Heights University Hospital

All Charges

Charge

Type

Setting

Price

M TUBERCULOSIS,PCR/CULTURE I

Facility

$146.00

Service Code	HCPCS 87015
Hospital Charge Code	3038087A
Hospital Revenue Code	309
Min. Negotiated Rate	$3.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$21.64
Rate for Payer: Aetna Medicare Advantage	$6.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.48
Rate for Payer: Cigna Commercial	$6.68
Rate for Payer: Cigna Medicare Advantage	$3.34
Rate for Payer: Clover Medicare Advantage	$6.35
Rate for Payer: EmblemHealth Commercial	$20.04
Rate for Payer: Humana Medicare Advantage	$6.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.68
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.08
Rate for Payer: Wellcare Medicare Advantage	$6.68

M TUBERCULOSIS,PCR/CULTURE II

Facility

$295.25

Service Code	HCPCS 87116
Hospital Charge Code	3038087B
Hospital Revenue Code	309
Min. Negotiated Rate	$44.29
Max. Negotiated Rate	$44.29
Rate for Payer: Qualcare PPO/HMO/WC	$44.29

M TUBERCULOSIS,PCR/CULTURE II

Facility

$295.25

Service Code	HCPCS 87116
Hospital Charge Code	3038087B
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	$38.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.29
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

M TUBERCULOSIS,PCR/CULTURE III

Facility

$71.25

Service Code	HCPCS 87206
Hospital Charge Code	3038087C
Hospital Revenue Code	309
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$10.69
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

M TUBERCULOSIS,PCR/CULTURE III

Facility

$71.25

Service Code	HCPCS 87206
Hospital Charge Code	3038087C
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	$9.26
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
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

M TUBERCULOSIS,PCR/CULTURE IV

Facility

$846.00

Service Code	HCPCS 87556
Hospital Charge Code	3038087D
Hospital Revenue Code	306
Min. Negotiated Rate	$126.90
Max. Negotiated Rate	$126.90
Rate for Payer: Qualcare PPO/HMO/WC	$126.90

M TUBERCULOSIS,PCR/CULTURE IV

Facility

$846.00

Service Code	HCPCS 87556
Hospital Charge Code	3038087D
Hospital Revenue Code	306
Min. Negotiated Rate	$20.84
Max. Negotiated Rate	$152.72
Rate for Payer: Aetna Commercial	$135.04
Rate for Payer: Aetna Medicare Advantage	$41.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$152.72
Rate for Payer: Cigna Commercial	$41.68
Rate for Payer: Cigna Medicare Advantage	$20.84
Rate for Payer: Clover Medicare Advantage	$39.60
Rate for Payer: EmblemHealth Commercial	$125.04
Rate for Payer: Humana Medicare Advantage	$42.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$41.68
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$44.18
Rate for Payer: Wellcare Medicare Advantage	$41.68

MUCIN-MUCICARMINE STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005297
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

MUCIN-MUCICARMINE STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005297
Hospital Revenue Code	310
Min. Negotiated Rate	$46.48
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$201.60
Rate for Payer: Aetna Medicare Advantage	$201.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$46.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.80
Rate for Payer: UnitedHealthcare Commercial	$114.00

MUCIN TEST

Facility

$44.00

Service Code	HCPCS 83872
Hospital Charge Code	38475098
Hospital Revenue Code	301
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.99
Rate for Payer: Aetna Medicare Advantage	$5.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.47
Rate for Payer: Cigna Commercial	$5.86
Rate for Payer: Cigna Medicare Advantage	$2.93
Rate for Payer: Clover Medicare Advantage	$5.57
Rate for Payer: EmblemHealth Commercial	$17.58
Rate for Payer: Humana Medicare Advantage	$6.04
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
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.86
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.21
Rate for Payer: Wellcare Medicare Advantage	$5.86

MUCIN TEST

Facility

$44.00

Service Code	HCPCS 83872
Hospital Charge Code	38475098
Hospital Revenue Code	301
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

MUCOMYST-10 10% INHAL/30M

Facility

$279.00

Hospital Charge Code	60633464
Hospital Revenue Code	250
Min. Negotiated Rate	$41.85
Max. Negotiated Rate	$41.85
Rate for Payer: Qualcare PPO/HMO/WC	$41.85

MUCOMYST-10 10% INHAL/30M

Facility

$279.00

Hospital Charge Code	60633464
Hospital Revenue Code	250
Min. Negotiated Rate	$36.27
Max. Negotiated Rate	$139.50
Rate for Payer: Aetna Commercial	$83.70
Rate for Payer: Aetna Medicare Advantage	$83.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.14
Rate for Payer: Cigna Commercial	$139.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.27
Rate for Payer: Oxford Commercial	$139.50
Rate for Payer: Qualcare PPO/HMO/WC	$41.85
Rate for Payer: UnitedHealthcare Commercial	$139.50

MUCOMYST-10 10% INHAL/4ML

Facility

$41.00

Hospital Charge Code	60633465
Hospital Revenue Code	250
Min. Negotiated Rate	$5.33
Max. Negotiated Rate	$20.50
Rate for Payer: Aetna Commercial	$12.30
Rate for Payer: Aetna Medicare Advantage	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.46
Rate for Payer: Cigna Commercial	$20.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.33
Rate for Payer: Oxford Commercial	$20.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.15
Rate for Payer: UnitedHealthcare Commercial	$20.50

MUCOMYST-10 10% INHAL/4ML

Facility

$41.00

Hospital Charge Code	60633465
Hospital Revenue Code	250
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$6.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.15

MUCOMYST 10% 30ML VIAL

Facility

$76.11

Service Code	NDC 409330703
Hospital Charge Code	6063943283
Hospital Revenue Code	250
Min. Negotiated Rate	$11.42
Max. Negotiated Rate	$11.42
Rate for Payer: Qualcare PPO/HMO/WC	$11.42

MUCOMYST 10% 30ML VIAL

Facility

$76.11

Service Code	NDC 409330703
Hospital Charge Code	6063943283
Hospital Revenue Code	250
Min. Negotiated Rate	$9.89
Max. Negotiated Rate	$38.05
Rate for Payer: Aetna Commercial	$22.83
Rate for Payer: Aetna Medicare Advantage	$22.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.41
Rate for Payer: Cigna Commercial	$38.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.89
Rate for Payer: Oxford Commercial	$38.05
Rate for Payer: Qualcare PPO/HMO/WC	$11.42
Rate for Payer: UnitedHealthcare Commercial	$38.05

MUCOMYST 20% INHAL/30ML

Facility

$337.00

Hospital Charge Code	60633463
Hospital Revenue Code	250
Min. Negotiated Rate	$50.55
Max. Negotiated Rate	$50.55
Rate for Payer: Qualcare PPO/HMO/WC	$50.55

MUCOMYST 20% INHAL/30ML

Facility

$337.00

Hospital Charge Code	60633463
Hospital Revenue Code	250
Min. Negotiated Rate	$43.81
Max. Negotiated Rate	$168.50
Rate for Payer: Aetna Commercial	$101.10
Rate for Payer: Aetna Medicare Advantage	$101.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.94
Rate for Payer: Cigna Commercial	$168.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.81
Rate for Payer: Oxford Commercial	$168.50
Rate for Payer: Qualcare PPO/HMO/WC	$50.55
Rate for Payer: UnitedHealthcare Commercial	$168.50

MUCOMYST 20% INHAL/4ML

Facility

$51.00

Hospital Charge Code	60633462
Hospital Revenue Code	250
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$25.50
Rate for Payer: Aetna Commercial	$15.30
Rate for Payer: Aetna Medicare Advantage	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.01
Rate for Payer: Cigna Commercial	$25.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.63
Rate for Payer: Oxford Commercial	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$25.50

MUCOMYST 20% INHAL/4ML

Facility

$51.00

Hospital Charge Code	60633462
Hospital Revenue Code	250
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

MUGA SCAN

Facility

$1,579.25

Service Code	HCPCS 78472
Hospital Charge Code	94053020
Hospital Revenue Code	341
Min. Negotiated Rate	$236.89
Max. Negotiated Rate	$236.89
Rate for Payer: Qualcare PPO/HMO/WC	$236.89

MUGA SCAN

Facility

$1,321.00

Service Code	HCPCS 78473
Hospital Charge Code	74115006
Hospital Revenue Code	341
Min. Negotiated Rate	$171.73
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$396.30
Rate for Payer: Aetna Medicare Advantage	$396.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$336.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$336.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$336.86
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.73
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$198.15
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

MUGA SCAN

Facility

$1,579.25

Service Code	HCPCS 78472
Hospital Charge Code	5309010
Hospital Revenue Code	341
Min. Negotiated Rate	$236.89
Max. Negotiated Rate	$236.89
Rate for Payer: Qualcare PPO/HMO/WC	$236.89

MUGA SCAN

Facility

$1,321.00

Service Code	HCPCS 78473
Hospital Charge Code	74117006
Hospital Revenue Code	341
Min. Negotiated Rate	$171.73
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$396.30
Rate for Payer: Aetna Medicare Advantage	$396.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$336.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$336.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$243.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$336.86
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.73
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$198.15
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

Know your out-of-pocket cost for care.

All Charges