Heights University Hospital

All Charges

Charge

Type

Setting

Price

INF THERAPEUTIC 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96365
Hospital Charge Code	2300908
Hospital Revenue Code	260
Min. Negotiated Rate	$200.11
Max. Negotiated Rate	$200.11
Rate for Payer: Qualcare PPO/HMO/WC	$200.11

INF THERAPEUTIC 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96365
Hospital Charge Code	3401026
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Commercial	$840.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96365
Hospital Charge Code	93500019
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$400.23
Rate for Payer: Aetna Medicare Advantage	$400.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.19
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.43
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$200.11
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96365
Hospital Charge Code	2011452
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$400.23
Rate for Payer: Aetna Medicare Advantage	$400.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.19
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.43
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$200.11
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96365
Hospital Charge Code	8200515
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$400.23
Rate for Payer: Aetna Medicare Advantage	$400.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.19
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.43
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$200.11
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96365
Hospital Charge Code	100117
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Commercial	$840.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC 1ST HR

Facility

$1,334.09

Service Code	HCPCS 96365
Hospital Charge Code	1500108
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$400.23
Rate for Payer: Aetna Medicare Advantage	$400.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$340.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$340.19
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.43
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$200.11
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC 1ST HR

Facility

$2,800.00

Service Code	HCPCS 96365
Hospital Charge Code	73092055
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Commercial	$840.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC 1ST HR

Facility

$1,405.77

Service Code	HCPCS 96365
Hospital Charge Code	73050970
Hospital Revenue Code	260
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$421.73
Rate for Payer: Aetna Medicare Advantage	$421.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.47
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.75
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.87
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	74308240
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	3401028
Hospital Revenue Code	260
Min. Negotiated Rate	$13.87
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$99.56
Rate for Payer: Aetna Medicare Advantage	$99.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.63
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.14
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.78
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	1600531
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	2400616
Hospital Revenue Code	260
Min. Negotiated Rate	$13.87
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$99.56
Rate for Payer: Aetna Medicare Advantage	$99.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.63
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.14
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.78
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	100120
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	270329881
Hospital Revenue Code	260
Min. Negotiated Rate	$13.87
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$99.56
Rate for Payer: Aetna Medicare Advantage	$99.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.63
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.14
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.78
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	3401060
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	93500041
Hospital Revenue Code	260
Min. Negotiated Rate	$13.87
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$99.56
Rate for Payer: Aetna Medicare Advantage	$99.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.63
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.14
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.78
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	2011453
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	100118
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	100127
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$221.80

Service Code	HCPCS 96366
Hospital Charge Code	321096366
Hospital Revenue Code	260
Min. Negotiated Rate	$33.27
Max. Negotiated Rate	$33.27
Rate for Payer: Qualcare PPO/HMO/WC	$33.27

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	2301096
Hospital Revenue Code	260
Min. Negotiated Rate	$13.87
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$99.56
Rate for Payer: Aetna Medicare Advantage	$99.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.63
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.14
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.78
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	485096366
Hospital Revenue Code	260
Min. Negotiated Rate	$13.87
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$99.56
Rate for Payer: Aetna Medicare Advantage	$99.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.63
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.14
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.78
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	2400616
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	3401029
Hospital Revenue Code	260
Min. Negotiated Rate	$49.78
Max. Negotiated Rate	$49.78
Rate for Payer: Qualcare PPO/HMO/WC	$49.78

Know your out-of-pocket cost for care.

All Charges