Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATELET ANTIBODIES

Facility

$194.00

Service Code	HCPCS 86022
Hospital Charge Code	38477010
Hospital Revenue Code	300
Min. Negotiated Rate	$29.10
Max. Negotiated Rate	$29.10
Rate for Payer: Qualcare PPO/HMO/WC	$29.10

PLATELET ANTIBODIES

Facility

$194.00

Service Code	HCPCS 86022
Hospital Charge Code	38477010
Hospital Revenue Code	300
Min. Negotiated Rate	$9.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$59.52
Rate for Payer: Aetna Medicare Advantage	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.31
Rate for Payer: Cigna Commercial	$18.37
Rate for Payer: Cigna Medicare Advantage	$9.19
Rate for Payer: Clover Medicare Advantage	$17.45
Rate for Payer: EmblemHealth Commercial	$55.11
Rate for Payer: Humana Medicare Advantage	$18.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.22
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.47
Rate for Payer: Wellcare Medicare Advantage	$18.37

PLATELET ANTIBODY III

Facility

$662.00

Service Code	HCPCS 8602291
Hospital Charge Code	3007119C
Hospital Revenue Code	302
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$99.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

PLATELET ANTIBODY III

Facility

$662.00

Service Code	HCPCS 8602291
Hospital Charge Code	3007119C
Hospital Revenue Code	302
Min. Negotiated Rate	$86.06
Max. Negotiated Rate	$331.00
Rate for Payer: Aetna Commercial	$198.60
Rate for Payer: Aetna Medicare Advantage	$198.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.81
Rate for Payer: Cigna Commercial	$331.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.30
Rate for Payer: UnitedHealthcare Commercial	$114.00

PLATELET ANTIBODY IV

Facility

$662.00

Service Code	HCPCS 8602291
Hospital Charge Code	3007119D
Hospital Revenue Code	302
Min. Negotiated Rate	$86.06
Max. Negotiated Rate	$331.00
Rate for Payer: Aetna Commercial	$198.60
Rate for Payer: Aetna Medicare Advantage	$198.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.81
Rate for Payer: Cigna Commercial	$331.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.30
Rate for Payer: UnitedHealthcare Commercial	$114.00

PLATELET ANTIBODY IV

Facility

$662.00

Service Code	HCPCS 8602291
Hospital Charge Code	3007119D
Hospital Revenue Code	302
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$99.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

PLATELET ANTIBODY PROFILE

Facility

$1,974.60

Hospital Charge Code	3007119
Hospital Revenue Code	302
Min. Negotiated Rate	$296.19
Max. Negotiated Rate	$296.19
Rate for Payer: Qualcare PPO/HMO/WC	$296.19

PLATELET ANTIBODY PROFILE

Facility

$1,974.60

Hospital Charge Code	3007119
Hospital Revenue Code	302
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$987.30
Rate for Payer: Aetna Commercial	$592.38
Rate for Payer: Aetna Medicare Advantage	$592.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.52
Rate for Payer: Cigna Commercial	$987.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$296.19
Rate for Payer: UnitedHealthcare Commercial	$114.00

PLATELET BOUND ANTIBODY IGG

Facility

$471.00

Service Code	HCPCS 86022
Hospital Charge Code	38476026
Hospital Revenue Code	302
Min. Negotiated Rate	$9.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$59.52
Rate for Payer: Aetna Medicare Advantage	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.31
Rate for Payer: Cigna Commercial	$18.37
Rate for Payer: Cigna Medicare Advantage	$9.19
Rate for Payer: Clover Medicare Advantage	$17.45
Rate for Payer: EmblemHealth Commercial	$55.11
Rate for Payer: Humana Medicare Advantage	$18.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.23
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.47
Rate for Payer: Wellcare Medicare Advantage	$18.37

PLATELET BOUND ANTIBODY IGG

Facility

$471.00

Service Code	HCPCS 86022
Hospital Charge Code	38476026
Hospital Revenue Code	302
Min. Negotiated Rate	$70.65
Max. Negotiated Rate	$70.65
Rate for Payer: Qualcare PPO/HMO/WC	$70.65

PLATELET CONCENTRATE SYS 30ML

Facility

$3,625.00

Hospital Charge Code	270670801
Hospital Revenue Code	272
Min. Negotiated Rate	$471.25
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,087.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$471.25
Rate for Payer: Oxford Commercial	$1,812.50
Rate for Payer: Qualcare PPO/HMO/WC	$543.75
Rate for Payer: UnitedHealthcare Commercial	$1,812.50

PLATELET CONCENTRATE SYS 30ML

Facility

$3,625.00

Hospital Charge Code	270670801
Hospital Revenue Code	272
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$543.75
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

