Heights University Hospital

All Charges

Charge

Type

Setting

Price

ANTIB;LYMPHOCYTC CHORIOMENINGI

Facility

$91.00

Service Code	HCPCS 86727
Hospital Charge Code	38477108
Hospital Revenue Code	302
Min. Negotiated Rate	$6.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.70
Rate for Payer: Aetna Medicare Advantage	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.16
Rate for Payer: Cigna Commercial	$12.87
Rate for Payer: Cigna Medicare Advantage	$6.43
Rate for Payer: Clover Medicare Advantage	$12.23
Rate for Payer: EmblemHealth Commercial	$38.61
Rate for Payer: Humana Medicare Advantage	$13.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.87
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.64
Rate for Payer: Wellcare Medicare Advantage	$12.87

ANTIBODY,ACTINOMYCES

Facility

$72.00

Service Code	HCPCS 86602
Hospital Charge Code	38477066
Hospital Revenue Code	302
Min. Negotiated Rate	$5.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$32.98
Rate for Payer: Aetna Medicare Advantage	$10.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.30
Rate for Payer: Cigna Commercial	$10.18
Rate for Payer: Cigna Medicare Advantage	$5.09
Rate for Payer: Clover Medicare Advantage	$9.67
Rate for Payer: EmblemHealth Commercial	$30.54
Rate for Payer: Humana Medicare Advantage	$10.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.79
Rate for Payer: Wellcare Medicare Advantage	$10.18

ANTIBODY,ACTINOMYCES

Facility

$72.00

Service Code	HCPCS 86602
Hospital Charge Code	38477066
Hospital Revenue Code	302
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

ANTIBODY AUTOABSORPTION, COLD

Facility

$80.00

Hospital Charge Code	3100179
Hospital Revenue Code	302
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

ANTIBODY AUTOABSORPTION, COLD

Facility

$80.00

Hospital Charge Code	3100179
Hospital Revenue Code	302
Min. Negotiated Rate	$10.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$24.00
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Commercial	$114.00

ANTIBODY,BACTERIUM,NOT SPEC (1

Facility

$91.00

Service Code	HCPCS 86609
Hospital Charge Code	38476264
Hospital Revenue Code	302
Min. Negotiated Rate	$6.44
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.73
Rate for Payer: Aetna Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.19
Rate for Payer: Cigna Commercial	$12.88
Rate for Payer: Cigna Medicare Advantage	$6.44
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.65
Rate for Payer: Wellcare Medicare Advantage	$12.88

ANTIBODY,BACTERIUM,NOT SPEC (1

Facility

$91.00

Service Code	HCPCS 86609
Hospital Charge Code	38476264
Hospital Revenue Code	302
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

ANTIBODY,BACTERIUM,NOT SPEC(2)

Facility

$91.00

Service Code	HCPCS 86609
Hospital Charge Code	38476265
Hospital Revenue Code	302
Min. Negotiated Rate	$6.44
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.73
Rate for Payer: Aetna Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.19
Rate for Payer: Cigna Commercial	$12.88
Rate for Payer: Cigna Medicare Advantage	$6.44
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.65
Rate for Payer: Wellcare Medicare Advantage	$12.88

ANTIBODY,BACTERIUM,NOT SPEC(2)

Facility

$91.00

Service Code	HCPCS 86609
Hospital Charge Code	38476265
Hospital Revenue Code	302
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

ANTIBODY, BARTONELLA

Facility

$72.00

Service Code	HCPCS 86611
Hospital Charge Code	38476307
Hospital Revenue Code	302
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

ANTIBODY, BARTONELLA

Facility

$72.00

Service Code	HCPCS 86611
Hospital Charge Code	38476307
Hospital Revenue Code	302
Min. Negotiated Rate	$5.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$32.98
Rate for Payer: Aetna Medicare Advantage	$10.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.30
Rate for Payer: Cigna Commercial	$10.18
Rate for Payer: Cigna Medicare Advantage	$5.09
Rate for Payer: Clover Medicare Advantage	$9.67
Rate for Payer: EmblemHealth Commercial	$30.54
Rate for Payer: Humana Medicare Advantage	$10.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.79
Rate for Payer: Wellcare Medicare Advantage	$10.18

ANTIBODY BORDETELLA I

Facility

$131.65

Service Code	HCPCS 86615
Hospital Charge Code	3036003A
Hospital Revenue Code	302
Min. Negotiated Rate	$6.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.74
Rate for Payer: Aetna Medicare Advantage	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.33
Rate for Payer: Cigna Commercial	$13.19
Rate for Payer: Cigna Medicare Advantage	$6.59
Rate for Payer: Clover Medicare Advantage	$12.53
Rate for Payer: EmblemHealth Commercial	$39.57
Rate for Payer: Humana Medicare Advantage	$13.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.19
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.98
Rate for Payer: Wellcare Medicare Advantage	$13.19

