Heights University Hospital

All Charges

Charge

Type

Setting

Price

LUNG TRANSPLANT

Facility

$436,679.20

Service Code	MSDRG 007
Min. Negotiated Rate	$122,775.26
Max. Negotiated Rate	$436,679.20
Rate for Payer: Aetna Commercial	$436,679.20
Rate for Payer: Aetna Medicare Advantage	$141,320.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$338,247.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$338,247.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$129,237.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$338,247.09
Rate for Payer: Cigna Medicare Advantage	$129,237.12
Rate for Payer: Clover Medicare Advantage	$122,775.26
Rate for Payer: EmblemHealth Commercial	$387,711.36
Rate for Payer: Humana Medicare Advantage	$133,114.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$129,237.12
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$136,991.35
Rate for Payer: Wellcare Medicare Advantage	$129,237.12

LUNG VOLUMES UP TO 2 YRS

Facility

$1,434.60

Service Code	HCPCS 94013
Hospital Charge Code	9501293
Hospital Revenue Code	460
Min. Negotiated Rate	$215.19
Max. Negotiated Rate	$215.19
Rate for Payer: Qualcare PPO/HMO/WC	$215.19

LUNG VOLUMES UP TO 2 YRS

Facility

$1,434.60

Service Code	HCPCS 94013
Hospital Charge Code	9501293
Hospital Revenue Code	460
Min. Negotiated Rate	$186.50
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$430.38
Rate for Payer: Aetna Medicare Advantage	$430.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$365.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$365.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$365.82
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.50
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$215.19
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

LUPRON/1MG/0.2ML

Facility

$1,241.00

Hospital Charge Code	60633336
Hospital Revenue Code	636
Min. Negotiated Rate	$186.15
Max. Negotiated Rate	$300.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.32
Rate for Payer: Qualcare PPO/HMO/WC	$186.15

LUPRON/1MG/0.2ML

Facility

$1,241.00

Hospital Charge Code	60633336
Hospital Revenue Code	636
Min. Negotiated Rate	$186.15
Max. Negotiated Rate	$620.50
Rate for Payer: Aetna Commercial	$372.30
Rate for Payer: Aetna Medicare Advantage	$372.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.45
Rate for Payer: Cigna Commercial	$620.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.32
Rate for Payer: Qualcare PPO/HMO/WC	$186.15

LUPRON DEPOT/3.75MG/EACH

Facility

$2,064.00

Hospital Charge Code	60633337
Hospital Revenue Code	636
Min. Negotiated Rate	$309.60
Max. Negotiated Rate	$1,032.00
Rate for Payer: Aetna Commercial	$619.20
Rate for Payer: Aetna Medicare Advantage	$619.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$526.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$526.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$526.32
Rate for Payer: Cigna Commercial	$1,032.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$499.49
Rate for Payer: Qualcare PPO/HMO/WC	$309.60

LUPRON DEPOT/3.75MG/EACH

Facility

$2,064.00

Hospital Charge Code	60633337
Hospital Revenue Code	636
Min. Negotiated Rate	$309.60
Max. Negotiated Rate	$499.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$499.49
Rate for Payer: Qualcare PPO/HMO/WC	$309.60

LUPUS ANTICOAG,HEXAGONAL

Facility

$667.59

Service Code	HCPCS 85598
Hospital Charge Code	39900179
Hospital Revenue Code	305
Min. Negotiated Rate	$8.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.26
Rate for Payer: Aetna Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.88
Rate for Payer: Cigna Commercial	$17.98
Rate for Payer: Cigna Medicare Advantage	$8.99
Rate for Payer: Clover Medicare Advantage	$17.08
Rate for Payer: EmblemHealth Commercial	$53.94
Rate for Payer: Humana Medicare Advantage	$18.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.06
Rate for Payer: Wellcare Medicare Advantage	$17.98

LUPUS ANTICOAG,HEXAGONAL

Facility

$667.59

Service Code	HCPCS 85598
Hospital Charge Code	39900179
Hospital Revenue Code	305
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

LUPUS ANTICOAGULANT

Facility

$107.00

Service Code	HCPCS 85613
Hospital Charge Code	38478074
Hospital Revenue Code	305
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

LUPUS ANTICOAGULANT

Facility

$107.00

Service Code	HCPCS 85613
Hospital Charge Code	38478074
Hospital Revenue Code	305
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.04
Rate for Payer: Aetna Medicare Advantage	$9.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.58
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	$35.10
Rate for Payer: Cigna Commercial	$9.58
Rate for Payer: Cigna Medicare Advantage	$4.79
Rate for Payer: Clover Medicare Advantage	$9.10
Rate for Payer: EmblemHealth Commercial	$28.74
Rate for Payer: Humana Medicare Advantage	$9.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.58
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.15
Rate for Payer: Wellcare Medicare Advantage	$9.58

LUPUS DRVVT CONFIRM

Facility

$123.55

Service Code	HCPCS 85597
Hospital Charge Code	39900178
Hospital Revenue Code	305
Min. Negotiated Rate	$18.53
Max. Negotiated Rate	$18.53
Rate for Payer: Qualcare PPO/HMO/WC	$18.53

LUPUS DRVVT CONFIRM

Facility

$123.55

Service Code	HCPCS 85597
Hospital Charge Code	39900178
Hospital Revenue Code	305
Min. Negotiated Rate	$8.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.26
Rate for Payer: Aetna Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.88
Rate for Payer: Cigna Commercial	$17.98
Rate for Payer: Cigna Medicare Advantage	$8.99
Rate for Payer: Clover Medicare Advantage	$17.08
Rate for Payer: EmblemHealth Commercial	$53.94
Rate for Payer: Humana Medicare Advantage	$18.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.53
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.06
Rate for Payer: Wellcare Medicare Advantage	$17.98

LUPUS EV

Facility

$255.00

Service Code	HCPCS 85613
Hospital Charge Code	3035076A
Hospital Revenue Code	300
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.04
Rate for Payer: Aetna Medicare Advantage	$9.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.58
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	$35.10
Rate for Payer: Cigna Commercial	$9.58
Rate for Payer: Cigna Medicare Advantage	$4.79
Rate for Payer: Clover Medicare Advantage	$9.10
Rate for Payer: EmblemHealth Commercial	$28.74
Rate for Payer: Humana Medicare Advantage	$9.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.15
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.58
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.15
Rate for Payer: Wellcare Medicare Advantage	$9.58

LUPUS EV

Facility

$255.00

Service Code	HCPCS 85613
Hospital Charge Code	3035076A
Hospital Revenue Code	300
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$38.25
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

LUPUS;HEX PHASE NEUT

Facility

$123.55

Service Code	HCPCS 85598
Hospital Charge Code	39900180
Hospital Revenue Code	305
Min. Negotiated Rate	$8.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.26
Rate for Payer: Aetna Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.88
Rate for Payer: Cigna Commercial	$17.98
Rate for Payer: Cigna Medicare Advantage	$8.99
Rate for Payer: Clover Medicare Advantage	$17.08
Rate for Payer: EmblemHealth Commercial	$53.94
Rate for Payer: Humana Medicare Advantage	$18.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.53
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.06
Rate for Payer: Wellcare Medicare Advantage	$17.98

LUPUS;HEX PHASE NEUT

Facility

$123.55

Service Code	HCPCS 85598
Hospital Charge Code	39900180
Hospital Revenue Code	305
Min. Negotiated Rate	$18.53
Max. Negotiated Rate	$18.53
Rate for Payer: Qualcare PPO/HMO/WC	$18.53

LUPUS PROFILE I

Facility

$667.59

Service Code	HCPCS 85613
Hospital Charge Code	39990077A
Hospital Revenue Code	305
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.04
Rate for Payer: Aetna Medicare Advantage	$9.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.58
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	$35.10
Rate for Payer: Cigna Commercial	$9.58
Rate for Payer: Cigna Medicare Advantage	$4.79
Rate for Payer: Clover Medicare Advantage	$9.10
Rate for Payer: EmblemHealth Commercial	$28.74
Rate for Payer: Humana Medicare Advantage	$9.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.58
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.15
Rate for Payer: Wellcare Medicare Advantage	$9.58

LUPUS PROFILE I

Facility

$667.59

Service Code	HCPCS 85613
Hospital Charge Code	39990077A
Hospital Revenue Code	305
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

LUPUS PROFILE II

Facility

$667.59

Service Code	HCPCS 85730
Hospital Charge Code	39990077B
Hospital Revenue Code	305
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

LUPUS PROFILE II

Facility

$667.59

Service Code	HCPCS 85730
Hospital Charge Code	39990077B
Hospital Revenue Code	305
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$19.47
Rate for Payer: Aetna Medicare Advantage	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.01
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	$22.02
Rate for Payer: Cigna Commercial	$6.01
Rate for Payer: Cigna Medicare Advantage	$3.00
Rate for Payer: Clover Medicare Advantage	$5.71
Rate for Payer: EmblemHealth Commercial	$18.03
Rate for Payer: Humana Medicare Advantage	$6.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.01
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.37
Rate for Payer: Wellcare Medicare Advantage	$6.01

LURIDE/1MG/TAB

Facility

$3.00

Hospital Charge Code	60633338
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

LURIDE/1MG/TAB

Facility

$3.00

Hospital Charge Code	60633338
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

LURIDE-SF/1MG/TAB

Facility

$3.00

Hospital Charge Code	60633340
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

LURIDE-SF/1MG/TAB

Facility

$3.00

Hospital Charge Code	60633340
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

Know your out-of-pocket cost for care.

All Charges