Heights University Hospital

All Charges

Charge

Type

Setting

Price

IMMUNE COMPETENCE

Facility

$414.45

Hospital Charge Code	3006673
Hospital Revenue Code	302
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IMMUNE COMPETENCE

Facility

$414.45

Hospital Charge Code	3006673
Hospital Revenue Code	302
Min. Negotiated Rate	$53.88
Max. Negotiated Rate	$207.22
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.68
Rate for Payer: Cigna Commercial	$207.22
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

IMMUNE COMPETENCE PANEL A

Facility

$105.65

Service Code	HCPCS 86332
Hospital Charge Code	3006673A
Hospital Revenue Code	302
Min. Negotiated Rate	$12.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.96
Rate for Payer: Aetna Medicare Advantage	$24.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.29
Rate for Payer: Cigna Commercial	$24.37
Rate for Payer: Cigna Medicare Advantage	$12.19
Rate for Payer: Clover Medicare Advantage	$23.15
Rate for Payer: EmblemHealth Commercial	$73.11
Rate for Payer: Humana Medicare Advantage	$25.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.83
Rate for Payer: Wellcare Medicare Advantage	$24.37

IMMUNE COMPETENCE PANEL A

Facility

$105.65

Service Code	HCPCS 86332
Hospital Charge Code	3006673A
Hospital Revenue Code	302
Min. Negotiated Rate	$15.85
Max. Negotiated Rate	$15.85
Rate for Payer: Qualcare PPO/HMO/WC	$15.85

IMMUNE COMPETENCE PANEL B

Facility

$105.65

Service Code	HCPCS 86332
Hospital Charge Code	3006673B
Hospital Revenue Code	302
Min. Negotiated Rate	$12.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.96
Rate for Payer: Aetna Medicare Advantage	$24.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.29
Rate for Payer: Cigna Commercial	$24.37
Rate for Payer: Cigna Medicare Advantage	$12.19
Rate for Payer: Clover Medicare Advantage	$23.15
Rate for Payer: EmblemHealth Commercial	$73.11
Rate for Payer: Humana Medicare Advantage	$25.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.83
Rate for Payer: Wellcare Medicare Advantage	$24.37

IMMUNE COMPETENCE PANEL B

Facility

$105.65

Service Code	HCPCS 86332
Hospital Charge Code	3006673B
Hospital Revenue Code	302
Min. Negotiated Rate	$15.85
Max. Negotiated Rate	$15.85
Rate for Payer: Qualcare PPO/HMO/WC	$15.85

IMMUNE COMPLEX DETECTION(RALI

Facility

$348.00

Service Code	HCPCS 86332
Hospital Charge Code	38476216
Hospital Revenue Code	302
Min. Negotiated Rate	$12.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.96
Rate for Payer: Aetna Medicare Advantage	$24.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.29
Rate for Payer: Cigna Commercial	$24.37
Rate for Payer: Cigna Medicare Advantage	$12.19
Rate for Payer: Clover Medicare Advantage	$23.15
Rate for Payer: EmblemHealth Commercial	$73.11
Rate for Payer: Humana Medicare Advantage	$25.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.24
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.83
Rate for Payer: Wellcare Medicare Advantage	$24.37

IMMUNE COMPLEX DETECTION(RALI

Facility

$348.00

Service Code	HCPCS 86332
Hospital Charge Code	38476216
Hospital Revenue Code	302
Min. Negotiated Rate	$52.20
Max. Negotiated Rate	$52.20
Rate for Payer: Qualcare PPO/HMO/WC	$52.20

IMMUNE COMPLEX (RAJI CELL)

Facility

$105.65

Service Code	HCPCS 86332
Hospital Charge Code	3008307
Hospital Revenue Code	302
Min. Negotiated Rate	$12.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.96
Rate for Payer: Aetna Medicare Advantage	$24.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.29
Rate for Payer: Cigna Commercial	$24.37
Rate for Payer: Cigna Medicare Advantage	$12.19
Rate for Payer: Clover Medicare Advantage	$23.15
Rate for Payer: EmblemHealth Commercial	$73.11
Rate for Payer: Humana Medicare Advantage	$25.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.83
Rate for Payer: Wellcare Medicare Advantage	$24.37

IMMUNE COMPLEX (RAJI CELL)

Facility

$105.65

Service Code	HCPCS 86332
Hospital Charge Code	3008307
Hospital Revenue Code	302
Min. Negotiated Rate	$15.85
Max. Negotiated Rate	$15.85
Rate for Payer: Qualcare PPO/HMO/WC	$15.85

IMMUNE GLOBULIN 10% 100ML

Facility

$4,783.80

Service Code	HCPCS J1568
Hospital Charge Code	6063943334
Hospital Revenue Code	636
Min. Negotiated Rate	$717.57
Max. Negotiated Rate	$1,157.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,157.68
Rate for Payer: Qualcare PPO/HMO/WC	$717.57

