Heights University Hospital

All Charges

Charge

Type

Setting

Price

PROTECTOR TEETH PLASTIC

Facility

$292.85

Hospital Charge Code	270600309
Hospital Revenue Code	272
Min. Negotiated Rate	$38.07
Max. Negotiated Rate	$146.43
Rate for Payer: Aetna Commercial	$87.86
Rate for Payer: Aetna Medicare Advantage	$87.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.68
Rate for Payer: Cigna Commercial	$146.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.07
Rate for Payer: Oxford Commercial	$146.43
Rate for Payer: Qualcare PPO/HMO/WC	$43.93
Rate for Payer: UnitedHealthcare Commercial	$146.43

PROTECTOR TOOTH DISPOSABLE

Facility

$12.81

Hospital Charge Code	270682850
Hospital Revenue Code	272
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.92

PROTECTOR TOOTH DISPOSABLE

Facility

$12.81

Hospital Charge Code	270682850
Hospital Revenue Code	272
Min. Negotiated Rate	$1.67
Max. Negotiated Rate	$6.41
Rate for Payer: Aetna Commercial	$3.84
Rate for Payer: Aetna Medicare Advantage	$3.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.27
Rate for Payer: Cigna Commercial	$6.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.67
Rate for Payer: Oxford Commercial	$6.41
Rate for Payer: Qualcare PPO/HMO/WC	$1.92
Rate for Payer: UnitedHealthcare Commercial	$6.41

PROTECTOR TRANSDUCER

Facility

$4.00

Hospital Charge Code	270606660
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PROTECTOR TRANSDUCER

Facility

$4.00

Hospital Charge Code	270606660
Hospital Revenue Code	272
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

PROTECTOR ULNA NERVE EA/PR FOA

Facility

$10.95

Hospital Charge Code	270664524
Hospital Revenue Code	278
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$2.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

PROTECTOR ULNA NERVE EA/PR FOA

Facility

$10.95

Hospital Charge Code	270664524
Hospital Revenue Code	278
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$5.47
Rate for Payer: Aetna Commercial	$3.29
Rate for Payer: Aetna Medicare Advantage	$3.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.79
Rate for Payer: Cigna Commercial	$5.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

PROTEINASE -3

Facility

$390.00

Service Code	HCPCS 86021
Hospital Charge Code	39900509
Hospital Revenue Code	302
Min. Negotiated Rate	$7.53
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.76
Rate for Payer: Aetna Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
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	$55.14
Rate for Payer: Cigna Commercial	$15.05
Rate for Payer: Cigna Medicare Advantage	$7.53
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
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	$15.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.95
Rate for Payer: Wellcare Medicare Advantage	$15.05

PROTEINASE -3

Facility

$390.00

Service Code	HCPCS 86021
Hospital Charge Code	39900509
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PROTEIN, BODY FLUID***

Facility

$42.00

Service Code	HCPCS 84155
Hospital Charge Code	3030129
Hospital Revenue Code	301
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

PROTEIN, BODY FLUID***

Facility

$42.00

Service Code	HCPCS 84155
Hospital Charge Code	3030129
Hospital Revenue Code	301
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$11.89
Rate for Payer: Aetna Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.45
Rate for Payer: Cigna Commercial	$3.67
Rate for Payer: Cigna Medicare Advantage	$1.83
Rate for Payer: Clover Medicare Advantage	$3.49
Rate for Payer: EmblemHealth Commercial	$11.01
Rate for Payer: Humana Medicare Advantage	$3.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.67
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.89
Rate for Payer: Wellcare Medicare Advantage	$3.67

PROTEIN BOUND GLUCOSE

Facility

$51.00

Hospital Charge Code	38472433
Hospital Revenue Code	301
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

PROTEIN BOUND GLUCOSE

Facility

$51.00

Hospital Charge Code	38472433
Hospital Revenue Code	301
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$114.00
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	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$114.00

PROTEIN BOUND GLUCOSE PROFILE

Facility

$141.65

Service Code	HCPCS 82985
Hospital Charge Code	3030061
Hospital Revenue Code	301
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

PROTEIN BOUND GLUCOSE PROFILE

Facility

$141.65

Service Code	HCPCS 82985
Hospital Charge Code	3030061
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.30
Rate for Payer: Aetna Medicare Advantage	$16.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.41
Rate for Payer: Cigna Commercial	$16.76
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.92
Rate for Payer: EmblemHealth Commercial	$50.28
Rate for Payer: Humana Medicare Advantage	$17.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.76
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.77
Rate for Payer: Wellcare Medicare Advantage	$16.76

