Heights University Hospital

All Charges

Charge

Type

Setting

Price

VIRAL MENINGITIS WITHOUT CC/MCC

Facility

$35,774.25

Service Code	MSDRG 076
Min. Negotiated Rate	$9,005.06
Max. Negotiated Rate	$35,774.25
Rate for Payer: Aetna Commercial	$27,825.64
Rate for Payer: Aetna Medicare Advantage	$9,005.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,361.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,361.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,924.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,361.64
Rate for Payer: Cigna Medicare Advantage	$11,924.75
Rate for Payer: Clover Medicare Advantage	$11,328.51
Rate for Payer: EmblemHealth Commercial	$35,774.25
Rate for Payer: Humana Medicare Advantage	$12,282.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,924.75
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12,640.24
Rate for Payer: Wellcare Medicare Advantage	$11,924.75

VIRAL RESP DFA SCREEN W/ REFLX

Facility

$183.25

Service Code	HCPCS 87299
Hospital Charge Code	3006773
Hospital Revenue Code	309
Min. Negotiated Rate	$8.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.16
Rate for Payer: Aetna Medicare Advantage	$16.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.99
Rate for Payer: Cigna Commercial	$16.10
Rate for Payer: Cigna Medicare Advantage	$8.05
Rate for Payer: Clover Medicare Advantage	$15.29
Rate for Payer: EmblemHealth Commercial	$48.30
Rate for Payer: Humana Medicare Advantage	$16.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.49
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.10
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.07
Rate for Payer: Wellcare Medicare Advantage	$16.10

VIRAL RESP DFA SCREEN W/ REFLX

Facility

$183.25

Service Code	HCPCS 87299
Hospital Charge Code	3006773
Hospital Revenue Code	309
Min. Negotiated Rate	$27.49
Max. Negotiated Rate	$27.49
Rate for Payer: Qualcare PPO/HMO/WC	$27.49

VIRAMUNE 200MG TAB

Facility

$72.63

Service Code	NDC 51991033106
Hospital Charge Code	60635185
Hospital Revenue Code	250
Min. Negotiated Rate	$9.44
Max. Negotiated Rate	$36.31
Rate for Payer: Aetna Commercial	$21.79
Rate for Payer: Aetna Medicare Advantage	$21.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.52
Rate for Payer: Cigna Commercial	$36.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.44
Rate for Payer: Oxford Commercial	$36.31
Rate for Payer: Qualcare PPO/HMO/WC	$10.89
Rate for Payer: UnitedHealthcare Commercial	$36.31

VIRAMUNE 200MG TAB

Facility

$72.63

Service Code	NDC 51991033106
Hospital Charge Code	60635185
Hospital Revenue Code	250
Min. Negotiated Rate	$10.89
Max. Negotiated Rate	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$10.89

VIROLOGY

Facility

$90.65

Service Code	HCPCS 86695
Hospital Charge Code	39900241
Hospital Revenue Code	302
Min. Negotiated Rate	$13.60
Max. Negotiated Rate	$13.60
Rate for Payer: Qualcare PPO/HMO/WC	$13.60

VIROLOGY

Facility

$90.65

Service Code	HCPCS 86695
Hospital Charge Code	39900241
Hospital Revenue Code	302
Min. Negotiated Rate	$6.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.74
Rate for Payer: Aetna Medicare Advantage	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.33
Rate for Payer: Cigna Commercial	$13.19
Rate for Payer: Cigna Medicare Advantage	$6.59
Rate for Payer: Clover Medicare Advantage	$12.53
Rate for Payer: EmblemHealth Commercial	$39.57
Rate for Payer: Humana Medicare Advantage	$13.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.78
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.19
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.98
Rate for Payer: Wellcare Medicare Advantage	$13.19

VIROPTIC 1% OPHTH SOLN

Facility

$182.00

Hospital Charge Code	60634813
Hospital Revenue Code	250
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$27.30

VIROPTIC 1% OPHTH SOLN

Facility

$182.00

Hospital Charge Code	60634813
Hospital Revenue Code	250
Min. Negotiated Rate	$23.66
Max. Negotiated Rate	$91.00
Rate for Payer: Aetna Commercial	$54.60
Rate for Payer: Aetna Medicare Advantage	$54.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.41
Rate for Payer: Cigna Commercial	$91.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.66
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.30
Rate for Payer: UnitedHealthcare Commercial	$91.00

VIROPTIC 1% OPHTH SOLN

Facility

$28.00

Hospital Charge Code	60634801
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

VIROPTIC 1% OPHTH SOLN

Facility

$28.00

Hospital Charge Code	60634801
Hospital Revenue Code	250
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$14.00

VIRTU LORDOTIC 14X12X7MM

Facility

$12,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270685321
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

VIRTU LORDOTIC 14X12X7MM

Facility

$12,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270685321
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$3,600.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

