Heights University Hospital

All Charges

Charge

Type

Setting

Price

BLANKET LOWER BODY 525 *****

Facility

$44.00

Hospital Charge Code	1608306
Hospital Revenue Code	272
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$13.20
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.72
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$22.00

BLANKET LOWER BODY 525 *****

Facility

$44.00

Hospital Charge Code	1608306
Hospital Revenue Code	272
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

BLANKET RECEIVING 30x40

Facility

$183.75

Hospital Charge Code	270651610
Hospital Revenue Code	272
Min. Negotiated Rate	$27.56
Max. Negotiated Rate	$27.56
Rate for Payer: Qualcare PPO/HMO/WC	$27.56

BLANKET RECEIVING 30x40

Facility

$183.75

Hospital Charge Code	270651610
Hospital Revenue Code	272
Min. Negotiated Rate	$23.89
Max. Negotiated Rate	$91.88
Rate for Payer: Aetna Commercial	$55.12
Rate for Payer: Aetna Medicare Advantage	$55.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.86
Rate for Payer: Cigna Commercial	$91.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.89
Rate for Payer: Oxford Commercial	$91.88
Rate for Payer: Qualcare PPO/HMO/WC	$27.56
Rate for Payer: UnitedHealthcare Commercial	$91.88

BLANKET THERMAL 74x100

Facility

$69.25

Hospital Charge Code	270651611
Hospital Revenue Code	272
Min. Negotiated Rate	$10.39
Max. Negotiated Rate	$10.39
Rate for Payer: Qualcare PPO/HMO/WC	$10.39

BLANKET THERMAL 74x100

Facility

$69.25

Hospital Charge Code	270651611
Hospital Revenue Code	272
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$34.62
Rate for Payer: Aetna Commercial	$20.77
Rate for Payer: Aetna Medicare Advantage	$20.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.66
Rate for Payer: Cigna Commercial	$34.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.00
Rate for Payer: Oxford Commercial	$34.62
Rate for Payer: Qualcare PPO/HMO/WC	$10.39
Rate for Payer: UnitedHealthcare Commercial	$34.62

BLANKET UPPER BODY 522 ******

Facility

$44.00

Hospital Charge Code	1608280
Hospital Revenue Code	272
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

BLANKET UPPER BODY 522 ******

Facility

$44.00

Hospital Charge Code	1608280
Hospital Revenue Code	272
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$13.20
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.72
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$22.00

BLANKET VEST SMALL/MED

Facility

$271.35

Hospital Charge Code	270649706
Hospital Revenue Code	272
Min. Negotiated Rate	$40.70
Max. Negotiated Rate	$40.70
Rate for Payer: Qualcare PPO/HMO/WC	$40.70

BLANKET VEST SMALL/MED

Facility

$271.35

Hospital Charge Code	270649706
Hospital Revenue Code	272
Min. Negotiated Rate	$35.28
Max. Negotiated Rate	$135.68
Rate for Payer: Aetna Commercial	$81.41
Rate for Payer: Aetna Medicare Advantage	$81.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.19
Rate for Payer: Cigna Commercial	$135.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.28
Rate for Payer: Oxford Commercial	$135.68
Rate for Payer: Qualcare PPO/HMO/WC	$40.70
Rate for Payer: UnitedHealthcare Commercial	$135.68

BLANKET WARMING LOW BODY BH525

Facility

$26.75

Hospital Charge Code	270600855
Hospital Revenue Code	272
Min. Negotiated Rate	$4.01
Max. Negotiated Rate	$4.01
Rate for Payer: Qualcare PPO/HMO/WC	$4.01

BLANKET WARMING LOW BODY BH525

Facility

$26.75

Hospital Charge Code	270600855
Hospital Revenue Code	272
Min. Negotiated Rate	$3.48
Max. Negotiated Rate	$13.38
Rate for Payer: Aetna Commercial	$8.03
Rate for Payer: Aetna Medicare Advantage	$8.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.82
Rate for Payer: Cigna Commercial	$13.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.48
Rate for Payer: Oxford Commercial	$13.38
Rate for Payer: Qualcare PPO/HMO/WC	$4.01
Rate for Payer: UnitedHealthcare Commercial	$13.38

BLASTOMYCES AB IMMUNODIFFUSION

Facility

$390.00

Service Code	HCPCS 86612
Hospital Charge Code	3847979
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BLASTOMYCES AB IMMUNODIFFUSION

Facility

$390.00

Service Code	HCPCS 86612
Hospital Charge Code	3847979
Hospital Revenue Code	302
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.27
Rate for Payer: Cigna Commercial	$12.90
Rate for Payer: Cigna Medicare Advantage	$6.45
Rate for Payer: Clover Medicare Advantage	$12.26
Rate for Payer: EmblemHealth Commercial	$38.70
Rate for Payer: Humana Medicare Advantage	$13.29
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	$12.90
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.67
Rate for Payer: Wellcare Medicare Advantage	$12.90

