Heights University Hospital

All Charges

Charge

Type

Setting

Price

IMMUNOHISTO AB SLIDE EA ADD

Facility

$1,082.30

Service Code	HCPCS 88341
Hospital Charge Code	397080021
Hospital Revenue Code	310
Min. Negotiated Rate	$53.73
Max. Negotiated Rate	$324.69
Rate for Payer: Aetna Commercial	$324.69
Rate for Payer: Aetna Medicare Advantage	$324.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.99
Rate for Payer: Cigna Commercial	$107.45
Rate for Payer: Cigna Medicare Advantage	$53.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.34
Rate for Payer: UnitedHealthcare Commercial	$114.00

IMMUNOHISTO AB SLIDE EA ADD

Facility

$1,082.30

Service Code	HCPCS 88341
Hospital Charge Code	397061381
Hospital Revenue Code	310
Min. Negotiated Rate	$162.34
Max. Negotiated Rate	$162.34
Rate for Payer: Qualcare PPO/HMO/WC	$162.34

IMMUNOHISTO AB SLIDE EA ADD

Facility

$1,082.30

Service Code	HCPCS 88341
Hospital Charge Code	397061381
Hospital Revenue Code	310
Min. Negotiated Rate	$53.73
Max. Negotiated Rate	$324.69
Rate for Payer: Aetna Commercial	$324.69
Rate for Payer: Aetna Medicare Advantage	$324.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.99
Rate for Payer: Cigna Commercial	$107.45
Rate for Payer: Cigna Medicare Advantage	$53.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.34
Rate for Payer: UnitedHealthcare Commercial	$114.00

IMMUNOHISTO AB SLIDE EA ADD

Facility

$1,082.30

Service Code	HCPCS 88341
Hospital Charge Code	397080021
Hospital Revenue Code	310
Min. Negotiated Rate	$162.34
Max. Negotiated Rate	$162.34
Rate for Payer: Qualcare PPO/HMO/WC	$162.34

IMMUNOHISTO AB SLIDE EA ADD

Facility

$1,082.30

Service Code	HCPCS 88341
Hospital Charge Code	397061382
Hospital Revenue Code	310
Min. Negotiated Rate	$162.34
Max. Negotiated Rate	$162.34
Rate for Payer: Qualcare PPO/HMO/WC	$162.34

IMMUNOHISTO AB SLIDE EA ADD

Facility

$1,082.30

Service Code	HCPCS 88341
Hospital Charge Code	397061382
Hospital Revenue Code	310
Min. Negotiated Rate	$53.73
Max. Negotiated Rate	$324.69
Rate for Payer: Aetna Commercial	$324.69
Rate for Payer: Aetna Medicare Advantage	$324.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.99
Rate for Payer: Cigna Commercial	$107.45
Rate for Payer: Cigna Medicare Advantage	$53.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.34
Rate for Payer: UnitedHealthcare Commercial	$114.00

IMMUNOPEROXIDASE 1 BK,ANT 1ST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	397061050
Hospital Revenue Code	310
Min. Negotiated Rate	$62.80
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$324.69
Rate for Payer: Aetna Medicare Advantage	$324.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.99
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$62.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.34
Rate for Payer: UnitedHealthcare Commercial	$114.00

IMMUNOPEROXIDASE 1 BK,ANT 1ST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	397061050
Hospital Revenue Code	310
Min. Negotiated Rate	$162.34
Max. Negotiated Rate	$162.34
Rate for Payer: Qualcare PPO/HMO/WC	$162.34

IMMUNOPEROXIDASE STAIN 1ST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	38474067
Hospital Revenue Code	310
Min. Negotiated Rate	$62.80
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$324.69
Rate for Payer: Aetna Medicare Advantage	$324.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.99
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$62.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.34
Rate for Payer: UnitedHealthcare Commercial	$114.00

IMMUNOPEROXIDASE STAIN 1ST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	38474067
Hospital Revenue Code	310
Min. Negotiated Rate	$162.34
Max. Negotiated Rate	$162.34
Rate for Payer: Qualcare PPO/HMO/WC	$162.34

