Heights University Hospital

All Charges

Charge

Type

Setting

Price

BLOOD - ADM

Facility

$20.00

Hospital Charge Code	3200011
Hospital Revenue Code	391
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

BLOOD ADMIN/TRANSF (NSG DEPT)

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	38471065
Hospital Revenue Code	391
Min. Negotiated Rate	$182.49
Max. Negotiated Rate	$1,050.61
Rate for Payer: Aetna Commercial	$421.12
Rate for Payer: Aetna Medicare Advantage	$421.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.96
Rate for Payer: Cigna Commercial	$1,050.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.49
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.56
Rate for Payer: UnitedHealthcare Commercial	$756.00

BLOOD ADMIN/TRANSF (NSG DEPT)

Facility

$1,403.75

Service Code	HCPCS 36430
Hospital Charge Code	38471065
Hospital Revenue Code	391
Min. Negotiated Rate	$210.56
Max. Negotiated Rate	$210.56
Rate for Payer: Qualcare PPO/HMO/WC	$210.56

BLOOD/CLOT PATCH, LUMB EPI INJ

Facility

$3,107.20

Service Code	HCPCS 62273
Hospital Charge Code	84506010
Hospital Revenue Code	361
Min. Negotiated Rate	$403.94
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$932.16
Rate for Payer: Aetna Medicare Advantage	$932.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$792.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$792.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$792.34
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$403.94
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$466.08
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

BLOOD/CLOT PATCH, LUMB EPI INJ

Facility

$3,107.20

Service Code	HCPCS 62273
Hospital Charge Code	84506010
Hospital Revenue Code	361
Min. Negotiated Rate	$466.08
Max. Negotiated Rate	$466.08
Rate for Payer: Qualcare PPO/HMO/WC	$466.08

BLOOD/CLOT PATCH, LUMB EPI INJ

Facility

$3,450.90

Hospital Charge Code	93082086
Hospital Revenue Code	361
Min. Negotiated Rate	$448.62
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$1,035.27
Rate for Payer: Aetna Medicare Advantage	$1,035.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$879.98
Rate for Payer: Cigna Commercial	$1,725.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.62
Rate for Payer: Qualcare PPO/HMO/WC	$517.63

BLOOD/CLOT PATCH, LUMB EPI INJ

Facility

$3,450.90

Hospital Charge Code	93082086
Hospital Revenue Code	361
Min. Negotiated Rate	$517.63
Max. Negotiated Rate	$517.63
Rate for Payer: Qualcare PPO/HMO/WC	$517.63

BLOOD COLLECTION 25 SAFTY LOC

Facility

$4.20

Hospital Charge Code	270651617
Hospital Revenue Code	272
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$0.63
Rate for Payer: Qualcare PPO/HMO/WC	$0.63

BLOOD COLLECTION 25 SAFTY LOC

Facility

$4.20

Hospital Charge Code	270651617
Hospital Revenue Code	272
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$2.10
Rate for Payer: Aetna Commercial	$1.26
Rate for Payer: Aetna Medicare Advantage	$1.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.07
Rate for Payer: Cigna Commercial	$2.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.55
Rate for Payer: Oxford Commercial	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$0.63
Rate for Payer: UnitedHealthcare Commercial	$2.10

BLOOD COLLECTION KIT

Facility

$195.00

Hospital Charge Code	270653930
Hospital Revenue Code	272
Min. Negotiated Rate	$25.35
Max. Negotiated Rate	$97.50
Rate for Payer: Aetna Commercial	$58.50
Rate for Payer: Aetna Medicare Advantage	$58.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.73
Rate for Payer: Cigna Commercial	$97.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.35
Rate for Payer: Oxford Commercial	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$29.25
Rate for Payer: UnitedHealthcare Commercial	$97.50

BLOOD COLLECTION KIT

Facility

$195.00

Hospital Charge Code	270653930
Hospital Revenue Code	272
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$29.25
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

BLOOD COLLECTION SET *****

Facility

$10.00

Hospital Charge Code	7000664
Hospital Revenue Code	279
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$3.00
Rate for Payer: Aetna Medicare Advantage	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.55
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$5.00

BLOOD COLLECTION SET *****

Facility

$10.00

Hospital Charge Code	7000664
Hospital Revenue Code	279
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

BLOOD COLLECTION SET ANGEL WNG

Facility

$3.29

Hospital Charge Code	270649769
Hospital Revenue Code	270
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$0.49
Rate for Payer: Qualcare PPO/HMO/WC	$0.49

