Heights University Hospital

All Charges

Charge

Type

Setting

Price

TOXOPLASMA GONDII AB, IGM, QN

Facility

$141.65

Service Code	HCPCS 86778
Hospital Charge Code	3004413
Hospital Revenue Code	302
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

TOXOPLASMA GONDII AB, IGM, QN

Facility

$141.65

Service Code	HCPCS 86778
Hospital Charge Code	3004413
Hospital Revenue Code	302
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.69
Rate for Payer: Aetna Medicare Advantage	$14.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.41
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	$52.80
Rate for Payer: Cigna Commercial	$14.41
Rate for Payer: Cigna Medicare Advantage	$7.21
Rate for Payer: Clover Medicare Advantage	$13.69
Rate for Payer: EmblemHealth Commercial	$43.23
Rate for Payer: Humana Medicare Advantage	$14.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.41
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.27
Rate for Payer: Wellcare Medicare Advantage	$14.41

TOXOPLASMA GONDII DNA RTPCR

Facility

$151.41

Service Code	HCPCS 87798
Hospital Charge Code	401387798B
Hospital Revenue Code	306
Min. Negotiated Rate	$22.71
Max. Negotiated Rate	$22.71
Rate for Payer: Qualcare PPO/HMO/WC	$22.71

TOXOPLASMA GONDII DNA RTPCR

Facility

$151.41

Service Code	HCPCS 87798
Hospital Charge Code	401387798B
Hospital Revenue Code	306
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$147.80
Rate for Payer: Aetna Commercial	$113.69
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.57
Rate for Payer: Cigna Commercial	$35.09
Rate for Payer: Cigna Medicare Advantage	$17.55
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.68
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.71
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

TOXOPLASMA GONDII IGG CSF

Facility

$390.00

Service Code	HCPCS 86777
Hospital Charge Code	39900255
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TOXOPLASMA GONDII IGG CSF

Facility

$390.00

Service Code	HCPCS 86777
Hospital Charge Code	39900255
Hospital Revenue Code	302
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.72
Rate for Payer: Cigna Commercial	$14.39
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
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	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

TOXOPLASMA GONDII PCR CSF

Facility

$482.51

Service Code	HCPCS 87799
Hospital Charge Code	401387799B
Hospital Revenue Code	306
Min. Negotiated Rate	$21.42
Max. Negotiated Rate	$156.97
Rate for Payer: Aetna Commercial	$138.80
Rate for Payer: Aetna Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.97
Rate for Payer: Cigna Commercial	$42.84
Rate for Payer: Cigna Medicare Advantage	$21.42
Rate for Payer: Clover Medicare Advantage	$40.70
Rate for Payer: EmblemHealth Commercial	$128.52
Rate for Payer: Humana Medicare Advantage	$44.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.38
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$45.41
Rate for Payer: Wellcare Medicare Advantage	$42.84

TOXOPLASMA GONDII PCR CSF

Facility

$482.51

Service Code	HCPCS 87799
Hospital Charge Code	401387799B
Hospital Revenue Code	306
Min. Negotiated Rate	$72.38
Max. Negotiated Rate	$72.38
Rate for Payer: Qualcare PPO/HMO/WC	$72.38

TOXOPLASMA IGG AB

Facility

$131.25

Service Code	HCPCS 86777
Hospital Charge Code	3004405
Hospital Revenue Code	302
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.72
Rate for Payer: Cigna Commercial	$14.39
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

TOXOPLASMA IGG AB

Facility

$131.25

Service Code	HCPCS 86777
Hospital Charge Code	3004405
Hospital Revenue Code	302
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$19.69
Rate for Payer: Qualcare PPO/HMO/WC	$19.69

TOXOPLASMA IGG/IGM

Facility

$233.65

Hospital Charge Code	3004411
Hospital Revenue Code	301
Min. Negotiated Rate	$30.37
Max. Negotiated Rate	$116.83
Rate for Payer: Aetna Commercial	$70.09
Rate for Payer: Aetna Medicare Advantage	$70.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.58
Rate for Payer: Cigna Commercial	$116.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.37
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.05
Rate for Payer: UnitedHealthcare Commercial	$114.00

TOXOPLASMA IGG/IGM

Facility

$233.65

Hospital Charge Code	3004411
Hospital Revenue Code	301
Min. Negotiated Rate	$35.05
Max. Negotiated Rate	$35.05
Rate for Payer: Qualcare PPO/HMO/WC	$35.05

TOXOPLASMA IGG,IGM I

Facility

$390.00

Service Code	HCPCS 86777
Hospital Charge Code	39980146A
Hospital Revenue Code	302
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.72
Rate for Payer: Cigna Commercial	$14.39
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
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	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

TOXOPLASMA IGG,IGM I

Facility

$390.00

Service Code	HCPCS 86777
Hospital Charge Code	39980146A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TOXOPLASMA IGG,IGM II

Facility

$390.00

Service Code	HCPCS 86778
Hospital Charge Code	39990146B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TOXOPLASMA IGG,IGM II

