Heights University Hospital

All Charges

Charge

Type

Setting

Price

SDS GLUCOSE CAPILLARY FINGERST

Facility

$390.00

Service Code	HCPCS 82948
Hospital Charge Code	1001182
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SDS HEMOGLOBIN HGB

Facility

$390.00

Service Code	HCPCS 85018
Hospital Charge Code	1001181
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SDS HEMOGLOBIN HGB

Facility

$390.00

Service Code	HCPCS 85018
Hospital Charge Code	1001181
Hospital Revenue Code	305
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.68
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.68
Rate for Payer: Cigna Commercial	$2.37
Rate for Payer: Cigna Medicare Advantage	$1.19
Rate for Payer: Clover Medicare Advantage	$2.25
Rate for Payer: EmblemHealth Commercial	$7.11
Rate for Payer: Humana Medicare Advantage	$2.44
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	$2.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.51
Rate for Payer: Wellcare Medicare Advantage	$2.37

SDS INJ BEDSIDE PAIN MANGEMENT

Facility

$1,590.00

Hospital Charge Code	1001167
Hospital Revenue Code	360
Min. Negotiated Rate	$238.50
Max. Negotiated Rate	$238.50
Rate for Payer: Qualcare PPO/HMO/WC	$238.50

SDS INJ BEDSIDE PAIN MANGEMENT

Facility

$1,590.00

Hospital Charge Code	1001167
Hospital Revenue Code	360
Min. Negotiated Rate	$206.70
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$477.00
Rate for Payer: Aetna Medicare Advantage	$477.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$405.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$405.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$405.45
Rate for Payer: Cigna Commercial	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.70
Rate for Payer: Qualcare PPO/HMO/WC	$238.50

SDS IV SOL 1000CC

Facility

$120.00

Hospital Charge Code	1001187
Hospital Revenue Code	258
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

SDS IV SOL 1000CC

Facility

$120.00

Hospital Charge Code	1001187
Hospital Revenue Code	258
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$36.00
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$60.00

SDS IV SOL 100CC

Facility

$81.00

Hospital Charge Code	1001185
Hospital Revenue Code	258
Min. Negotiated Rate	$10.53
Max. Negotiated Rate	$40.50
Rate for Payer: Aetna Commercial	$24.30
Rate for Payer: Aetna Medicare Advantage	$24.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.66
Rate for Payer: Cigna Commercial	$40.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.53
Rate for Payer: Oxford Commercial	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$12.15
Rate for Payer: UnitedHealthcare Commercial	$40.50

SDS IV SOL 100CC

Facility

$81.00

Hospital Charge Code	1001185
Hospital Revenue Code	258
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$12.15
Rate for Payer: Qualcare PPO/HMO/WC	$12.15

SDS IV SOL 500 CC

Facility

$120.00

Hospital Charge Code	1001186
Hospital Revenue Code	258
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

SDS IV SOL 500 CC

Facility

$120.00

Hospital Charge Code	1001186
Hospital Revenue Code	258
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$36.00
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$60.00

SDS JELCO QUICKCATH (IV CATH)

Facility

$17.00

Hospital Charge Code	1001184
Hospital Revenue Code	272
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$8.50
Rate for Payer: Aetna Commercial	$5.10
Rate for Payer: Aetna Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.33
Rate for Payer: Cigna Commercial	$8.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.21
Rate for Payer: Oxford Commercial	$8.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$8.50

SDS JELCO QUICKCATH (IV CATH)

Facility

$17.00

Hospital Charge Code	1001184
Hospital Revenue Code	272
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

SDS OBSERVATION EA ADD'L 2 HRS

Facility

$270.00

Service Code	HCPCS 99218
Hospital Charge Code	83034001
Hospital Revenue Code	762
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$81.00
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$621.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.10
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Commercial	$6,873.00
Rate for Payer: Wellpoint Medicaid Managed Care	$50.00

