Heights University Hospital

All Charges

Charge

Type

Setting

Price

LIOTHYRONINE TAB 5MCG

Facility

$9.11

Service Code	NDC 60793011501
Hospital Charge Code	60628260
Hospital Revenue Code	250
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$1.37
Rate for Payer: Qualcare PPO/HMO/WC	$1.37

LIPASE

Facility

$317.80

Service Code	HCPCS 83690
Hospital Charge Code	38472455
Hospital Revenue Code	301
Min. Negotiated Rate	$47.67
Max. Negotiated Rate	$47.67
Rate for Payer: Qualcare PPO/HMO/WC	$47.67

LIPASE

Facility

$317.80

Service Code	HCPCS 83690
Hospital Charge Code	38472455
Hospital Revenue Code	301
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$22.32
Rate for Payer: Aetna Medicare Advantage	$6.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.24
Rate for Payer: Cigna Commercial	$6.89
Rate for Payer: Cigna Medicare Advantage	$3.44
Rate for Payer: Clover Medicare Advantage	$6.55
Rate for Payer: EmblemHealth Commercial	$20.67
Rate for Payer: Humana Medicare Advantage	$7.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.31
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.67
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.89
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.30
Rate for Payer: Wellcare Medicare Advantage	$6.89

LIPASE***

Facility

$25.00

Hospital Charge Code	3011822
Hospital Revenue Code	309
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

LIPASE***

Facility

$25.00

Hospital Charge Code	3011822
Hospital Revenue Code	309
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

LIPASE, JP DRAINAGE

Facility

$47.35

Service Code	HCPCS 83690
Hospital Charge Code	39900103
Hospital Revenue Code	301
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$22.32
Rate for Payer: Aetna Medicare Advantage	$6.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.24
Rate for Payer: Cigna Commercial	$6.89
Rate for Payer: Cigna Medicare Advantage	$3.44
Rate for Payer: Clover Medicare Advantage	$6.55
Rate for Payer: EmblemHealth Commercial	$20.67
Rate for Payer: Humana Medicare Advantage	$7.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.16
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.89
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.30
Rate for Payer: Wellcare Medicare Advantage	$6.89

LIPASE, JP DRAINAGE

Facility

$47.35

Service Code	HCPCS 83690
Hospital Charge Code	39900103
Hospital Revenue Code	301
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$7.10
Rate for Payer: Qualcare PPO/HMO/WC	$7.10

LIPASE, SERUM

Facility

$707.67

Service Code	HCPCS 83690
Hospital Charge Code	3001823
Hospital Revenue Code	301
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$22.32
Rate for Payer: Aetna Medicare Advantage	$6.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.24
Rate for Payer: Cigna Commercial	$6.89
Rate for Payer: Cigna Medicare Advantage	$3.44
Rate for Payer: Clover Medicare Advantage	$6.55
Rate for Payer: EmblemHealth Commercial	$20.67
Rate for Payer: Humana Medicare Advantage	$7.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$106.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.89
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.30
Rate for Payer: Wellcare Medicare Advantage	$6.89

LIPASE, SERUM

Facility

$707.67

Service Code	HCPCS 83690
Hospital Charge Code	3001823
Hospital Revenue Code	301
Min. Negotiated Rate	$106.15
Max. Negotiated Rate	$106.15
Rate for Payer: Qualcare PPO/HMO/WC	$106.15

LIPASE, URINE, 24 HOUR***

Facility

$110.00

Service Code	HCPCS 83690
Hospital Charge Code	3032240
Hospital Revenue Code	309
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

LIPASE, URINE, 24 HOUR***

Facility

$110.00

Service Code	HCPCS 83690
Hospital Charge Code	3032240
Hospital Revenue Code	309
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$22.32
Rate for Payer: Aetna Medicare Advantage	$6.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.24
Rate for Payer: Cigna Commercial	$6.89
Rate for Payer: Cigna Medicare Advantage	$3.44
Rate for Payer: Clover Medicare Advantage	$6.55
Rate for Payer: EmblemHealth Commercial	$20.67
Rate for Payer: Humana Medicare Advantage	$7.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.89
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.30
Rate for Payer: Wellcare Medicare Advantage	$6.89

LIPID

Facility

$758.80

Service Code	HCPCS 80061
Hospital Charge Code	38472023
Hospital Revenue Code	301
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.38
Rate for Payer: Aetna Medicare Advantage	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.39
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	$49.06
Rate for Payer: Cigna Commercial	$13.39
Rate for Payer: Cigna Medicare Advantage	$6.70
Rate for Payer: Clover Medicare Advantage	$12.72
Rate for Payer: EmblemHealth Commercial	$40.17
Rate for Payer: Humana Medicare Advantage	$13.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$113.82
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.19
Rate for Payer: Wellcare Medicare Advantage	$13.39

LIPID

Facility

$758.80

Service Code	HCPCS 80061
Hospital Charge Code	38472023
Hospital Revenue Code	301
Min. Negotiated Rate	$113.82
Max. Negotiated Rate	$113.82
Rate for Payer: Qualcare PPO/HMO/WC	$113.82

LIPID

Facility

$758.80

Service Code	HCPCS 80061
Hospital Charge Code	38479458
Hospital Revenue Code	301
Min. Negotiated Rate	$113.82
Max. Negotiated Rate	$113.82
Rate for Payer: Qualcare PPO/HMO/WC	$113.82

