Heights University Hospital

All Charges

Charge

Type

Setting

Price

SEROTONIN REL ASSAY UNFR

Facility

$390.00

Service Code	HCPCS 86022
Hospital Charge Code	39900358
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

SEROTONIN REL ASSAY UNFR

Facility

$390.00

Service Code	HCPCS 86022
Hospital Charge Code	39900358
Hospital Revenue Code	302
Min. Negotiated Rate	$9.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$59.52
Rate for Payer: Aetna Medicare Advantage	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.37
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	$67.31
Rate for Payer: Cigna Commercial	$18.37
Rate for Payer: Cigna Medicare Advantage	$9.19
Rate for Payer: Clover Medicare Advantage	$17.45
Rate for Payer: EmblemHealth Commercial	$55.11
Rate for Payer: Humana Medicare Advantage	$18.92
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	$18.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.47
Rate for Payer: Wellcare Medicare Advantage	$18.37

SEROTONIN SERUM

Facility

$373.45

Service Code	HCPCS 84260
Hospital Charge Code	401184260
Hospital Revenue Code	301
Min. Negotiated Rate	$15.49
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$100.38
Rate for Payer: Aetna Medicare Advantage	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.51
Rate for Payer: Cigna Commercial	$30.98
Rate for Payer: Cigna Medicare Advantage	$15.49
Rate for Payer: Clover Medicare Advantage	$29.43
Rate for Payer: EmblemHealth Commercial	$92.94
Rate for Payer: Humana Medicare Advantage	$31.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.55
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.02
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$30.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$32.84
Rate for Payer: Wellcare Medicare Advantage	$30.98

SEROTONIN SERUM

Facility

$373.45

Service Code	HCPCS 84260
Hospital Charge Code	401184260
Hospital Revenue Code	301
Min. Negotiated Rate	$56.02
Max. Negotiated Rate	$56.02
Rate for Payer: Qualcare PPO/HMO/WC	$56.02

SEROTONIN, WHOLE BLOOD

Facility

$460.85

Service Code	HCPCS 84260
Hospital Charge Code	3002417
Hospital Revenue Code	301
Min. Negotiated Rate	$15.49
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$100.38
Rate for Payer: Aetna Medicare Advantage	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.51
Rate for Payer: Cigna Commercial	$30.98
Rate for Payer: Cigna Medicare Advantage	$15.49
Rate for Payer: Clover Medicare Advantage	$29.43
Rate for Payer: EmblemHealth Commercial	$92.94
Rate for Payer: Humana Medicare Advantage	$31.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.13
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$30.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$32.84
Rate for Payer: Wellcare Medicare Advantage	$30.98

SEROTONIN, WHOLE BLOOD

Facility

$460.85

Service Code	HCPCS 84260
Hospital Charge Code	3002417
Hospital Revenue Code	301
Min. Negotiated Rate	$69.13
Max. Negotiated Rate	$69.13
Rate for Payer: Qualcare PPO/HMO/WC	$69.13

SERO TYPING

Facility

$69.00

Service Code	HCPCS 87140
Hospital Charge Code	38475077
Hospital Revenue Code	309
Min. Negotiated Rate	$2.79
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.05
Rate for Payer: Aetna Medicare Advantage	$5.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.57
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	$20.41
Rate for Payer: Cigna Commercial	$5.57
Rate for Payer: Cigna Medicare Advantage	$2.79
Rate for Payer: Clover Medicare Advantage	$5.29
Rate for Payer: EmblemHealth Commercial	$16.71
Rate for Payer: Humana Medicare Advantage	$5.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.57
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.90
Rate for Payer: Wellcare Medicare Advantage	$5.57

SERO TYPING

Facility

$69.00

Service Code	HCPCS 87140
Hospital Charge Code	38475077
Hospital Revenue Code	309
Min. Negotiated Rate	$10.35
Max. Negotiated Rate	$10.35
Rate for Payer: Qualcare PPO/HMO/WC	$10.35

SERPASIL/0.1MG/TAB

Facility

$3.00

Hospital Charge Code	60634396
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

SERPASIL/0.1MG/TAB

Facility

$3.00

Hospital Charge Code	60634396
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

SERPASIL/0.25MG/TAB

Facility

$3.00

Hospital Charge Code	60633877
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

SERPASIL/0.25MG/TAB

Facility

$3.00

Hospital Charge Code	60633877
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

SERTRALINE 100 MG TAB

Facility

$50.38

Service Code	NDC 49491041
Hospital Charge Code	6008700
Hospital Revenue Code	250
Min. Negotiated Rate	$6.55
Max. Negotiated Rate	$25.19
Rate for Payer: Aetna Commercial	$15.11
Rate for Payer: Aetna Medicare Advantage	$15.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.85
Rate for Payer: Cigna Commercial	$25.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.55
Rate for Payer: Oxford Commercial	$25.19
Rate for Payer: Qualcare PPO/HMO/WC	$7.56
Rate for Payer: UnitedHealthcare Commercial	$25.19

