Heights University Hospital

All Charges

Charge

Type

Setting

Price

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	73237022
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	100121
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	411096366
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	100121
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	1001176
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	8200516
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	100126
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	5700261
Hospital Revenue Code	260
Min. Negotiated Rate	$13.87
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$66.54
Rate for Payer: Aetna Medicare Advantage	$66.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.56
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	$56.56
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.83
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.27
Rate for Payer: UnitedHealthcare Commercial	$802.00

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	100122
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	270339104
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	5100783
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	2250415
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	3401030
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	100122
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	3401027
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	2250415
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	$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	$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	4501036
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	2301096
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	100119
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	73190097
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	73190097
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

$598.74

Service Code	HCPCS 96366
Hospital Charge Code	5700376
Hospital Revenue Code	450
Min. Negotiated Rate	$89.81
Max. Negotiated Rate	$89.81
Rate for Payer: Qualcare PPO/HMO/WC	$89.81

INF THERAPEUTIC EA ADDL HR

Facility

$331.87

Service Code	HCPCS 96366
Hospital Charge Code	73050920
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