LIPID

Facility

$758.80

Service Code	HCPCS 80061
Hospital Charge Code	38479458
Hospital Revenue Code	301
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.38
Rate for Payer: Aetna Medicare Advantage	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.39
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	$49.06
Rate for Payer: Cigna Commercial	$13.39
Rate for Payer: Cigna Medicare Advantage	$6.70
Rate for Payer: Clover Medicare Advantage	$12.72
Rate for Payer: EmblemHealth Commercial	$40.17
Rate for Payer: Humana Medicare Advantage	$13.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$113.82
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.19
Rate for Payer: Wellcare Medicare Advantage	$13.39

LIPID-ASSOCIATED SIALIC ACID

Facility

$153.65

Service Code	HCPCS 84275
Hospital Charge Code	3007580
Hospital Revenue Code	301
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.55
Rate for Payer: Aetna Medicare Advantage	$13.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.24
Rate for Payer: Cigna Commercial	$13.44
Rate for Payer: Cigna Medicare Advantage	$6.72
Rate for Payer: Clover Medicare Advantage	$12.77
Rate for Payer: EmblemHealth Commercial	$40.32
Rate for Payer: Humana Medicare Advantage	$13.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.44
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.25
Rate for Payer: Wellcare Medicare Advantage	$13.44

LIPID-ASSOCIATED SIALIC ACID

Facility

$153.65

Service Code	HCPCS 84275
Hospital Charge Code	3007580
Hospital Revenue Code	301
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$23.05
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

LIPID PROFILE***

Facility

$87.00

Service Code	HCPCS 82465
Hospital Charge Code	3006384
Hospital Revenue Code	301
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.09
Rate for Payer: Aetna Medicare Advantage	$4.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.94
Rate for Payer: Cigna Commercial	$4.35
Rate for Payer: Cigna Medicare Advantage	$2.17
Rate for Payer: Clover Medicare Advantage	$4.13
Rate for Payer: EmblemHealth Commercial	$13.05
Rate for Payer: Humana Medicare Advantage	$4.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.31
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.61
Rate for Payer: Wellcare Medicare Advantage	$4.35

LIPID PROFILE***

Facility

$87.00

Service Code	HCPCS 82465
Hospital Charge Code	3006384
Hospital Revenue Code	301
Min. Negotiated Rate	$13.05
Max. Negotiated Rate	$13.05
Rate for Payer: Qualcare PPO/HMO/WC	$13.05

LIPID PROFILE PANEL

Facility

$1,475.31

Service Code	HCPCS 80061
Hospital Charge Code	3006459
Hospital Revenue Code	301
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$221.30
Rate for Payer: Aetna Commercial	$43.38
Rate for Payer: Aetna Medicare Advantage	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.39
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	$49.06
Rate for Payer: Cigna Commercial	$13.39
Rate for Payer: Cigna Medicare Advantage	$6.70
Rate for Payer: Clover Medicare Advantage	$12.72
Rate for Payer: EmblemHealth Commercial	$40.17
Rate for Payer: Humana Medicare Advantage	$13.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.19
Rate for Payer: Wellcare Medicare Advantage	$13.39

LIPID PROFILE PANEL

Facility

$1,475.31

Service Code	HCPCS 80061
Hospital Charge Code	3006459
Hospital Revenue Code	301
Min. Negotiated Rate	$221.30
Max. Negotiated Rate	$221.30
Rate for Payer: Qualcare PPO/HMO/WC	$221.30

LIPID RESCUE KIT

Facility

$257.88

Service Code	NDC 338051904
Hospital Charge Code	606351002
Hospital Revenue Code	250
Min. Negotiated Rate	$33.52
Max. Negotiated Rate	$128.94
Rate for Payer: Aetna Commercial	$77.36
Rate for Payer: Aetna Medicare Advantage	$77.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.76
Rate for Payer: Cigna Commercial	$128.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.52
Rate for Payer: Oxford Commercial	$128.94
Rate for Payer: Qualcare PPO/HMO/WC	$38.68
Rate for Payer: UnitedHealthcare Commercial	$128.94

LIPID RESCUE KIT

Facility

$257.88

Service Code	NDC 338051904
Hospital Charge Code	606351002
Hospital Revenue Code	250
Min. Negotiated Rate	$38.68
Max. Negotiated Rate	$38.68
Rate for Payer: Qualcare PPO/HMO/WC	$38.68

LIPIDS STOOL, QUAL

Facility

$264.00

Service Code	HCPCS 82705
Hospital Charge Code	38472030
Hospital Revenue Code	301
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.52
Rate for Payer: Aetna Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.69
Rate for Payer: Cigna Commercial	$5.10
Rate for Payer: Cigna Medicare Advantage	$2.55
Rate for Payer: Clover Medicare Advantage	$4.84
Rate for Payer: EmblemHealth Commercial	$15.30
Rate for Payer: Humana Medicare Advantage	$5.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.10
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.41
Rate for Payer: Wellcare Medicare Advantage	$5.10

LIPIDS STOOL, QUAL

Facility

$264.00

Service Code	HCPCS 82705
Hospital Charge Code	38472030
Hospital Revenue Code	301
Min. Negotiated Rate	$39.60
Max. Negotiated Rate	$39.60
Rate for Payer: Qualcare PPO/HMO/WC	$39.60

Know your out-of-pocket cost for care.

All Charges