Heights University Hospital

All Charges

Charge

Type

Setting

Price

INJECTION IA NON-CHEMO

Facility

$250.00

Service Code	HCPCS 96373
Hospital Charge Code	3400257
Hospital Revenue Code	260
Min. Negotiated Rate	$12.12
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.50
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.50
Rate for Payer: UnitedHealthcare Commercial	$802.00

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	93500049
Hospital Revenue Code	260
Min. Negotiated Rate	$13.49
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	$13.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$171.47
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

INJECTION IM/SUBQ

Facility

$345.05

Service Code	HCPCS 96372
Hospital Charge Code	84310135
Hospital Revenue Code	510
Min. Negotiated Rate	$51.76
Max. Negotiated Rate	$51.76
Rate for Payer: Qualcare PPO/HMO/WC	$51.76

INJECTION IM/SUBQ

Facility

$554.81

Service Code	HCPCS 96372
Hospital Charge Code	5700247
Hospital Revenue Code	450
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$171.47
Rate for Payer: Aetna Commercial	$166.44
Rate for Payer: Aetna Medicare Advantage	$166.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.48
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.13
Rate for Payer: Qualcare PPO/HMO/WC	$83.22

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	73190105
Hospital Revenue Code	260
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$840.00
Rate for Payer: Cigna Commercial	$171.47
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	$13.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
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

INJECTION IM/SUBQ

Facility

$554.81

Service Code	HCPCS 96372
Hospital Charge Code	5700247
Hospital Revenue Code	450
Min. Negotiated Rate	$83.22
Max. Negotiated Rate	$83.22
Rate for Payer: Qualcare PPO/HMO/WC	$83.22

INJECTION IM/SUBQ

Facility

$320.48

Service Code	HCPCS 96372
Hospital Charge Code	2400611
Hospital Revenue Code	260
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$96.14
Rate for Payer: Aetna Medicare Advantage	$96.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.72
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.66
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.07
Rate for Payer: UnitedHealthcare Commercial	$802.00

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	1600505
Hospital Revenue Code	260
Min. Negotiated Rate	$13.49
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	$13.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$171.47
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

INJECTION IM/SUBQ

Facility

$343.00

Service Code	HCPCS 96372
Hospital Charge Code	3400256M
Hospital Revenue Code	260
Min. Negotiated Rate	$51.45
Max. Negotiated Rate	$51.45
Rate for Payer: Qualcare PPO/HMO/WC	$51.45

INJECTION IM/SUBQ

Facility

$320.48

Service Code	HCPCS 96372
Hospital Charge Code	1500103
Hospital Revenue Code	260
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$96.14
Rate for Payer: Aetna Medicare Advantage	$96.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.72
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.66
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.07
Rate for Payer: UnitedHealthcare Commercial	$802.00

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	4818524
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	411096372
Hospital Revenue Code	260
Min. Negotiated Rate	$13.49
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	$13.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$171.47
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

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	2301091
Hospital Revenue Code	260
Min. Negotiated Rate	$13.49
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	$13.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$171.47
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

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	4832524
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INJECTION IM/SUBQ

Facility

$343.00

Service Code	HCPCS 96372
Hospital Charge Code	73050935
Hospital Revenue Code	260
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$102.90
Rate for Payer: Aetna Medicare Advantage	$102.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.47
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.59
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.45
Rate for Payer: UnitedHealthcare Commercial	$802.00

INJECTION IM/SUBQ

Facility

$320.48

Service Code	HCPCS 96372
Hospital Charge Code	87504135
Hospital Revenue Code	260
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$96.14
Rate for Payer: Aetna Medicare Advantage	$96.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.72
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.66
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.07
Rate for Payer: UnitedHealthcare Commercial	$802.00

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	4818524
Hospital Revenue Code	260
Min. Negotiated Rate	$13.49
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	$13.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$171.47
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

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	8200511
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INJECTION IM/SUBQ

Facility

$345.05

Service Code	HCPCS 96372
Hospital Charge Code	84206300
Hospital Revenue Code	510
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$171.47
Rate for Payer: Aetna Commercial	$103.52
Rate for Payer: Aetna Medicare Advantage	$103.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.99
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.86
Rate for Payer: Qualcare PPO/HMO/WC	$51.76

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	3400256
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

INJECTION IM/SUBQ

Facility

$345.05

Service Code	HCPCS 96372
Hospital Charge Code	84206300
Hospital Revenue Code	510
Min. Negotiated Rate	$51.76
Max. Negotiated Rate	$51.76
Rate for Payer: Qualcare PPO/HMO/WC	$51.76

INJECTION IM/SUBQ

Facility

$320.48

Service Code	HCPCS 96372
Hospital Charge Code	2250410
Hospital Revenue Code	260
Min. Negotiated Rate	$48.07
Max. Negotiated Rate	$48.07
Rate for Payer: Qualcare PPO/HMO/WC	$48.07

INJECTION IM/SUBQ

Facility

$320.48

Service Code	HCPCS 96372
Hospital Charge Code	5100778
Hospital Revenue Code	260
Min. Negotiated Rate	$48.07
Max. Negotiated Rate	$48.07
Rate for Payer: Qualcare PPO/HMO/WC	$48.07

INJECTION IM/SUBQ

Facility

$206.86

Service Code	HCPCS 96372
Hospital Charge Code	36540003
Hospital Revenue Code	260
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$62.06
Rate for Payer: Aetna Medicare Advantage	$62.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.75
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.89
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.03
Rate for Payer: UnitedHealthcare Commercial	$802.00

INJECTION IM/SUBQ

Facility

$2,800.00

Service Code	HCPCS 96372
Hospital Charge Code	93500049
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

Know your out-of-pocket cost for care.

All Charges