Heights University Hospital

All Charges

Charge

Type

Setting

Price

URINALYSIS DIP TEST

Facility

$16.00

Service Code	HCPCS 81002
Hospital Charge Code	3002681
Hospital Revenue Code	307
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

URINALYSIS DIP TEST

Facility

$16.00

Service Code	HCPCS 81002
Hospital Charge Code	3002681
Hospital Revenue Code	307
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$11.28
Rate for Payer: Aetna Medicare Advantage	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$3.48
Rate for Payer: Cigna Medicare Advantage	$1.74
Rate for Payer: Clover Medicare Advantage	$3.31
Rate for Payer: EmblemHealth Commercial	$10.44
Rate for Payer: Humana Medicare Advantage	$3.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.69
Rate for Payer: Wellcare Medicare Advantage	$3.48

URINALYSIS, ROUTINE

Facility

$655.28

Service Code	HCPCS 81003
Hospital Charge Code	3002680
Hospital Revenue Code	307
Min. Negotiated Rate	$98.29
Max. Negotiated Rate	$98.29
Rate for Payer: Qualcare PPO/HMO/WC	$98.29

URINALYSIS, ROUTINE

Facility

$655.28

Service Code	HCPCS 81003
Hospital Charge Code	3002680
Hospital Revenue Code	307
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.29
Rate for Payer: Aetna Medicare Advantage	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.24
Rate for Payer: Cigna Commercial	$2.25
Rate for Payer: Cigna Medicare Advantage	$1.12
Rate for Payer: Clover Medicare Advantage	$2.14
Rate for Payer: EmblemHealth Commercial	$6.75
Rate for Payer: Humana Medicare Advantage	$2.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.19
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.29
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.25
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.38
Rate for Payer: Wellcare Medicare Advantage	$2.25

URINARY DIVERSON*******

Facility

$140.00

Hospital Charge Code	8001349
Hospital Revenue Code	279
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

URINARY DIVERSON*******

Facility

$140.00

Hospital Charge Code	8001349
Hospital Revenue Code	279
Min. Negotiated Rate	$18.20
Max. Negotiated Rate	$70.00
Rate for Payer: Aetna Commercial	$42.00
Rate for Payer: Aetna Medicare Advantage	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.70
Rate for Payer: Cigna Commercial	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.20
Rate for Payer: Oxford Commercial	$70.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.00
Rate for Payer: UnitedHealthcare Commercial	$70.00

URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$13,896.33

Service Code	APR-DRG 4653
Min. Negotiated Rate	$8,590.44
Max. Negotiated Rate	$13,896.33
Rate for Payer: Aetna Better Health Medicaid	$13,623.85
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,896.33
Rate for Payer: Wellpoint Medicaid Managed Care	$8,590.44

URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$8,409.40

Service Code	APR-DRG 4652
Min. Negotiated Rate	$5,605.34
Max. Negotiated Rate	$8,409.40
Rate for Payer: Aetna Better Health Medicaid	$8,244.51
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,409.40
Rate for Payer: Wellpoint Medicaid Managed Care	$5,605.34

URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$23,406.84

Service Code	APR-DRG 4654
Min. Negotiated Rate	$18,730.42
Max. Negotiated Rate	$23,406.84
Rate for Payer: Aetna Better Health Medicaid	$22,947.88
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,406.84
Rate for Payer: Wellpoint Medicaid Managed Care	$18,730.42

URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION

Facility

$6,986.82

Service Code	APR-DRG 4651
Min. Negotiated Rate	$4,680.81
Max. Negotiated Rate	$6,986.82
Rate for Payer: Aetna Better Health Medicaid	$6,849.82
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,986.82
Rate for Payer: Wellpoint Medicaid Managed Care	$4,680.81

URINARY STONES WITH MCC

Facility

$50,847.33

Service Code	MSDRG 693
Min. Negotiated Rate	$14,671.97
Max. Negotiated Rate	$50,847.33
Rate for Payer: Aetna Commercial	$45,336.39
Rate for Payer: Aetna Medicare Advantage	$14,671.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39,145.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39,145.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,949.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39,145.14
Rate for Payer: Cigna Commercial	$28,934.98
Rate for Payer: Cigna Medicare Advantage	$16,949.11
Rate for Payer: Clover Medicare Advantage	$16,101.65
Rate for Payer: EmblemHealth Commercial	$50,847.33
Rate for Payer: Humana Medicare Advantage	$17,457.58
Rate for Payer: Oxford Commercial	$18,083.53
Rate for Payer: UnitedHealthcare Commercial	$20,526.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,949.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17,966.06
Rate for Payer: Wellcare Medicare Advantage	$16,949.11

