Heights University Hospital

All Charges

Charge

Type

Setting

Price

RBC FRAGILITY-INCUBATED

Facility

$91.85

Service Code	HCPCS 85557
Hospital Charge Code	39900177
Hospital Revenue Code	305
Min. Negotiated Rate	$6.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.29
Rate for Payer: Aetna Medicare Advantage	$13.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.95
Rate for Payer: Cigna Commercial	$13.36
Rate for Payer: Cigna Medicare Advantage	$6.68
Rate for Payer: Clover Medicare Advantage	$12.69
Rate for Payer: EmblemHealth Commercial	$40.08
Rate for Payer: Humana Medicare Advantage	$13.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.94
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.78
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.36
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.16
Rate for Payer: Wellcare Medicare Advantage	$13.36

RBC FRAGILITY (UNINCUBATED)

Facility

$50.45

Service Code	HCPCS 85555
Hospital Charge Code	3030343
Hospital Revenue Code	305
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$7.57
Rate for Payer: Qualcare PPO/HMO/WC	$7.57

RBC FRAGILITY (UNINCUBATED)

Facility

$50.45

Service Code	HCPCS 85555
Hospital Charge Code	3030343
Hospital Revenue Code	305
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$24.20
Rate for Payer: Aetna Medicare Advantage	$7.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.37
Rate for Payer: Cigna Commercial	$7.47
Rate for Payer: Cigna Medicare Advantage	$3.73
Rate for Payer: Clover Medicare Advantage	$7.10
Rate for Payer: EmblemHealth Commercial	$22.41
Rate for Payer: Humana Medicare Advantage	$7.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.56
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.57
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.92
Rate for Payer: Wellcare Medicare Advantage	$7.47

RBC HISTOGRAM***

Facility

$44.00

Service Code	HCPCS 85025
Hospital Charge Code	3031184
Hospital Revenue Code	309
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

RBC HISTOGRAM***

Facility

$44.00

Service Code	HCPCS 85025
Hospital Charge Code	3031184
Hospital Revenue Code	309
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$25.17
Rate for Payer: Aetna Medicare Advantage	$7.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.77
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	$28.47
Rate for Payer: Cigna Commercial	$7.77
Rate for Payer: Cigna Medicare Advantage	$3.88
Rate for Payer: Clover Medicare Advantage	$7.38
Rate for Payer: EmblemHealth Commercial	$23.31
Rate for Payer: Humana Medicare Advantage	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.72
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.24
Rate for Payer: Wellcare Medicare Advantage	$7.77

RBC IRRADIATED EACH UNIT

Facility

$1,378.79

Hospital Charge Code	3101516
Hospital Revenue Code	390
Min. Negotiated Rate	$179.24
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$413.64
Rate for Payer: Aetna Medicare Advantage	$413.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.59
Rate for Payer: Cigna Commercial	$689.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.24
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$206.82
Rate for Payer: UnitedHealthcare Commercial	$756.00

RBC IRRADIATED EACH UNIT

Facility

$1,378.79

Hospital Charge Code	3101516
Hospital Revenue Code	390
Min. Negotiated Rate	$206.82
Max. Negotiated Rate	$206.82
Rate for Payer: Qualcare PPO/HMO/WC	$206.82

RBC IRRADIATED LEUKO REDUCED

Facility

$1,036.00

Service Code	HCPCS P9040
Hospital Charge Code	3101038
Hospital Revenue Code	390
Min. Negotiated Rate	$155.40
Max. Negotiated Rate	$155.40
Rate for Payer: Qualcare PPO/HMO/WC	$155.40

RBC IRRADIATED LEUKO REDUCED

Facility

$1,036.00

Service Code	HCPCS P9040
Hospital Charge Code	3101038
Hospital Revenue Code	390
Min. Negotiated Rate	$134.68
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$310.80
Rate for Payer: Aetna Medicare Advantage	$310.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$264.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$264.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$264.18
Rate for Payer: Cigna Commercial	$618.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.68
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.40
Rate for Payer: UnitedHealthcare Commercial	$756.00

RBC LEUKO DEGLYC/WASHED IRR

Facility

$1,242.45

Hospital Charge Code	3100310
Hospital Revenue Code	390
Min. Negotiated Rate	$186.37
Max. Negotiated Rate	$186.37
Rate for Payer: Qualcare PPO/HMO/WC	$186.37

RBC LEUKO DEGLYC/WASHED IRR

Facility

$1,242.45

Hospital Charge Code	3100310
Hospital Revenue Code	390
Min. Negotiated Rate	$161.52
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$372.74
Rate for Payer: Aetna Medicare Advantage	$372.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.82
Rate for Payer: Cigna Commercial	$621.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$161.52
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$186.37
Rate for Payer: UnitedHealthcare Commercial	$756.00

RBC LEUKO IRRAD CMV NEG

Facility

$1,816.35

Hospital Charge Code	38471215
Hospital Revenue Code	390
Min. Negotiated Rate	$236.13
Max. Negotiated Rate	$908.17
Rate for Payer: Aetna Commercial	$544.90
Rate for Payer: Aetna Medicare Advantage	$544.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$463.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$463.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$463.17
Rate for Payer: Cigna Commercial	$908.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.13
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$272.45
Rate for Payer: UnitedHealthcare Commercial	$756.00

