Heights University Hospital

All Charges

Charge

Type

Setting

Price

VITAMIN D 1,25 - DIHYDROXY

Facility

$1,691.20

Service Code	HCPCS 82652
Hospital Charge Code	38472039
Hospital Revenue Code	301
Min. Negotiated Rate	$253.68
Max. Negotiated Rate	$253.68
Rate for Payer: Qualcare PPO/HMO/WC	$253.68

VITAMIN D 1,25 - DIHYDROXY

Facility

$1,691.20

Service Code	HCPCS 82652
Hospital Charge Code	38472039
Hospital Revenue Code	301
Min. Negotiated Rate	$19.25
Max. Negotiated Rate	$253.68
Rate for Payer: Aetna Commercial	$124.74
Rate for Payer: Aetna Medicare Advantage	$38.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$38.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.06
Rate for Payer: Cigna Commercial	$38.50
Rate for Payer: Cigna Medicare Advantage	$19.25
Rate for Payer: Clover Medicare Advantage	$36.58
Rate for Payer: EmblemHealth Commercial	$115.50
Rate for Payer: Humana Medicare Advantage	$39.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$253.68
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$38.50
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$40.81
Rate for Payer: Wellcare Medicare Advantage	$38.50

VITAMIN D 25 DI-HYDROXY

Facility

$390.00

Service Code	HCPCS 82652
Hospital Charge Code	39900329
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VITAMIN D 25 DI-HYDROXY

Facility

$390.00

Service Code	HCPCS 82652
Hospital Charge Code	39900329
Hospital Revenue Code	301
Min. Negotiated Rate	$19.25
Max. Negotiated Rate	$141.06
Rate for Payer: Aetna Commercial	$124.74
Rate for Payer: Aetna Medicare Advantage	$38.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$38.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.06
Rate for Payer: Cigna Commercial	$38.50
Rate for Payer: Cigna Medicare Advantage	$19.25
Rate for Payer: Clover Medicare Advantage	$36.58
Rate for Payer: EmblemHealth Commercial	$115.50
Rate for Payer: Humana Medicare Advantage	$39.66
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	$38.50
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$40.81
Rate for Payer: Wellcare Medicare Advantage	$38.50

Vitamin D, 25-Hydroxy

Facility

$667.59

Service Code	HCPCS 82306
Hospital Charge Code	39888005
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

Vitamin D, 25-Hydroxy

Facility

$667.59

Service Code	HCPCS 82306
Hospital Charge Code	39888005
Hospital Revenue Code	301
Min. Negotiated Rate	$14.80
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$95.90
Rate for Payer: Aetna Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.45
Rate for Payer: Cigna Commercial	$29.60
Rate for Payer: Cigna Medicare Advantage	$14.80
Rate for Payer: Clover Medicare Advantage	$28.12
Rate for Payer: EmblemHealth Commercial	$88.80
Rate for Payer: Humana Medicare Advantage	$30.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$31.38
Rate for Payer: Wellcare Medicare Advantage	$29.60

VITAMIN D, 25 HYDROXY

Facility

$390.00

Service Code	HCPCS 82306
Hospital Charge Code	39900050
Hospital Revenue Code	301
Min. Negotiated Rate	$14.80
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$95.90
Rate for Payer: Aetna Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.45
Rate for Payer: Cigna Commercial	$29.60
Rate for Payer: Cigna Medicare Advantage	$14.80
Rate for Payer: Clover Medicare Advantage	$28.12
Rate for Payer: EmblemHealth Commercial	$88.80
Rate for Payer: Humana Medicare Advantage	$30.49
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	$29.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$31.38
Rate for Payer: Wellcare Medicare Advantage	$29.60

VITAMIN D, 25 HYDROXY

Facility

$390.00

Service Code	HCPCS 82306
Hospital Charge Code	39900050
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VITAMIN D, 25 HYDROXY***

Facility

$252.00

Hospital Charge Code	3010634
Hospital Revenue Code	301
Min. Negotiated Rate	$32.76
Max. Negotiated Rate	$126.00
Rate for Payer: Aetna Commercial	$75.60
Rate for Payer: Aetna Medicare Advantage	$75.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.26
Rate for Payer: Cigna Commercial	$126.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.80
Rate for Payer: UnitedHealthcare Commercial	$114.00

VITAMIN D, 25 HYDROXY***

Facility

$252.00

Hospital Charge Code	3010634
Hospital Revenue Code	301
Min. Negotiated Rate	$37.80
Max. Negotiated Rate	$37.80
Rate for Payer: Qualcare PPO/HMO/WC	$37.80

