Heights University Hospital

All Charges

Charge

Type

Setting

Price

ANTIEPILEPTICS NOS 1-3

Facility

$190.45

Service Code	HCPCS 80339
Hospital Charge Code	39990219
Hospital Revenue Code	301
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.13
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$114.00

ANTIEPILEPTICS NOS 1-3

Facility

$190.45

Service Code	HCPCS 80339
Hospital Charge Code	38430019
Hospital Revenue Code	301
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.13
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$114.00

ANTIEPILEPTICS NOS 1-3

Facility

$190.45

Service Code	HCPCS 80339
Hospital Charge Code	3039019
Hospital Revenue Code	301
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.13
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$114.00

ANTIEPILEPTICS NOS 1-3

Facility

$190.45

Service Code	HCPCS 80339
Hospital Charge Code	39990219
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANTIEPILEPTICS NOS 4-6

Facility

$190.45

Service Code	HCPCS 80340
Hospital Charge Code	3039020
Hospital Revenue Code	301
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.13
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$114.00

ANTIEPILEPTICS NOS 4-6

Facility

$190.45

Service Code	HCPCS 80340
Hospital Charge Code	39990220
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANTIEPILEPTICS NOS 4-6

Facility

$190.45

Service Code	HCPCS 80340
Hospital Charge Code	39990220
Hospital Revenue Code	301
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.13
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$114.00

ANTIEPILEPTICS NOS 4-6

Facility

$190.45

Service Code	HCPCS 80340
Hospital Charge Code	3039020
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANTIEPILEPTICS NOS 7/MORE

Facility

$190.45

Service Code	HCPCS 80341
Hospital Charge Code	39990221
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANTIEPILEPTICS NOS 7/MORE

Facility

$190.45

Service Code	HCPCS 80341
Hospital Charge Code	38430021
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANTIEPILEPTICS NOS 7/MORE

Facility

$190.45

Service Code	HCPCS 80341
Hospital Charge Code	38430021
Hospital Revenue Code	301
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.13
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$114.00

ANTIEPILEPTICS NOS 7/MORE

Facility

$190.45

Service Code	HCPCS 80341
Hospital Charge Code	3039021
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANTIEPILEPTICS NOS 7/MORE

Facility

$190.45

Service Code	HCPCS 80341
Hospital Charge Code	3039021
Hospital Revenue Code	301
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.13
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$114.00

ANTIEPILEPTICS NOS 7/MORE

Facility

$190.45

Service Code	HCPCS 80341
Hospital Charge Code	39990221
Hospital Revenue Code	301
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.13
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$114.00

ANTIFUNGAL CREAM

Facility

$15.81

Service Code	NDC 472073514
Hospital Charge Code	6063943303
Hospital Revenue Code	250
Min. Negotiated Rate	$2.37
Max. Negotiated Rate	$2.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.37

ANTIFUNGAL CREAM

Facility

$15.81

Service Code	NDC 472073514
Hospital Charge Code	6063943303
Hospital Revenue Code	250
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$7.91
Rate for Payer: Aetna Commercial	$4.74
Rate for Payer: Aetna Medicare Advantage	$4.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.03
Rate for Payer: Cigna Commercial	$7.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.06
Rate for Payer: Oxford Commercial	$7.91
Rate for Payer: Qualcare PPO/HMO/WC	$2.37
Rate for Payer: UnitedHealthcare Commercial	$7.91

ANTIGEN DETECT BY IMMUNOFLUOR

Facility

$77.95

Service Code	HCPCS 87260
Hospital Charge Code	38477077
Hospital Revenue Code	309
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.75
Rate for Payer: Aetna Medicare Advantage	$14.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.87
Rate for Payer: Cigna Commercial	$14.43
Rate for Payer: Cigna Medicare Advantage	$7.21
Rate for Payer: Clover Medicare Advantage	$13.71
Rate for Payer: EmblemHealth Commercial	$43.29
Rate for Payer: Humana Medicare Advantage	$14.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.43
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.30
Rate for Payer: Wellcare Medicare Advantage	$14.43

ANTIGEN DETECT BY IMMUNOFLUOR

Facility

$77.95

Service Code	HCPCS 87260
Hospital Charge Code	38477077
Hospital Revenue Code	309
Min. Negotiated Rate	$11.69
Max. Negotiated Rate	$11.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.69

ANTIGEN DET IMMUNFLHERPES INFL

Facility

$77.95

Service Code	HCPCS 87275
Hospital Charge Code	38477083
Hospital Revenue Code	309
Min. Negotiated Rate	$11.69
Max. Negotiated Rate	$11.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.69

ANTIGEN DET IMMUNFLHERPES INFL

Facility

$77.95

Service Code	HCPCS 87275
Hospital Charge Code	38477083
Hospital Revenue Code	309
Min. Negotiated Rate	$6.12
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.69
Rate for Payer: Aetna Medicare Advantage	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.88
Rate for Payer: Cigna Commercial	$12.25
Rate for Payer: Cigna Medicare Advantage	$6.12
Rate for Payer: Clover Medicare Advantage	$11.64
Rate for Payer: EmblemHealth Commercial	$36.75
Rate for Payer: Humana Medicare Advantage	$12.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.25
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.98
Rate for Payer: Wellcare Medicare Advantage	$12.25

ANTIGEN DET/IMMUNOFL BORDETELL

Facility

$77.95

Service Code	HCPCS 87265
Hospital Charge Code	38477078
Hospital Revenue Code	309
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.82
Rate for Payer: Aetna Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.89
Rate for Payer: Cigna Commercial	$11.98
Rate for Payer: Cigna Medicare Advantage	$5.99
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.70
Rate for Payer: Wellcare Medicare Advantage	$11.98

ANTIGEN DET/IMMUNOFL BORDETELL

Facility

$77.95

Service Code	HCPCS 87265
Hospital Charge Code	38477078
Hospital Revenue Code	309
Min. Negotiated Rate	$11.69
Max. Negotiated Rate	$11.69
Rate for Payer: Qualcare PPO/HMO/WC	$11.69

ANTIGEN SCREEN (BLOOD TYPING)

Facility

$134.00

Service Code	HCPCS 86902
Hospital Charge Code	38471072
Hospital Revenue Code	309
Min. Negotiated Rate	$20.10
Max. Negotiated Rate	$20.10
Rate for Payer: Qualcare PPO/HMO/WC	$20.10

ANTIGEN SCREEN (BLOOD TYPING)

Facility

$134.00

Service Code	HCPCS 86902
Hospital Charge Code	38471072
Hospital Revenue Code	309
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$853.60
Rate for Payer: Aetna Commercial	$20.57
Rate for Payer: Aetna Medicare Advantage	$6.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.27
Rate for Payer: Cigna Commercial	$853.60
Rate for Payer: Cigna Medicare Advantage	$3.17
Rate for Payer: Clover Medicare Advantage	$6.03
Rate for Payer: EmblemHealth Commercial	$19.05
Rate for Payer: Humana Medicare Advantage	$6.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.42
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.73
Rate for Payer: Wellcare Medicare Advantage	$6.35

ANTI GLIADIN ANTIBODY IGG IGA

Facility

$253.45

Service Code	HCPCS 83520
Hospital Charge Code	3032364
Hospital Revenue Code	301
Min. Negotiated Rate	$38.02
Max. Negotiated Rate	$38.02
Rate for Payer: Qualcare PPO/HMO/WC	$38.02

Know your out-of-pocket cost for care.

All Charges