SDS OBSERVATION EA ADD'L 2 HRS

Facility

$270.00

Service Code	HCPCS 99218
Hospital Charge Code	83034001
Hospital Revenue Code	762
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

SDS PHASE II RECOV < 1 HOUR

Facility

$800.00

Hospital Charge Code	1000042
Hospital Revenue Code	710
Min. Negotiated Rate	$104.00
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$240.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$400.00

SDS PHASE II RECOV < 1 HOUR

Facility

$800.00

Hospital Charge Code	1000042
Hospital Revenue Code	710
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

SDS PHASE II RECOV 1 HOUR

Facility

$303.00

Hospital Charge Code	100043
Hospital Revenue Code	710
Min. Negotiated Rate	$39.39
Max. Negotiated Rate	$151.50
Rate for Payer: Aetna Commercial	$90.90
Rate for Payer: Aetna Medicare Advantage	$90.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.27
Rate for Payer: Cigna Commercial	$151.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.39
Rate for Payer: Oxford Commercial	$151.50
Rate for Payer: Qualcare PPO/HMO/WC	$45.45
Rate for Payer: UnitedHealthcare Commercial	$151.50

SDS PHASE II RECOV 1 HOUR

Facility

$303.00

Hospital Charge Code	100043
Hospital Revenue Code	710
Min. Negotiated Rate	$45.45
Max. Negotiated Rate	$45.45
Rate for Payer: Qualcare PPO/HMO/WC	$45.45

SDS PHASE II RECOV ADD1/2 HR

Facility

$551.00

Hospital Charge Code	100044
Hospital Revenue Code	710
Min. Negotiated Rate	$71.63
Max. Negotiated Rate	$275.50
Rate for Payer: Aetna Commercial	$165.30
Rate for Payer: Aetna Medicare Advantage	$165.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.50
Rate for Payer: Cigna Commercial	$275.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.63
Rate for Payer: Oxford Commercial	$275.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.65
Rate for Payer: UnitedHealthcare Commercial	$275.50

SDS PHASE II RECOV ADD1/2 HR

Facility

$551.00

Hospital Charge Code	100044
Hospital Revenue Code	710
Min. Negotiated Rate	$82.65
Max. Negotiated Rate	$82.65
Rate for Payer: Qualcare PPO/HMO/WC	$82.65

SDS URIN PREGNANCY TEST

Facility

$20.00

Service Code	HCPCS 81025
Hospital Charge Code	1001180
Hospital Revenue Code	300
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$27.90
Rate for Payer: Aetna Medicare Advantage	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.61
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	$31.55
Rate for Payer: Cigna Commercial	$8.61
Rate for Payer: Cigna Medicare Advantage	$4.30
Rate for Payer: Clover Medicare Advantage	$8.18
Rate for Payer: EmblemHealth Commercial	$25.83
Rate for Payer: Humana Medicare Advantage	$8.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.61
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.13
Rate for Payer: Wellcare Medicare Advantage	$8.61

SDS URIN PREGNANCY TEST

Facility

$20.00

Service Code	HCPCS 81025
Hospital Charge Code	1001180
Hospital Revenue Code	300
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

SDS VENIPUNCTURE

Facility

$26.25

Service Code	HCPCS 36415
Hospital Charge Code	1001183
Hospital Revenue Code	300
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.26
Rate for Payer: Aetna Medicare Advantage	$9.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.22
Rate for Payer: Cigna Commercial	$9.34
Rate for Payer: Cigna Medicare Advantage	$4.67
Rate for Payer: Clover Medicare Advantage	$8.87
Rate for Payer: EmblemHealth Commercial	$28.02
Rate for Payer: Humana Medicare Advantage	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.94
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.34
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.90
Rate for Payer: Wellcare Medicare Advantage	$9.34

SDS VENIPUNCTURE

Facility

$26.25

Service Code	HCPCS 36415
Hospital Charge Code	1001183
Hospital Revenue Code	300
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$3.94
Rate for Payer: Qualcare PPO/HMO/WC	$3.94

Know your out-of-pocket cost for care.

All Charges