Heights University Hospital

All Charges

Charge

Type

Setting

Price

RETEPLASE INJ 20 U

Facility

$6,051.00

Hospital Charge Code	60635242
Hospital Revenue Code	636
Min. Negotiated Rate	$907.65
Max. Negotiated Rate	$1,464.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,464.34
Rate for Payer: Qualcare PPO/HMO/WC	$907.65

RETEVASE 18.1MG-TRANSPORT

Facility

$6,382.00

Hospital Charge Code	60635394
Hospital Revenue Code	636
Min. Negotiated Rate	$957.30
Max. Negotiated Rate	$1,544.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,544.44
Rate for Payer: Qualcare PPO/HMO/WC	$957.30

RETEVASE 18.1MG-TRANSPORT

Facility

$6,382.00

Hospital Charge Code	60635394
Hospital Revenue Code	636
Min. Negotiated Rate	$957.30
Max. Negotiated Rate	$3,191.00
Rate for Payer: Aetna Commercial	$1,914.60
Rate for Payer: Aetna Medicare Advantage	$1,914.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,627.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,627.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,627.41
Rate for Payer: Cigna Commercial	$3,191.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,544.44
Rate for Payer: Qualcare PPO/HMO/WC	$957.30

RETEVASE 18.1MG/VIAL

Facility

$6,382.00

Hospital Charge Code	60635352
Hospital Revenue Code	636
Min. Negotiated Rate	$957.30
Max. Negotiated Rate	$1,544.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,544.44
Rate for Payer: Qualcare PPO/HMO/WC	$957.30

RETEVASE 18.1MG/VIAL

Facility

$6,382.00

Hospital Charge Code	60635352
Hospital Revenue Code	636
Min. Negotiated Rate	$957.30
Max. Negotiated Rate	$3,191.00
Rate for Payer: Aetna Commercial	$1,914.60
Rate for Payer: Aetna Medicare Advantage	$1,914.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,627.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,627.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,627.41
Rate for Payer: Cigna Commercial	$3,191.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,544.44
Rate for Payer: Qualcare PPO/HMO/WC	$957.30

RETICOLOCYTE COUNT

Facility

$57.00

Service Code	HCPCS 85044
Hospital Charge Code	38473012
Hospital Revenue Code	301
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$8.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.55

RETICOLOCYTE COUNT

Facility

$57.00

Service Code	HCPCS 85044
Hospital Charge Code	38473012
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	$7.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.55
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

RETICULINE IGG SCREEN W REFLEX

Facility

$60.25

Service Code	HCPCS 86255
Hospital Charge Code	401186255
Hospital Revenue Code	306
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.04
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

RETICULINE IGG SCREEN W REFLEX

Facility

$60.25

Service Code	HCPCS 86255
Hospital Charge Code	401186255
Hospital Revenue Code	306
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$9.04
Rate for Payer: Qualcare PPO/HMO/WC	$9.04

RETICULIN STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005317
Hospital Revenue Code	310
Min. Negotiated Rate	$46.48
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$201.60
Rate for Payer: Aetna Medicare Advantage	$201.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$46.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.80
Rate for Payer: UnitedHealthcare Commercial	$114.00

RETICULIN STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005317
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

RETICULOCYTES COUNT

Facility

$667.59

Service Code	HCPCS 85044
Hospital Charge Code	3002359
Hospital Revenue Code	305
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	$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	$4.31
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.57
Rate for Payer: Wellcare Medicare Advantage	$4.31

RETICULOCYTES COUNT

Facility

$667.59

Service Code	HCPCS 85044
Hospital Charge Code	3002359
Hospital Revenue Code	305
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC

Facility

$41,254.32

Service Code	MSDRG 815
Min. Negotiated Rate	$11,065.36
Max. Negotiated Rate	$41,254.32
Rate for Payer: Aetna Commercial	$34,191.96
Rate for Payer: Aetna Medicare Advantage	$11,065.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,291.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,291.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,751.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,291.33
Rate for Payer: Cigna Commercial	$21,822.29
Rate for Payer: Cigna Medicare Advantage	$13,751.44
Rate for Payer: Clover Medicare Advantage	$13,063.87
Rate for Payer: EmblemHealth Commercial	$41,254.32
Rate for Payer: Humana Medicare Advantage	$14,163.98
Rate for Payer: Oxford Commercial	$13,638.30
Rate for Payer: UnitedHealthcare Commercial	$15,480.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,751.44
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14,576.53
Rate for Payer: Wellcare Medicare Advantage	$13,751.44

RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC

Facility

$73,551.27

Service Code	MSDRG 814
Min. Negotiated Rate	$23,207.79
Max. Negotiated Rate	$73,551.27
Rate for Payer: Aetna Commercial	$71,712.07
Rate for Payer: Aetna Medicare Advantage	$23,207.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58,717.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58,717.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24,517.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58,717.71
Rate for Payer: Cigna Commercial	$45,768.71
Rate for Payer: Cigna Medicare Advantage	$24,517.09
Rate for Payer: Clover Medicare Advantage	$23,291.24
Rate for Payer: EmblemHealth Commercial	$73,551.27
Rate for Payer: Humana Medicare Advantage	$25,252.60
Rate for Payer: Oxford Commercial	$28,604.12
Rate for Payer: UnitedHealthcare Commercial	$32,468.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$24,517.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25,988.12
Rate for Payer: Wellcare Medicare Advantage	$24,517.09

RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC

Facility

$30,166.50

Service Code	MSDRG 816
Min. Negotiated Rate	$6,896.75
Max. Negotiated Rate	$30,166.50
Rate for Payer: Aetna Commercial	$21,310.96
Rate for Payer: Aetna Medicare Advantage	$6,896.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,572.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,572.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10,055.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19,572.57
Rate for Payer: Cigna Commercial	$13,601.27
Rate for Payer: Cigna Medicare Advantage	$10,055.50
Rate for Payer: Clover Medicare Advantage	$9,552.73
Rate for Payer: EmblemHealth Commercial	$30,166.50
Rate for Payer: Humana Medicare Advantage	$10,357.17
Rate for Payer: Oxford Commercial	$8,500.40
Rate for Payer: UnitedHealthcare Commercial	$9,648.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$10,055.50
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10,658.83
Rate for Payer: Wellcare Medicare Advantage	$10,055.50

RETIN-A 0.01%/15GM

Facility

$101.00

Hospital Charge Code	60633816
Hospital Revenue Code	250
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$50.50
Rate for Payer: Aetna Commercial	$30.30
Rate for Payer: Aetna Medicare Advantage	$30.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.75
Rate for Payer: Cigna Commercial	$50.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.13
Rate for Payer: Oxford Commercial	$50.50
Rate for Payer: Qualcare PPO/HMO/WC	$15.15
Rate for Payer: UnitedHealthcare Commercial	$50.50

RETIN-A 0.01%/15GM

Facility

$101.00

Hospital Charge Code	60633816
Hospital Revenue Code	250
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$15.15
Rate for Payer: Qualcare PPO/HMO/WC	$15.15

RETIN-A 0.025%/15GM

Facility

$118.00

Hospital Charge Code	60633818
Hospital Revenue Code	250
Min. Negotiated Rate	$17.70
Max. Negotiated Rate	$17.70
Rate for Payer: Qualcare PPO/HMO/WC	$17.70

RETIN-A 0.025%/15GM

Facility

$118.00

Hospital Charge Code	60633818
Hospital Revenue Code	250
Min. Negotiated Rate	$15.34
Max. Negotiated Rate	$59.00
Rate for Payer: Aetna Commercial	$35.40
Rate for Payer: Aetna Medicare Advantage	$35.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.09
Rate for Payer: Cigna Commercial	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.34
Rate for Payer: Oxford Commercial	$59.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$59.00

RETIN-A 0.025%/20GM

Facility

$127.00

Hospital Charge Code	60633817
Hospital Revenue Code	250
Min. Negotiated Rate	$19.05
Max. Negotiated Rate	$19.05
Rate for Payer: Qualcare PPO/HMO/WC	$19.05

RETIN-A 0.025%/20GM

Facility

$127.00

Hospital Charge Code	60633817
Hospital Revenue Code	250
Min. Negotiated Rate	$16.51
Max. Negotiated Rate	$63.50
Rate for Payer: Aetna Commercial	$38.10
Rate for Payer: Aetna Medicare Advantage	$38.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.38
Rate for Payer: Cigna Commercial	$63.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.51
Rate for Payer: Oxford Commercial	$63.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.05
Rate for Payer: UnitedHealthcare Commercial	$63.50

RETIN-A 0.05%/20GM

Facility

$129.00

Hospital Charge Code	60633819
Hospital Revenue Code	250
Min. Negotiated Rate	$19.35
Max. Negotiated Rate	$19.35
Rate for Payer: Qualcare PPO/HMO/WC	$19.35

RETIN-A 0.05%/20GM

Facility

$129.00

Hospital Charge Code	60633819
Hospital Revenue Code	250
Min. Negotiated Rate	$16.77
Max. Negotiated Rate	$64.50
Rate for Payer: Aetna Commercial	$38.70
Rate for Payer: Aetna Medicare Advantage	$38.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.90
Rate for Payer: Cigna Commercial	$64.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.77
Rate for Payer: Oxford Commercial	$64.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.35
Rate for Payer: UnitedHealthcare Commercial	$64.50

RETIN-A 0.1%/20GM

Facility

$152.00

Hospital Charge Code	60633820
Hospital Revenue Code	250
Min. Negotiated Rate	$19.76
Max. Negotiated Rate	$76.00
Rate for Payer: Aetna Commercial	$45.60
Rate for Payer: Aetna Medicare Advantage	$45.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.76
Rate for Payer: Cigna Commercial	$76.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.76
Rate for Payer: Oxford Commercial	$76.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.80
Rate for Payer: UnitedHealthcare Commercial	$76.00

Know your out-of-pocket cost for care.

All Charges