VIRUS ISOLATION CENTRIFUGE W I

Facility

$138.50

Service Code	HCPCS 87254
Hospital Charge Code	38477156
Hospital Revenue Code	309
Min. Negotiated Rate	$9.78
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$63.37
Rate for Payer: Aetna Medicare Advantage	$19.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.67
Rate for Payer: Cigna Commercial	$19.56
Rate for Payer: Cigna Medicare Advantage	$9.78
Rate for Payer: Clover Medicare Advantage	$18.58
Rate for Payer: EmblemHealth Commercial	$58.68
Rate for Payer: Humana Medicare Advantage	$20.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.77
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.56
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.73
Rate for Payer: Wellcare Medicare Advantage	$19.56

VIRUS ISOLATION CENTRIFUGE W I

Facility

$138.50

Service Code	HCPCS 87254
Hospital Charge Code	38477156
Hospital Revenue Code	309
Min. Negotiated Rate	$20.77
Max. Negotiated Rate	$20.77
Rate for Payer: Qualcare PPO/HMO/WC	$20.77

VIRUS ISOL/OTHER THAN BY CYTO

Facility

$239.85

Service Code	HCPCS 87255
Hospital Charge Code	38477188
Hospital Revenue Code	309
Min. Negotiated Rate	$35.98
Max. Negotiated Rate	$35.98
Rate for Payer: Qualcare PPO/HMO/WC	$35.98

VIRUS ISOL/OTHER THAN BY CYTO

Facility

$239.85

Service Code	HCPCS 87255
Hospital Charge Code	38477188
Hospital Revenue Code	309
Min. Negotiated Rate	$16.93
Max. Negotiated Rate	$124.06
Rate for Payer: Aetna Commercial	$109.71
Rate for Payer: Aetna Medicare Advantage	$33.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$33.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.06
Rate for Payer: Cigna Commercial	$33.86
Rate for Payer: Cigna Medicare Advantage	$16.93
Rate for Payer: Clover Medicare Advantage	$32.17
Rate for Payer: EmblemHealth Commercial	$101.58
Rate for Payer: Humana Medicare Advantage	$34.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.18
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.98
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$33.86
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$35.89
Rate for Payer: Wellcare Medicare Advantage	$33.86

VIRUS TYPING, EACH

Facility

$93.65

Service Code	HCPCS 86790
Hospital Charge Code	3009255A
Hospital Revenue Code	302
Min. Negotiated Rate	$14.05
Max. Negotiated Rate	$14.05
Rate for Payer: Qualcare PPO/HMO/WC	$14.05

VIRUS TYPING, EACH

Facility

$93.65

Service Code	HCPCS 86790
Hospital Charge Code	3009255B
Hospital Revenue Code	302
Min. Negotiated Rate	$14.05
Max. Negotiated Rate	$14.05
Rate for Payer: Qualcare PPO/HMO/WC	$14.05

VIRUS TYPING, EACH

Facility

$93.65

Service Code	HCPCS 86790
Hospital Charge Code	3009255A
Hospital Revenue Code	302
Min. Negotiated Rate	$6.44
Max. Negotiated Rate	$443.55
Rate for Payer: Aetna Commercial	$41.73
Rate for Payer: Aetna Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$443.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.19
Rate for Payer: Cigna Commercial	$12.88
Rate for Payer: Cigna Medicare Advantage	$6.44
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.65
Rate for Payer: Wellcare Medicare Advantage	$12.88

VIRUS TYPING, EACH

Facility

$93.65

Service Code	HCPCS 86790
Hospital Charge Code	3009255B
Hospital Revenue Code	302
Min. Negotiated Rate	$6.44
Max. Negotiated Rate	$443.55
Rate for Payer: Aetna Commercial	$41.73
Rate for Payer: Aetna Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$443.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.19
Rate for Payer: Cigna Commercial	$12.88
Rate for Payer: Cigna Medicare Advantage	$6.44
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.65
Rate for Payer: Wellcare Medicare Advantage	$12.88

VISCERAL ARTERIO

Facility

$6,122.00

Hospital Charge Code	2009070
Hospital Revenue Code	323
Min. Negotiated Rate	$918.30
Max. Negotiated Rate	$918.30
Rate for Payer: Qualcare PPO/HMO/WC	$918.30

VISCERAL ARTERIO

Facility

$6,122.00

Hospital Charge Code	2009070
Hospital Revenue Code	323
Min. Negotiated Rate	$795.86
Max. Negotiated Rate	$3,061.00
Rate for Payer: Aetna Commercial	$1,836.60
Rate for Payer: Aetna Medicare Advantage	$1,836.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,561.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,561.11
Rate for Payer: Cigna Commercial	$3,061.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$795.86
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$918.30
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

VISCERAL SELECTIVE-LT

Facility

$25,628.45

Service Code	HCPCS 75726LT
Hospital Charge Code	321075726L
Hospital Revenue Code	323
Min. Negotiated Rate	$1,311.00
Max. Negotiated Rate	$12,814.23
Rate for Payer: Aetna Commercial	$7,688.53
Rate for Payer: Aetna Medicare Advantage	$7,688.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,535.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,535.25
Rate for Payer: Cigna Commercial	$12,814.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,331.70
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

VISCERAL SELECTIVE-LT

Facility

$25,628.45

Service Code	HCPCS 75726LT
Hospital Charge Code	366875726L
Hospital Revenue Code	323
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

Know your out-of-pocket cost for care.

All Charges