Heights University Hospital

All Charges

Charge

Type

Setting

Price

ANTIBODY;FRANCISELLA TULARENSI

Facility

$73.64

Service Code	HCPCS 86668
Hospital Charge Code	38477073
Hospital Revenue Code	302
Min. Negotiated Rate	$7.08
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$45.88
Rate for Payer: Aetna Medicare Advantage	$14.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.88
Rate for Payer: Cigna Commercial	$14.16
Rate for Payer: Cigna Medicare Advantage	$7.08
Rate for Payer: Clover Medicare Advantage	$13.45
Rate for Payer: EmblemHealth Commercial	$42.48
Rate for Payer: Humana Medicare Advantage	$14.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.57
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.16
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.01
Rate for Payer: Wellcare Medicare Advantage	$14.16

ANTIBODY;FRANCISELLA TULARENSI

Facility

$73.64

Service Code	HCPCS 86668
Hospital Charge Code	38477073
Hospital Revenue Code	302
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$11.05
Rate for Payer: Qualcare PPO/HMO/WC	$11.05

ANTIBODY,GIARDIA LAMBIA

Facility

$104.00

Service Code	HCPCS 86674
Hospital Charge Code	38477126
Hospital Revenue Code	302
Min. Negotiated Rate	$7.36
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.69
Rate for Payer: Aetna Medicare Advantage	$14.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.93
Rate for Payer: Cigna Commercial	$14.72
Rate for Payer: Cigna Medicare Advantage	$7.36
Rate for Payer: Clover Medicare Advantage	$13.98
Rate for Payer: EmblemHealth Commercial	$44.16
Rate for Payer: Humana Medicare Advantage	$15.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.52
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.72
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.60
Rate for Payer: Wellcare Medicare Advantage	$14.72

ANTIBODY,GIARDIA LAMBIA

Facility

$104.00

Service Code	HCPCS 86674
Hospital Charge Code	38477126
Hospital Revenue Code	302
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

ANTIBODY;HAEMOPHILUS INFLUENZA

Facility

$112.00

Service Code	HCPCS 86684
Hospital Charge Code	38477133
Hospital Revenue Code	302
Min. Negotiated Rate	$7.92
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$51.32
Rate for Payer: Aetna Medicare Advantage	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.84
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	$58.04
Rate for Payer: Cigna Commercial	$15.84
Rate for Payer: Cigna Medicare Advantage	$7.92
Rate for Payer: Clover Medicare Advantage	$15.05
Rate for Payer: EmblemHealth Commercial	$47.52
Rate for Payer: Humana Medicare Advantage	$16.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.56
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.84
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.79
Rate for Payer: Wellcare Medicare Advantage	$15.84

ANTIBODY;HAEMOPHILUS INFLUENZA

Facility

$112.00

Service Code	HCPCS 86684
Hospital Charge Code	38477133
Hospital Revenue Code	302
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$16.80

ANTIBODY,HERPES SIMPLEX,NON

Facility

$101.94

Service Code	HCPCS 86694
Hospital Charge Code	38476303
Hospital Revenue Code	302
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.72
Rate for Payer: Cigna Commercial	$14.39
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.29
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

ANTIBODY,HERPES SIMPLEX,NON

Facility

$101.94

Service Code	HCPCS 86694
Hospital Charge Code	38476303
Hospital Revenue Code	302
Min. Negotiated Rate	$15.29
Max. Negotiated Rate	$15.29
Rate for Payer: Qualcare PPO/HMO/WC	$15.29

ANTIBODY;HIV-1 & HIV-2-SINGLA

Facility

$97.00

Service Code	HCPCS 86703
Hospital Charge Code	38477119
Hospital Revenue Code	302
Min. Negotiated Rate	$14.55
Max. Negotiated Rate	$14.55
Rate for Payer: Qualcare PPO/HMO/WC	$14.55

ANTIBODY;HIV-1 & HIV-2-SINGLA

Facility

$97.00

Service Code	HCPCS 86703
Hospital Charge Code	38477119
Hospital Revenue Code	302
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$44.42
Rate for Payer: Aetna Medicare Advantage	$13.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.23
Rate for Payer: Cigna Commercial	$13.71
Rate for Payer: Cigna Medicare Advantage	$6.86
Rate for Payer: Clover Medicare Advantage	$13.02
Rate for Payer: EmblemHealth Commercial	$41.13
Rate for Payer: Humana Medicare Advantage	$14.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.71
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.53
Rate for Payer: Wellcare Medicare Advantage	$13.71

ANTIBODY IDENTIFICATION

Facility

$667.59

Service Code	HCPCS 86870
Hospital Charge Code	3100542
Hospital Revenue Code	300
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

ANTIBODY IDENTIFICATION

Facility

$229.00

Service Code	HCPCS 86870
Hospital Charge Code	38471007
Hospital Revenue Code	302
Min. Negotiated Rate	$34.35
Max. Negotiated Rate	$34.35
Rate for Payer: Qualcare PPO/HMO/WC	$34.35

ANTIBODY IDENTIFICATION

Facility

$667.59

Service Code	HCPCS 86870
Hospital Charge Code	3100542
Hospital Revenue Code	300
Min. Negotiated Rate	$16.83
Max. Negotiated Rate	$853.60
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	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.24
Rate for Payer: Cigna Commercial	$853.60
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 IDENTIFICATION

