Heights University Hospital

All Charges

Charge

Type

Setting

Price

PARTICULES EMB 700-900

Facility

$1,840.00

Hospital Charge Code	270668927
Hospital Revenue Code	272
Min. Negotiated Rate	$276.00
Max. Negotiated Rate	$276.00
Rate for Payer: Qualcare PPO/HMO/WC	$276.00

PARTICULES EMB 700-900

Facility

$1,840.00

Hospital Charge Code	270668927
Hospital Revenue Code	272
Min. Negotiated Rate	$239.20
Max. Negotiated Rate	$920.00
Rate for Payer: Aetna Commercial	$552.00
Rate for Payer: Aetna Medicare Advantage	$552.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$469.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$469.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$469.20
Rate for Payer: Cigna Commercial	$920.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.20
Rate for Payer: Oxford Commercial	$920.00
Rate for Payer: Qualcare PPO/HMO/WC	$276.00
Rate for Payer: UnitedHealthcare Commercial	$920.00

PARTL EXC ANKLE OR HEEL BONELT

Facility

$22,175.00

Service Code	HCPCS 28120
Hospital Charge Code	16000572
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$6,652.50
Rate for Payer: Aetna Medicare Advantage	$6,652.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,654.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,654.62
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	$5,654.62
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,882.75
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,326.25
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

PARTL EXC ANKLE OR HEEL BONELT

Facility

$22,175.00

Service Code	HCPCS 28120
Hospital Charge Code	16000572
Hospital Revenue Code	360
Min. Negotiated Rate	$3,326.25
Max. Negotiated Rate	$3,326.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,326.25

PARTL EXC TRSL/MTARSL BONE-LT

Facility

$26,594.63

Service Code	HCPCS 28122
Hospital Charge Code	16000340
Hospital Revenue Code	360
Min. Negotiated Rate	$3,989.19
Max. Negotiated Rate	$3,989.19
Rate for Payer: Qualcare PPO/HMO/WC	$3,989.19

PARTL EXC TRSL/MTARSL BONE-LT

Facility

$26,594.63

Service Code	HCPCS 28122
Hospital Charge Code	16000340
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,978.39
Rate for Payer: Aetna Commercial	$7,978.39
Rate for Payer: Aetna Medicare Advantage	$7,978.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,781.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,781.63
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	$6,781.63
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,457.30
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,989.19
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

PART REMOVAL OF METATARSAL-50

Facility

$29,836.88

Service Code	HCPCS 28110
Hospital Charge Code	16000283
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$8,951.06
Rate for Payer: Aetna Commercial	$8,951.06
Rate for Payer: Aetna Medicare Advantage	$8,951.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,608.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,608.40
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	$7,608.40
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,878.79
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,475.53
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

PART REMOVAL OF METATARSAL-50

Facility

$29,836.88

Service Code	HCPCS 28110
Hospital Charge Code	16000283
Hospital Revenue Code	360
Min. Negotiated Rate	$4,475.53
Max. Negotiated Rate	$4,475.53
Rate for Payer: Qualcare PPO/HMO/WC	$4,475.53

PART THROMBOPLASTIN TIME (PTT)

Facility

$657.96

Service Code	HCPCS 85730
Hospital Charge Code	3002037
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	$85.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.69
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

PART THROMBOPLASTIN TIME (PTT)

Facility

$657.96

Service Code	HCPCS 85730
Hospital Charge Code	3002037
Hospital Revenue Code	305
Min. Negotiated Rate	$98.69
Max. Negotiated Rate	$98.69
Rate for Payer: Qualcare PPO/HMO/WC	$98.69

PARVOVIRUS ABS B19 IGG IGM

Facility

$408.85

Hospital Charge Code	3006855
Hospital Revenue Code	302
Min. Negotiated Rate	$53.15
Max. Negotiated Rate	$204.43
Rate for Payer: Aetna Commercial	$122.66
Rate for Payer: Aetna Medicare Advantage	$122.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.26
Rate for Payer: Cigna Commercial	$204.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.15
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.33
Rate for Payer: UnitedHealthcare Commercial	$114.00

PARVOVIRUS ABS B19 IGG IGM

Facility

$408.85

Hospital Charge Code	3006855
Hospital Revenue Code	302
Min. Negotiated Rate	$61.33
Max. Negotiated Rate	$61.33
Rate for Payer: Qualcare PPO/HMO/WC	$61.33

PARVOVIRUS ANTIBODY (HPV)

Facility

$581.00

Service Code	HCPCS 86747
Hospital Charge Code	38472902
Hospital Revenue Code	302
Min. Negotiated Rate	$7.51
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.70
Rate for Payer: Aetna Medicare Advantage	$15.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.03
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	$55.07
Rate for Payer: Cigna Commercial	$15.03
Rate for Payer: Cigna Medicare Advantage	$7.51
Rate for Payer: Clover Medicare Advantage	$14.28
Rate for Payer: EmblemHealth Commercial	$45.09
Rate for Payer: Humana Medicare Advantage	$15.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.03
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.93
Rate for Payer: Wellcare Medicare Advantage	$15.03

