Heights University Hospital

All Charges

Charge

Type

Setting

Price

UPPER MINOR KIT

Facility

$145.00

Hospital Charge Code	270338758
Hospital Revenue Code	272
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$21.75
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

UP TO 2 YRS OLD, SPIROMETRY

Facility

$464.65

Service Code	HCPCS 94011
Hospital Charge Code	9501291
Hospital Revenue Code	460
Min. Negotiated Rate	$60.40
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$139.40
Rate for Payer: Aetna Medicare Advantage	$139.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.49
Rate for Payer: Cigna Commercial	$306.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.40
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.70
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

UP TO 2 YRS OLD, SPIROMETRY

Facility

$464.65

Service Code	HCPCS 94011
Hospital Charge Code	9501291
Hospital Revenue Code	460
Min. Negotiated Rate	$69.70
Max. Negotiated Rate	$69.70
Rate for Payer: Qualcare PPO/HMO/WC	$69.70

UREA 10% LOTION

Facility

$120.00

Hospital Charge Code	60628462
Hospital Revenue Code	250
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

UREA 10% LOTION

Facility

$120.00

Hospital Charge Code	60628462
Hospital Revenue Code	250
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

UREA 40GM

Facility

$306.60

Hospital Charge Code	6017032
Hospital Revenue Code	636
Min. Negotiated Rate	$45.99
Max. Negotiated Rate	$74.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.20
Rate for Payer: Qualcare PPO/HMO/WC	$45.99

UREA 40GM

Facility

$306.60

Hospital Charge Code	6017032
Hospital Revenue Code	636
Min. Negotiated Rate	$45.99
Max. Negotiated Rate	$153.30
Rate for Payer: Aetna Commercial	$91.98
Rate for Payer: Aetna Medicare Advantage	$91.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.18
Rate for Payer: Cigna Commercial	$153.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.20
Rate for Payer: Qualcare PPO/HMO/WC	$45.99

UREA NITROGEN, 24 HOUR URINE

Facility

$390.00

Service Code	HCPCS 84540
Hospital Charge Code	3030864
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

UREA NITROGEN, 24 HOUR URINE

Facility

$390.00

Service Code	HCPCS 84540
Hospital Charge Code	3030864
Hospital Revenue Code	301
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.01
Rate for Payer: Aetna Medicare Advantage	$5.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.56
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	$20.37
Rate for Payer: Cigna Commercial	$5.56
Rate for Payer: Cigna Medicare Advantage	$2.78
Rate for Payer: Clover Medicare Advantage	$5.28
Rate for Payer: EmblemHealth Commercial	$16.68
Rate for Payer: Humana Medicare Advantage	$5.73
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	$5.56
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.89
Rate for Payer: Wellcare Medicare Advantage	$5.56

UREA NITROGEN, CLEARANCE

Facility

$46.75

Service Code	HCPCS 84545
Hospital Charge Code	38477047
Hospital Revenue Code	301
Min. Negotiated Rate	$7.01
Max. Negotiated Rate	$7.01
Rate for Payer: Qualcare PPO/HMO/WC	$7.01

UREA NITROGEN, CLEARANCE

Facility

$46.75

Service Code	HCPCS 84545
Hospital Charge Code	38477047
Hospital Revenue Code	301
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$23.33
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.38
Rate for Payer: Cigna Commercial	$7.20
Rate for Payer: Cigna Medicare Advantage	$3.60
Rate for Payer: Clover Medicare Advantage	$6.84
Rate for Payer: EmblemHealth Commercial	$21.60
Rate for Payer: Humana Medicare Advantage	$7.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.01
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.20
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.63
Rate for Payer: Wellcare Medicare Advantage	$7.20

UREA NITROGEN PERITONEAL FLUID

Facility

$51.11

Service Code	HCPCS 84520
Hospital Charge Code	401184520
Hospital Revenue Code	306
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$12.80
Rate for Payer: Aetna Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.95
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	$14.47
Rate for Payer: Cigna Commercial	$3.95
Rate for Payer: Cigna Medicare Advantage	$1.98
Rate for Payer: Clover Medicare Advantage	$3.75
Rate for Payer: EmblemHealth Commercial	$11.85
Rate for Payer: Humana Medicare Advantage	$4.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.67
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.95
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.19
Rate for Payer: Wellcare Medicare Advantage	$3.95

UREA NITROGEN PERITONEAL FLUID

Facility

$51.11

Service Code	HCPCS 84520
Hospital Charge Code	401184520
Hospital Revenue Code	306
Min. Negotiated Rate	$7.67
Max. Negotiated Rate	$7.67
Rate for Payer: Qualcare PPO/HMO/WC	$7.67

