Heights University Hospital

All Charges

Charge

Type

Setting

Price

WEST NILE CSF I

Facility

$390.00

Service Code	HCPCS 86788
Hospital Charge Code	39990108A
Hospital Revenue Code	302
Min. Negotiated Rate	$8.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.59
Rate for Payer: Aetna Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.74
Rate for Payer: Cigna Commercial	$16.85
Rate for Payer: Cigna Medicare Advantage	$8.43
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
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	$16.85
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.86
Rate for Payer: Wellcare Medicare Advantage	$16.85

WEST NILE CSF I

Facility

$390.00

Service Code	HCPCS 86788
Hospital Charge Code	39990108A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

WEST NILE CSF II

Facility

$390.00

Service Code	HCPCS 86789
Hospital Charge Code	39990108B
Hospital Revenue Code	302
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.72
Rate for Payer: Cigna Commercial	$14.39
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
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	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

WEST NILE CSF II

Facility

$390.00

Service Code	HCPCS 86789
Hospital Charge Code	39990108B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

WEST NILE IGG/IGM II

Facility

$390.00

Service Code	HCPCS 86788
Hospital Charge Code	39990107A
Hospital Revenue Code	302
Min. Negotiated Rate	$8.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.59
Rate for Payer: Aetna Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.74
Rate for Payer: Cigna Commercial	$16.85
Rate for Payer: Cigna Medicare Advantage	$8.43
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
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	$16.85
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.86
Rate for Payer: Wellcare Medicare Advantage	$16.85

WEST NILE IGG/IGM II

Facility

$390.00

Service Code	HCPCS 86788
Hospital Charge Code	39990107A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

WEST NILE IGG/IGM III

Facility

$390.00

Service Code	HCPCS 86789
Hospital Charge Code	39990107B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

WEST NILE IGG/IGM III

Facility

$390.00

Service Code	HCPCS 86789
Hospital Charge Code	39990107B
Hospital Revenue Code	302
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.72
Rate for Payer: Cigna Commercial	$14.39
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
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	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

WEST NILE,RNA, RT-PCR (CSF)

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	3990521
Hospital Revenue Code	306
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$147.80
Rate for Payer: Aetna Commercial	$113.69
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$147.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.57
Rate for Payer: Cigna Commercial	$35.09
Rate for Payer: Cigna Medicare Advantage	$17.55
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
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	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

WEST NILE,RNA, RT-PCR (CSF)

Facility

$390.00

Service Code	HCPCS 87798
Hospital Charge Code	3990521
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

WEST NILE VIRS ANBD SERM I

Facility

$119.30

Service Code	HCPCS 86788
Hospital Charge Code	3037045A
Hospital Revenue Code	302
Min. Negotiated Rate	$8.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.59
Rate for Payer: Aetna Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.74
Rate for Payer: Cigna Commercial	$16.85
Rate for Payer: Cigna Medicare Advantage	$8.43
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.51
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.89
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.85
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.86
Rate for Payer: Wellcare Medicare Advantage	$16.85

WEST NILE VIRS ANBD SERM I

Facility

$119.30

Service Code	HCPCS 86788
Hospital Charge Code	3037045A
Hospital Revenue Code	302
Min. Negotiated Rate	$17.89
Max. Negotiated Rate	$17.89
Rate for Payer: Qualcare PPO/HMO/WC	$17.89

WEST NILE VIRS ANBD SERM II

Facility

$101.95

Service Code	HCPCS 86789
Hospital Charge Code	3037045B
Hospital Revenue Code	302
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.72
Rate for Payer: Cigna Commercial	$14.39
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.29
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

WEST NILE VIRS ANBD SERM II

Facility

$101.95

Service Code	HCPCS 86789
Hospital Charge Code	3037045B
Hospital Revenue Code	302
Min. Negotiated Rate	$15.29
Max. Negotiated Rate	$15.29
Rate for Payer: Qualcare PPO/HMO/WC	$15.29

WEST NILE VIRUS AB CSF

Facility

$93.65

Service Code	HCPCS 86790
Hospital Charge Code	3035040B
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

WEST NILE VIRUS AB CSF

Facility

$496.00

Hospital Charge Code	3035040
Hospital Revenue Code	302
Min. Negotiated Rate	$74.40
Max. Negotiated Rate	$74.40
Rate for Payer: Qualcare PPO/HMO/WC	$74.40

WEST NILE VIRUS AB CSF

Facility

$93.65

Service Code	HCPCS 86790
Hospital Charge Code	3035040A
Hospital Revenue Code	302
Min. Negotiated Rate	$14.05
Max. Negotiated Rate	$14.05
Rate for Payer: Qualcare PPO/HMO/WC	$14.05

WEST NILE VIRUS AB CSF

Facility

$496.00

Hospital Charge Code	3035040
Hospital Revenue Code	302
Min. Negotiated Rate	$64.48
Max. Negotiated Rate	$248.00
Rate for Payer: Aetna Commercial	$148.80
Rate for Payer: Aetna Medicare Advantage	$148.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.48
Rate for Payer: Cigna Commercial	$248.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.40
Rate for Payer: UnitedHealthcare Commercial	$114.00

WEST NILE VIRUS AB CSF

Facility

$93.65

Service Code	HCPCS 86790
Hospital Charge Code	3035040B
Hospital Revenue Code	302
Min. Negotiated Rate	$14.05
Max. Negotiated Rate	$14.05
Rate for Payer: Qualcare PPO/HMO/WC	$14.05

WEST NILE VIRUS AB CSF

Facility

$93.65

Service Code	HCPCS 86790
Hospital Charge Code	3035040A
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

WEST NILE VIRUS AB SERUM

Facility

$496.00

Hospital Charge Code	3035042
Hospital Revenue Code	302
Min. Negotiated Rate	$74.40
Max. Negotiated Rate	$74.40
Rate for Payer: Qualcare PPO/HMO/WC	$74.40

WEST NILE VIRUS AB SERUM

Facility

$93.65

Service Code	HCPCS 86790
Hospital Charge Code	3035042B
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

WEST NILE VIRUS AB SERUM

Facility

$93.65

Service Code	HCPCS 86790
Hospital Charge Code	3035042B
Hospital Revenue Code	302
Min. Negotiated Rate	$14.05
Max. Negotiated Rate	$14.05
Rate for Payer: Qualcare PPO/HMO/WC	$14.05

WEST NILE VIRUS AB SERUM

Facility

$496.00

Hospital Charge Code	3035042
Hospital Revenue Code	302
Min. Negotiated Rate	$64.48
Max. Negotiated Rate	$248.00
Rate for Payer: Aetna Commercial	$148.80
Rate for Payer: Aetna Medicare Advantage	$148.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.48
Rate for Payer: Cigna Commercial	$248.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.40
Rate for Payer: UnitedHealthcare Commercial	$114.00

WEST NILE VIRUS AB SERUM

Facility

$93.65

Service Code	HCPCS 86790
Hospital Charge Code	3035042A
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

Know your out-of-pocket cost for care.

All Charges