Heights University Hospital

All Charges

Charge

Type

Setting

Price

ARSENIC BLOOD

Facility

$218.00

Service Code	HCPCS 82175
Hospital Charge Code	38479442
Hospital Revenue Code	301
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$61.46
Rate for Payer: Aetna Medicare Advantage	$18.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.51
Rate for Payer: Cigna Commercial	$18.97
Rate for Payer: Cigna Medicare Advantage	$9.48
Rate for Payer: Clover Medicare Advantage	$18.02
Rate for Payer: EmblemHealth Commercial	$56.91
Rate for Payer: Humana Medicare Advantage	$19.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.97
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.11
Rate for Payer: Wellcare Medicare Advantage	$18.97

ARSENIC BLOOD

Facility

$218.00

Service Code	HCPCS 82175
Hospital Charge Code	38479442
Hospital Revenue Code	301
Min. Negotiated Rate	$32.70
Max. Negotiated Rate	$32.70
Rate for Payer: Qualcare PPO/HMO/WC	$32.70

ARSENIC,BLOOD

Facility

$218.00

Service Code	HCPCS 82175
Hospital Charge Code	38472122
Hospital Revenue Code	301
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$61.46
Rate for Payer: Aetna Medicare Advantage	$18.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.51
Rate for Payer: Cigna Commercial	$18.97
Rate for Payer: Cigna Medicare Advantage	$9.48
Rate for Payer: Clover Medicare Advantage	$18.02
Rate for Payer: EmblemHealth Commercial	$56.91
Rate for Payer: Humana Medicare Advantage	$19.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.97
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.11
Rate for Payer: Wellcare Medicare Advantage	$18.97

ARSENIC,BLOOD

Facility

$218.00

Service Code	HCPCS 82175
Hospital Charge Code	38472122
Hospital Revenue Code	301
Min. Negotiated Rate	$32.70
Max. Negotiated Rate	$32.70
Rate for Payer: Qualcare PPO/HMO/WC	$32.70

ARSENIC,BLOOD

Facility

$390.00

Service Code	HCPCS 82175
Hospital Charge Code	39900045
Hospital Revenue Code	301
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$61.46
Rate for Payer: Aetna Medicare Advantage	$18.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.51
Rate for Payer: Cigna Commercial	$18.97
Rate for Payer: Cigna Medicare Advantage	$9.48
Rate for Payer: Clover Medicare Advantage	$18.02
Rate for Payer: EmblemHealth Commercial	$56.91
Rate for Payer: Humana Medicare Advantage	$19.54
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	$18.97
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.11
Rate for Payer: Wellcare Medicare Advantage	$18.97

ARSENIC,BLOOD

Facility

$390.00

Service Code	HCPCS 82175
Hospital Charge Code	39900045
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ARSENIC (BLOOD) #044***

Facility

$131.00

Hospital Charge Code	3010352
Hospital Revenue Code	301
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$19.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

ARSENIC (BLOOD) #044***

Facility

$131.00

Hospital Charge Code	3010352
Hospital Revenue Code	301
Min. Negotiated Rate	$17.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.30
Rate for Payer: Aetna Medicare Advantage	$39.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.41
Rate for Payer: Cigna Commercial	$65.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.65
Rate for Payer: UnitedHealthcare Commercial	$114.00

ARSENIC MISC

Facility

$205.65

Service Code	HCPCS 82175
Hospital Charge Code	3032166
Hospital Revenue Code	301
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

ARSENIC MISC

Facility

$205.65

Service Code	HCPCS 82175
Hospital Charge Code	3032166
Hospital Revenue Code	301
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$61.46
Rate for Payer: Aetna Medicare Advantage	$18.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.51
Rate for Payer: Cigna Commercial	$18.97
Rate for Payer: Cigna Medicare Advantage	$9.48
Rate for Payer: Clover Medicare Advantage	$18.02
Rate for Payer: EmblemHealth Commercial	$56.91
Rate for Payer: Humana Medicare Advantage	$19.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.97
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.11
Rate for Payer: Wellcare Medicare Advantage	$18.97