URINARY STONES WITHOUT MCC

Facility

$34,511.64

Service Code	MSDRG 694
Min. Negotiated Rate	$8,530.37
Max. Negotiated Rate	$34,511.64
Rate for Payer: Aetna Commercial	$26,358.84
Rate for Payer: Aetna Medicare Advantage	$8,530.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,502.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,502.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,503.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21,502.26
Rate for Payer: Cigna Commercial	$16,822.97
Rate for Payer: Cigna Medicare Advantage	$11,503.88
Rate for Payer: Clover Medicare Advantage	$10,928.69
Rate for Payer: EmblemHealth Commercial	$34,511.64
Rate for Payer: Humana Medicare Advantage	$11,849.00
Rate for Payer: Oxford Commercial	$10,513.86
Rate for Payer: UnitedHealthcare Commercial	$11,934.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,503.88
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12,194.11
Rate for Payer: Wellcare Medicare Advantage	$11,503.88

URINE COLLECTION FEE

Facility

$120.00

Service Code	HCPCS 81002
Hospital Charge Code	3008607
Hospital Revenue Code	300
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

URINE COLLECTION FEE

Facility

$120.00

Service Code	HCPCS 81002
Hospital Charge Code	3008607
Hospital Revenue Code	300
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$11.28
Rate for Payer: Aetna Medicare Advantage	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$3.48
Rate for Payer: Cigna Medicare Advantage	$1.74
Rate for Payer: Clover Medicare Advantage	$3.31
Rate for Payer: EmblemHealth Commercial	$10.44
Rate for Payer: Humana Medicare Advantage	$3.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.69
Rate for Payer: Wellcare Medicare Advantage	$3.48

URINE CULTURE

Facility

$305.20

Service Code	HCPCS 87086
Hospital Charge Code	38475020
Hospital Revenue Code	306
Min. Negotiated Rate	$45.78
Max. Negotiated Rate	$45.78
Rate for Payer: Qualcare PPO/HMO/WC	$45.78

URINE CULTURE

Facility

$305.20

Service Code	HCPCS 87086
Hospital Charge Code	38475020
Hospital Revenue Code	306
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.15
Rate for Payer: Aetna Medicare Advantage	$8.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.07
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	$29.57
Rate for Payer: Cigna Commercial	$8.07
Rate for Payer: Cigna Medicare Advantage	$4.04
Rate for Payer: Clover Medicare Advantage	$7.67
Rate for Payer: EmblemHealth Commercial	$24.21
Rate for Payer: Humana Medicare Advantage	$8.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.68
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.78
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.07
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.55
Rate for Payer: Wellcare Medicare Advantage	$8.07

URINE CYTOLOGY

Facility

$264.85

Service Code	HCPCS 88104
Hospital Charge Code	3005350
Hospital Revenue Code	311
Min. Negotiated Rate	$34.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$79.45
Rate for Payer: Aetna Medicare Advantage	$79.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.54
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$47.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.73
Rate for Payer: UnitedHealthcare Commercial	$114.00

URINE CYTOLOGY

Facility

$264.85

Service Code	HCPCS 88104
Hospital Charge Code	3005350
Hospital Revenue Code	311
Min. Negotiated Rate	$39.73
Max. Negotiated Rate	$39.73
Rate for Payer: Qualcare PPO/HMO/WC	$39.73

URINE DIP STICK

Facility

$390.00

Service Code	HCPCS 81002
Hospital Charge Code	5780265
Hospital Revenue Code	307
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$11.28
Rate for Payer: Aetna Medicare Advantage	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$3.48
Rate for Payer: Cigna Medicare Advantage	$1.74
Rate for Payer: Clover Medicare Advantage	$3.31
Rate for Payer: EmblemHealth Commercial	$10.44
Rate for Payer: Humana Medicare Advantage	$3.58
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	$3.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.69
Rate for Payer: Wellcare Medicare Advantage	$3.48

URINE DIP STICK

Facility

$390.00

Service Code	HCPCS 81002
Hospital Charge Code	5780265
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

URINE DIPSTICK, NON-AUTOM W MI

Facility

$24.85

Service Code	HCPCS 81000
Hospital Charge Code	2500368
Hospital Revenue Code	307
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

URINE DIPSTICK, NON-AUTOM W MI

Facility

$24.85

Service Code	HCPCS 81000
Hospital Charge Code	2500368
Hospital Revenue Code	307
Min. Negotiated Rate	$2.01
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.02
Rate for Payer: Aetna Medicare Advantage	$4.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.73
Rate for Payer: Cigna Commercial	$4.02
Rate for Payer: Cigna Medicare Advantage	$2.01
Rate for Payer: Clover Medicare Advantage	$3.82
Rate for Payer: EmblemHealth Commercial	$12.06
Rate for Payer: Humana Medicare Advantage	$4.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.23
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.02
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.26
Rate for Payer: Wellcare Medicare Advantage	$4.02

URINE DRUG SCR COLLECTION FEE

Facility

$20.00

Hospital Charge Code	3000347
Hospital Revenue Code	301
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

URINE DRUG SCR COLLECTION FEE

Facility

$20.00

Hospital Charge Code	3000347
Hospital Revenue Code	301
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$6.00
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$114.00

URINE DRUG SCRN-COC-CHAIN STDY

Facility

$79.00

Hospital Charge Code	3010311
Hospital Revenue Code	301
Min. Negotiated Rate	$11.85
Max. Negotiated Rate	$11.85
Rate for Payer: Qualcare PPO/HMO/WC	$11.85

Know your out-of-pocket cost for care.

All Charges