Heights University Hospital

All Charges

Charge

Type

Setting

Price

LENS RESTORE

Facility

$4,475.00

Hospital Charge Code	270663666
Hospital Revenue Code	276
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

LENS RESTORE

Facility

$4,475.00

Service Code	HCPCS V2788
Hospital Charge Code	270663818
Hospital Revenue Code	276
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,342.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

LENS RESTORE

Facility

$4,475.00

Hospital Charge Code	270663737
Hospital Revenue Code	276
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

LENS RESTORE ACRYSOF

Facility

$4,475.00

Service Code	HCPCS V2788
Hospital Charge Code	270656057
Hospital Revenue Code	276
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,342.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

LENS RESTORE ACRYSOF

Facility

$4,475.00

Service Code	HCPCS V2788
Hospital Charge Code	270656057
Hospital Revenue Code	276
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

LENTELS IGE(F235)SERUM

Facility

$15.17

Service Code	HCPCS 86003
Hospital Charge Code	397080014
Hospital Revenue Code	305
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.91
Rate for Payer: Aetna Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.13
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: Cigna Medicare Advantage	$2.61
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.28
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.53
Rate for Payer: Wellcare Medicare Advantage	$5.22

LENTELS IGE(F235)SERUM

Facility

$15.17

Service Code	HCPCS 86003
Hospital Charge Code	397080014
Hospital Revenue Code	305
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$2.28
Rate for Payer: Qualcare PPO/HMO/WC	$2.28

LEPIRUDIN INJ 50 MG/ML

Facility

$803.85

Hospital Charge Code	60629003
Hospital Revenue Code	636
Min. Negotiated Rate	$120.58
Max. Negotiated Rate	$401.93
Rate for Payer: Aetna Commercial	$241.16
Rate for Payer: Aetna Medicare Advantage	$241.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.98
Rate for Payer: Cigna Commercial	$401.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.53
Rate for Payer: Qualcare PPO/HMO/WC	$120.58

LEPIRUDIN INJ 50 MG/ML

Facility

$803.85

Hospital Charge Code	60629003
Hospital Revenue Code	636
Min. Negotiated Rate	$120.58
Max. Negotiated Rate	$194.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.53
Rate for Payer: Qualcare PPO/HMO/WC	$120.58

LEPIRUDIN IVCI 100MG/500ML

Facility

$1,607.05

Hospital Charge Code	60629004
Hospital Revenue Code	250
Min. Negotiated Rate	$208.92
Max. Negotiated Rate	$803.52
Rate for Payer: Aetna Commercial	$482.12
Rate for Payer: Aetna Medicare Advantage	$482.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$409.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$409.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$409.80
Rate for Payer: Cigna Commercial	$803.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.92
Rate for Payer: Oxford Commercial	$803.52
Rate for Payer: Qualcare PPO/HMO/WC	$241.06
Rate for Payer: UnitedHealthcare Commercial	$803.52

LEPIRUDIN IVCI 100MG/500ML

Facility

$1,607.05

Hospital Charge Code	60629004
Hospital Revenue Code	250
Min. Negotiated Rate	$241.06
Max. Negotiated Rate	$241.06
Rate for Payer: Qualcare PPO/HMO/WC	$241.06

LEPTIN, SERUM

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	3038140
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LEPTIN, SERUM

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	3038140
Hospital Revenue Code	301
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.95
Rate for Payer: Aetna Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.28
Rate for Payer: Cigna Commercial	$17.27
Rate for Payer: Cigna Medicare Advantage	$8.63
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
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	$17.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.31
Rate for Payer: Wellcare Medicare Advantage	$17.27

LEPTOSPIRA AGGLUTININS

Facility

$126.00

Service Code	HCPCS 86403
Hospital Charge Code	38476195
Hospital Revenue Code	302
Min. Negotiated Rate	$5.77
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.39
Rate for Payer: Aetna Medicare Advantage	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.28
Rate for Payer: Cigna Commercial	$11.54
Rate for Payer: Cigna Medicare Advantage	$5.77
Rate for Payer: Clover Medicare Advantage	$10.96
Rate for Payer: EmblemHealth Commercial	$34.62
Rate for Payer: Humana Medicare Advantage	$11.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.54
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.23
Rate for Payer: Wellcare Medicare Advantage	$11.54

