Heights University Hospital

All Charges

Charge

Type

Setting

Price

URINE TOX OPIATES

Facility

$656.39

Service Code	HCPCS 80361
Hospital Charge Code	3038531F
Hospital Revenue Code	301
Min. Negotiated Rate	$85.33
Max. Negotiated Rate	$328.19
Rate for Payer: Aetna Commercial	$196.92
Rate for Payer: Aetna Medicare Advantage	$196.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.38
Rate for Payer: Cigna Commercial	$328.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.33
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.46
Rate for Payer: UnitedHealthcare Commercial	$114.00

URINE TOX OPIATES

Facility

$656.39

Service Code	HCPCS 80361
Hospital Charge Code	3038531F
Hospital Revenue Code	301
Min. Negotiated Rate	$98.46
Max. Negotiated Rate	$98.46
Rate for Payer: Qualcare PPO/HMO/WC	$98.46

URINE TOX PCP

Facility

$656.39

Service Code	HCPCS 83992
Hospital Charge Code	3038531G
Hospital Revenue Code	301
Min. Negotiated Rate	$33.66
Max. Negotiated Rate	$328.19
Rate for Payer: Aetna Commercial	$196.92
Rate for Payer: Aetna Medicare Advantage	$196.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.38
Rate for Payer: Cigna Commercial	$328.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.33
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.46
Rate for Payer: UnitedHealthcare Commercial	$114.00

URINE TOX PCP

Facility

$656.39

Service Code	HCPCS 83992
Hospital Charge Code	3038531G
Hospital Revenue Code	301
Min. Negotiated Rate	$98.46
Max. Negotiated Rate	$98.46
Rate for Payer: Qualcare PPO/HMO/WC	$98.46

URINLYSIS DIP STICK/TAB REAGEN

Facility

$18.00

Service Code	HCPCS 81002
Hospital Charge Code	38477015
Hospital Revenue Code	307
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

URINLYSIS DIP STICK/TAB REAGEN

Facility

$18.00

Service Code	HCPCS 81002
Hospital Charge Code	38477015
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	$2.34
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	$3.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.69
Rate for Payer: Wellcare Medicare Advantage	$3.48

URISED/TAB

Facility

$3.00

Hospital Charge Code	60634115
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

URISED/TAB

Facility

$3.00

Hospital Charge Code	60634115
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

URISPAS/100MG/TAB

Facility

$3.00

Hospital Charge Code	60634407
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

URISPAS/100MG/TAB

Facility

$3.00

Hospital Charge Code	60634407
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

UR MICROALBUMIN QNT

Facility

$390.00

Service Code	HCPCS 82043
Hospital Charge Code	3038548A
Hospital Revenue Code	307
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.73
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.18
Rate for Payer: Cigna Commercial	$5.78
Rate for Payer: Cigna Medicare Advantage	$2.89
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
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	$5.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.13
Rate for Payer: Wellcare Medicare Advantage	$5.78

UR MICROALBUMIN QNT

Facility

$390.00

Service Code	HCPCS 82043
Hospital Charge Code	3038548A
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

UROBILINOGEN URINE

Facility

$118.00

Service Code	HCPCS 84580
Hospital Charge Code	38473127
Hospital Revenue Code	301
Min. Negotiated Rate	$17.70
Max. Negotiated Rate	$17.70
Rate for Payer: Qualcare PPO/HMO/WC	$17.70

UROBILINOGEN URINE

Facility

$118.00

Service Code	HCPCS 84580
Hospital Charge Code	38473127
Hospital Revenue Code	301
Min. Negotiated Rate	$3.93
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.94
Rate for Payer: Aetna Medicare Advantage	$9.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.99
Rate for Payer: Cigna Commercial	$9.55
Rate for Payer: Cigna Medicare Advantage	$4.78
Rate for Payer: Clover Medicare Advantage	$9.07
Rate for Payer: EmblemHealth Commercial	$28.65
Rate for Payer: Humana Medicare Advantage	$9.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.55
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10.12
Rate for Payer: Wellcare Medicare Advantage	$9.55

UROBILINOGEN (URINE QUAL)