IMMUNE GLOBULIN 10% 100ML

Facility

$4,783.80

Service Code	HCPCS J1568
Hospital Charge Code	6063943334
Hospital Revenue Code	636
Min. Negotiated Rate	$717.57
Max. Negotiated Rate	$1,435.14
Rate for Payer: Aetna Commercial	$1,435.14
Rate for Payer: Aetna Medicare Advantage	$1,435.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,219.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,219.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,219.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,157.68
Rate for Payer: Qualcare PPO/HMO/WC	$717.57

IMMUNE GLOBULIN 10% 50ML

Facility

$2,391.90

Service Code	HCPCS J1568
Hospital Charge Code	6063943335
Hospital Revenue Code	636
Min. Negotiated Rate	$358.79
Max. Negotiated Rate	$578.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.84
Rate for Payer: Qualcare PPO/HMO/WC	$358.79

IMMUNE GLOBULIN 10% 50ML

Facility

$2,391.90

Service Code	HCPCS J1568
Hospital Charge Code	6063943335
Hospital Revenue Code	636
Min. Negotiated Rate	$358.79
Max. Negotiated Rate	$717.57
Rate for Payer: Aetna Commercial	$717.57
Rate for Payer: Aetna Medicare Advantage	$717.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$609.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$609.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$609.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$578.84
Rate for Payer: Qualcare PPO/HMO/WC	$358.79

IMMUNE GLOBULIN/10 G

Facility

$310.00

Hospital Charge Code	60634826
Hospital Revenue Code	636
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$75.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

IMMUNE GLOBULIN/10 G

Facility

$310.00

Hospital Charge Code	60634826
Hospital Revenue Code	636
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$93.00
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

IMMUNE GLOBULIN 1GM

Facility

$378.00

Hospital Charge Code	60635367
Hospital Revenue Code	636
Min. Negotiated Rate	$56.70
Max. Negotiated Rate	$91.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.48
Rate for Payer: Qualcare PPO/HMO/WC	$56.70

IMMUNE GLOBULIN 1GM

Facility

$378.00

Hospital Charge Code	60635367
Hospital Revenue Code	636
Min. Negotiated Rate	$56.70
Max. Negotiated Rate	$189.00
Rate for Payer: Aetna Commercial	$113.40
Rate for Payer: Aetna Medicare Advantage	$113.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.39
Rate for Payer: Cigna Commercial	$189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.48
Rate for Payer: Qualcare PPO/HMO/WC	$56.70

IMMUNE GLOBULIN/2.5GM

Facility

$1,032.00

Hospital Charge Code	60634512
Hospital Revenue Code	636
Min. Negotiated Rate	$154.80
Max. Negotiated Rate	$516.00
Rate for Payer: Aetna Commercial	$309.60
Rate for Payer: Aetna Medicare Advantage	$309.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.16
Rate for Payer: Cigna Commercial	$516.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.74
Rate for Payer: Qualcare PPO/HMO/WC	$154.80

IMMUNE GLOBULIN/2.5GM

Facility

$1,032.00

Hospital Charge Code	60634512
Hospital Revenue Code	636
Min. Negotiated Rate	$154.80
Max. Negotiated Rate	$249.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$249.74
Rate for Payer: Qualcare PPO/HMO/WC	$154.80

IMMUNE GLOBULIN 2ML 1M

Facility

$112.00

Hospital Charge Code	60629094
Hospital Revenue Code	636
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$27.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.10
Rate for Payer: Qualcare PPO/HMO/WC	$16.80

IMMUNE GLOBULIN 2ML 1M

Facility

$112.00

Hospital Charge Code	60629094
Hospital Revenue Code	636
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$56.00
Rate for Payer: Aetna Commercial	$33.60
Rate for Payer: Aetna Medicare Advantage	$33.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.56
Rate for Payer: Cigna Commercial	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.10
Rate for Payer: Qualcare PPO/HMO/WC	$16.80

IMMUNE GLOBULIN/5GM

Facility

$1,892.00

Hospital Charge Code	60634513
Hospital Revenue Code	636
Min. Negotiated Rate	$283.80
Max. Negotiated Rate	$457.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.86
Rate for Payer: Qualcare PPO/HMO/WC	$283.80

IMMUNE GLOBULIN/5GM

Facility

$1,892.00

Hospital Charge Code	60634513
Hospital Revenue Code	636
Min. Negotiated Rate	$283.80
Max. Negotiated Rate	$946.00
Rate for Payer: Aetna Commercial	$567.60
Rate for Payer: Aetna Medicare Advantage	$567.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$482.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$482.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$482.46
Rate for Payer: Cigna Commercial	$946.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$457.86
Rate for Payer: Qualcare PPO/HMO/WC	$283.80

IMMUNE GLOBULIN INJ 10ML

Facility

$22.00

Hospital Charge Code	6002620
Hospital Revenue Code	259
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$11.00
Rate for Payer: Aetna Commercial	$6.60
Rate for Payer: Aetna Medicare Advantage	$6.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.61
Rate for Payer: Cigna Commercial	$11.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.86
Rate for Payer: Oxford Commercial	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$11.00

Know your out-of-pocket cost for care.

All Charges