Heights University Hospital

All Charges

Charge

Type

Setting

Price

BETA-2 MICROGLOBIN, URINE

Facility

$167.25

Service Code	HCPCS 82232
Hospital Charge Code	3007216
Hospital Revenue Code	301
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$25.09
Rate for Payer: Qualcare PPO/HMO/WC	$25.09

BETA-2 MICROGLOBULIN

Facility

$390.00

Service Code	HCPCS 82232
Hospital Charge Code	401082232
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BETA-2 MICROGLOBULIN

Facility

$390.00

Service Code	HCPCS 82232
Hospital Charge Code	401082232
Hospital Revenue Code	301
Min. Negotiated Rate	$8.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.42
Rate for Payer: Aetna Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.28
Rate for Payer: Cigna Commercial	$16.18
Rate for Payer: Cigna Medicare Advantage	$8.09
Rate for Payer: Clover Medicare Advantage	$15.37
Rate for Payer: EmblemHealth Commercial	$48.54
Rate for Payer: Humana Medicare Advantage	$16.67
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	$16.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.15
Rate for Payer: Wellcare Medicare Advantage	$16.18

BETA-2-MICROGLOBULIN

Facility

$174.00

Service Code	HCPCS 82232
Hospital Charge Code	38473077
Hospital Revenue Code	301
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

BETA-2-MICROGLOBULIN

Facility

$174.00

Service Code	HCPCS 82232
Hospital Charge Code	38473077
Hospital Revenue Code	301
Min. Negotiated Rate	$8.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.42
Rate for Payer: Aetna Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.28
Rate for Payer: Cigna Commercial	$16.18
Rate for Payer: Cigna Medicare Advantage	$8.09
Rate for Payer: Clover Medicare Advantage	$15.37
Rate for Payer: EmblemHealth Commercial	$48.54
Rate for Payer: Humana Medicare Advantage	$16.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.15
Rate for Payer: Wellcare Medicare Advantage	$16.18

BETA-2-MICROGLOBULIN,CSF

Facility

$390.00

Service Code	HCPCS 82232
Hospital Charge Code	39900327
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BETA-2-MICROGLOBULIN,CSF

Facility

$390.00

Service Code	HCPCS 82232
Hospital Charge Code	39900327
Hospital Revenue Code	301
Min. Negotiated Rate	$8.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.42
Rate for Payer: Aetna Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.28
Rate for Payer: Cigna Commercial	$16.18
Rate for Payer: Cigna Medicare Advantage	$8.09
Rate for Payer: Clover Medicare Advantage	$15.37
Rate for Payer: EmblemHealth Commercial	$48.54
Rate for Payer: Humana Medicare Advantage	$16.67
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	$16.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.15
Rate for Payer: Wellcare Medicare Advantage	$16.18

BETA-2 MICROGLOBULIN, SERUM

Facility

$167.25

Service Code	HCPCS 82232
Hospital Charge Code	3007218
Hospital Revenue Code	301
Min. Negotiated Rate	$8.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.42
Rate for Payer: Aetna Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.28
Rate for Payer: Cigna Commercial	$16.18
Rate for Payer: Cigna Medicare Advantage	$8.09
Rate for Payer: Clover Medicare Advantage	$15.37
Rate for Payer: EmblemHealth Commercial	$48.54
Rate for Payer: Humana Medicare Advantage	$16.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.09
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.15
Rate for Payer: Wellcare Medicare Advantage	$16.18

BETA-2 MICROGLOBULIN, SERUM

Facility

$167.25

Service Code	HCPCS 82232
Hospital Charge Code	3007218
Hospital Revenue Code	301
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$25.09
Rate for Payer: Qualcare PPO/HMO/WC	$25.09

BETA-2 MICROGLOBULIN, URINE***

Facility

$209.00

Service Code	HCPCS 82232
Hospital Charge Code	3007200
Hospital Revenue Code	301
Min. Negotiated Rate	$8.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.42
Rate for Payer: Aetna Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.28
Rate for Payer: Cigna Commercial	$16.18
Rate for Payer: Cigna Medicare Advantage	$8.09
Rate for Payer: Clover Medicare Advantage	$15.37
Rate for Payer: EmblemHealth Commercial	$48.54
Rate for Payer: Humana Medicare Advantage	$16.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.15
Rate for Payer: Wellcare Medicare Advantage	$16.18

BETA-2 MICROGLOBULIN, URINE***

Facility

$209.00

Service Code	HCPCS 82232
Hospital Charge Code	3007200
Hospital Revenue Code	301
Min. Negotiated Rate	$31.35
Max. Negotiated Rate	$31.35
Rate for Payer: Qualcare PPO/HMO/WC	$31.35