PLATELET CONCENTRATION SYSTEM

Facility

$10,750.00

Hospital Charge Code	270670760
Hospital Revenue Code	272
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$1,612.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

PLATELET CONCENTRATION SYSTEM

Facility

$10,750.00

Hospital Charge Code	270670760
Hospital Revenue Code	272
Min. Negotiated Rate	$1,397.50
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$3,225.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,397.50
Rate for Payer: Oxford Commercial	$5,375.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50
Rate for Payer: UnitedHealthcare Commercial	$5,375.00

PLATELET COUNT

Facility

$390.00

Service Code	HCPCS 85049
Hospital Charge Code	3002128
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PLATELET COUNT

Facility

$104.00

Service Code	HCPCS 85032
Hospital Charge Code	38473016
Hospital Revenue Code	309
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

PLATELET COUNT

Facility

$104.00

Service Code	HCPCS 85032
Hospital Charge Code	38473016
Hospital Revenue Code	309
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.96
Rate for Payer: Aetna Medicare Advantage	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.31
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	$15.79
Rate for Payer: Cigna Commercial	$4.31
Rate for Payer: Cigna Medicare Advantage	$2.15
Rate for Payer: Clover Medicare Advantage	$4.09
Rate for Payer: EmblemHealth Commercial	$12.93
Rate for Payer: Humana Medicare Advantage	$4.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.52
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.31
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.57
Rate for Payer: Wellcare Medicare Advantage	$4.31

PLATELET COUNT

Facility

$390.00

Service Code	HCPCS 85049
Hospital Charge Code	3002128
Hospital Revenue Code	301
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.52
Rate for Payer: Aetna Medicare Advantage	$4.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.41
Rate for Payer: Cigna Commercial	$4.48
Rate for Payer: Cigna Medicare Advantage	$2.24
Rate for Payer: Clover Medicare Advantage	$4.26
Rate for Payer: EmblemHealth Commercial	$13.44
Rate for Payer: Humana Medicare Advantage	$4.61
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	$4.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.75
Rate for Payer: Wellcare Medicare Advantage	$4.48

PLATELET COUNT

Facility

$43.25

Service Code	HCPCS 85049
Hospital Charge Code	8200341RS
Hospital Revenue Code	301
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.52
Rate for Payer: Aetna Medicare Advantage	$4.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.41
Rate for Payer: Cigna Commercial	$4.48
Rate for Payer: Cigna Medicare Advantage	$2.24
Rate for Payer: Clover Medicare Advantage	$4.26
Rate for Payer: EmblemHealth Commercial	$13.44
Rate for Payer: Humana Medicare Advantage	$4.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.75
Rate for Payer: Wellcare Medicare Advantage	$4.48

PLATELET COUNT

Facility

$43.25

Service Code	HCPCS 85049
Hospital Charge Code	8200341RS
Hospital Revenue Code	301
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

PLATELET COUNT

Facility

$135.00

Service Code	HCPCS 85032
Hospital Charge Code	38479050
Hospital Revenue Code	309
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.96
Rate for Payer: Aetna Medicare Advantage	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.31
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	$15.79
Rate for Payer: Cigna Commercial	$4.31
Rate for Payer: Cigna Medicare Advantage	$2.15
Rate for Payer: Clover Medicare Advantage	$4.09
Rate for Payer: EmblemHealth Commercial	$12.93
Rate for Payer: Humana Medicare Advantage	$4.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.55
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.31
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.57
Rate for Payer: Wellcare Medicare Advantage	$4.31

PLATELET COUNT

Facility

$135.00

Service Code	HCPCS 85032
Hospital Charge Code	38479050
Hospital Revenue Code	309
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$20.25
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

PLATELET COUNT***

Facility

$18.00

Hospital Charge Code	3012127
Hospital Revenue Code	309
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$5.40
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$114.00

PLATELET COUNT***

Facility

$18.00

Hospital Charge Code	3012127
Hospital Revenue Code	309
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

PLATELET COUNT, MANUAL

Facility

$44.85

Service Code	HCPCS 85032
Hospital Charge Code	3008570
Hospital Revenue Code	301
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.96
Rate for Payer: Aetna Medicare Advantage	$4.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.31
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	$15.79
Rate for Payer: Cigna Commercial	$4.31
Rate for Payer: Cigna Medicare Advantage	$2.15
Rate for Payer: Clover Medicare Advantage	$4.09
Rate for Payer: EmblemHealth Commercial	$12.93
Rate for Payer: Humana Medicare Advantage	$4.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.73
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.31
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.57
Rate for Payer: Wellcare Medicare Advantage	$4.31

Know your out-of-pocket cost for care.

All Charges