Heights University Hospital

All Charges

Charge

Type

Setting

Price

PYRUVATE,BLOOD

Facility

$74.60

Service Code	HCPCS 84210
Hospital Charge Code	39900127
Hospital Revenue Code	301
Min. Negotiated Rate	$11.19
Max. Negotiated Rate	$11.19
Rate for Payer: Qualcare PPO/HMO/WC	$11.19

PYRUVATE, CSF

Facility

$360.00

Service Code	HCPCS 84210
Hospital Charge Code	38472929
Hospital Revenue Code	301
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00

PYRUVATE, CSF

Facility

$360.00

Service Code	HCPCS 84210
Hospital Charge Code	38472929
Hospital Revenue Code	301
Min. Negotiated Rate	$7.24
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.92
Rate for Payer: Aetna Medicare Advantage	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.05
Rate for Payer: Cigna Commercial	$14.48
Rate for Payer: Cigna Medicare Advantage	$7.24
Rate for Payer: Clover Medicare Advantage	$13.76
Rate for Payer: EmblemHealth Commercial	$43.44
Rate for Payer: Humana Medicare Advantage	$14.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.35
Rate for Payer: Wellcare Medicare Advantage	$14.48

PYSCH DIAG EVAL NONMD 30 MIN

Facility

$6,800.00

Service Code	HCPCS 90791
Hospital Charge Code	4546762
Hospital Revenue Code	918
Min. Negotiated Rate	$171.99
Max. Negotiated Rate	$2,040.00
Rate for Payer: Aetna Commercial	$2,040.00
Rate for Payer: Aetna Medicare Advantage	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,734.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,734.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$308.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,734.00
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$884.00
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00
Rate for Payer: UnitedHealthcare Commercial	$1,994.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$171.99

PYSCH DIAG EVAL NONMD 30 MIN

Facility

$6,800.00

Service Code	HCPCS 90791
Hospital Charge Code	4546762
Hospital Revenue Code	918
Min. Negotiated Rate	$1,020.00
Max. Negotiated Rate	$1,020.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00

QC DRILL BIT 2.5MM DIA X 110MM

Facility

$269.60

Hospital Charge Code	270663182
Hospital Revenue Code	272
Min. Negotiated Rate	$35.05
Max. Negotiated Rate	$134.80
Rate for Payer: Aetna Commercial	$80.88
Rate for Payer: Aetna Medicare Advantage	$80.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.75
Rate for Payer: Cigna Commercial	$134.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.05
Rate for Payer: Oxford Commercial	$134.80
Rate for Payer: Qualcare PPO/HMO/WC	$40.44
Rate for Payer: UnitedHealthcare Commercial	$134.80

QC DRILL BIT 2.5MM DIA X 110MM

Facility

$269.60

Hospital Charge Code	270663182
Hospital Revenue Code	272
Min. Negotiated Rate	$40.44
Max. Negotiated Rate	$40.44
Rate for Payer: Qualcare PPO/HMO/WC	$40.44

QCKFIX SCREW4.0X46

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270686388
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

QCKFIX SCREW4.0X46

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270686388
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$247.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

QCKFIX SCREW 4.0X54

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270686389
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$247.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

QCKFIX SCREW 4.0X54

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270686389
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

QCKFIX SCREW TI CANN ST 4.0x22

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270688390
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$247.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

QCKFIX SCREW TI CANN ST 4.0x22

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270688390
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

Q FEVER ANTIBODY

Facility

$85.90

Service Code	HCPCS 86638
Hospital Charge Code	38476245
Hospital Revenue Code	302
Min. Negotiated Rate	$12.88
Max. Negotiated Rate	$12.88
Rate for Payer: Qualcare PPO/HMO/WC	$12.88

Q FEVER ANTIBODY

Facility

$558.45

Service Code	HCPCS 86638
Hospital Charge Code	3032273
Hospital Revenue Code	302
Min. Negotiated Rate	$83.77
Max. Negotiated Rate	$83.77
Rate for Payer: Qualcare PPO/HMO/WC	$83.77

Q FEVER ANTIBODY

Facility

$558.45

Service Code	HCPCS 86638
Hospital Charge Code	3032273
Hospital Revenue Code	302
Min. Negotiated Rate	$6.06
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.27
Rate for Payer: Aetna Medicare Advantage	$12.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.41
Rate for Payer: Cigna Commercial	$12.12
Rate for Payer: Cigna Medicare Advantage	$6.06
Rate for Payer: Clover Medicare Advantage	$11.51
Rate for Payer: EmblemHealth Commercial	$36.36
Rate for Payer: Humana Medicare Advantage	$12.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$83.77
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.12
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.85
Rate for Payer: Wellcare Medicare Advantage	$12.12

Q FEVER ANTIBODY

Facility

$85.90

Service Code	HCPCS 86638
Hospital Charge Code	38476245
Hospital Revenue Code	302
Min. Negotiated Rate	$6.06
Max. Negotiated Rate	$114.00
Rate for Payer: Clover Medicare Advantage	$11.51
Rate for Payer: Aetna Commercial	$39.27
Rate for Payer: Aetna Medicare Advantage	$12.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.41
Rate for Payer: Cigna Commercial	$12.12
Rate for Payer: Cigna Medicare Advantage	$6.06
Rate for Payer: EmblemHealth Commercial	$36.36
Rate for Payer: Humana Medicare Advantage	$12.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.88
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.12
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.85
Rate for Payer: Wellcare Medicare Advantage	$12.12

QFIX 1.8 MINI SUTURE ANCHOR KI

Facility

$3,415.00

Hospital Charge Code	2707229012
Hospital Revenue Code	272
Min. Negotiated Rate	$512.25
Max. Negotiated Rate	$512.25
Rate for Payer: Qualcare PPO/HMO/WC	$512.25

QFIX 1.8 MINI SUTURE ANCHOR KI

Facility

$3,415.00

Hospital Charge Code	2707229012
Hospital Revenue Code	272
Min. Negotiated Rate	$443.95
Max. Negotiated Rate	$1,707.50
Rate for Payer: Aetna Commercial	$1,024.50
Rate for Payer: Aetna Medicare Advantage	$1,024.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$870.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$870.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$870.83
Rate for Payer: Cigna Commercial	$1,707.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$443.95
Rate for Payer: Oxford Commercial	$1,707.50
Rate for Payer: Qualcare PPO/HMO/WC	$512.25
Rate for Payer: UnitedHealthcare Commercial	$1,707.50

QHERIT EXPANDED CARRIER SCREEN

Facility

$12,242.80

Service Code	HCPCS 81443
Hospital Charge Code	401181443
Hospital Revenue Code	300
Min. Negotiated Rate	$1,836.42
Max. Negotiated Rate	$1,836.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,836.42

QHERIT EXPANDED CARRIER SCREEN

Facility

$12,242.80

Service Code	HCPCS 81443
Hospital Charge Code	401181443
Hospital Revenue Code	300
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$8,971.52
Rate for Payer: Aetna Commercial	$7,933.33
Rate for Payer: Aetna Medicare Advantage	$2,448.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,971.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,971.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,448.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,831.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,971.52
Rate for Payer: Cigna Commercial	$2,448.56
Rate for Payer: Cigna Medicare Advantage	$1,224.28
Rate for Payer: Clover Medicare Advantage	$2,326.13
Rate for Payer: EmblemHealth Commercial	$7,345.68
Rate for Payer: Humana Medicare Advantage	$2,522.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,591.56
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,836.42
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,448.56
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2,595.47
Rate for Payer: Wellcare Medicare Advantage	$2,448.56

Q-INFLUENZA A&B ANTIGEN ASSAY

Facility

$246.24

Service Code	HCPCS 87804
Hospital Charge Code	4013878042
Hospital Revenue Code	306
Min. Negotiated Rate	$36.94
Max. Negotiated Rate	$36.94
Rate for Payer: Qualcare PPO/HMO/WC	$36.94

Q-INFLUENZA A&B ANTIGEN ASSAY

Facility

$246.24

Service Code	HCPCS 87804
Hospital Charge Code	4013878042
Hospital Revenue Code	306
Min. Negotiated Rate	$8.28
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$53.62
Rate for Payer: Aetna Medicare Advantage	$16.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.64
Rate for Payer: Cigna Commercial	$16.55
Rate for Payer: Cigna Medicare Advantage	$8.28
Rate for Payer: Clover Medicare Advantage	$15.72
Rate for Payer: EmblemHealth Commercial	$49.65
Rate for Payer: Humana Medicare Advantage	$17.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.01
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.94
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.55
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.54
Rate for Payer: Wellcare Medicare Advantage	$16.55

QLASE LASER FIBER USED

Facility

$3,975.00

Hospital Charge Code	270677530
Hospital Revenue Code	272
Min. Negotiated Rate	$516.75
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,192.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$516.75
Rate for Payer: Oxford Commercial	$1,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Commercial	$1,987.50

QLASE LASER FIBER USED

Facility

$3,975.00

Hospital Charge Code	270677530
Hospital Revenue Code	272
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$596.25
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

Know your out-of-pocket cost for care.

All Charges