Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLATELET COUNT, MANUAL

Facility

$44.85

Service Code	HCPCS 85032
Hospital Charge Code	3008570
Hospital Revenue Code	301
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$6.73
Rate for Payer: Qualcare PPO/HMO/WC	$6.73

PLATELET IGG

Facility

$662.00

Service Code	HCPCS 86022
Hospital Charge Code	3035073A
Hospital Revenue Code	300
Min. Negotiated Rate	$99.30
Max. Negotiated Rate	$99.30
Rate for Payer: Qualcare PPO/HMO/WC	$99.30

PLATELET IGG

Facility

$662.00

Service Code	HCPCS 86022
Hospital Charge Code	3035073A
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	$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
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 INDIRECT

Facility

$728.00

Service Code	HCPCS 86023
Hospital Charge Code	3035073B
Hospital Revenue Code	300
Min. Negotiated Rate	$109.20
Max. Negotiated Rate	$109.20
Rate for Payer: Qualcare PPO/HMO/WC	$109.20

PLATELET INDIRECT

Facility

$728.00

Service Code	HCPCS 86023
Hospital Charge Code	3035073B
Hospital Revenue Code	300
Min. Negotiated Rate	$6.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$40.37
Rate for Payer: Aetna Medicare Advantage	$12.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.65
Rate for Payer: Cigna Commercial	$12.46
Rate for Payer: Cigna Medicare Advantage	$6.23
Rate for Payer: Clover Medicare Advantage	$11.84
Rate for Payer: EmblemHealth Commercial	$37.38
Rate for Payer: Humana Medicare Advantage	$12.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$109.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.46
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.21
Rate for Payer: Wellcare Medicare Advantage	$12.46

PLATELET NEUTRALIZATION

Facility

$127.00

Service Code	HCPCS 85597
Hospital Charge Code	38477147
Hospital Revenue Code	305
Min. Negotiated Rate	$19.05
Max. Negotiated Rate	$19.05
Rate for Payer: Qualcare PPO/HMO/WC	$19.05

PLATELET NEUTRALIZATION

Facility

$127.00

Service Code	HCPCS 85597
Hospital Charge Code	38477147
Hospital Revenue Code	305
Min. Negotiated Rate	$8.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.26
Rate for Payer: Aetna Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.88
Rate for Payer: Cigna Commercial	$17.98
Rate for Payer: Cigna Medicare Advantage	$8.99
Rate for Payer: Clover Medicare Advantage	$17.08
Rate for Payer: EmblemHealth Commercial	$53.94
Rate for Payer: Humana Medicare Advantage	$18.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.51
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.06
Rate for Payer: Wellcare Medicare Advantage	$17.98

PLATELETPHERESIS

Facility

$1,057.00

Service Code	HCPCS 36520
Hospital Charge Code	3400025
Hospital Revenue Code	761
Min. Negotiated Rate	$158.55
Max. Negotiated Rate	$158.55
Rate for Payer: Qualcare PPO/HMO/WC	$158.55

PLATELETPHERESIS

Facility

$1,057.00

Service Code	HCPCS 36520
Hospital Charge Code	3400025
Hospital Revenue Code	761
Min. Negotiated Rate	$137.41
Max. Negotiated Rate	$528.50
Rate for Payer: Aetna Commercial	$317.10
Rate for Payer: Aetna Medicare Advantage	$317.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.54
Rate for Payer: Cigna Commercial	$528.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.41
Rate for Payer: Oxford Commercial	$528.50
Rate for Payer: Qualcare PPO/HMO/WC	$158.55
Rate for Payer: UnitedHealthcare Commercial	$528.50

PLATELET, PHERESIS, EACH UNIT

Facility

$2,722.00

Hospital Charge Code	38471090
Hospital Revenue Code	390
Min. Negotiated Rate	$353.86
Max. Negotiated Rate	$1,361.00
Rate for Payer: Aetna Commercial	$816.60
Rate for Payer: Aetna Medicare Advantage	$816.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$694.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$694.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$694.11
Rate for Payer: Cigna Commercial	$1,361.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$353.86
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$408.30
Rate for Payer: UnitedHealthcare Commercial	$756.00

PLATELET, PHERESIS, EACH UNIT

Facility

$2,722.00

Hospital Charge Code	38471090
Hospital Revenue Code	390
Min. Negotiated Rate	$408.30
Max. Negotiated Rate	$408.30
Rate for Payer: Qualcare PPO/HMO/WC	$408.30

PLATELET PHERESIS HLA, L/R

Facility

$4,767.94

Service Code	HCPCS P9052
Hospital Charge Code	38471095
Hospital Revenue Code	390
Min. Negotiated Rate	$619.83
Max. Negotiated Rate	$1,650.43
Rate for Payer: Aetna Commercial	$1,430.38
Rate for Payer: Aetna Medicare Advantage	$1,430.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,215.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,215.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,215.82
Rate for Payer: Cigna Commercial	$1,650.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$619.83
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$715.19
Rate for Payer: UnitedHealthcare Commercial	$756.00

PLATELET PHERESIS HLA, L/R

Facility

$4,767.94

Service Code	HCPCS P9052
Hospital Charge Code	38471095
Hospital Revenue Code	390
Min. Negotiated Rate	$715.19
Max. Negotiated Rate	$715.19
Rate for Payer: Qualcare PPO/HMO/WC	$715.19

