Heights University Hospital

All Charges

Charge

Type

Setting

Price

MOLECULAR DIAGNOSTICS

Facility

$105.00

Hospital Charge Code	3004168C
Hospital Revenue Code	301
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.50
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.65
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

MOLECULAR DIAGNOSTICS

Facility

$105.00

Hospital Charge Code	3004168C
Hospital Revenue Code	301
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

MOLECULAR DIAGNOSTICS

Facility

$105.00

Hospital Charge Code	3004168B
Hospital Revenue Code	301
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$31.50
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.65
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

MOLECULAR DIAG SEPARATION (1)

Facility

$44.00

Service Code	HCPCS 83894
Hospital Charge Code	38473134
Hospital Revenue Code	301
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$114.00
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	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$114.00

MOLECULAR DIAG SEPARATION (1)

Facility

$44.00

Service Code	HCPCS 83894
Hospital Charge Code	38473134
Hospital Revenue Code	301
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

MOLECULAR DIAG SEPARATION (5)

Facility

$44.00

Service Code	HCPCS 83894
Hospital Charge Code	38473146
Hospital Revenue Code	301
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

MOLECULAR DIAG SEPARATION (5)

Facility

$44.00

Service Code	HCPCS 83894
Hospital Charge Code	38473146
Hospital Revenue Code	301
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$114.00
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	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$114.00

MOLECULAR DIAG SEPARAT W IDENT

Facility

$120.05

Hospital Charge Code	3036025A
Hospital Revenue Code	309
Min. Negotiated Rate	$15.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$36.02
Rate for Payer: Aetna Medicare Advantage	$36.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.61
Rate for Payer: Cigna Commercial	$60.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.01
Rate for Payer: UnitedHealthcare Commercial	$114.00

MOLECULAR DIAG SEPARAT W IDENT

Facility

$120.05

Hospital Charge Code	3036025A
Hospital Revenue Code	309
Min. Negotiated Rate	$18.01
Max. Negotiated Rate	$18.01
Rate for Payer: Qualcare PPO/HMO/WC	$18.01

MOLECULAR DX INTERPRETATION

Facility

$85.00

Service Code	HCPCS 83912
Hospital Charge Code	38479425
Hospital Revenue Code	301
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$114.00
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: Aetna Commercial	$25.50
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

MOLECULAR DX INTERPRETATION

Facility

$85.00

Service Code	HCPCS 83912
Hospital Charge Code	38479425
Hospital Revenue Code	301
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

MOLECULAR DX LYSIS PRIOR TO NA

Facility

$94.60

Service Code	HCPCS 83907
Hospital Charge Code	38477114
Hospital Revenue Code	301
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$28.38
Rate for Payer: Aetna Medicare Advantage	$28.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.12
Rate for Payer: Cigna Commercial	$47.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.19
Rate for Payer: UnitedHealthcare Commercial	$114.00

MOLECULAR DX LYSIS PRIOR TO NA

Facility

$94.60

Service Code	HCPCS 83907
Hospital Charge Code	38477114
Hospital Revenue Code	301
Min. Negotiated Rate	$14.19
Max. Negotiated Rate	$14.19
Rate for Payer: Qualcare PPO/HMO/WC	$14.19

MOLECULAR DX;MUTATION SCANNIG

Facility

$118.69

Service Code	HCPCS 83903
Hospital Charge Code	38477139
Hospital Revenue Code	301
Min. Negotiated Rate	$15.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$35.61
Rate for Payer: Aetna Medicare Advantage	$35.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.27
Rate for Payer: Cigna Commercial	$59.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.80
Rate for Payer: UnitedHealthcare Commercial	$114.00

MOLECULAR DX;MUTATION SCANNIG

Facility

$118.69

Service Code	HCPCS 83903
Hospital Charge Code	38477139
Hospital Revenue Code	301
Min. Negotiated Rate	$17.80
Max. Negotiated Rate	$17.80
Rate for Payer: Qualcare PPO/HMO/WC	$17.80

MOLECULAR DX NUCLEIC ACID TRAN

Facility

$28.00

Service Code	HCPCS 83897
Hospital Charge Code	38477024
Hospital Revenue Code	301
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$114.00

MOLECULAR DX NUCLEIC ACID TRAN

Facility

$28.00

Service Code	HCPCS 83897
Hospital Charge Code	38477024
Hospital Revenue Code	301
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

MOLECULAR DX RNA STABILIZATION

Facility

$94.60

Service Code	HCPCS 83913
Hospital Charge Code	38477115
Hospital Revenue Code	301
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$28.38
Rate for Payer: Aetna Medicare Advantage	$28.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.12
Rate for Payer: Cigna Commercial	$47.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.19
Rate for Payer: UnitedHealthcare Commercial	$114.00

MOLECULAR DX RNA STABILIZATION

Facility

$94.60

Service Code	HCPCS 83913
Hospital Charge Code	38477115
Hospital Revenue Code	301
Min. Negotiated Rate	$14.19
Max. Negotiated Rate	$14.19
Rate for Payer: Qualcare PPO/HMO/WC	$14.19

MOLECULAR ISOLATION (1)

Facility

$478.00

Service Code	HCPCS 83890
Hospital Charge Code	38473131
Hospital Revenue Code	301
Min. Negotiated Rate	$71.70
Max. Negotiated Rate	$71.70
Rate for Payer: Qualcare PPO/HMO/WC	$71.70

MOLECULAR ISOLATION (1)

Facility

$478.00

Service Code	HCPCS 83890
Hospital Charge Code	38473131
Hospital Revenue Code	301
Min. Negotiated Rate	$62.14
Max. Negotiated Rate	$239.00
Rate for Payer: Aetna Commercial	$143.40
Rate for Payer: Aetna Medicare Advantage	$143.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.89
Rate for Payer: Cigna Commercial	$239.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.70
Rate for Payer: UnitedHealthcare Commercial	$114.00

MOLECULAR ISOLATION (2)

Facility

$568.00

Service Code	HCPCS 83890
Hospital Charge Code	38473132
Hospital Revenue Code	301
Min. Negotiated Rate	$85.20
Max. Negotiated Rate	$85.20
Rate for Payer: Qualcare PPO/HMO/WC	$85.20

MOLECULAR ISOLATION (2)

Facility

$568.00

Service Code	HCPCS 83890
Hospital Charge Code	38473132
Hospital Revenue Code	301
Min. Negotiated Rate	$73.84
Max. Negotiated Rate	$284.00
Rate for Payer: Aetna Commercial	$170.40
Rate for Payer: Aetna Medicare Advantage	$170.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.84
Rate for Payer: Cigna Commercial	$284.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.20
Rate for Payer: UnitedHealthcare Commercial	$114.00

MOLECULE ISOLATE NUCLEIC

Facility

$111.00

Hospital Charge Code	3004168A
Hospital Revenue Code	301
Min. Negotiated Rate	$14.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$33.30
Rate for Payer: Aetna Medicare Advantage	$33.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.30
Rate for Payer: Cigna Commercial	$55.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.65
Rate for Payer: UnitedHealthcare Commercial	$114.00

MOLECULE ISOLATE NUCLEIC

Facility

$111.00

Hospital Charge Code	3004168A
Hospital Revenue Code	301
Min. Negotiated Rate	$16.65
Max. Negotiated Rate	$16.65
Rate for Payer: Qualcare PPO/HMO/WC	$16.65

Know your out-of-pocket cost for care.

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