Heights University Hospital

All Charges

Charge

Type

Setting

Price

MYOGLOBIN (SERUM)

Facility

$122.50

Service Code	HCPCS 83874
Hospital Charge Code	3030251
Hospital Revenue Code	301
Min. Negotiated Rate	$18.38
Max. Negotiated Rate	$18.38
Rate for Payer: Qualcare PPO/HMO/WC	$18.38

MYOGLOBIN,SERUM

Facility

$489.00

Service Code	HCPCS 83874
Hospital Charge Code	38472516
Hospital Revenue Code	301
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.86
Rate for Payer: Aetna Medicare Advantage	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.34
Rate for Payer: Cigna Commercial	$12.92
Rate for Payer: Cigna Medicare Advantage	$6.46
Rate for Payer: Clover Medicare Advantage	$12.27
Rate for Payer: EmblemHealth Commercial	$38.76
Rate for Payer: Humana Medicare Advantage	$13.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.57
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.92
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.70
Rate for Payer: Wellcare Medicare Advantage	$12.92

MYOGLOBIN,SERUM

Facility

$489.00

Service Code	HCPCS 83874
Hospital Charge Code	38472516
Hospital Revenue Code	301
Min. Negotiated Rate	$73.35
Max. Negotiated Rate	$73.35
Rate for Payer: Qualcare PPO/HMO/WC	$73.35

MYOGLOBIN URINE

Facility

$390.00

Service Code	HCPCS 83874
Hospital Charge Code	39900110
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MYOGLOBIN URINE

Facility

$390.00

Service Code	HCPCS 83874
Hospital Charge Code	39900110
Hospital Revenue Code	301
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.86
Rate for Payer: Aetna Medicare Advantage	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.34
Rate for Payer: Cigna Commercial	$12.92
Rate for Payer: Cigna Medicare Advantage	$6.46
Rate for Payer: Clover Medicare Advantage	$12.27
Rate for Payer: EmblemHealth Commercial	$38.76
Rate for Payer: Humana Medicare Advantage	$13.31
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	$12.92
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.70
Rate for Payer: Wellcare Medicare Advantage	$12.92

MYOGLOBIN,URINE

Facility

$411.00

Service Code	HCPCS 83874
Hospital Charge Code	38472517
Hospital Revenue Code	301
Min. Negotiated Rate	$61.65
Max. Negotiated Rate	$61.65
Rate for Payer: Qualcare PPO/HMO/WC	$61.65

MYOGLOBIN,URINE

Facility

$411.00

Service Code	HCPCS 83874
Hospital Charge Code	38472517
Hospital Revenue Code	301
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.86
Rate for Payer: Aetna Medicare Advantage	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.34
Rate for Payer: Cigna Commercial	$12.92
Rate for Payer: Cigna Medicare Advantage	$6.46
Rate for Payer: Clover Medicare Advantage	$12.27
Rate for Payer: EmblemHealth Commercial	$38.76
Rate for Payer: Humana Medicare Advantage	$13.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.92
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.70
Rate for Payer: Wellcare Medicare Advantage	$12.92

MYOGLOBIN, URINE

Facility

$122.50

Service Code	HCPCS 83874
Hospital Charge Code	3006280
Hospital Revenue Code	301
Min. Negotiated Rate	$18.38
Max. Negotiated Rate	$18.38
Rate for Payer: Qualcare PPO/HMO/WC	$18.38

MYOGLOBIN, URINE

Facility

$122.50

Service Code	HCPCS 83874
Hospital Charge Code	3006280
Hospital Revenue Code	301
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.86
Rate for Payer: Aetna Medicare Advantage	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.34
Rate for Payer: Cigna Commercial	$12.92
Rate for Payer: Cigna Medicare Advantage	$6.46
Rate for Payer: Clover Medicare Advantage	$12.27
Rate for Payer: EmblemHealth Commercial	$38.76
Rate for Payer: Humana Medicare Advantage	$13.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.38
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.92
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.70
Rate for Payer: Wellcare Medicare Advantage	$12.92

MYOMECTMY ABDOM CMPX 5+MYOMAS

Facility

$18,219.48

Service Code	HCPCS 58146
Hospital Charge Code	160000208
Hospital Revenue Code	360
Min. Negotiated Rate	$1,102.16
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$5,465.84
Rate for Payer: Aetna Medicare Advantage	$5,465.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,645.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,645.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,645.97
Rate for Payer: Cigna Commercial	$1,102.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,368.53
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,732.92
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

MYOMECTMY ABDOM CMPX 5+MYOMAS

Facility

$18,219.48

Service Code	HCPCS 58146
Hospital Charge Code	160000208
Hospital Revenue Code	360
Min. Negotiated Rate	$2,732.92
Max. Negotiated Rate	$2,732.92
Rate for Payer: Qualcare PPO/HMO/WC	$2,732.92