LEPTOSPIRA AGGLUTININS

Facility

$126.00

Service Code	HCPCS 86403
Hospital Charge Code	38476195
Hospital Revenue Code	302
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

LEPTOSPIRA CULTURE

Facility

$99.00

Service Code	HCPCS 87116
Hospital Charge Code	38475091
Hospital Revenue Code	309
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$14.85
Rate for Payer: Qualcare PPO/HMO/WC	$14.85

LEPTOSPIRA CULTURE

Facility

$99.00

Service Code	HCPCS 87116
Hospital Charge Code	38475091
Hospital Revenue Code	309
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$34.99
Rate for Payer: Aetna Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.57
Rate for Payer: Cigna Commercial	$10.80
Rate for Payer: Cigna Medicare Advantage	$5.40
Rate for Payer: Clover Medicare Advantage	$10.26
Rate for Payer: EmblemHealth Commercial	$32.40
Rate for Payer: Humana Medicare Advantage	$11.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.87
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.45
Rate for Payer: Wellcare Medicare Advantage	$10.80

LEPTOSPIRA CULTURE I

Facility

$45.60

Service Code	HCPCS 87081
Hospital Charge Code	39990162A
Hospital Revenue Code	309
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$21.48
Rate for Payer: Aetna Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.29
Rate for Payer: Cigna Commercial	$6.63
Rate for Payer: Cigna Medicare Advantage	$3.31
Rate for Payer: Clover Medicare Advantage	$6.30
Rate for Payer: EmblemHealth Commercial	$19.89
Rate for Payer: Humana Medicare Advantage	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.84
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.63
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.03
Rate for Payer: Wellcare Medicare Advantage	$6.63

LEPTOSPIRA CULTURE I

Facility

$45.60

Service Code	HCPCS 87081
Hospital Charge Code	39990162A
Hospital Revenue Code	309
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$6.84
Rate for Payer: Qualcare PPO/HMO/WC	$6.84

LEPTOSPIRA CULTURE II

Facility

$36.70

Service Code	HCPCS 87206
Hospital Charge Code	39990162B
Hospital Revenue Code	309
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$5.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.50

LEPTOSPIRA CULTURE II

Facility

$36.70

Service Code	HCPCS 87206
Hospital Charge Code	39990162B
Hospital Revenue Code	309
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.46
Rate for Payer: Aetna Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.39
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	$19.75
Rate for Payer: Cigna Commercial	$5.39
Rate for Payer: Cigna Medicare Advantage	$2.69
Rate for Payer: Clover Medicare Advantage	$5.12
Rate for Payer: EmblemHealth Commercial	$16.17
Rate for Payer: Humana Medicare Advantage	$5.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.71
Rate for Payer: Wellcare Medicare Advantage	$5.39

LEPTOSPIRA DNA QUAL RT PCR

Facility

$1,625.00

Service Code	HCPCS 87798
Hospital Charge Code	4010877982
Hospital Revenue Code	306
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$243.75
Rate for Payer: Aetna Commercial	$113.69
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.57
Rate for Payer: Cigna Commercial	$35.09
Rate for Payer: Cigna Medicare Advantage	$17.55
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

LEPTOSPIRA DNA QUAL RT PCR

Facility

$1,625.00

Service Code	HCPCS 87798
Hospital Charge Code	4010877982
Hospital Revenue Code	306
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$243.75
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

LEPTOSPIRAL AB

Facility

$390.00

Service Code	HCPCS 86720
Hospital Charge Code	397041287
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LEPTOSPIRAL AB

Facility

$390.00

Service Code	HCPCS 86720
Hospital Charge Code	397041287
Hospital Revenue Code	302
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.49
Rate for Payer: Aetna Medicare Advantage	$16.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.20
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	$59.36
Rate for Payer: Cigna Commercial	$16.20
Rate for Payer: Cigna Medicare Advantage	$8.10
Rate for Payer: Clover Medicare Advantage	$15.39
Rate for Payer: EmblemHealth Commercial	$48.60
Rate for Payer: Humana Medicare Advantage	$16.69
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	$16.20
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.17
Rate for Payer: Wellcare Medicare Advantage	$16.20

Know your out-of-pocket cost for care.

All Charges