UREA NITROGEN, URINE

Facility

$390.00

Service Code	HCPCS 84540
Hospital Charge Code	3030863
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

UREA NITROGEN, URINE

Facility

$160.00

Service Code	HCPCS 84540
Hospital Charge Code	38472655
Hospital Revenue Code	301
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

UREA NITROGEN, URINE

Facility

$160.00

Service Code	HCPCS 84540
Hospital Charge Code	38472655
Hospital Revenue Code	301
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.01
Rate for Payer: Aetna Medicare Advantage	$5.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.56
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	$20.37
Rate for Payer: Cigna Commercial	$5.56
Rate for Payer: Cigna Medicare Advantage	$2.78
Rate for Payer: Clover Medicare Advantage	$5.28
Rate for Payer: EmblemHealth Commercial	$16.68
Rate for Payer: Humana Medicare Advantage	$5.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.56
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.89
Rate for Payer: Wellcare Medicare Advantage	$5.56

UREA NITROGEN, URINE

Facility

$390.00

Service Code	HCPCS 84540
Hospital Charge Code	3030863
Hospital Revenue Code	301
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.01
Rate for Payer: Aetna Medicare Advantage	$5.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.56
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	$20.37
Rate for Payer: Cigna Commercial	$5.56
Rate for Payer: Cigna Medicare Advantage	$2.78
Rate for Payer: Clover Medicare Advantage	$5.28
Rate for Payer: EmblemHealth Commercial	$16.68
Rate for Payer: Humana Medicare Advantage	$5.73
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	$5.56
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.89
Rate for Payer: Wellcare Medicare Advantage	$5.56

UREA NITROGEN, URINE, RANDOM

Facility

$18.00

Service Code	HCPCS 84540
Hospital Charge Code	3030897
Hospital Revenue Code	301
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.01
Rate for Payer: Aetna Medicare Advantage	$5.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.56
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	$20.37
Rate for Payer: Cigna Commercial	$5.56
Rate for Payer: Cigna Medicare Advantage	$2.78
Rate for Payer: Clover Medicare Advantage	$5.28
Rate for Payer: EmblemHealth Commercial	$16.68
Rate for Payer: Humana Medicare Advantage	$5.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.56
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.89
Rate for Payer: Wellcare Medicare Advantage	$5.56

UREA NITROGEN, URINE, RANDOM

Facility

$18.00

Service Code	HCPCS 84540
Hospital Charge Code	3030897
Hospital Revenue Code	301
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

UREA REDUCTION RATIO I

Facility

$40.00

Service Code	HCPCS 84520
Hospital Charge Code	3038525A
Hospital Revenue Code	300
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

UREA REDUCTION RATIO I

Facility

$40.00

Service Code	HCPCS 84520
Hospital Charge Code	3038525A
Hospital Revenue Code	300
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$12.80
Rate for Payer: Aetna Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.95
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	$14.47
Rate for Payer: Cigna Commercial	$3.95
Rate for Payer: Cigna Medicare Advantage	$1.98
Rate for Payer: Clover Medicare Advantage	$3.75
Rate for Payer: EmblemHealth Commercial	$11.85
Rate for Payer: Humana Medicare Advantage	$4.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.95
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.19
Rate for Payer: Wellcare Medicare Advantage	$3.95

UREA REDUCTION RATIO II

Facility

$40.00

Service Code	HCPCS 84520
Hospital Charge Code	3038525B
Hospital Revenue Code	300
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

UREA REDUCTION RATIO II

Facility

$40.00

Service Code	HCPCS 84520
Hospital Charge Code	3038525B
Hospital Revenue Code	300
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$12.80
Rate for Payer: Aetna Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.95
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	$14.47
Rate for Payer: Cigna Commercial	$3.95
Rate for Payer: Cigna Medicare Advantage	$1.98
Rate for Payer: Clover Medicare Advantage	$3.75
Rate for Payer: EmblemHealth Commercial	$11.85
Rate for Payer: Humana Medicare Advantage	$4.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.95
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.19
Rate for Payer: Wellcare Medicare Advantage	$3.95

URECHOLINE INJ/5MG/ML

Facility

$23.00

Hospital Charge Code	60634269
Hospital Revenue Code	636
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$5.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.57
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

URECHOLINE INJ/5MG/ML

Facility

$23.00

Hospital Charge Code	60634269
Hospital Revenue Code	636
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$6.90
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.57
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

Know your out-of-pocket cost for care.

All Charges