PLATELET PHERESIS IRRADIATED

Facility

$3,294.22

Hospital Charge Code	38471097
Hospital Revenue Code	390
Min. Negotiated Rate	$428.25
Max. Negotiated Rate	$1,647.11
Rate for Payer: Aetna Commercial	$988.27
Rate for Payer: Aetna Medicare Advantage	$988.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$840.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$840.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$840.03
Rate for Payer: Cigna Commercial	$1,647.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$428.25
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$494.13
Rate for Payer: UnitedHealthcare Commercial	$756.00

PLATELET PHERESIS IRRADIATED

Facility

$2,582.41

Hospital Charge Code	3101514
Hospital Revenue Code	390
Min. Negotiated Rate	$335.71
Max. Negotiated Rate	$1,291.20
Rate for Payer: Aetna Commercial	$774.72
Rate for Payer: Aetna Medicare Advantage	$774.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$658.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$658.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$658.51
Rate for Payer: Cigna Commercial	$1,291.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.71
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$387.36
Rate for Payer: UnitedHealthcare Commercial	$756.00

PLATELET PHERESIS IRRADIATED

Facility

$3,294.22

Hospital Charge Code	38471097
Hospital Revenue Code	390
Min. Negotiated Rate	$494.13
Max. Negotiated Rate	$494.13
Rate for Payer: Qualcare PPO/HMO/WC	$494.13

PLATELET PHERESIS IRRADIATED

Facility

$2,582.41

Hospital Charge Code	3101514
Hospital Revenue Code	390
Min. Negotiated Rate	$387.36
Max. Negotiated Rate	$387.36
Rate for Payer: Qualcare PPO/HMO/WC	$387.36

PLATELET PHERESIS LEUKOREDUCED

Facility

$5,626.57

Service Code	HCPCS P9035
Hospital Charge Code	3101513
Hospital Revenue Code	390
Min. Negotiated Rate	$843.99
Max. Negotiated Rate	$843.99
Rate for Payer: Qualcare PPO/HMO/WC	$843.99

PLATELET PHERESIS LEUKOREDUCED

Facility

$5,626.57

Service Code	HCPCS P9035
Hospital Charge Code	3101513
Hospital Revenue Code	390
Min. Negotiated Rate	$666.00
Max. Negotiated Rate	$1,687.97
Rate for Payer: Aetna Commercial	$1,687.97
Rate for Payer: Aetna Medicare Advantage	$1,687.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,434.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,434.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,434.78
Rate for Payer: Cigna Commercial	$1,192.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$731.45
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$843.99
Rate for Payer: UnitedHealthcare Commercial	$756.00

PLATELET PHER LEUK CMV NEG IRR

Facility

$3,706.00

Hospital Charge Code	38471210
Hospital Revenue Code	390
Min. Negotiated Rate	$481.78
Max. Negotiated Rate	$1,853.00
Rate for Payer: Aetna Commercial	$1,111.80
Rate for Payer: Aetna Medicare Advantage	$1,111.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$945.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$945.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$945.03
Rate for Payer: Cigna Commercial	$1,853.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$481.78
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$555.90
Rate for Payer: UnitedHealthcare Commercial	$756.00

PLATELET PHER LEUK CMV NEG IRR

Facility

$3,706.00

Hospital Charge Code	38471210
Hospital Revenue Code	390
Min. Negotiated Rate	$555.90
Max. Negotiated Rate	$555.90
Rate for Payer: Qualcare PPO/HMO/WC	$555.90

PLATELET P PLASMA

Facility

$348.85

Hospital Charge Code	8002578
Hospital Revenue Code	270
Min. Negotiated Rate	$52.33
Max. Negotiated Rate	$52.33
Rate for Payer: Qualcare PPO/HMO/WC	$52.33

PLATELET P PLASMA

Facility

$348.85

Hospital Charge Code	8002578
Hospital Revenue Code	270
Min. Negotiated Rate	$45.35
Max. Negotiated Rate	$174.43
Rate for Payer: Aetna Commercial	$104.66
Rate for Payer: Aetna Medicare Advantage	$104.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.96
Rate for Payer: Cigna Commercial	$174.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.35
Rate for Payer: Oxford Commercial	$174.43
Rate for Payer: Qualcare PPO/HMO/WC	$52.33
Rate for Payer: UnitedHealthcare Commercial	$174.43

PLATELET RICH PLASMA EACH UNIT

Facility

$2,172.22

Hospital Charge Code	3101505
Hospital Revenue Code	390
Min. Negotiated Rate	$282.39
Max. Negotiated Rate	$1,086.11
Rate for Payer: Aetna Commercial	$651.67
Rate for Payer: Aetna Medicare Advantage	$651.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$553.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$553.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$553.92
Rate for Payer: Cigna Commercial	$1,086.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$282.39
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$325.83
Rate for Payer: UnitedHealthcare Commercial	$756.00

PLATELET RICH PLASMA EACH UNIT

Facility

$2,172.22

Hospital Charge Code	3101505
Hospital Revenue Code	390
Min. Negotiated Rate	$325.83
Max. Negotiated Rate	$325.83
Rate for Payer: Qualcare PPO/HMO/WC	$325.83

Know your out-of-pocket cost for care.

All Charges