Heights University Hospital

All Charges

Charge

Type

Setting

Price

B.BURGDORFERI AB (IGG,M), II

Facility

$667.59

Service Code	HCPCS 8661791
Hospital Charge Code	39990036B
Hospital Revenue Code	302
Min. Negotiated Rate	$86.79
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$200.28
Rate for Payer: Aetna Medicare Advantage	$200.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.24
Rate for Payer: Cigna Commercial	$333.80
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

B.BURGDORFERI AB SCREEN W

Facility

$117.05

Service Code	HCPCS 86618
Hospital Charge Code	39900228
Hospital Revenue Code	302
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$114.00
Rate for Payer: Cigna Commercial	$17.03
Rate for Payer: Cigna Medicare Advantage	$8.52
Rate for Payer: Aetna Commercial	$55.18
Rate for Payer: Aetna Medicare Advantage	$17.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.40
Rate for Payer: Clover Medicare Advantage	$16.18
Rate for Payer: EmblemHealth Commercial	$51.09
Rate for Payer: Humana Medicare Advantage	$17.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.22
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.56
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.03
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.05
Rate for Payer: Wellcare Medicare Advantage	$17.03

B.BURGDORFERI AB SCREEN W

Facility

$117.05

Service Code	HCPCS 86618
Hospital Charge Code	39900228
Hospital Revenue Code	302
Min. Negotiated Rate	$17.56
Max. Negotiated Rate	$17.56
Rate for Payer: Qualcare PPO/HMO/WC	$17.56

BC ACHI SPDBRG W/ KL DX CC 3.9

Facility

$14,909.25

Hospital Charge Code	270702069
Hospital Revenue Code	278
Min. Negotiated Rate	$2,236.39
Max. Negotiated Rate	$3,608.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,981.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,608.04
Rate for Payer: Qualcare PPO/HMO/WC	$2,236.39

BC ACHI SPDBRG W/ KL DX CC 3.9

Facility

$14,909.25

Hospital Charge Code	270702069
Hospital Revenue Code	278
Min. Negotiated Rate	$2,236.39
Max. Negotiated Rate	$7,454.62
Rate for Payer: Aetna Commercial	$4,472.77
Rate for Payer: Aetna Medicare Advantage	$4,472.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,801.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,801.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,981.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,801.86
Rate for Payer: Cigna Commercial	$7,454.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,608.04
Rate for Payer: Qualcare PPO/HMO/WC	$2,236.39

B-CELL CLONALITY (HEAVY CHAIN)

Facility

$393.00

Service Code	HCPCS 88182
Hospital Charge Code	38476227
Hospital Revenue Code	311
Min. Negotiated Rate	$58.95
Max. Negotiated Rate	$58.95
Rate for Payer: Qualcare PPO/HMO/WC	$58.95

B-CELL CLONALITY (HEAVY CHAIN)

Facility

$393.00

Service Code	HCPCS 88182
Hospital Charge Code	38476227
Hospital Revenue Code	311
Min. Negotiated Rate	$51.09
Max. Negotiated Rate	$124.10
Rate for Payer: Aetna Commercial	$117.90
Rate for Payer: Aetna Medicare Advantage	$117.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.22
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$85.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.95
Rate for Payer: UnitedHealthcare Commercial	$114.00

B-CELL CLONALITY (LIGHT CHAIN)

Facility

$393.00

Service Code	HCPCS 88182
Hospital Charge Code	38476226
Hospital Revenue Code	311
Min. Negotiated Rate	$51.09
Max. Negotiated Rate	$124.10
Rate for Payer: Aetna Commercial	$117.90
Rate for Payer: Aetna Medicare Advantage	$117.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.22
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$85.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.95
Rate for Payer: UnitedHealthcare Commercial	$114.00

B-CELL CLONALITY (LIGHT CHAIN)

Facility

$393.00

Service Code	HCPCS 88182
Hospital Charge Code	38476226
Hospital Revenue Code	311
Min. Negotiated Rate	$58.95
Max. Negotiated Rate	$58.95
Rate for Payer: Qualcare PPO/HMO/WC	$58.95

B-CELL CLONALITY SCREEN

Facility

$280.00

Service Code	HCPCS 88180
Hospital Charge Code	3006533
Hospital Revenue Code	309
Min. Negotiated Rate	$36.40
Max. Negotiated Rate	$140.00
Rate for Payer: Aetna Commercial	$84.00
Rate for Payer: Aetna Medicare Advantage	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.40
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Commercial	$114.00

B-CELL CLONALITY SCREEN

Facility

$280.00

Service Code	HCPCS 88180
Hospital Charge Code	3006533
Hospital Revenue Code	309
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

B CELLS,TOTAL COUNT

Facility

$267.15

Service Code	HCPCS 86355
Hospital Charge Code	38477200
Hospital Revenue Code	302
Min. Negotiated Rate	$18.86
Max. Negotiated Rate	$138.24
Rate for Payer: Aetna Commercial	$122.25
Rate for Payer: Aetna Medicare Advantage	$37.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.24
Rate for Payer: Cigna Commercial	$37.73
Rate for Payer: Cigna Medicare Advantage	$18.86
Rate for Payer: Clover Medicare Advantage	$35.84
Rate for Payer: EmblemHealth Commercial	$113.19
Rate for Payer: Humana Medicare Advantage	$38.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.07
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$37.73
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$39.99
Rate for Payer: Wellcare Medicare Advantage	$37.73

B CELLS,TOTAL COUNT

Facility

$267.15

Service Code	HCPCS 86355
Hospital Charge Code	38477200
Hospital Revenue Code	302
Min. Negotiated Rate	$40.07
Max. Negotiated Rate	$40.07
Rate for Payer: Qualcare PPO/HMO/WC	$40.07

BCG 50MG

Facility

$608.00

Service Code	HCPCS 90585
Hospital Charge Code	60635567
Hospital Revenue Code	636
Min. Negotiated Rate	$91.20
Max. Negotiated Rate	$304.00
Rate for Payer: Aetna Commercial	$182.40
Rate for Payer: Aetna Medicare Advantage	$182.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.04
Rate for Payer: Cigna Commercial	$304.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.14
Rate for Payer: Qualcare PPO/HMO/WC	$91.20

BCG 50MG

Facility

$608.00

Service Code	HCPCS 90585
Hospital Charge Code	60635567
Hospital Revenue Code	636
Min. Negotiated Rate	$91.20
Max. Negotiated Rate	$147.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.14
Rate for Payer: Qualcare PPO/HMO/WC	$91.20

BCG VACCINE 800MIL CFU/27MG

Facility

$1,343.40

Hospital Charge Code	6006951
Hospital Revenue Code	636
Min. Negotiated Rate	$201.51
Max. Negotiated Rate	$325.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.10
Rate for Payer: Qualcare PPO/HMO/WC	$201.51

BCG VACCINE 800MIL CFU/27MG

Facility

$1,343.40

Hospital Charge Code	6006951
Hospital Revenue Code	636
Min. Negotiated Rate	$201.51
Max. Negotiated Rate	$671.70
Rate for Payer: Aetna Commercial	$403.02
Rate for Payer: Aetna Medicare Advantage	$403.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.57
Rate for Payer: Cigna Commercial	$671.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.10
Rate for Payer: Qualcare PPO/HMO/WC	$201.51

B COMPLEX THIAM C B12 INJ

Facility

$3.85

Hospital Charge Code	6025043
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

B COMPLEX THIAM C B12 INJ

Facility

$3.85

Hospital Charge Code	6025043
Hospital Revenue Code	250
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.16
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.50
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$1.93

B COMPLEX VIT C FOLIC ACD CAP

Facility

$5.65

Hospital Charge Code	60628496
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

B COMPLEX VIT C FOLIC ACD CAP

Facility

$5.65

Hospital Charge Code	60628496
Hospital Revenue Code	250
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$1.70
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.73
Rate for Payer: Oxford Commercial	$2.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$2.83

BCR1

Facility

$1,118.45

Service Code	HCPCS 81206
Hospital Charge Code	39708026A
Hospital Revenue Code	310
Min. Negotiated Rate	$81.98
Max. Negotiated Rate	$600.75
Rate for Payer: Aetna Commercial	$531.23
Rate for Payer: Aetna Medicare Advantage	$163.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$600.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$600.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$163.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$600.75
Rate for Payer: Cigna Commercial	$163.96
Rate for Payer: Cigna Medicare Advantage	$81.98
Rate for Payer: Clover Medicare Advantage	$155.76
Rate for Payer: EmblemHealth Commercial	$491.88
Rate for Payer: Humana Medicare Advantage	$168.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$167.77
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$163.96
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$173.80
Rate for Payer: Wellcare Medicare Advantage	$163.96

BCR1

Facility

$1,118.45

Service Code	HCPCS 81206
Hospital Charge Code	39708026A
Hospital Revenue Code	310
Min. Negotiated Rate	$167.77
Max. Negotiated Rate	$167.77
Rate for Payer: Qualcare PPO/HMO/WC	$167.77

BCR2

Facility

$987.95

Service Code	HCPCS 81207
Hospital Charge Code	39708026B
Hospital Revenue Code	310
Min. Negotiated Rate	$72.42
Max. Negotiated Rate	$530.69
Rate for Payer: Aetna Commercial	$469.28
Rate for Payer: Aetna Medicare Advantage	$144.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$530.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$530.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$144.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$530.69
Rate for Payer: Cigna Commercial	$144.84
Rate for Payer: Cigna Medicare Advantage	$72.42
Rate for Payer: Clover Medicare Advantage	$137.60
Rate for Payer: EmblemHealth Commercial	$434.52
Rate for Payer: Humana Medicare Advantage	$149.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$148.19
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$144.84
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$153.53
Rate for Payer: Wellcare Medicare Advantage	$144.84

BCR2

Facility

$987.95

Service Code	HCPCS 81207
Hospital Charge Code	39708026B
Hospital Revenue Code	310
Min. Negotiated Rate	$148.19
Max. Negotiated Rate	$148.19
Rate for Payer: Qualcare PPO/HMO/WC	$148.19

Know your out-of-pocket cost for care.

All Charges