SERTRALINE 100 MG TAB

Facility

$50.38

Service Code	NDC 49491041
Hospital Charge Code	6008700
Hospital Revenue Code	250
Min. Negotiated Rate	$7.56
Max. Negotiated Rate	$7.56
Rate for Payer: Qualcare PPO/HMO/WC	$7.56

SERTRALINE 20MG/ML ORAL

Facility

$7.50

Service Code	NDC 16714060102
Hospital Charge Code	606390295
Hospital Revenue Code	250
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$1.12
Rate for Payer: Qualcare PPO/HMO/WC	$1.12

SERTRALINE 20MG/ML ORAL

Facility

$7.50

Service Code	NDC 16714060102
Hospital Charge Code	606390295
Hospital Revenue Code	250
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$3.75
Rate for Payer: Aetna Commercial	$2.25
Rate for Payer: Aetna Medicare Advantage	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.91
Rate for Payer: Cigna Commercial	$3.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.98
Rate for Payer: Oxford Commercial	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$1.12
Rate for Payer: UnitedHealthcare Commercial	$3.75

SERTRALINE 25 MG TAB

Facility

$19.10

Service Code	NDC 68180035106
Hospital Charge Code	60629304
Hospital Revenue Code	250
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$9.55
Rate for Payer: Aetna Commercial	$5.73
Rate for Payer: Aetna Medicare Advantage	$5.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.87
Rate for Payer: Cigna Commercial	$9.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.48
Rate for Payer: Oxford Commercial	$9.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.87
Rate for Payer: UnitedHealthcare Commercial	$9.55

SERTRALINE 25 MG TAB

Facility

$19.10

Service Code	NDC 68180035106
Hospital Charge Code	60629304
Hospital Revenue Code	250
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$2.87
Rate for Payer: Qualcare PPO/HMO/WC	$2.87

SERTRALINE 50 MG TAB

Facility

$50.38

Service Code	NDC 58151057588
Hospital Charge Code	60627781
Hospital Revenue Code	250
Min. Negotiated Rate	$6.55
Max. Negotiated Rate	$25.19
Rate for Payer: Aetna Commercial	$15.11
Rate for Payer: Aetna Medicare Advantage	$15.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.85
Rate for Payer: Cigna Commercial	$25.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.55
Rate for Payer: Oxford Commercial	$25.19
Rate for Payer: Qualcare PPO/HMO/WC	$7.56
Rate for Payer: UnitedHealthcare Commercial	$25.19

SERTRALINE 50 MG TAB

Facility

$50.38

Service Code	NDC 58151057588
Hospital Charge Code	60627781
Hospital Revenue Code	250
Min. Negotiated Rate	$7.56
Max. Negotiated Rate	$7.56
Rate for Payer: Qualcare PPO/HMO/WC	$7.56

SERUM BACTERICIDAL TITER

Facility

$82.00

Service Code	HCPCS 87197
Hospital Charge Code	38477103
Hospital Revenue Code	309
Min. Negotiated Rate	$7.51
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.66
Rate for Payer: Aetna Medicare Advantage	$15.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.03
Rate for Payer: Cigna Commercial	$15.02
Rate for Payer: Cigna Medicare Advantage	$7.51
Rate for Payer: Clover Medicare Advantage	$14.27
Rate for Payer: EmblemHealth Commercial	$45.06
Rate for Payer: Humana Medicare Advantage	$15.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.02
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.92
Rate for Payer: Wellcare Medicare Advantage	$15.02

SERUM BACTERICIDAL TITER

Facility

$82.00

Service Code	HCPCS 87197
Hospital Charge Code	38477103
Hospital Revenue Code	309
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$12.30
Rate for Payer: Qualcare PPO/HMO/WC	$12.30

SERUM FREE CORTISOL I

Facility

$139.25

Service Code	HCPCS 82533
Hospital Charge Code	3038537A
Hospital Revenue Code	301
Min. Negotiated Rate	$20.89
Max. Negotiated Rate	$20.89
Rate for Payer: Qualcare PPO/HMO/WC	$20.89

SERUM FREE CORTISOL I

Facility

$139.25

Service Code	HCPCS 82533
Hospital Charge Code	3038537A
Hospital Revenue Code	301
Min. Negotiated Rate	$8.15
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.81
Rate for Payer: Aetna Medicare Advantage	$16.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.72
Rate for Payer: Cigna Commercial	$16.30
Rate for Payer: Cigna Medicare Advantage	$8.15
Rate for Payer: Clover Medicare Advantage	$15.48
Rate for Payer: EmblemHealth Commercial	$48.90
Rate for Payer: Humana Medicare Advantage	$16.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.89
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.30
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.28
Rate for Payer: Wellcare Medicare Advantage	$16.30

SERUM FREE CORTISOL II

Facility

$123.70

Service Code	HCPCS 84449
Hospital Charge Code	3038537B
Hospital Revenue Code	301
Min. Negotiated Rate	$18.55
Max. Negotiated Rate	$18.55
Rate for Payer: Qualcare PPO/HMO/WC	$18.55

Know your out-of-pocket cost for care.

All Charges