BLASTOMYCES AB, SERUM I

Facility

$121.65

Service Code	HCPCS 86612
Hospital Charge Code	3009545A
Hospital Revenue Code	302
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.27
Rate for Payer: Cigna Commercial	$12.90
Rate for Payer: Cigna Medicare Advantage	$6.45
Rate for Payer: Clover Medicare Advantage	$12.26
Rate for Payer: EmblemHealth Commercial	$38.70
Rate for Payer: Humana Medicare Advantage	$13.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.81
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.90
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.67
Rate for Payer: Wellcare Medicare Advantage	$12.90

BLASTOMYCES AB, SERUM I

Facility

$121.65

Service Code	HCPCS 86612
Hospital Charge Code	3009545A
Hospital Revenue Code	302
Min. Negotiated Rate	$18.25
Max. Negotiated Rate	$18.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.25

BLASTOMYCES AB, SERUM II

Facility

$121.65

Service Code	HCPCS 86612
Hospital Charge Code	3009545B
Hospital Revenue Code	302
Min. Negotiated Rate	$18.25
Max. Negotiated Rate	$18.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.25

BLASTOMYCES AB, SERUM II

Facility

$121.65

Service Code	HCPCS 86612
Hospital Charge Code	3009545B
Hospital Revenue Code	302
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.27
Rate for Payer: Cigna Commercial	$12.90
Rate for Payer: Cigna Medicare Advantage	$6.45
Rate for Payer: Clover Medicare Advantage	$12.26
Rate for Payer: EmblemHealth Commercial	$38.70
Rate for Payer: Humana Medicare Advantage	$13.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.81
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.90
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.67
Rate for Payer: Wellcare Medicare Advantage	$12.90

BLASTOMYCES ANTIBODY

Facility

$148.00

Service Code	HCPCS 86612
Hospital Charge Code	38473069
Hospital Revenue Code	302
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.27
Rate for Payer: Cigna Commercial	$12.90
Rate for Payer: Cigna Medicare Advantage	$6.45
Rate for Payer: Clover Medicare Advantage	$12.26
Rate for Payer: EmblemHealth Commercial	$38.70
Rate for Payer: Humana Medicare Advantage	$13.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.24
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.90
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.67
Rate for Payer: Wellcare Medicare Advantage	$12.90

BLASTOMYCES ANTIBODY

Facility

$148.00

Service Code	HCPCS 86612
Hospital Charge Code	38473069
Hospital Revenue Code	302
Min. Negotiated Rate	$22.20
Max. Negotiated Rate	$22.20
Rate for Payer: Qualcare PPO/HMO/WC	$22.20

BLD 4m RAD 12 CRV M4 1884012HR

Facility

$779.00

Hospital Charge Code	270640165
Hospital Revenue Code	272
Min. Negotiated Rate	$101.27
Max. Negotiated Rate	$389.50
Rate for Payer: Aetna Commercial	$233.70
Rate for Payer: Aetna Medicare Advantage	$233.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.65
Rate for Payer: Cigna Commercial	$389.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.27
Rate for Payer: Oxford Commercial	$389.50
Rate for Payer: Qualcare PPO/HMO/WC	$116.85
Rate for Payer: UnitedHealthcare Commercial	$389.50

BLD 4m RAD 12 CRV M4 1884012HR

Facility

$779.00

Hospital Charge Code	270640165
Hospital Revenue Code	272
Min. Negotiated Rate	$116.85
Max. Negotiated Rate	$116.85
Rate for Payer: Qualcare PPO/HMO/WC	$116.85

BLD CT PLATELET AUTO

Facility

$390.00

Service Code	HCPCS 85049
Hospital Charge Code	401185049
Hospital Revenue Code	300
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.52
Rate for Payer: Aetna Medicare Advantage	$4.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.41
Rate for Payer: Cigna Commercial	$4.48
Rate for Payer: Cigna Medicare Advantage	$2.24
Rate for Payer: Clover Medicare Advantage	$4.26
Rate for Payer: EmblemHealth Commercial	$13.44
Rate for Payer: Humana Medicare Advantage	$4.61
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	$4.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.75
Rate for Payer: Wellcare Medicare Advantage	$4.48

BLD CT PLATELET AUTO

Facility

$390.00

Service Code	HCPCS 85049
Hospital Charge Code	401185049
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BLD TYPE & RH***

Facility

$22.00

Service Code	HCPCS 86900
Hospital Charge Code	3000486
Hospital Revenue Code	309
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$9.69
Rate for Payer: Aetna Medicare Advantage	$2.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$1.50
Rate for Payer: Clover Medicare Advantage	$2.84
Rate for Payer: EmblemHealth Commercial	$8.97
Rate for Payer: Humana Medicare Advantage	$3.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.99
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$3.17
Rate for Payer: Wellcare Medicare Advantage	$2.99

Know your out-of-pocket cost for care.

All Charges