Facility

$32.00

Service Code	HCPCS 84578
Hospital Charge Code	3002706
Hospital Revenue Code	301
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.48
Rate for Payer: Aetna Medicare Advantage	$4.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.38
Rate for Payer: Cigna Commercial	$4.47
Rate for Payer: Cigna Medicare Advantage	$2.23
Rate for Payer: Clover Medicare Advantage	$4.25
Rate for Payer: EmblemHealth Commercial	$13.41
Rate for Payer: Humana Medicare Advantage	$4.60
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	$4.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.74
Rate for Payer: Wellcare Medicare Advantage	$4.47

UROBILINOGEN (URINE QUAL)

Facility

$32.00

Service Code	HCPCS 84578
Hospital Charge Code	3002706
Hospital Revenue Code	301
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

UROBILINOGEN,URINE,QUALITATIVE

Facility

$23.00

Service Code	HCPCS 84578
Hospital Charge Code	38477016
Hospital Revenue Code	301
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

UROBILINOGEN,URINE,QUALITATIVE

Facility

$23.00

Service Code	HCPCS 84578
Hospital Charge Code	38477016
Hospital Revenue Code	301
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.48
Rate for Payer: Aetna Medicare Advantage	$4.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.38
Rate for Payer: Cigna Commercial	$4.47
Rate for Payer: Cigna Medicare Advantage	$2.23
Rate for Payer: Clover Medicare Advantage	$4.25
Rate for Payer: EmblemHealth Commercial	$13.41
Rate for Payer: Humana Medicare Advantage	$4.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.74
Rate for Payer: Wellcare Medicare Advantage	$4.47

UROCULT

Facility

$14.00

Hospital Charge Code	270335184
Hospital Revenue Code	272
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

UROCULT

Facility

$14.00

Hospital Charge Code	270335184
Hospital Revenue Code	272
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$7.00
Rate for Payer: Aetna Commercial	$4.20
Rate for Payer: Aetna Medicare Advantage	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.57
Rate for Payer: Cigna Commercial	$7.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.82
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$7.00

UROFORCE BALLOON 8MM X 6CM

Facility

$1,002.10

Service Code	HCPCS C1726
Hospital Charge Code	270682486
Hospital Revenue Code	278
Min. Negotiated Rate	$150.31
Max. Negotiated Rate	$501.05
Rate for Payer: Qualcare PPO/HMO/WC	$150.31
Rate for Payer: Aetna Commercial	$300.63
Rate for Payer: Aetna Medicare Advantage	$300.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.54
Rate for Payer: Cigna Commercial	$501.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.51

UROFORCE BALLOON 8MM X 6CM

Facility

$1,002.10

Service Code	HCPCS C1726
Hospital Charge Code	270682486
Hospital Revenue Code	278
Min. Negotiated Rate	$150.31
Max. Negotiated Rate	$242.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.51
Rate for Payer: Qualcare PPO/HMO/WC	$150.31

UROKINASE 250,000 UNITS INJ

Facility

$2,692.10

Hospital Charge Code	60627541
Hospital Revenue Code	636
Min. Negotiated Rate	$403.81
Max. Negotiated Rate	$651.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$651.49
Rate for Payer: Qualcare PPO/HMO/WC	$403.81

UROKINASE 250,000 UNITS INJ

Facility

$2,692.10

Hospital Charge Code	60627541
Hospital Revenue Code	636
Min. Negotiated Rate	$403.81
Max. Negotiated Rate	$1,346.05
Rate for Payer: Aetna Commercial	$807.63
Rate for Payer: Aetna Medicare Advantage	$807.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$686.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$686.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$686.49
Rate for Payer: Cigna Commercial	$1,346.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$651.49
Rate for Payer: Qualcare PPO/HMO/WC	$403.81

UROKINASE 5000 UNITS/ML INJ

Facility

$74.50

Hospital Charge Code	6008536
Hospital Revenue Code	250
Min. Negotiated Rate	$11.18
Max. Negotiated Rate	$11.18
Rate for Payer: Qualcare PPO/HMO/WC	$11.18

Know your out-of-pocket cost for care.

All Charges