RBC LEUKO IRRAD CMV NEG

Facility

$1,816.35

Hospital Charge Code	38471215
Hospital Revenue Code	390
Min. Negotiated Rate	$272.45
Max. Negotiated Rate	$272.45
Rate for Payer: Qualcare PPO/HMO/WC	$272.45

RBC LEUKO REDUCED CMV-NEG

Facility

$990.90

Hospital Charge Code	3101527
Hospital Revenue Code	390
Min. Negotiated Rate	$128.82
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$297.27
Rate for Payer: Aetna Medicare Advantage	$297.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.68
Rate for Payer: Cigna Commercial	$495.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.82
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$148.63
Rate for Payer: UnitedHealthcare Commercial	$756.00

RBC LEUKO REDUCED CMV-NEG

Facility

$990.90

Hospital Charge Code	3101527
Hospital Revenue Code	390
Min. Negotiated Rate	$148.63
Max. Negotiated Rate	$148.63
Rate for Payer: Qualcare PPO/HMO/WC	$148.63

RBC LEUK REDU CMV-NEG IRRADIAT

Facility

$2,072.35

Hospital Charge Code	3101534
Hospital Revenue Code	390
Min. Negotiated Rate	$310.85
Max. Negotiated Rate	$310.85
Rate for Payer: Qualcare PPO/HMO/WC	$310.85

RBC LEUK REDU CMV-NEG IRRADIAT

Facility

$2,072.35

Hospital Charge Code	3101534
Hospital Revenue Code	390
Min. Negotiated Rate	$269.41
Max. Negotiated Rate	$1,036.17
Rate for Payer: Aetna Commercial	$621.71
Rate for Payer: Aetna Medicare Advantage	$621.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$528.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$528.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$528.45
Rate for Payer: Cigna Commercial	$1,036.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$269.41
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$310.85
Rate for Payer: UnitedHealthcare Commercial	$756.00

RBC LEUK REDU FROZ DEGLY WSH

Facility

$699.05

Hospital Charge Code	3101530
Hospital Revenue Code	390
Min. Negotiated Rate	$104.86
Max. Negotiated Rate	$104.86
Rate for Payer: Qualcare PPO/HMO/WC	$104.86

RBC LEUK REDU FROZ DEGLY WSH

Facility

$699.05

Hospital Charge Code	3101530
Hospital Revenue Code	390
Min. Negotiated Rate	$90.88
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$209.72
Rate for Payer: Aetna Medicare Advantage	$209.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.26
Rate for Payer: Cigna Commercial	$349.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.88
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.86
Rate for Payer: UnitedHealthcare Commercial	$756.00

RBC MAGNESIUM

Facility

$390.00

Service Code	HCPCS 83735
Hospital Charge Code	39900443
Hospital Revenue Code	301
Min. Negotiated Rate	$3.35
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$21.71
Rate for Payer: Aetna Medicare Advantage	$6.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.55
Rate for Payer: Cigna Commercial	$6.70
Rate for Payer: Cigna Medicare Advantage	$3.35
Rate for Payer: Clover Medicare Advantage	$6.37
Rate for Payer: EmblemHealth Commercial	$20.10
Rate for Payer: Humana Medicare Advantage	$6.90
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	$6.70
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.10
Rate for Payer: Wellcare Medicare Advantage	$6.70

RBC MAGNESIUM

Facility

$390.00

Service Code	HCPCS 83735
Hospital Charge Code	39900443
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

RBC OSMOTIC FRAGILITY (INCUB)

Facility

$187.25

Service Code	HCPCS 85557
Hospital Charge Code	3002326
Hospital Revenue Code	305
Min. Negotiated Rate	$28.09
Max. Negotiated Rate	$28.09
Rate for Payer: Qualcare PPO/HMO/WC	$28.09

RBC OSMOTIC FRAGILITY (INCUB)

Facility

$187.25

Service Code	HCPCS 85557
Hospital Charge Code	3002326
Hospital Revenue Code	305
Min. Negotiated Rate	$6.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.29
Rate for Payer: Aetna Medicare Advantage	$13.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.95
Rate for Payer: Cigna Commercial	$13.36
Rate for Payer: Cigna Medicare Advantage	$6.68
Rate for Payer: Clover Medicare Advantage	$12.69
Rate for Payer: EmblemHealth Commercial	$40.08
Rate for Payer: Humana Medicare Advantage	$13.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.09
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.36
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.16
Rate for Payer: Wellcare Medicare Advantage	$13.36

RBC OSMOTIC FRAGILITY INCUBATE

Facility

$187.25

Service Code	HCPCS 85557
Hospital Charge Code	3000726
Hospital Revenue Code	305
Min. Negotiated Rate	$6.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.29
Rate for Payer: Aetna Medicare Advantage	$13.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.95
Rate for Payer: Cigna Commercial	$13.36
Rate for Payer: Cigna Medicare Advantage	$6.68
Rate for Payer: Clover Medicare Advantage	$12.69
Rate for Payer: EmblemHealth Commercial	$40.08
Rate for Payer: Humana Medicare Advantage	$13.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.09
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.36
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.16
Rate for Payer: Wellcare Medicare Advantage	$13.36

RBC OSMOTIC FRAGILITY INCUBATE

Facility

$187.25

Service Code	HCPCS 85557
Hospital Charge Code	3000726
Hospital Revenue Code	305
Min. Negotiated Rate	$28.09
Max. Negotiated Rate	$28.09
Rate for Payer: Qualcare PPO/HMO/WC	$28.09

Know your out-of-pocket cost for care.

All Charges