ANTIBODY BORDETELLA I

Facility

$131.65

Service Code	HCPCS 86615
Hospital Charge Code	3036003A
Hospital Revenue Code	302
Min. Negotiated Rate	$19.75
Max. Negotiated Rate	$19.75
Rate for Payer: Qualcare PPO/HMO/WC	$19.75

ANTIBODY BORDETELLA II

Facility

$131.65

Service Code	HCPCS 86615
Hospital Charge Code	3036003B
Hospital Revenue Code	302
Min. Negotiated Rate	$6.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.74
Rate for Payer: Aetna Medicare Advantage	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.33
Rate for Payer: Cigna Commercial	$13.19
Rate for Payer: Cigna Medicare Advantage	$6.59
Rate for Payer: Clover Medicare Advantage	$12.53
Rate for Payer: EmblemHealth Commercial	$39.57
Rate for Payer: Humana Medicare Advantage	$13.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.19
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.98
Rate for Payer: Wellcare Medicare Advantage	$13.19

ANTIBODY BORDETELLA II

Facility

$131.65

Service Code	HCPCS 86615
Hospital Charge Code	3036003B
Hospital Revenue Code	302
Min. Negotiated Rate	$19.75
Max. Negotiated Rate	$19.75
Rate for Payer: Qualcare PPO/HMO/WC	$19.75

ANTIBODY,COCCIDIODES

Facility

$116.00

Service Code	HCPCS 86635
Hospital Charge Code	38479403
Hospital Revenue Code	302
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

ANTIBODY,COCCIDIODES

Facility

$116.00

Service Code	HCPCS 86635
Hospital Charge Code	38479403
Hospital Revenue Code	302
Min. Negotiated Rate	$5.74
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.16
Rate for Payer: Aetna Medicare Advantage	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.03
Rate for Payer: Cigna Commercial	$11.47
Rate for Payer: Cigna Medicare Advantage	$5.74
Rate for Payer: Clover Medicare Advantage	$10.90
Rate for Payer: EmblemHealth Commercial	$34.41
Rate for Payer: Humana Medicare Advantage	$11.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.16
Rate for Payer: Wellcare Medicare Advantage	$11.47

ANTIBODY;DIPHTHERIA

Facility

$107.70

Service Code	HCPCS 86648
Hospital Charge Code	38477129
Hospital Revenue Code	302
Min. Negotiated Rate	$16.16
Max. Negotiated Rate	$16.16
Rate for Payer: Qualcare PPO/HMO/WC	$16.16

ANTIBODY;DIPHTHERIA

Facility

$107.70

Service Code	HCPCS 86648
Hospital Charge Code	38477129
Hospital Revenue Code	302
Min. Negotiated Rate	$7.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$49.28
Rate for Payer: Aetna Medicare Advantage	$15.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.73
Rate for Payer: Cigna Commercial	$15.21
Rate for Payer: Cigna Medicare Advantage	$7.61
Rate for Payer: Clover Medicare Advantage	$14.45
Rate for Payer: EmblemHealth Commercial	$45.63
Rate for Payer: Humana Medicare Advantage	$15.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.16
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.21
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.12
Rate for Payer: Wellcare Medicare Advantage	$15.21

ANTIBODY, EHRLICHIA

Facility

$72.00

Service Code	HCPCS 86666
Hospital Charge Code	38476302
Hospital Revenue Code	302
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

ANTIBODY, EHRLICHIA

Facility

$72.00

Service Code	HCPCS 86666
Hospital Charge Code	38476302
Hospital Revenue Code	302
Min. Negotiated Rate	$5.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$32.98
Rate for Payer: Aetna Medicare Advantage	$10.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.30
Rate for Payer: Cigna Commercial	$10.18
Rate for Payer: Cigna Medicare Advantage	$5.09
Rate for Payer: Clover Medicare Advantage	$9.67
Rate for Payer: EmblemHealth Commercial	$30.54
Rate for Payer: Humana Medicare Advantage	$10.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.79
Rate for Payer: Wellcare Medicare Advantage	$10.18

ANTIBODY ELUTION

Facility

$223.00

Service Code	HCPCS 86860
Hospital Charge Code	38471041
Hospital Revenue Code	300
Min. Negotiated Rate	$33.45
Max. Negotiated Rate	$33.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.45

ANTIBODY ELUTION

Facility

$667.59

Service Code	HCPCS 86860
Hospital Charge Code	3100187
Hospital Revenue Code	300
Min. Negotiated Rate	$8.64
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$200.28
Rate for Payer: Aetna Medicare Advantage	$200.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.24
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00

ANTIBODY ELUTION

Facility

$667.59

Service Code	HCPCS 86860
Hospital Charge Code	3100187
Hospital Revenue Code	300
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

ANTIBODY ELUTION

Facility

$223.00

Service Code	HCPCS 86860
Hospital Charge Code	38471041
Hospital Revenue Code	300
Min. Negotiated Rate	$8.64
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$66.90
Rate for Payer: Aetna Medicare Advantage	$66.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.87
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.99
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.45
Rate for Payer: UnitedHealthcare Commercial	$114.00

Know your out-of-pocket cost for care.

All Charges