Heights University Hospital

All Charges

Charge

Type

Setting

Price

LIPOPROTEIN ELECTROPHORESIS

Facility

$242.00

Service Code	HCPCS 83700
Hospital Charge Code	38472458
Hospital Revenue Code	301
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

LIPOPROTEIN FRACTIONATION I

Facility

$390.00

Service Code	HCPCS 82465
Hospital Charge Code	39990161A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LIPOPROTEIN FRACTIONATION I

Facility

$390.00

Service Code	HCPCS 82465
Hospital Charge Code	39990161A
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	$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	$4.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.61
Rate for Payer: Wellcare Medicare Advantage	$4.35

LIPOPROTEIN FRACTIONATION II

Facility

$390.00

Service Code	HCPCS 83701
Hospital Charge Code	39990161B
Hospital Revenue Code	301
Min. Negotiated Rate	$16.93
Max. Negotiated Rate	$124.06
Rate for Payer: Aetna Commercial	$109.71
Rate for Payer: Aetna Medicare Advantage	$33.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$33.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.06
Rate for Payer: Cigna Commercial	$33.86
Rate for Payer: Cigna Medicare Advantage	$16.93
Rate for Payer: Clover Medicare Advantage	$32.17
Rate for Payer: EmblemHealth Commercial	$101.58
Rate for Payer: Humana Medicare Advantage	$34.88
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	$33.86
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$35.89
Rate for Payer: Wellcare Medicare Advantage	$33.86

LIPOPROTEIN FRACTIONATION II

Facility

$390.00

Service Code	HCPCS 83701
Hospital Charge Code	39990161B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LIPOPROTEIN FRACTIONATION III

Facility

$390.00

Service Code	HCPCS 84478
Hospital Charge Code	39990161C
Hospital Revenue Code	301
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.60
Rate for Payer: Aetna Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.03
Rate for Payer: Cigna Commercial	$5.74
Rate for Payer: Cigna Medicare Advantage	$2.87
Rate for Payer: Clover Medicare Advantage	$5.45
Rate for Payer: EmblemHealth Commercial	$17.22
Rate for Payer: Humana Medicare Advantage	$5.91
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	$5.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.08
Rate for Payer: Wellcare Medicare Advantage	$5.74

LIPOPROTEIN FRACTIONATION III

Facility

$390.00

Service Code	HCPCS 84478
Hospital Charge Code	39990161C
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

LIPOPROTEIN FRACTIONATION NMR

Facility

$50.00

Service Code	HCPCS 83704
Hospital Charge Code	401183704
Hospital Revenue Code	301
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

LIPOPROTEIN FRACTIONATION NMR

Facility

$50.00

Service Code	HCPCS 83704
Hospital Charge Code	401183704
Hospital Revenue Code	301
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$125.27
Rate for Payer: Aetna Commercial	$110.78
Rate for Payer: Aetna Medicare Advantage	$34.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.27
Rate for Payer: Cigna Commercial	$34.19
Rate for Payer: Cigna Medicare Advantage	$17.09
Rate for Payer: Clover Medicare Advantage	$32.48
Rate for Payer: EmblemHealth Commercial	$102.57
Rate for Payer: Humana Medicare Advantage	$35.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.19
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$36.24
Rate for Payer: Wellcare Medicare Advantage	$34.19

LIPOPROTEINS PHENTYPE ELECTR**

Facility

$48.00

Hospital Charge Code	3011848
Hospital Revenue Code	309
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.40
Rate for Payer: Aetna Medicare Advantage	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.24
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.24
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$114.00

LIPOPROTEINS PHENTYPE ELECTR**

Facility

$48.00

Hospital Charge Code	3011848
Hospital Revenue Code	309
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

LIPOPROTEIN SUBFRACT

Facility

$113.00

Service Code	HCPCS 84478
Hospital Charge Code	3035044A
Hospital Revenue Code	301
Min. Negotiated Rate	$16.95
Max. Negotiated Rate	$16.95
Rate for Payer: Qualcare PPO/HMO/WC	$16.95

LIPOPROTEIN SUBFRACT

Facility

$113.00

Service Code	HCPCS 84478
Hospital Charge Code	3035044A
Hospital Revenue Code	301
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.60
Rate for Payer: Aetna Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.03
Rate for Payer: Cigna Commercial	$5.74
Rate for Payer: Cigna Medicare Advantage	$2.87
Rate for Payer: Clover Medicare Advantage	$5.45
Rate for Payer: EmblemHealth Commercial	$17.22
Rate for Payer: Humana Medicare Advantage	$5.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.69
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.08
Rate for Payer: Wellcare Medicare Advantage	$5.74