PARVOVIRUS ANTIBODY (HPV)

Facility

$581.00

Service Code	HCPCS 86747
Hospital Charge Code	38472902
Hospital Revenue Code	302
Min. Negotiated Rate	$87.15
Max. Negotiated Rate	$87.15
Rate for Payer: Qualcare PPO/HMO/WC	$87.15

PARVOVIRUS ANTIBODY, IGG

Facility

$205.65

Service Code	HCPCS 86747
Hospital Charge Code	3006855A
Hospital Revenue Code	302
Min. Negotiated Rate	$7.51
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.70
Rate for Payer: Aetna Medicare Advantage	$15.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.03
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	$55.07
Rate for Payer: Cigna Commercial	$15.03
Rate for Payer: Cigna Medicare Advantage	$7.51
Rate for Payer: Clover Medicare Advantage	$14.28
Rate for Payer: EmblemHealth Commercial	$45.09
Rate for Payer: Humana Medicare Advantage	$15.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.03
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.93
Rate for Payer: Wellcare Medicare Advantage	$15.03

PARVOVIRUS ANTIBODY, IGG

Facility

$205.65

Service Code	HCPCS 86747
Hospital Charge Code	3006855A
Hospital Revenue Code	302
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

PARVOVIRUS ANTIBODY, IGM

Facility

$205.65

Service Code	HCPCS 86747
Hospital Charge Code	3006855B
Hospital Revenue Code	302
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

PARVOVIRUS ANTIBODY, IGM

Facility

$205.65

Service Code	HCPCS 86747
Hospital Charge Code	3006855B
Hospital Revenue Code	302
Min. Negotiated Rate	$7.51
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.70
Rate for Payer: Aetna Medicare Advantage	$15.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.03
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	$55.07
Rate for Payer: Cigna Commercial	$15.03
Rate for Payer: Cigna Medicare Advantage	$7.51
Rate for Payer: Clover Medicare Advantage	$14.28
Rate for Payer: EmblemHealth Commercial	$45.09
Rate for Payer: Humana Medicare Advantage	$15.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.03
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.93
Rate for Payer: Wellcare Medicare Advantage	$15.03

PARVOVIRUS B19 AB (IGG)

Facility

$205.65

Service Code	HCPCS 86747
Hospital Charge Code	3035153
Hospital Revenue Code	302
Min. Negotiated Rate	$7.51
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.70
Rate for Payer: Aetna Medicare Advantage	$15.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.03
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	$55.07
Rate for Payer: Cigna Commercial	$15.03
Rate for Payer: Cigna Medicare Advantage	$7.51
Rate for Payer: Clover Medicare Advantage	$14.28
Rate for Payer: EmblemHealth Commercial	$45.09
Rate for Payer: Humana Medicare Advantage	$15.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.03
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.93
Rate for Payer: Wellcare Medicare Advantage	$15.03

PARVOVIRUS B19 AB (IGG)

Facility

$205.65

Service Code	HCPCS 86747
Hospital Charge Code	3035153
Hospital Revenue Code	302
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

PARVOVIRUS B19 AB (IGG,M) I

Facility

$390.00

Service Code	HCPCS 86747
Hospital Charge Code	39990047A
Hospital Revenue Code	302
Min. Negotiated Rate	$7.51
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.70
Rate for Payer: Aetna Medicare Advantage	$15.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.03
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	$55.07
Rate for Payer: Cigna Commercial	$15.03
Rate for Payer: Cigna Medicare Advantage	$7.51
Rate for Payer: Clover Medicare Advantage	$14.28
Rate for Payer: EmblemHealth Commercial	$45.09
Rate for Payer: Humana Medicare Advantage	$15.48
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	$15.03
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.93
Rate for Payer: Wellcare Medicare Advantage	$15.03

PARVOVIRUS B19 AB (IGG,M) I

Facility

$390.00

Service Code	HCPCS 86747
Hospital Charge Code	39990047A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PARVOVIRUS B19 AB (IGG,M) II

Facility

$390.00

Service Code	HCPCS 86747
Hospital Charge Code	39990047B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PARVOVIRUS B19 AB (IGG,M) II

Facility

$390.00

Service Code	HCPCS 86747
Hospital Charge Code	39990047B
Hospital Revenue Code	302
Min. Negotiated Rate	$7.51
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.70
Rate for Payer: Aetna Medicare Advantage	$15.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.03
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	$55.07
Rate for Payer: Cigna Commercial	$15.03
Rate for Payer: Cigna Medicare Advantage	$7.51
Rate for Payer: Clover Medicare Advantage	$14.28
Rate for Payer: EmblemHealth Commercial	$45.09
Rate for Payer: Humana Medicare Advantage	$15.48
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	$15.03
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.93
Rate for Payer: Wellcare Medicare Advantage	$15.03

PARVOVIRUS B19 DNA,QL,PCR

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	39900402
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges