Heights University Hospital

All Charges

Charge

Type

Setting

Price

LDH BODY FLUID

Facility

$419.12

Service Code	HCPCS 83615
Hospital Charge Code	3000510
Hospital Revenue Code	301
Min. Negotiated Rate	$62.87
Max. Negotiated Rate	$62.87
Rate for Payer: Qualcare PPO/HMO/WC	$62.87

LDH, CSF

Facility

$419.12

Service Code	HCPCS 83615
Hospital Charge Code	3030939
Hospital Revenue Code	301
Min. Negotiated Rate	$62.87
Max. Negotiated Rate	$62.87
Rate for Payer: Qualcare PPO/HMO/WC	$62.87

LDH, CSF

Facility

$419.12

Service Code	HCPCS 83615
Hospital Charge Code	3030939
Hospital Revenue Code	301
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$19.57
Rate for Payer: Aetna Medicare Advantage	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.13
Rate for Payer: Cigna Commercial	$6.04
Rate for Payer: Cigna Medicare Advantage	$3.02
Rate for Payer: Clover Medicare Advantage	$5.74
Rate for Payer: EmblemHealth Commercial	$18.12
Rate for Payer: Humana Medicare Advantage	$6.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.87
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.04
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.40
Rate for Payer: Wellcare Medicare Advantage	$6.04

LDH ISOENZYMES

Facility

$149.00

Service Code	HCPCS 83625
Hospital Charge Code	3001765B
Hospital Revenue Code	301
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.44
Rate for Payer: Aetna Medicare Advantage	$12.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.79
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	$46.86
Rate for Payer: Cigna Commercial	$12.79
Rate for Payer: Cigna Medicare Advantage	$6.39
Rate for Payer: Clover Medicare Advantage	$12.15
Rate for Payer: EmblemHealth Commercial	$38.37
Rate for Payer: Humana Medicare Advantage	$13.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.37
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.79
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.56
Rate for Payer: Wellcare Medicare Advantage	$12.79

LDH ISOENZYMES

Facility

$149.00

Service Code	HCPCS 83625
Hospital Charge Code	3001765B
Hospital Revenue Code	301
Min. Negotiated Rate	$22.35
Max. Negotiated Rate	$22.35
Rate for Payer: Qualcare PPO/HMO/WC	$22.35

LDH ISOENZYMES I

Facility

$390.00

Service Code	HCPCS 83615
Hospital Charge Code	39990135A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LDH ISOENZYMES I

Facility

$390.00

Service Code	HCPCS 83615
Hospital Charge Code	39990135A
Hospital Revenue Code	301
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$19.57
Rate for Payer: Aetna Medicare Advantage	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.13
Rate for Payer: Cigna Commercial	$6.04
Rate for Payer: Cigna Medicare Advantage	$3.02
Rate for Payer: Clover Medicare Advantage	$5.74
Rate for Payer: EmblemHealth Commercial	$18.12
Rate for Payer: Humana Medicare Advantage	$6.22
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	$6.04
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.40
Rate for Payer: Wellcare Medicare Advantage	$6.04

LDH ISOENZYMES II

Facility

$390.00

Service Code	HCPCS 83625
Hospital Charge Code	39990135B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LDH ISOENZYMES II

Facility

$390.00

Service Code	HCPCS 83625
Hospital Charge Code	39990135B
Hospital Revenue Code	301
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.44
Rate for Payer: Aetna Medicare Advantage	$12.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.79
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	$46.86
Rate for Payer: Cigna Commercial	$12.79
Rate for Payer: Cigna Medicare Advantage	$6.39
Rate for Payer: Clover Medicare Advantage	$12.15
Rate for Payer: EmblemHealth Commercial	$38.37
Rate for Payer: Humana Medicare Advantage	$13.17
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	$12.79
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.56
Rate for Payer: Wellcare Medicare Advantage	$12.79

LDH PERICARDIAL FLUID

Facility

$419.12

Service Code	HCPCS 83615
Hospital Charge Code	3000511
Hospital Revenue Code	301
Min. Negotiated Rate	$62.87
Max. Negotiated Rate	$62.87
Rate for Payer: Qualcare PPO/HMO/WC	$62.87

LDH PERICARDIAL FLUID

Facility

$419.12

Service Code	HCPCS 83615
Hospital Charge Code	3000511
Hospital Revenue Code	301
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$19.57
Rate for Payer: Aetna Medicare Advantage	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.13
Rate for Payer: Cigna Commercial	$6.04
Rate for Payer: Cigna Medicare Advantage	$3.02
Rate for Payer: Clover Medicare Advantage	$5.74
Rate for Payer: EmblemHealth Commercial	$18.12
Rate for Payer: Humana Medicare Advantage	$6.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.87
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.04
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.40
Rate for Payer: Wellcare Medicare Advantage	$6.04

LDH PERITONEAL FLUID

Facility

$717.44

Service Code	HCPCS 83615
Hospital Charge Code	3000513
Hospital Revenue Code	301
Min. Negotiated Rate	$107.62
Max. Negotiated Rate	$107.62
Rate for Payer: Qualcare PPO/HMO/WC	$107.62

LDH PERITONEAL FLUID

Facility

$717.44

Service Code	HCPCS 83615
Hospital Charge Code	3000513
Hospital Revenue Code	301
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$19.57
Rate for Payer: Aetna Medicare Advantage	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.13
Rate for Payer: Cigna Commercial	$6.04
Rate for Payer: Cigna Medicare Advantage	$3.02
Rate for Payer: Clover Medicare Advantage	$5.74
Rate for Payer: EmblemHealth Commercial	$18.12
Rate for Payer: Humana Medicare Advantage	$6.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.27
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$107.62
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.04
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.40
Rate for Payer: Wellcare Medicare Advantage	$6.04

LDH, REFERENCE LAB***

Facility

$46.00

Service Code	HCPCS 83625
Hospital Charge Code	3032182
Hospital Revenue Code	301
Min. Negotiated Rate	$5.98
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.44
Rate for Payer: Aetna Medicare Advantage	$12.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.79
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	$46.86
Rate for Payer: Cigna Commercial	$12.79
Rate for Payer: Cigna Medicare Advantage	$6.39
Rate for Payer: Clover Medicare Advantage	$12.15
Rate for Payer: EmblemHealth Commercial	$38.37
Rate for Payer: Humana Medicare Advantage	$13.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.79
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.56
Rate for Payer: Wellcare Medicare Advantage	$12.79

LDH, REFERENCE LAB***

Facility

$46.00

Service Code	HCPCS 83625
Hospital Charge Code	3032182
Hospital Revenue Code	301
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$6.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.90

LDH ROCHE***

Facility

$36.00

Service Code	HCPCS 83615
Hospital Charge Code	3008133
Hospital Revenue Code	301
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$114.00
Rate for Payer: Cigna Medicare Advantage	$3.02
Rate for Payer: Aetna Commercial	$19.57
Rate for Payer: Aetna Medicare Advantage	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.13
Rate for Payer: Cigna Commercial	$6.04
Rate for Payer: Clover Medicare Advantage	$5.74
Rate for Payer: EmblemHealth Commercial	$18.12
Rate for Payer: Humana Medicare Advantage	$6.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.68
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.04
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.40
Rate for Payer: Wellcare Medicare Advantage	$6.04

LDH ROCHE***

Facility

$36.00

Service Code	HCPCS 83615
Hospital Charge Code	3008133
Hospital Revenue Code	301
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

LDH SYNOVIAL FLUID

Facility

$419.12

Service Code	HCPCS 83615
Hospital Charge Code	3000512
Hospital Revenue Code	301
Min. Negotiated Rate	$62.87
Max. Negotiated Rate	$62.87
Rate for Payer: Qualcare PPO/HMO/WC	$62.87

LDH SYNOVIAL FLUID

Facility

$419.12

Service Code	HCPCS 83615
Hospital Charge Code	3000512
Hospital Revenue Code	301
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$19.57
Rate for Payer: Aetna Medicare Advantage	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.13
Rate for Payer: Cigna Commercial	$6.04
Rate for Payer: Cigna Medicare Advantage	$3.02
Rate for Payer: Clover Medicare Advantage	$5.74
Rate for Payer: EmblemHealth Commercial	$18.12
Rate for Payer: Humana Medicare Advantage	$6.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.87
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.04
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.40
Rate for Payer: Wellcare Medicare Advantage	$6.04

LD ISOENZYMES

Facility

$349.00

Service Code	HCPCS 83625
Hospital Charge Code	38472010
Hospital Revenue Code	301
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.44
Rate for Payer: Aetna Medicare Advantage	$12.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.79
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	$46.86
Rate for Payer: Cigna Commercial	$12.79
Rate for Payer: Cigna Medicare Advantage	$6.39
Rate for Payer: Clover Medicare Advantage	$12.15
Rate for Payer: EmblemHealth Commercial	$38.37
Rate for Payer: Humana Medicare Advantage	$13.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.37
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.79
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.56
Rate for Payer: Wellcare Medicare Advantage	$12.79

LD ISOENZYMES

Facility

$349.00

Service Code	HCPCS 83625
Hospital Charge Code	38472010
Hospital Revenue Code	301
Min. Negotiated Rate	$52.35
Max. Negotiated Rate	$52.35
Rate for Payer: Qualcare PPO/HMO/WC	$52.35

LDL CHOLESTEROL

Facility

$125.75

Service Code	HCPCS 83721
Hospital Charge Code	3006459C
Hospital Revenue Code	301
Min. Negotiated Rate	$18.86
Max. Negotiated Rate	$18.86
Rate for Payer: Qualcare PPO/HMO/WC	$18.86

LDL CHOLESTEROL

Facility

$125.75

Service Code	HCPCS 83721
Hospital Charge Code	3006459C
Hospital Revenue Code	301
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$34.02
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.50
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	$38.47
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: Cigna Medicare Advantage	$5.25
Rate for Payer: Clover Medicare Advantage	$9.97
Rate for Payer: EmblemHealth Commercial	$31.50
Rate for Payer: Humana Medicare Advantage	$10.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.86
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.50
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.13
Rate for Payer: Wellcare Medicare Advantage	$10.50

LDL CHOLESTEROL***

Facility

$61.20

Service Code	HCPCS 83721
Hospital Charge Code	3030940
Hospital Revenue Code	301
Min. Negotiated Rate	$9.18
Max. Negotiated Rate	$9.18
Rate for Payer: Qualcare PPO/HMO/WC	$9.18

LDL CHOLESTEROL***

Facility

$61.20

Service Code	HCPCS 83721
Hospital Charge Code	3030940
Hospital Revenue Code	301
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$34.02
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.50
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	$38.47
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: Cigna Medicare Advantage	$5.25
Rate for Payer: Clover Medicare Advantage	$9.97
Rate for Payer: EmblemHealth Commercial	$31.50
Rate for Payer: Humana Medicare Advantage	$10.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.96
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.18
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.50
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.13
Rate for Payer: Wellcare Medicare Advantage	$10.50

Know your out-of-pocket cost for care.

All Charges