Facility

$229.00

Service Code	HCPCS 86870
Hospital Charge Code	38471007
Hospital Revenue Code	302
Min. Negotiated Rate	$16.83
Max. Negotiated Rate	$853.60
Rate for Payer: Aetna Commercial	$68.70
Rate for Payer: Aetna Medicare Advantage	$68.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.40
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	$58.40
Rate for Payer: Cigna Commercial	$853.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.35
Rate for Payer: UnitedHealthcare Commercial	$114.00

ANTIBODY IDENTIFICATION COLD

Facility

$220.85

Service Code	HCPCS 86921
Hospital Charge Code	3100543
Hospital Revenue Code	309
Min. Negotiated Rate	$33.13
Max. Negotiated Rate	$33.13
Rate for Payer: Qualcare PPO/HMO/WC	$33.13

ANTIBODY IDENTIFICATION COLD

Facility

$220.85

Service Code	HCPCS 86921
Hospital Charge Code	3100543
Hospital Revenue Code	309
Min. Negotiated Rate	$24.68
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$66.25
Rate for Payer: Aetna Medicare Advantage	$66.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.32
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.71
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.13
Rate for Payer: UnitedHealthcare Commercial	$114.00

ANTIBODY ID - LEUKOCYTE AB

Facility

$390.00

Service Code	HCPCS 86021
Hospital Charge Code	3032059A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ANTIBODY ID - LEUKOCYTE AB

Facility

$390.00

Service Code	HCPCS 86021
Hospital Charge Code	3032059A
Hospital Revenue Code	302
Min. Negotiated Rate	$7.53
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.76
Rate for Payer: Aetna Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
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	$55.14
Rate for Payer: Cigna Commercial	$15.05
Rate for Payer: Cigna Medicare Advantage	$7.53
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.95
Rate for Payer: Wellcare Medicare Advantage	$15.05

ANTIBODY ID PLATELET ASCT/IMMO

Facility

$88.00

Service Code	HCPCS 86023
Hospital Charge Code	38477105
Hospital Revenue Code	302
Min. Negotiated Rate	$13.20
Max. Negotiated Rate	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$13.20

ANTIBODY ID PLATELET ASCT/IMMO

Facility

$88.00

Service Code	HCPCS 86023
Hospital Charge Code	38477105
Hospital Revenue Code	302
Min. Negotiated Rate	$6.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$40.37
Rate for Payer: Aetna Medicare Advantage	$12.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.46
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	$45.65
Rate for Payer: Cigna Commercial	$12.46
Rate for Payer: Cigna Medicare Advantage	$6.23
Rate for Payer: Clover Medicare Advantage	$11.84
Rate for Payer: EmblemHealth Commercial	$37.38
Rate for Payer: Humana Medicare Advantage	$12.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.44
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.46
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.21
Rate for Payer: Wellcare Medicare Advantage	$12.46

ANTIBODY INDENTIFICATION ENZ

Facility

$88.75

Service Code	HCPCS 86971
Hospital Charge Code	3100188
Hospital Revenue Code	300
Min. Negotiated Rate	$11.54
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$26.62
Rate for Payer: Aetna Medicare Advantage	$26.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.63
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.31
Rate for Payer: UnitedHealthcare Commercial	$114.00

ANTIBODY INDENTIFICATION ENZ

Facility

$88.75

Service Code	HCPCS 86971
Hospital Charge Code	3100188
Hospital Revenue Code	300
Min. Negotiated Rate	$13.31
Max. Negotiated Rate	$13.31
Rate for Payer: Qualcare PPO/HMO/WC	$13.31

ANTIBODY; LEPTOSPIRA

Facility

$93.00

Service Code	HCPCS 86720
Hospital Charge Code	38477113
Hospital Revenue Code	302
Min. Negotiated Rate	$13.95
Max. Negotiated Rate	$13.95
Rate for Payer: Qualcare PPO/HMO/WC	$13.95

ANTIBODY; LEPTOSPIRA

Facility

$93.00

Service Code	HCPCS 86720
Hospital Charge Code	38477113
Hospital Revenue Code	302
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.49
Rate for Payer: Aetna Medicare Advantage	$16.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.20
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	$59.36
Rate for Payer: Cigna Commercial	$16.20
Rate for Payer: Cigna Medicare Advantage	$8.10
Rate for Payer: Clover Medicare Advantage	$15.39
Rate for Payer: EmblemHealth Commercial	$48.60
Rate for Payer: Humana Medicare Advantage	$16.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.20
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.17
Rate for Payer: Wellcare Medicare Advantage	$16.20

ANTIBODY,RICKETTSIA

Facility

$137.49

Service Code	HCPCS 86757
Hospital Charge Code	38476305
Hospital Revenue Code	302
Min. Negotiated Rate	$9.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$62.69
Rate for Payer: Aetna Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.90
Rate for Payer: Cigna Commercial	$19.35
Rate for Payer: Cigna Medicare Advantage	$9.68
Rate for Payer: Clover Medicare Advantage	$18.38
Rate for Payer: EmblemHealth Commercial	$58.05
Rate for Payer: Humana Medicare Advantage	$19.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.87
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.62
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.51
Rate for Payer: Wellcare Medicare Advantage	$19.35

Know your out-of-pocket cost for care.

All Charges