IMMUNOSUPPRESSIVE ACIDIC PROT

Facility

$224.00

Service Code	HCPCS 84199
Hospital Charge Code	3007549
Hospital Revenue Code	301
Min. Negotiated Rate	$29.12
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$67.20
Rate for Payer: Aetna Medicare Advantage	$67.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.12
Rate for Payer: Cigna Commercial	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.60
Rate for Payer: UnitedHealthcare Commercial	$114.00

IMMUNOSUPPRESSIVE ACIDIC PROT

Facility

$224.00

Service Code	HCPCS 84199
Hospital Charge Code	3007549
Hospital Revenue Code	301
Min. Negotiated Rate	$33.60
Max. Negotiated Rate	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$33.60

IMMUNOTYPING BONE MARROW 1ST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	3005105
Hospital Revenue Code	310
Min. Negotiated Rate	$62.80
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$324.69
Rate for Payer: Aetna Medicare Advantage	$324.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.99
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$62.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.34
Rate for Payer: UnitedHealthcare Commercial	$114.00

IMMUNOTYPING BONE MARROW 1ST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	3005105
Hospital Revenue Code	310
Min. Negotiated Rate	$162.34
Max. Negotiated Rate	$162.34
Rate for Payer: Qualcare PPO/HMO/WC	$162.34

IMMU OTHER-INFECTIOUS AB OR AG

Facility

$77.95

Service Code	HCPCS 83516
Hospital Charge Code	38478112
Hospital Revenue Code	301
Min. Negotiated Rate	$11.69
Max. Negotiated Rate	$11.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.69

IMMU OTHER-INFECTIOUS AB OR AG

Facility

$77.95

Service Code	HCPCS 83516
Hospital Charge Code	38478112
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	$10.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.69
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

IMN INST SYSTEM

Facility

$1,757.80

Hospital Charge Code	270703691
Hospital Revenue Code	272
Min. Negotiated Rate	$263.67
Max. Negotiated Rate	$263.67
Rate for Payer: Qualcare PPO/HMO/WC	$263.67

IMN INST SYSTEM

Facility

$1,757.80

Hospital Charge Code	270703691
Hospital Revenue Code	272
Min. Negotiated Rate	$228.51
Max. Negotiated Rate	$878.90
Rate for Payer: Aetna Commercial	$527.34
Rate for Payer: Aetna Medicare Advantage	$527.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.24
Rate for Payer: Cigna Commercial	$878.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.51
Rate for Payer: Oxford Commercial	$878.90
Rate for Payer: Qualcare PPO/HMO/WC	$263.67
Rate for Payer: UnitedHealthcare Commercial	$878.90

IMN SCREW 5X52.5MM

Facility

$1,621.95

Service Code	HCPCS C1713
Hospital Charge Code	270705683
Hospital Revenue Code	278
Min. Negotiated Rate	$243.29
Max. Negotiated Rate	$392.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$324.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.51
Rate for Payer: Qualcare PPO/HMO/WC	$243.29

IMN SCREW 5X52.5MM

Facility

$1,621.95

Service Code	HCPCS C1713
Hospital Charge Code	270705683
Hospital Revenue Code	278
Min. Negotiated Rate	$243.29
Max. Negotiated Rate	$810.98
Rate for Payer: Aetna Commercial	$486.58
Rate for Payer: Aetna Medicare Advantage	$486.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$413.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$413.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$324.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$413.60
Rate for Payer: Cigna Commercial	$810.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.51
Rate for Payer: Qualcare PPO/HMO/WC	$243.29

IMODIUM/1MG/5ML

Facility

$23.00

Hospital Charge Code	60633163
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

IMODIUM/1MG/5ML

Facility

$23.00

Hospital Charge Code	60633163
Hospital Revenue Code	250
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$6.90
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Oxford Commercial	$11.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$11.50

IMODIUM/1MG/5ML

Facility

$5.00

Hospital Charge Code	60633162
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

IMODIUM/1MG/5ML

Facility

$5.00

Hospital Charge Code	60633162
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

IMODIUM/2MG/CAP

Facility

$7.00

Hospital Charge Code	60633161
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.10
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.91
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$3.50

Know your out-of-pocket cost for care.

All Charges