VITAMIN D, 25-HYDROXY

Facility

$278.45

Service Code	HCPCS 82306
Hospital Charge Code	3000635
Hospital Revenue Code	301
Min. Negotiated Rate	$41.77
Max. Negotiated Rate	$41.77
Rate for Payer: Qualcare PPO/HMO/WC	$41.77

VITAMIN D, 25-HYDROXY

Facility

$278.45

Service Code	HCPCS 82306
Hospital Charge Code	3000635
Hospital Revenue Code	301
Min. Negotiated Rate	$14.80
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$95.90
Rate for Payer: Aetna Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.45
Rate for Payer: Cigna Commercial	$29.60
Rate for Payer: Cigna Medicare Advantage	$14.80
Rate for Payer: Clover Medicare Advantage	$28.12
Rate for Payer: EmblemHealth Commercial	$88.80
Rate for Payer: Humana Medicare Advantage	$30.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.77
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$31.38
Rate for Payer: Wellcare Medicare Advantage	$29.60

VITAMIN D 25 - HYDROXY

Facility

$618.80

Service Code	HCPCS 82306
Hospital Charge Code	38472040
Hospital Revenue Code	301
Min. Negotiated Rate	$92.82
Max. Negotiated Rate	$92.82
Rate for Payer: Qualcare PPO/HMO/WC	$92.82

VITAMIN D 25 - HYDROXY

Facility

$618.80

Service Code	HCPCS 82306
Hospital Charge Code	38472040
Hospital Revenue Code	301
Min. Negotiated Rate	$14.80
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$95.90
Rate for Payer: Aetna Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.45
Rate for Payer: Cigna Commercial	$29.60
Rate for Payer: Cigna Medicare Advantage	$14.80
Rate for Payer: Clover Medicare Advantage	$28.12
Rate for Payer: EmblemHealth Commercial	$88.80
Rate for Payer: Humana Medicare Advantage	$30.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.44
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.82
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$31.38
Rate for Payer: Wellcare Medicare Advantage	$29.60

VITAMIN D, 25-OH, LCMSMS

Facility

$278.45

Service Code	HCPCS 82306
Hospital Charge Code	3035110
Hospital Revenue Code	301
Min. Negotiated Rate	$41.77
Max. Negotiated Rate	$41.77
Rate for Payer: Qualcare PPO/HMO/WC	$41.77

VITAMIN D, 25-OH, LCMSMS

Facility

$278.45

Service Code	HCPCS 82306
Hospital Charge Code	3035110
Hospital Revenue Code	301
Min. Negotiated Rate	$14.80
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$95.90
Rate for Payer: Aetna Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.45
Rate for Payer: Cigna Commercial	$29.60
Rate for Payer: Cigna Medicare Advantage	$14.80
Rate for Payer: Clover Medicare Advantage	$28.12
Rate for Payer: EmblemHealth Commercial	$88.80
Rate for Payer: Humana Medicare Advantage	$30.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.77
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$31.38
Rate for Payer: Wellcare Medicare Advantage	$29.60

VITAMIN D3 5000IU 125MCG TAB

Facility

$4.00

Service Code	NDC 7610017840
Hospital Charge Code	606390340
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

VITAMIN D3 5000IU 125MCG TAB

Facility

$4.00

Service Code	NDC 7610017840
Hospital Charge Code	606390340
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

VITAMIN D/50,000U

Facility

$3.00

Hospital Charge Code	60634795
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

VITAMIN D/50,000U

Facility

$3.00

Hospital Charge Code	60634795
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

VITAMIN D (CALCIFEROL)

Facility

$278.45

Service Code	HCPCS 82306
Hospital Charge Code	3007788
Hospital Revenue Code	301
Min. Negotiated Rate	$14.80
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$95.90
Rate for Payer: Aetna Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.45
Rate for Payer: Cigna Commercial	$29.60
Rate for Payer: Cigna Medicare Advantage	$14.80
Rate for Payer: Clover Medicare Advantage	$28.12
Rate for Payer: EmblemHealth Commercial	$88.80
Rate for Payer: Humana Medicare Advantage	$30.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.77
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$31.38
Rate for Payer: Wellcare Medicare Advantage	$29.60

VITAMIN D (CALCIFEROL)

Facility

$278.45

Service Code	HCPCS 82306
Hospital Charge Code	3007788
Hospital Revenue Code	301
Min. Negotiated Rate	$41.77
Max. Negotiated Rate	$41.77
Rate for Payer: Qualcare PPO/HMO/WC	$41.77

VITAMIN D TAB 400 IU

Facility

$4.00

Service Code	NDC 43292055881
Hospital Charge Code	60628737
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

VITAMIN D TAB 400 IU

Facility

$4.00

Service Code	NDC 43292055881
Hospital Charge Code	60628737
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

VITAMIN E

Facility

$390.00

Service Code	HCPCS 84446
Hospital Charge Code	39900143
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges