Heights University Hospital

All Charges

Charge

Type

Setting

Price

ANTI-THROMBIN III,ANTIGEN

Facility

$74.30

Service Code	HCPCS 85301
Hospital Charge Code	39900164
Hospital Revenue Code	305
Min. Negotiated Rate	$11.14
Max. Negotiated Rate	$11.14
Rate for Payer: Qualcare PPO/HMO/WC	$11.14

ANTI THROMBIN III, ENZYMATIC

Facility

$256.00

Service Code	HCPCS 85300
Hospital Charge Code	3007135A
Hospital Revenue Code	305
Min. Negotiated Rate	$5.92
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.39
Rate for Payer: Aetna Medicare Advantage	$11.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.85
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	$43.42
Rate for Payer: Cigna Commercial	$11.85
Rate for Payer: Cigna Medicare Advantage	$5.92
Rate for Payer: Clover Medicare Advantage	$11.26
Rate for Payer: EmblemHealth Commercial	$35.55
Rate for Payer: Humana Medicare Advantage	$12.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.85
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.56
Rate for Payer: Wellcare Medicare Advantage	$11.85

ANTI THROMBIN III, ENZYMATIC

Facility

$256.00

Service Code	HCPCS 85300
Hospital Charge Code	3007135A
Hospital Revenue Code	305
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

ANTI THROMBIN III FUNCTIONAL

Facility

$256.00

Service Code	HCPCS 85300
Hospital Charge Code	3007136
Hospital Revenue Code	305
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

ANTI THROMBIN III FUNCTIONAL

Facility

$256.00

Service Code	HCPCS 85300
Hospital Charge Code	3007136
Hospital Revenue Code	305
Min. Negotiated Rate	$5.92
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.39
Rate for Payer: Aetna Medicare Advantage	$11.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.85
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	$43.42
Rate for Payer: Cigna Commercial	$11.85
Rate for Payer: Cigna Medicare Advantage	$5.92
Rate for Payer: Clover Medicare Advantage	$11.26
Rate for Payer: EmblemHealth Commercial	$35.55
Rate for Payer: Humana Medicare Advantage	$12.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.85
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.56
Rate for Payer: Wellcare Medicare Advantage	$11.85

ANTI THROMBIN III PANEL

Facility

$256.00

Service Code	HCPCS 85300
Hospital Charge Code	3007135
Hospital Revenue Code	305
Min. Negotiated Rate	$5.92
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.39
Rate for Payer: Aetna Medicare Advantage	$11.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.85
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	$43.42
Rate for Payer: Cigna Commercial	$11.85
Rate for Payer: Cigna Medicare Advantage	$5.92
Rate for Payer: Clover Medicare Advantage	$11.26
Rate for Payer: EmblemHealth Commercial	$35.55
Rate for Payer: Humana Medicare Advantage	$12.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.85
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.56
Rate for Payer: Wellcare Medicare Advantage	$11.85

ANTI THROMBIN III PANEL

Facility

$256.00

Service Code	HCPCS 85300
Hospital Charge Code	3007135
Hospital Revenue Code	305
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

ANTI-THYROGLOBULIN AB

Facility

$523.00

Service Code	HCPCS 86800
Hospital Charge Code	38476010
Hospital Revenue Code	302
Min. Negotiated Rate	$7.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$51.55
Rate for Payer: Aetna Medicare Advantage	$15.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.29
Rate for Payer: Cigna Commercial	$15.91
Rate for Payer: Cigna Medicare Advantage	$7.96
Rate for Payer: Clover Medicare Advantage	$15.11
Rate for Payer: EmblemHealth Commercial	$47.73
Rate for Payer: Humana Medicare Advantage	$16.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.99
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.91
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.86
Rate for Payer: Wellcare Medicare Advantage	$15.91

ANTI-THYROGLOBULIN AB

Facility

$523.00

Service Code	HCPCS 86800
Hospital Charge Code	38476010
Hospital Revenue Code	302
Min. Negotiated Rate	$78.45
Max. Negotiated Rate	$78.45
Rate for Payer: Qualcare PPO/HMO/WC	$78.45

ANTI-THYROGLOBULIN AND MICROSO

Facility

$823.20

Service Code	HCPCS 86376
Hospital Charge Code	38476069
Hospital Revenue Code	302
Min. Negotiated Rate	$123.48
Max. Negotiated Rate	$123.48
Rate for Payer: Qualcare PPO/HMO/WC	$123.48

ANTI-THYROGLOBULIN AND MICROSO

Facility

$823.20

Service Code	HCPCS 86376
Hospital Charge Code	38476069
Hospital Revenue Code	302
Min. Negotiated Rate	$7.28
Max. Negotiated Rate	$123.48
Rate for Payer: Aetna Commercial	$47.14
Rate for Payer: Aetna Medicare Advantage	$14.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.31
Rate for Payer: Cigna Commercial	$14.55
Rate for Payer: Cigna Medicare Advantage	$7.28
Rate for Payer: Clover Medicare Advantage	$13.82
Rate for Payer: EmblemHealth Commercial	$43.65
Rate for Payer: Humana Medicare Advantage	$14.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.02
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.48
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.55
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.42
Rate for Payer: Wellcare Medicare Advantage	$14.55

***ANTI-THYROID AB***

Facility

$195.85

Service Code	HCPCS 86800
Hospital Charge Code	3031119
Hospital Revenue Code	302
Min. Negotiated Rate	$7.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$51.55
Rate for Payer: Aetna Medicare Advantage	$15.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.29
Rate for Payer: Cigna Commercial	$15.91
Rate for Payer: Cigna Medicare Advantage	$7.96
Rate for Payer: Clover Medicare Advantage	$15.11
Rate for Payer: EmblemHealth Commercial	$47.73
Rate for Payer: Humana Medicare Advantage	$16.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.38
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.91
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.86
Rate for Payer: Wellcare Medicare Advantage	$15.91

***ANTI-THYROID AB***

Facility

$195.85

Service Code	HCPCS 86800
Hospital Charge Code	3031119
Hospital Revenue Code	302
Min. Negotiated Rate	$29.38
Max. Negotiated Rate	$29.38
Rate for Payer: Qualcare PPO/HMO/WC	$29.38

ANTI-THYROID MICROSOMAL AB

Facility

$823.20

Service Code	HCPCS 86376
Hospital Charge Code	38476011
Hospital Revenue Code	302
Min. Negotiated Rate	$123.48
Max. Negotiated Rate	$123.48
Rate for Payer: Qualcare PPO/HMO/WC	$123.48

ANTI-THYROID MICROSOMAL AB

Facility

$823.20

Service Code	HCPCS 86376
Hospital Charge Code	38476011
Hospital Revenue Code	302
Min. Negotiated Rate	$7.28
Max. Negotiated Rate	$123.48
Rate for Payer: Aetna Commercial	$47.14
Rate for Payer: Aetna Medicare Advantage	$14.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.31
Rate for Payer: Cigna Commercial	$14.55
Rate for Payer: Cigna Medicare Advantage	$7.28
Rate for Payer: Clover Medicare Advantage	$13.82
Rate for Payer: EmblemHealth Commercial	$43.65
Rate for Payer: Humana Medicare Advantage	$14.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.02
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.48
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.55
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.42
Rate for Payer: Wellcare Medicare Advantage	$14.55

ANTIVENIN CROTAL INJ 10ML

Facility

$1,116.80

Hospital Charge Code	6000459
Hospital Revenue Code	250
Min. Negotiated Rate	$145.18
Max. Negotiated Rate	$558.40
Rate for Payer: Aetna Commercial	$335.04
Rate for Payer: Aetna Medicare Advantage	$335.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$284.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$284.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$284.78
Rate for Payer: Cigna Commercial	$558.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.18
Rate for Payer: Oxford Commercial	$558.40
Rate for Payer: Qualcare PPO/HMO/WC	$167.52
Rate for Payer: UnitedHealthcare Commercial	$558.40

ANTIVENIN CROTAL INJ 10ML

Facility

$1,116.80

Hospital Charge Code	6000459
Hospital Revenue Code	250
Min. Negotiated Rate	$167.52
Max. Negotiated Rate	$167.52
Rate for Payer: Qualcare PPO/HMO/WC	$167.52

ANTI YO ANTIBODY

Facility

$329.00

Service Code	HCPCS 86235
Hospital Charge Code	38476233
Hospital Revenue Code	302
Min. Negotiated Rate	$49.35
Max. Negotiated Rate	$49.35
Rate for Payer: Qualcare PPO/HMO/WC	$49.35

ANTI YO ANTIBODY

Facility

$329.00

Service Code	HCPCS 86235
Hospital Charge Code	38476233
Hospital Revenue Code	302
Min. Negotiated Rate	$8.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.09
Rate for Payer: Aetna Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.70
Rate for Payer: Cigna Commercial	$17.93
Rate for Payer: Cigna Medicare Advantage	$8.96
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.01
Rate for Payer: Wellcare Medicare Advantage	$17.93

ANT LUM CAGE 10X25X33MMX10D

Facility

$42,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704776
Hospital Revenue Code	278
Min. Negotiated Rate	$6,300.00
Max. Negotiated Rate	$21,000.00
Rate for Payer: Aetna Commercial	$12,600.00
Rate for Payer: Aetna Medicare Advantage	$12,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,710.00
Rate for Payer: Cigna Commercial	$21,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,164.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,300.00

ANT LUM CAGE 10X25X33MMX10D

Facility

$42,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704776
Hospital Revenue Code	278
Min. Negotiated Rate	$6,300.00
Max. Negotiated Rate	$10,164.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,164.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,300.00

ANT LUM CAGE 12X28X36MM 10DEG

Facility

$42,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270706016
Hospital Revenue Code	278
Min. Negotiated Rate	$6,300.00
Max. Negotiated Rate	$10,164.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,164.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,300.00

ANT LUM CAGE 12X28X36MM 10DEG

Facility

$42,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270706016
Hospital Revenue Code	278
Min. Negotiated Rate	$6,300.00
Max. Negotiated Rate	$21,000.00
Rate for Payer: Aetna Commercial	$12,600.00
Rate for Payer: Aetna Medicare Advantage	$12,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,710.00
Rate for Payer: Cigna Commercial	$21,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,164.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,300.00

ANT LUM CAGE 12X28X36MM 15DEG

Facility

$42,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270706017
Hospital Revenue Code	278
Min. Negotiated Rate	$6,300.00
Max. Negotiated Rate	$10,164.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,164.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,300.00

ANT LUM CAGE 12X28X36MM 15DEG

Facility

$42,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270706017
Hospital Revenue Code	278
Min. Negotiated Rate	$6,300.00
Max. Negotiated Rate	$21,000.00
Rate for Payer: Aetna Commercial	$12,600.00
Rate for Payer: Aetna Medicare Advantage	$12,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,710.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,710.00
Rate for Payer: Cigna Commercial	$21,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,164.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,300.00

Know your out-of-pocket cost for care.

All Charges