LIPOPROTEIN SUBFRACTIONATION

Facility

$858.15

Service Code	HCPCS 83701
Hospital Charge Code	3035044
Hospital Revenue Code	301
Min. Negotiated Rate	$16.93
Max. Negotiated Rate	$128.72
Rate for Payer: Aetna Commercial	$109.71
Rate for Payer: Aetna Medicare Advantage	$33.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$33.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.06
Rate for Payer: Cigna Commercial	$33.86
Rate for Payer: Cigna Medicare Advantage	$16.93
Rate for Payer: Clover Medicare Advantage	$32.17
Rate for Payer: EmblemHealth Commercial	$101.58
Rate for Payer: Humana Medicare Advantage	$34.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.56
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$128.72
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$33.86
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$35.89
Rate for Payer: Wellcare Medicare Advantage	$33.86

LIPOPROTEIN SUBFRACTIONATION

Facility

$858.15

Service Code	HCPCS 83701
Hospital Charge Code	3035044
Hospital Revenue Code	301
Min. Negotiated Rate	$128.72
Max. Negotiated Rate	$128.72
Rate for Payer: Qualcare PPO/HMO/WC	$128.72

LIPOSUCTION PANEL (DR. PELOSI)

Facility

$243.25

Hospital Charge Code	3007581
Hospital Revenue Code	300
Min. Negotiated Rate	$36.49
Max. Negotiated Rate	$36.49
Rate for Payer: Qualcare PPO/HMO/WC	$36.49

LIPOSUCTION PANEL (DR. PELOSI)

Facility

$243.25

Hospital Charge Code	3007581
Hospital Revenue Code	300
Min. Negotiated Rate	$31.62
Max. Negotiated Rate	$121.62
Rate for Payer: Aetna Commercial	$72.97
Rate for Payer: Aetna Medicare Advantage	$72.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.03
Rate for Payer: Cigna Commercial	$121.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.49
Rate for Payer: UnitedHealthcare Commercial	$114.00

LIPOSYN II 10%/500ML

Facility

$289.00

Hospital Charge Code	60633309
Hospital Revenue Code	250
Min. Negotiated Rate	$37.57
Max. Negotiated Rate	$144.50
Rate for Payer: Aetna Commercial	$86.70
Rate for Payer: Aetna Medicare Advantage	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.69
Rate for Payer: Cigna Commercial	$144.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.57
Rate for Payer: Oxford Commercial	$144.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.35
Rate for Payer: UnitedHealthcare Commercial	$144.50

LIPOSYN II 10%/500ML

Facility

$289.00

Hospital Charge Code	60633309
Hospital Revenue Code	250
Min. Negotiated Rate	$43.35
Max. Negotiated Rate	$43.35
Rate for Payer: Qualcare PPO/HMO/WC	$43.35

LIPOSYN II 20%/500ML

Facility

$44.00

Hospital Charge Code	60634540
Hospital Revenue Code	250
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

LIPOSYN II 20%/500ML

Facility

$44.00

Hospital Charge Code	60634540
Hospital Revenue Code	250
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$13.20
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.72
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$22.00

LIPROPR0TEIN ELECTROPHORESIS

Facility

$1,028.49

Hospital Charge Code	3001849
Hospital Revenue Code	301
Min. Negotiated Rate	$154.27
Max. Negotiated Rate	$154.27
Rate for Payer: Qualcare PPO/HMO/WC	$154.27

LIPROPR0TEIN ELECTROPHORESIS

Facility

$1,028.49

Hospital Charge Code	3001849
Hospital Revenue Code	301
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$514.25
Rate for Payer: Aetna Commercial	$308.55
Rate for Payer: Aetna Medicare Advantage	$308.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$262.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$262.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$262.26
Rate for Payer: Cigna Commercial	$514.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$154.27
Rate for Payer: UnitedHealthcare Commercial	$114.00

LIPROPR0TEIN ELECTROPHORESIS I

Facility

$69.00

Service Code	HCPCS 83700
Hospital Charge Code	3001849B
Hospital Revenue Code	301
Min. Negotiated Rate	$10.35
Max. Negotiated Rate	$10.35
Rate for Payer: Qualcare PPO/HMO/WC	$10.35

LIPROPR0TEIN ELECTROPHORESIS I

Facility

$69.00

Service Code	HCPCS 83700
Hospital Charge Code	3001849B
Hospital Revenue Code	301
Min. Negotiated Rate	$5.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$36.48
Rate for Payer: Aetna Medicare Advantage	$11.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.26
Rate for Payer: Cigna Commercial	$11.26
Rate for Payer: Cigna Medicare Advantage	$5.63
Rate for Payer: Clover Medicare Advantage	$10.70
Rate for Payer: EmblemHealth Commercial	$33.78
Rate for Payer: Humana Medicare Advantage	$11.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.26
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.94
Rate for Payer: Wellcare Medicare Advantage	$11.26

Know your out-of-pocket cost for care.

All Charges