Heights University Hospital

All Charges

Charge

Type

Setting

Price

IGA

Facility

$379.00

Service Code	HCPCS 82784
Hospital Charge Code	38479496
Hospital Revenue Code	301
Min. Negotiated Rate	$56.85
Max. Negotiated Rate	$56.85
Rate for Payer: Qualcare PPO/HMO/WC	$56.85

IGA

Facility

$379.00

Service Code	HCPCS 82784
Hospital Charge Code	38479496
Hospital Revenue Code	301
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.13
Rate for Payer: Aetna Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.08
Rate for Payer: Cigna Commercial	$9.30
Rate for Payer: Cigna Medicare Advantage	$4.65
Rate for Payer: Clover Medicare Advantage	$8.84
Rate for Payer: EmblemHealth Commercial	$27.90
Rate for Payer: Humana Medicare Advantage	$9.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.27
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.30
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.86
Rate for Payer: Wellcare Medicare Advantage	$9.30

IGA

Facility

$379.00

Service Code	HCPCS 82784
Hospital Charge Code	38479415
Hospital Revenue Code	301
Min. Negotiated Rate	$56.85
Max. Negotiated Rate	$56.85
Rate for Payer: Qualcare PPO/HMO/WC	$56.85

IGA FIBRONECTION

Facility

$187.25

Service Code	HCPCS 83516
Hospital Charge Code	3038089
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	$24.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.09
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

IGA FIBRONECTION

Facility

$187.25

Service Code	HCPCS 83516
Hospital Charge Code	3038089
Hospital Revenue Code	301
Min. Negotiated Rate	$28.09
Max. Negotiated Rate	$28.09
Rate for Payer: Qualcare PPO/HMO/WC	$28.09

IGA SUBCLASSES I

Facility

$1,008.00

Service Code	HCPCS 82787
Hospital Charge Code	3000368A
Hospital Revenue Code	301
Min. Negotiated Rate	$151.20
Max. Negotiated Rate	$151.20
Rate for Payer: Qualcare PPO/HMO/WC	$151.20

IGA SUBCLASSES I

Facility

$1,008.00

Service Code	HCPCS 82787
Hospital Charge Code	3000368A
Hospital Revenue Code	301
Min. Negotiated Rate	$4.01
Max. Negotiated Rate	$151.20
Rate for Payer: Aetna Commercial	$25.98
Rate for Payer: Aetna Medicare Advantage	$8.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.39
Rate for Payer: Cigna Commercial	$8.02
Rate for Payer: Cigna Medicare Advantage	$4.01
Rate for Payer: Clover Medicare Advantage	$7.62
Rate for Payer: EmblemHealth Commercial	$24.06
Rate for Payer: Humana Medicare Advantage	$8.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.04
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$151.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.02
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.50
Rate for Payer: Wellcare Medicare Advantage	$8.02

IGA SUBCLASSES II

Facility

$961.00

Service Code	HCPCS 83883
Hospital Charge Code	3000368B
Hospital Revenue Code	301
Min. Negotiated Rate	$144.15
Max. Negotiated Rate	$144.15
Rate for Payer: Qualcare PPO/HMO/WC	$144.15

IGA SUBCLASSES II

Facility

$961.00

Service Code	HCPCS 83883
Hospital Charge Code	3000368B
Hospital Revenue Code	301
Min. Negotiated Rate	$6.80
Max. Negotiated Rate	$165.64
Rate for Payer: Aetna Commercial	$44.06
Rate for Payer: Aetna Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.83
Rate for Payer: Cigna Commercial	$13.60
Rate for Payer: Cigna Medicare Advantage	$6.80
Rate for Payer: Clover Medicare Advantage	$12.92
Rate for Payer: EmblemHealth Commercial	$40.80
Rate for Payer: Humana Medicare Advantage	$14.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$144.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.42
Rate for Payer: Wellcare Medicare Advantage	$13.60

IGA SUBCLASSES III

Facility

$961.00

Service Code	HCPCS 83883
Hospital Charge Code	3000368C
Hospital Revenue Code	301
Min. Negotiated Rate	$144.15
Max. Negotiated Rate	$144.15
Rate for Payer: Qualcare PPO/HMO/WC	$144.15

IGA SUBCLASSES III

Facility

$961.00

Service Code	HCPCS 83883
Hospital Charge Code	3000368C
Hospital Revenue Code	301
Min. Negotiated Rate	$6.80
Max. Negotiated Rate	$165.64
Rate for Payer: Aetna Commercial	$44.06
Rate for Payer: Aetna Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.83
Rate for Payer: Cigna Commercial	$13.60
Rate for Payer: Cigna Medicare Advantage	$6.80
Rate for Payer: Clover Medicare Advantage	$12.92
Rate for Payer: EmblemHealth Commercial	$40.80
Rate for Payer: Humana Medicare Advantage	$14.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$144.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.42
Rate for Payer: Wellcare Medicare Advantage	$13.60

IGD

Facility

$390.00

Service Code	HCPCS 82784
Hospital Charge Code	38472027
Hospital Revenue Code	301
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.13
Rate for Payer: Aetna Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.08
Rate for Payer: Cigna Commercial	$9.30
Rate for Payer: Cigna Medicare Advantage	$4.65
Rate for Payer: Clover Medicare Advantage	$8.84
Rate for Payer: EmblemHealth Commercial	$27.90
Rate for Payer: Humana Medicare Advantage	$9.58
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	$9.30
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.86
Rate for Payer: Wellcare Medicare Advantage	$9.30

IGD

Facility

$390.00

Service Code	HCPCS 82784
Hospital Charge Code	38472027
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

IgE

Facility

$574.00

Service Code	HCPCS 82785
Hospital Charge Code	38472416
Hospital Revenue Code	301
Min. Negotiated Rate	$8.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$53.33
Rate for Payer: Aetna Medicare Advantage	$16.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.31
Rate for Payer: Cigna Commercial	$16.46
Rate for Payer: Cigna Medicare Advantage	$8.23
Rate for Payer: Clover Medicare Advantage	$15.64
Rate for Payer: EmblemHealth Commercial	$49.38
Rate for Payer: Humana Medicare Advantage	$16.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.46
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.45
Rate for Payer: Wellcare Medicare Advantage	$16.46

IgE

Facility

$574.00

Service Code	HCPCS 82785
Hospital Charge Code	38472416
Hospital Revenue Code	301
Min. Negotiated Rate	$86.10
Max. Negotiated Rate	$86.10
Rate for Payer: Qualcare PPO/HMO/WC	$86.10

IGE LATEX SPECIFIC

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3035000
Hospital Revenue Code	305
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.91
Rate for Payer: Aetna Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.13
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: Cigna Medicare Advantage	$2.61
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.53
Rate for Payer: Wellcare Medicare Advantage	$5.22

IGE LATEX SPECIFIC

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3035000
Hospital Revenue Code	305
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

IGE,SERUM

Facility

$113.20

Service Code	HCPCS 82785
Hospital Charge Code	39900083
Hospital Revenue Code	301
Min. Negotiated Rate	$16.98
Max. Negotiated Rate	$16.98
Rate for Payer: Qualcare PPO/HMO/WC	$16.98

IGE,SERUM

Facility

$113.20

Service Code	HCPCS 82785
Hospital Charge Code	39900083
Hospital Revenue Code	301
Min. Negotiated Rate	$8.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$53.33
Rate for Payer: Aetna Medicare Advantage	$16.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.31
Rate for Payer: Cigna Commercial	$16.46
Rate for Payer: Cigna Medicare Advantage	$8.23
Rate for Payer: Clover Medicare Advantage	$15.64
Rate for Payer: EmblemHealth Commercial	$49.38
Rate for Payer: Humana Medicare Advantage	$16.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.72
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.98
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.46
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.45
Rate for Payer: Wellcare Medicare Advantage	$16.46

IGF-1

Facility

$192.85

Service Code	HCPCS 84305
Hospital Charge Code	3009404
Hospital Revenue Code	301
Min. Negotiated Rate	$10.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$68.88
Rate for Payer: Aetna Medicare Advantage	$21.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.90
Rate for Payer: Cigna Commercial	$21.26
Rate for Payer: Cigna Medicare Advantage	$10.63
Rate for Payer: Clover Medicare Advantage	$20.20
Rate for Payer: EmblemHealth Commercial	$63.78
Rate for Payer: Humana Medicare Advantage	$21.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.93
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.26
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.54
Rate for Payer: Wellcare Medicare Advantage	$21.26

IGF-1

Facility

$192.85

Service Code	HCPCS 84305
Hospital Charge Code	3009404
Hospital Revenue Code	301
Min. Negotiated Rate	$28.93
Max. Negotiated Rate	$28.93
Rate for Payer: Qualcare PPO/HMO/WC	$28.93

IGF-1 ELECTROCHEMILUMINES

Facility

$390.00

Service Code	HCPCS 84305
Hospital Charge Code	39900134
Hospital Revenue Code	301
Min. Negotiated Rate	$10.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$68.88
Rate for Payer: Aetna Medicare Advantage	$21.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.90
Rate for Payer: Cigna Commercial	$21.26
Rate for Payer: Cigna Medicare Advantage	$10.63
Rate for Payer: Clover Medicare Advantage	$20.20
Rate for Payer: EmblemHealth Commercial	$63.78
Rate for Payer: Humana Medicare Advantage	$21.90
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	$21.26
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.54
Rate for Payer: Wellcare Medicare Advantage	$21.26

IGF-1 ELECTROCHEMILUMINES

Facility

$390.00

Service Code	HCPCS 84305
Hospital Charge Code	39900134
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

IGF-2

Facility

$585.17

Service Code	HCPCS 83519
Hospital Charge Code	3038115
Hospital Revenue Code	300
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$59.62
Rate for Payer: Aetna Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.42
Rate for Payer: Cigna Commercial	$18.40
Rate for Payer: Cigna Medicare Advantage	$9.20
Rate for Payer: Clover Medicare Advantage	$17.48
Rate for Payer: EmblemHealth Commercial	$55.20
Rate for Payer: Humana Medicare Advantage	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.78
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.40
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.50
Rate for Payer: Wellcare Medicare Advantage	$18.40

IGF-2

Facility

$585.17

Service Code	HCPCS 83519
Hospital Charge Code	3038115
Hospital Revenue Code	300
Min. Negotiated Rate	$87.78
Max. Negotiated Rate	$87.78
Rate for Payer: Qualcare PPO/HMO/WC	$87.78

Know your out-of-pocket cost for care.

All Charges