BLOOD COLLECTION SET ANGEL WNG

Facility

$3.29

Hospital Charge Code	270649769
Hospital Revenue Code	270
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$1.65
Rate for Payer: Aetna Commercial	$0.99
Rate for Payer: Aetna Medicare Advantage	$0.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.84
Rate for Payer: Cigna Commercial	$1.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.43
Rate for Payer: Oxford Commercial	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$0.49
Rate for Payer: UnitedHealthcare Commercial	$1.65

BLOOD COLLECTION SET MALE ADPT

Facility

$4.53

Hospital Charge Code	270650195
Hospital Revenue Code	270
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$2.27
Rate for Payer: Aetna Commercial	$1.36
Rate for Payer: Aetna Medicare Advantage	$1.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.16
Rate for Payer: Cigna Commercial	$2.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.59
Rate for Payer: Oxford Commercial	$2.27
Rate for Payer: Qualcare PPO/HMO/WC	$0.68
Rate for Payer: UnitedHealthcare Commercial	$2.27

BLOOD COLLECTION SET MALE ADPT

Facility

$4.53

Hospital Charge Code	270650195
Hospital Revenue Code	270
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$0.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.68

BLOOD CONSERVATION SYSTEM

Facility

$2,715.38

Hospital Charge Code	27065822
Hospital Revenue Code	278
Min. Negotiated Rate	$407.31
Max. Negotiated Rate	$657.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$543.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$657.12
Rate for Payer: Qualcare PPO/HMO/WC	$407.31

BLOOD CONSERVATION SYSTEM

Facility

$835.63

Hospital Charge Code	270655822
Hospital Revenue Code	272
Min. Negotiated Rate	$108.63
Max. Negotiated Rate	$417.81
Rate for Payer: Aetna Commercial	$250.69
Rate for Payer: Aetna Medicare Advantage	$250.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$213.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$213.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$213.09
Rate for Payer: Cigna Commercial	$417.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.63
Rate for Payer: Oxford Commercial	$417.81
Rate for Payer: Qualcare PPO/HMO/WC	$125.34
Rate for Payer: UnitedHealthcare Commercial	$417.81

BLOOD CONSERVATION SYSTEM

Facility

$835.63

Hospital Charge Code	270655822
Hospital Revenue Code	272
Min. Negotiated Rate	$125.34
Max. Negotiated Rate	$125.34
Rate for Payer: Qualcare PPO/HMO/WC	$125.34

BLOOD CONSERVATION SYSTEM

Facility

$2,715.38

Hospital Charge Code	27065822
Hospital Revenue Code	278
Min. Negotiated Rate	$407.31
Max. Negotiated Rate	$1,357.69
Rate for Payer: Aetna Commercial	$814.61
Rate for Payer: Aetna Medicare Advantage	$814.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$692.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$692.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$543.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$692.42
Rate for Payer: Cigna Commercial	$1,357.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$657.12
Rate for Payer: Qualcare PPO/HMO/WC	$407.31

BLOOD COUNT;AUTO DIFF.WBC COUN

Facility

$45.85

Service Code	HCPCS 85004
Hospital Charge Code	38477219
Hospital Revenue Code	301
Min. Negotiated Rate	$6.88
Max. Negotiated Rate	$6.88
Rate for Payer: Qualcare PPO/HMO/WC	$6.88

BLOOD COUNT;AUTO DIFF.WBC COUN

Facility

$45.85

Service Code	HCPCS 85004
Hospital Charge Code	38477219
Hospital Revenue Code	301
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$20.96
Rate for Payer: Aetna Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.71
Rate for Payer: Cigna Commercial	$6.47
Rate for Payer: Cigna Medicare Advantage	$3.23
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.96
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.88
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.86
Rate for Payer: Wellcare Medicare Advantage	$6.47

BLOOD COUNT;HEMOGLOBIN (HGB)

Facility

$25.00

Service Code	HCPCS 85018
Hospital Charge Code	38474120
Hospital Revenue Code	305
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

BLOOD COUNT;HEMOGLOBIN (HGB)

Facility

$25.00

Service Code	HCPCS 85018
Hospital Charge Code	38474120
Hospital Revenue Code	305
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.68
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.68
Rate for Payer: Cigna Commercial	$2.37
Rate for Payer: Cigna Medicare Advantage	$1.19
Rate for Payer: Clover Medicare Advantage	$2.25
Rate for Payer: EmblemHealth Commercial	$7.11
Rate for Payer: Humana Medicare Advantage	$2.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.51
Rate for Payer: Wellcare Medicare Advantage	$2.37

Know your out-of-pocket cost for care.

All Charges