ARSENIC URINE

Facility

$802.00

Service Code	HCPCS 82175
Hospital Charge Code	3000361A
Hospital Revenue Code	301
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$120.30
Rate for Payer: Aetna Commercial	$61.46
Rate for Payer: Aetna Medicare Advantage	$18.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.51
Rate for Payer: Cigna Commercial	$18.97
Rate for Payer: Cigna Medicare Advantage	$9.48
Rate for Payer: Clover Medicare Advantage	$18.02
Rate for Payer: EmblemHealth Commercial	$56.91
Rate for Payer: Humana Medicare Advantage	$19.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.26
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.97
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.11
Rate for Payer: Wellcare Medicare Advantage	$18.97

ARSENIC URINE

Facility

$802.00

Service Code	HCPCS 82175
Hospital Charge Code	3000361A
Hospital Revenue Code	301
Min. Negotiated Rate	$120.30
Max. Negotiated Rate	$120.30
Rate for Payer: Qualcare PPO/HMO/WC	$120.30

ARSENIC URINE***

Facility

$104.00

Hospital Charge Code	3010360
Hospital Revenue Code	309
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

ARSENIC URINE***

Facility

$104.00

Hospital Charge Code	3010360
Hospital Revenue Code	309
Min. Negotiated Rate	$13.52
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.20
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
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

ARTANE/2MG/TAB

Facility

$3.00

Hospital Charge Code	60632485
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

ARTANE/2MG/TAB

Facility

$3.00

Hospital Charge Code	60632485
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ARTANE/5MG

Facility

$3.00

Hospital Charge Code	60634771
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

ARTANE/5MG

Facility

$3.00

Hospital Charge Code	60634771
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ARTANE LIQUID/16OZ

Facility

$22.00

Hospital Charge Code	60634587
Hospital Revenue Code	250
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$11.00
Rate for Payer: Aetna Commercial	$6.60
Rate for Payer: Aetna Medicare Advantage	$6.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.61
Rate for Payer: Cigna Commercial	$11.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.86
Rate for Payer: Oxford Commercial	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$11.00

ARTANE LIQUID/16OZ

Facility

$22.00

Hospital Charge Code	60634587
Hospital Revenue Code	250
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

ART BMC PLUS KIT

Facility

$8,500.00

Hospital Charge Code	270691940
Hospital Revenue Code	272
Min. Negotiated Rate	$1,105.00
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$2,550.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,105.00
Rate for Payer: Oxford Commercial	$4,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00
Rate for Payer: UnitedHealthcare Commercial	$4,250.00

ART BMC PLUS KIT

Facility

$8,500.00

Hospital Charge Code	270691940
Hospital Revenue Code	272
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$1,275.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

ART BYP FEM-ANT-POST-TIB/PRL

Facility

$32,300.40

Service Code	HCPCS 35566
Hospital Charge Code	1600000873
Hospital Revenue Code	360
Min. Negotiated Rate	$4,845.06
Max. Negotiated Rate	$4,845.06
Rate for Payer: Qualcare PPO/HMO/WC	$4,845.06

ART BYP FEM-ANT-POST-TIB/PRL

Facility

$32,300.40

Service Code	HCPCS 35566
Hospital Charge Code	1600000873
Hospital Revenue Code	360
Min. Negotiated Rate	$1,615.02
Max. Negotiated Rate	$9,690.12
Rate for Payer: Aetna Commercial	$9,690.12
Rate for Payer: Aetna Medicare Advantage	$9,690.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,236.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,236.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,236.60
Rate for Payer: Cigna Commercial	$1,615.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,199.05
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,845.06
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

ART BYP FEMORAL- FEMORAL

Facility

$8,481.00

Service Code	HCPCS 35661
Hospital Charge Code	1600000680
Hospital Revenue Code	360
Min. Negotiated Rate	$1,059.73
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$2,544.30
Rate for Payer: Aetna Medicare Advantage	$2,544.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,162.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,162.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,162.66
Rate for Payer: Cigna Commercial	$1,059.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,102.53
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,272.15
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

Know your out-of-pocket cost for care.

All Charges