Heights University Hospital

All Charges

Charge

Type

Setting

Price

ANTIPSYCHOTICS NOS 1-3

Facility

$190.45

Service Code	HCPCS 80342
Hospital Charge Code	3039022
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

ANTIPSYCHOTICS NOS 1-3

Facility

$190.45

Service Code	HCPCS 80342
Hospital Charge Code	38430022
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANTIPSYCHOTICS NOS 1-3

Facility

$190.45

Service Code	HCPCS 80342
Hospital Charge Code	39990222
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

ANTIPSYCHOTICS NOS 1-3

Facility

$190.45

Service Code	HCPCS 80342
Hospital Charge Code	39990222
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANTIPSYCHOTICS NOS 1-3

Facility

$190.45

Service Code	HCPCS 80342
Hospital Charge Code	3039022
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANTIPSYCHOTICS NOS 4-6

Facility

$190.45

Service Code	HCPCS 80343
Hospital Charge Code	39990223
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

ANTIPSYCHOTICS NOS 4-6

Facility

$190.45

Service Code	HCPCS 80343
Hospital Charge Code	38430023
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANTIPSYCHOTICS NOS 4-6

Facility

$190.45

Service Code	HCPCS 80343
Hospital Charge Code	3039023
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANTIPSYCHOTICS NOS 4-6

Facility

$190.45

Service Code	HCPCS 80343
Hospital Charge Code	39990223
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANTIPSYCHOTICS NOS 4-6

Facility

$190.45

Service Code	HCPCS 80343
Hospital Charge Code	38430023
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

ANTIPSYCHOTICS NOS 4-6

Facility

$190.45

Service Code	HCPCS 80343
Hospital Charge Code	3039023
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

ANTIPSYCHOTICS NOS 7/MORE

Facility

$190.45

Service Code	HCPCS 80344
Hospital Charge Code	38430024
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

ANTIPSYCHOTICS NOS 7/MORE

Facility

$190.45

Service Code	HCPCS 80344
Hospital Charge Code	39990224
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

ANTIPSYCHOTICS NOS 7/MORE

Facility

$190.45

Service Code	HCPCS 80344
Hospital Charge Code	3039024
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANTIPSYCHOTICS NOS 7/MORE

Facility

$190.45

Service Code	HCPCS 80344
Hospital Charge Code	39990224
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANTIPSYCHOTICS NOS 7/MORE

Facility

$190.45

Service Code	HCPCS 80344
Hospital Charge Code	3039024
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

ANTIPSYCHOTICS NOS 7/MORE

Facility

$190.45

Service Code	HCPCS 80344
Hospital Charge Code	38430024
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANTI-RETICULIN AB SCREEN (SER)

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3007127
Hospital Revenue Code	302
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

ANTI-RETICULIN AB SCREEN (SER)

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3007127
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

ANTI RI ANTOBODIES

Facility

$98.00

Service Code	HCPCS 86256
Hospital Charge Code	3038071
Hospital Revenue Code	300
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

ANTI RI ANTOBODIES

Facility

$98.00

Service Code	HCPCS 86256
Hospital Charge Code	3038071
Hospital Revenue Code	300
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$14.70
Rate for Payer: Qualcare PPO/HMO/WC	$14.70

ANTIROTATION SCREW 85MM

Facility

$1,835.00

Service Code	HCPCS C1713
Hospital Charge Code	270687017
Hospital Revenue Code	278
Min. Negotiated Rate	$275.25
Max. Negotiated Rate	$444.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$367.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$444.07
Rate for Payer: Qualcare PPO/HMO/WC	$275.25

ANTIROTATION SCREW 85MM

Facility

$1,835.00

Service Code	HCPCS C1713
Hospital Charge Code	270687017
Hospital Revenue Code	278
Min. Negotiated Rate	$275.25
Max. Negotiated Rate	$917.50
Rate for Payer: Aetna Commercial	$550.50
Rate for Payer: Aetna Medicare Advantage	$550.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$467.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$467.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$367.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$467.93
Rate for Payer: Cigna Commercial	$917.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$444.07
Rate for Payer: Qualcare PPO/HMO/WC	$275.25

ANTIROT SCR FEM NECK 90MMSTER

Facility

$1,077.10

Service Code	HCPCS C1713
Hospital Charge Code	270686944
Hospital Revenue Code	278
Min. Negotiated Rate	$161.56
Max. Negotiated Rate	$260.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.66
Rate for Payer: Qualcare PPO/HMO/WC	$161.56

ANTIROT SCR FEM NECK 90MMSTER

Facility

$1,077.10

Service Code	HCPCS C1713
Hospital Charge Code	270686944
Hospital Revenue Code	278
Min. Negotiated Rate	$161.56
Max. Negotiated Rate	$538.55
Rate for Payer: Aetna Commercial	$323.13
Rate for Payer: Aetna Medicare Advantage	$323.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.66
Rate for Payer: Cigna Commercial	$538.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.66
Rate for Payer: Qualcare PPO/HMO/WC	$161.56

Know your out-of-pocket cost for care.

All Charges