MYOMECTMY ABDOM METHOD 1-4MYMS

Facility

$14,539.99

Service Code	HCPCS 58140
Hospital Charge Code	14539.99
Hospital Revenue Code	360
Min. Negotiated Rate	$2,181.00
Max. Negotiated Rate	$2,181.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,181.00

MYOMECTMY ABDOM METHOD 1-4MYMS

Facility

$14,539.99

Service Code	HCPCS 58140
Hospital Charge Code	14539.99
Hospital Revenue Code	360
Min. Negotiated Rate	$884.86
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,362.00
Rate for Payer: Aetna Medicare Advantage	$4,362.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,707.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,707.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,707.70
Rate for Payer: Cigna Commercial	$884.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,890.20
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,181.00
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

MYOMECTMY ABDOM METHOD 1-4MYMS

Facility

$14,539.99

Service Code	HCPCS 58140
Hospital Charge Code	16001004
Hospital Revenue Code	360
Min. Negotiated Rate	$884.86
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$4,362.00
Rate for Payer: Aetna Medicare Advantage	$4,362.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,707.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,707.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,707.70
Rate for Payer: Cigna Commercial	$884.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,890.20
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,181.00
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

MYOMECTMY ABDOM METHOD 1-4MYMS

Facility

$14,539.99

Service Code	HCPCS 58140
Hospital Charge Code	16001004
Hospital Revenue Code	360
Min. Negotiated Rate	$2,181.00
Max. Negotiated Rate	$2,181.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,181.00

MYOMECTOMY,EXC FIBROIDS-UTER

Facility

$9,489.90

Service Code	HCPCS 58140
Hospital Charge Code	73190009
Hospital Revenue Code	361
Min. Negotiated Rate	$884.86
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$2,846.97
Rate for Payer: Aetna Medicare Advantage	$2,846.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,419.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,419.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,419.92
Rate for Payer: Cigna Commercial	$884.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,233.69
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,423.48
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

MYOMECTOMY,EXC FIBROIDS-UTER

Facility

$9,489.90

Service Code	HCPCS 58140
Hospital Charge Code	73190009
Hospital Revenue Code	361
Min. Negotiated Rate	$1,423.48
Max. Negotiated Rate	$1,423.48
Rate for Payer: Qualcare PPO/HMO/WC	$1,423.48

MYOPLASMA PNEUMONIAE ANTIBODIE

Facility

$272.00

Service Code	HCPCS 86738
Hospital Charge Code	38476138
Hospital Revenue Code	302
Min. Negotiated Rate	$40.80
Max. Negotiated Rate	$40.80
Rate for Payer: Qualcare PPO/HMO/WC	$40.80

MYOPLASMA PNEUMONIAE ANTIBODIE

Facility

$272.00

Service Code	HCPCS 86738
Hospital Charge Code	38476138
Hospital Revenue Code	302
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.90
Rate for Payer: Aetna Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.51
Rate for Payer: Cigna Commercial	$13.24
Rate for Payer: Cigna Medicare Advantage	$6.62
Rate for Payer: Clover Medicare Advantage	$12.58
Rate for Payer: EmblemHealth Commercial	$39.72
Rate for Payer: Humana Medicare Advantage	$13.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.24
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.03
Rate for Payer: Wellcare Medicare Advantage	$13.24

MYOREGEN PRP KIT

Facility

$1,400.00

Hospital Charge Code	270703613
Hospital Revenue Code	272
Min. Negotiated Rate	$182.00
Max. Negotiated Rate	$700.00
Rate for Payer: Aetna Commercial	$420.00
Rate for Payer: Aetna Medicare Advantage	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.00
Rate for Payer: Cigna Commercial	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.00
Rate for Payer: Oxford Commercial	$700.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00
Rate for Payer: UnitedHealthcare Commercial	$700.00

MYOREGEN PRP KIT

Facility

$1,400.00

Hospital Charge Code	270703613
Hospital Revenue Code	272
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

MYOSITIS ASSESSR

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3009990A
Hospital Revenue Code	302
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

MYOSITIS ASSESSR

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3009990C
Hospital Revenue Code	302
Min. Negotiated Rate	$8.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Medicare Advantage	$17.93
Rate for Payer: Aetna Commercial	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.70
Rate for Payer: Cigna Commercial	$17.93
Rate for Payer: Cigna Medicare Advantage	$8.96
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.01
Rate for Payer: Wellcare Medicare Advantage	$17.93

MYOSITIS ASSESSR

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3009990G
Hospital Revenue Code	302
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

MYOSITIS ASSESSR

Facility

$247.00

Service Code	HCPCS 86235
Hospital Charge Code	3009990B
Hospital Revenue Code	302
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

Know your out-of-pocket cost for care.

All Charges