PROTEIN C

Facility

$347.00

Service Code	HCPCS 85302
Hospital Charge Code	38473061
Hospital Revenue Code	305
Min. Negotiated Rate	$52.05
Max. Negotiated Rate	$52.05
Rate for Payer: Qualcare PPO/HMO/WC	$52.05

PROTEIN C

Facility

$347.00

Service Code	HCPCS 85302
Hospital Charge Code	38473061
Hospital Revenue Code	305
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.91
Rate for Payer: Aetna Medicare Advantage	$12.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.00
Rate for Payer: Cigna Commercial	$12.01
Rate for Payer: Cigna Medicare Advantage	$6.00
Rate for Payer: Clover Medicare Advantage	$11.41
Rate for Payer: EmblemHealth Commercial	$36.03
Rate for Payer: Humana Medicare Advantage	$12.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.01
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.73
Rate for Payer: Wellcare Medicare Advantage	$12.01

PROTEIN C, ACTIVITY

Facility

$128.00

Service Code	HCPCS 85302
Hospital Charge Code	3035128
Hospital Revenue Code	305
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

PROTEIN C, ACTIVITY

Facility

$128.00

Service Code	HCPCS 85302
Hospital Charge Code	3035128
Hospital Revenue Code	305
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.91
Rate for Payer: Aetna Medicare Advantage	$12.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.00
Rate for Payer: Cigna Commercial	$12.01
Rate for Payer: Cigna Medicare Advantage	$6.00
Rate for Payer: Clover Medicare Advantage	$11.41
Rate for Payer: EmblemHealth Commercial	$36.03
Rate for Payer: Humana Medicare Advantage	$12.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.01
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.73
Rate for Payer: Wellcare Medicare Advantage	$12.01

PROTEIN C,ACTIVITY

Facility

$667.59

Service Code	HCPCS 85303
Hospital Charge Code	39900166
Hospital Revenue Code	305
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

PROTEIN C,ACTIVITY

Facility

$667.59

Service Code	HCPCS 85303
Hospital Charge Code	39900166
Hospital Revenue Code	305
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$44.84
Rate for Payer: Aetna Medicare Advantage	$13.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.71
Rate for Payer: Cigna Commercial	$13.84
Rate for Payer: Cigna Medicare Advantage	$6.92
Rate for Payer: Clover Medicare Advantage	$13.15
Rate for Payer: EmblemHealth Commercial	$41.52
Rate for Payer: Humana Medicare Advantage	$14.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.84
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.67
Rate for Payer: Wellcare Medicare Advantage	$13.84

PROTEIN C ANTIGEN

Facility

$128.00

Service Code	HCPCS 85302
Hospital Charge Code	3007655
Hospital Revenue Code	305
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.91
Rate for Payer: Aetna Medicare Advantage	$12.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.00
Rate for Payer: Cigna Commercial	$12.01
Rate for Payer: Cigna Medicare Advantage	$6.00
Rate for Payer: Clover Medicare Advantage	$11.41
Rate for Payer: EmblemHealth Commercial	$36.03
Rate for Payer: Humana Medicare Advantage	$12.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.01
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.73
Rate for Payer: Wellcare Medicare Advantage	$12.01

PROTEIN C ANTIGEN

Facility

$128.00

Service Code	HCPCS 85302
Hospital Charge Code	3007655
Hospital Revenue Code	305
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

PROTEIN C,ANTIGENIC

Facility

$82.60

Service Code	HCPCS 85302
Hospital Charge Code	39900165
Hospital Revenue Code	305
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$12.39
Rate for Payer: Qualcare PPO/HMO/WC	$12.39

PROTEIN C,ANTIGENIC

Facility

$82.60

Service Code	HCPCS 85302
Hospital Charge Code	39900165
Hospital Revenue Code	305
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.91
Rate for Payer: Aetna Medicare Advantage	$12.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.00
Rate for Payer: Cigna Commercial	$12.01
Rate for Payer: Cigna Medicare Advantage	$6.00
Rate for Payer: Clover Medicare Advantage	$11.41
Rate for Payer: EmblemHealth Commercial	$36.03
Rate for Payer: Humana Medicare Advantage	$12.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.39
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.01
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.73
Rate for Payer: Wellcare Medicare Advantage	$12.01

Know your out-of-pocket cost for care.

All Charges