Facility

$390.00

Service Code	HCPCS 86778
Hospital Charge Code	39990146B
Hospital Revenue Code	302
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.69
Rate for Payer: Aetna Medicare Advantage	$14.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.41
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	$52.80
Rate for Payer: Cigna Commercial	$14.41
Rate for Payer: Cigna Medicare Advantage	$7.21
Rate for Payer: Clover Medicare Advantage	$13.69
Rate for Payer: EmblemHealth Commercial	$43.23
Rate for Payer: Humana Medicare Advantage	$14.84
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	$14.41
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.27
Rate for Payer: Wellcare Medicare Advantage	$14.41

T-PC SWIVEL ADT 12x4x54 215158

Facility

$80.90

Hospital Charge Code	270633995
Hospital Revenue Code	272
Min. Negotiated Rate	$12.13
Max. Negotiated Rate	$12.13
Rate for Payer: Qualcare PPO/HMO/WC	$12.13

T-PC SWIVEL ADT 12x4x54 215158

Facility

$80.90

Hospital Charge Code	270633995
Hospital Revenue Code	272
Min. Negotiated Rate	$10.52
Max. Negotiated Rate	$40.45
Rate for Payer: Aetna Commercial	$24.27
Rate for Payer: Aetna Medicare Advantage	$24.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.63
Rate for Payer: Cigna Commercial	$40.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.52
Rate for Payer: Oxford Commercial	$40.45
Rate for Payer: Qualcare PPO/HMO/WC	$12.13
Rate for Payer: UnitedHealthcare Commercial	$40.45

T-PLATE 1.5MM 3HOLE/8HOLE

Facility

$967.15

Service Code	HCPCS C1713
Hospital Charge Code	270654815
Hospital Revenue Code	278
Min. Negotiated Rate	$145.07
Max. Negotiated Rate	$234.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.05
Rate for Payer: Qualcare PPO/HMO/WC	$145.07

T-PLATE 1.5MM 3HOLE/8HOLE

Facility

$967.15

Service Code	HCPCS C1713
Hospital Charge Code	270654815
Hospital Revenue Code	278
Min. Negotiated Rate	$145.07
Max. Negotiated Rate	$483.57
Rate for Payer: Aetna Commercial	$290.14
Rate for Payer: Aetna Medicare Advantage	$290.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$246.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$246.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$246.62
Rate for Payer: Cigna Commercial	$483.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.05
Rate for Payer: Qualcare PPO/HMO/WC	$145.07

T-PLATE 1.5MM 4HOLE/8HOLE

Facility

$1,007.35

Service Code	HCPCS C1713
Hospital Charge Code	270654816
Hospital Revenue Code	278
Min. Negotiated Rate	$151.10
Max. Negotiated Rate	$503.68
Rate for Payer: Aetna Commercial	$302.20
Rate for Payer: Aetna Medicare Advantage	$302.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.87
Rate for Payer: Cigna Commercial	$503.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.78
Rate for Payer: Qualcare PPO/HMO/WC	$151.10

T-PLATE 1.5MM 4HOLE/8HOLE

Facility

$1,007.35

Service Code	HCPCS C1713
Hospital Charge Code	270654816
Hospital Revenue Code	278
Min. Negotiated Rate	$151.10
Max. Negotiated Rate	$243.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$243.78
Rate for Payer: Qualcare PPO/HMO/WC	$151.10

T-PLATE 2.0MM 2HOLE/8HOLE

Facility

$1,037.55

Service Code	HCPCS C1713
Hospital Charge Code	270654826
Hospital Revenue Code	278
Min. Negotiated Rate	$155.63
Max. Negotiated Rate	$251.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$207.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$251.09
Rate for Payer: Qualcare PPO/HMO/WC	$155.63

T-PLATE 2.0MM 2HOLE/8HOLE

Facility

$1,037.55

Service Code	HCPCS C1713
Hospital Charge Code	270654826
Hospital Revenue Code	278
Min. Negotiated Rate	$155.63
Max. Negotiated Rate	$518.77
Rate for Payer: Aetna Commercial	$311.26
Rate for Payer: Aetna Medicare Advantage	$311.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$264.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$264.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$207.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$264.58
Rate for Payer: Cigna Commercial	$518.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$251.09
Rate for Payer: Qualcare PPO/HMO/WC	$155.63

T-PLATE 2.0MM 3HOLE/8HOLE

Facility

$1,096.95

Service Code	HCPCS C1713
Hospital Charge Code	270654827
Hospital Revenue Code	278
Min. Negotiated Rate	$164.54
Max. Negotiated Rate	$548.48
Rate for Payer: Aetna Commercial	$329.08
Rate for Payer: Aetna Medicare Advantage	$329.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$279.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$219.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$279.72
Rate for Payer: Cigna Commercial	$548.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$265.46
Rate for Payer: Qualcare PPO/HMO/WC	$164.54

Know your out-of-pocket cost for care.

All Charges