate for Payer: Cigna Commercial	$22.98
Rate for Payer: Cigna Medicare Advantage	$11.49
Rate for Payer: Clover Medicare Advantage	$21.83
Rate for Payer: EmblemHealth Commercial	$68.94
Rate for Payer: Humana Medicare Advantage	$23.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.59
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$186.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.36
Rate for Payer: Wellcare Medicare Advantage	$22.98

HOMOCYSTEINE (CARDIO),FPI

Facility

$390.00

Service Code	HCPCS 83090
Hospital Charge Code	39990005EX
Hospital Revenue Code	301
Min. Negotiated Rate	$8.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.06
Rate for Payer: Aetna Medicare Advantage	$17.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.66
Rate for Payer: Cigna Commercial	$17.92
Rate for Payer: Cigna Medicare Advantage	$8.96
Rate for Payer: Clover Medicare Advantage	$17.02
Rate for Payer: EmblemHealth Commercial	$53.76
Rate for Payer: Humana Medicare Advantage	$18.46
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	$17.92
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.00
Rate for Payer: Wellcare Medicare Advantage	$17.92

HOMOCYSTEINE (CARDIO),FPI

Facility

$390.00

Service Code	HCPCS 83090
Hospital Charge Code	39990005EX
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HOMOCYSTEINE (CARDIO),FPI I

Facility

$115.90

Service Code	HCPCS 82131
Hospital Charge Code	39990005A
Hospital Revenue Code	301
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$17.39
Rate for Payer: Qualcare PPO/HMO/WC	$17.39

HOMOCYSTEINE (CARDIO),FPI I

Facility

$115.90

Service Code	HCPCS 82131
Hospital Charge Code	39990005A
Hospital Revenue Code	301
Min. Negotiated Rate	$11.49
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$74.46
Rate for Payer: Aetna Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.20
Rate for Payer: Cigna Commercial	$22.98
Rate for Payer: Cigna Medicare Advantage	$11.49
Rate for Payer: Clover Medicare Advantage	$21.83
Rate for Payer: EmblemHealth Commercial	$68.94
Rate for Payer: Humana Medicare Advantage	$23.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.39
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24.36
Rate for Payer: Wellcare Medicare Advantage	$22.98

HOMOCYSTEINE (CARDIO),FPI II

Facility

$115.95

Service Code	HCPCS 83090
Hospital Charge Code	39990005B
Hospital Revenue Code	301
Min. Negotiated Rate	$8.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.06
Rate for Payer: Aetna Medicare Advantage	$17.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.66
Rate for Payer: Cigna Commercial	$17.92
Rate for Payer: Cigna Medicare Advantage	$8.96
Rate for Payer: Clover Medicare Advantage	$17.02
Rate for Payer: EmblemHealth Commercial	$53.76
Rate for Payer: Humana Medicare Advantage	$18.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.39
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.92
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.00
Rate for Payer: Wellcare Medicare Advantage	$17.92

HOMOCYSTEINE (CARDIO),FPI II

Facility

$115.95

Service Code	HCPCS 83090
Hospital Charge Code	39990005B
Hospital Revenue Code	301
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$17.39
Rate for Payer: Qualcare PPO/HMO/WC	$17.39

Know your out-of-pocket cost for care.

All Charges