BETA-2 TRANSFERRIN I

Facility

$153.55

Service Code	HCPCS 86334
Hospital Charge Code	3038517A
Hospital Revenue Code	300
Min. Negotiated Rate	$11.17
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$72.38
Rate for Payer: Aetna Medicare Advantage	$22.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.85
Rate for Payer: Cigna Commercial	$22.34
Rate for Payer: Cigna Medicare Advantage	$11.17
Rate for Payer: Clover Medicare Advantage	$21.22
Rate for Payer: EmblemHealth Commercial	$67.02
Rate for Payer: Humana Medicare Advantage	$23.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.96
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.03
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.34
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$23.68
Rate for Payer: Wellcare Medicare Advantage	$22.34

BETA-2 TRANSFERRIN I

Facility

$153.55

Service Code	HCPCS 86334
Hospital Charge Code	3038517A
Hospital Revenue Code	300
Min. Negotiated Rate	$23.03
Max. Negotiated Rate	$23.03
Rate for Payer: Qualcare PPO/HMO/WC	$23.03

BETA-2 TRANSFERRIN II

Facility

$1,502.00

Service Code	HCPCS 86335
Hospital Charge Code	3038517B
Hospital Revenue Code	300
Min. Negotiated Rate	$14.68
Max. Negotiated Rate	$225.30
Rate for Payer: Aetna Commercial	$95.09
Rate for Payer: Aetna Medicare Advantage	$29.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.54
Rate for Payer: Cigna Commercial	$29.35
Rate for Payer: Cigna Medicare Advantage	$14.68
Rate for Payer: Clover Medicare Advantage	$27.88
Rate for Payer: EmblemHealth Commercial	$88.05
Rate for Payer: Humana Medicare Advantage	$30.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.26
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$31.11
Rate for Payer: Wellcare Medicare Advantage	$29.35

BETA-2 TRANSFERRIN II

Facility

$1,502.00

Service Code	HCPCS 86335
Hospital Charge Code	3038517B
Hospital Revenue Code	300
Min. Negotiated Rate	$225.30
Max. Negotiated Rate	$225.30
Rate for Payer: Qualcare PPO/HMO/WC	$225.30

BETA CAROTENE 25,000 IU SGL

Facility

$4.00

Service Code	NDC 10135012801
Hospital Charge Code	6063943185
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

BETA CAROTENE 25,000 IU SGL

Facility

$4.00

Service Code	NDC 10135012801
Hospital Charge Code	6063943185
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

BETA CAROTENE, SERUM***

Facility

$32.00

Service Code	HCPCS 82380
Hospital Charge Code	3030764
Hospital Revenue Code	301
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

BETA CAROTENE, SERUM***

Facility

$32.00

Service Code	HCPCS 82380
Hospital Charge Code	3030764
Hospital Revenue Code	301
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$29.87
Rate for Payer: Aetna Medicare Advantage	$9.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.78
Rate for Payer: Cigna Commercial	$9.22
Rate for Payer: Cigna Medicare Advantage	$4.61
Rate for Payer: Clover Medicare Advantage	$8.76
Rate for Payer: EmblemHealth Commercial	$27.66
Rate for Payer: Humana Medicare Advantage	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.77
Rate for Payer: Wellcare Medicare Advantage	$9.22

BETADINE 1%/88ML

Facility

$38.00

Hospital Charge Code	60632547
Hospital Revenue Code	250
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

BETADINE 1%/88ML

Facility

$38.00

Hospital Charge Code	60632547
Hospital Revenue Code	250
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$19.00
Rate for Payer: Aetna Commercial	$11.40
Rate for Payer: Aetna Medicare Advantage	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.69
Rate for Payer: Cigna Commercial	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.94
Rate for Payer: Oxford Commercial	$19.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$19.00

BETADINE AEROSOL SPRAY

Facility

$22.00

Hospital Charge Code	270331179
Hospital Revenue Code	272
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$11.00
Rate for Payer: Aetna Commercial	$6.60
Rate for Payer: Aetna Medicare Advantage	$6.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.61
Rate for Payer: Cigna Commercial	$11.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.86
Rate for Payer: Oxford Commercial	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$11.00

BETADINE AEROSOL SPRAY

Facility

$22.00

Hospital Charge Code	270331179
Hospital Revenue Code	272
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

BETADINE OPHTH SOL 5%

Facility

$51.00

Hospital Charge Code	60635596
Hospital Revenue Code	250
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

BETADINE OPHTH SOL 5%

Facility

$51.00

Hospital Charge Code	60635596
Hospital Revenue Code	250
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$25.50
Rate for Payer: Aetna Commercial	$15.30
Rate for Payer: Aetna Medicare Advantage	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.01
Rate for Payer: Cigna Commercial	$25.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.63
Rate for Payer: Oxford Commercial	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$25.50

Know your out-of-pocket cost for care.

All Charges