Heights University Hospital

All Charges

Charge

Type

Setting

Price

BLOOD TYPE

Facility

$626.42

Service Code	HCPCS 86900
Hospital Charge Code	3100617A
Hospital Revenue Code	300
Min. Negotiated Rate	$93.96
Max. Negotiated Rate	$93.96
Rate for Payer: Qualcare PPO/HMO/WC	$93.96

BLOOD TYPE

Facility

$626.42

Service Code	HCPCS 86900
Hospital Charge Code	3100617A
Hospital Revenue Code	300
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	$81.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.96
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

BLOOD TYPE:RBC AG NOT ABO,RH(D

Facility

$125.00

Service Code	HCPCS 86905
Hospital Charge Code	38471073
Hospital Revenue Code	309
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

BLOOD TYPE:RBC AG NOT ABO,RH(D

Facility

$125.00

Service Code	HCPCS 86905
Hospital Charge Code	38471073
Hospital Revenue Code	309
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$853.60
Rate for Payer: Aetna Commercial	$12.41
Rate for Payer: Aetna Medicare Advantage	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$853.60
Rate for Payer: Cigna Medicare Advantage	$1.92
Rate for Payer: Clover Medicare Advantage	$3.64
Rate for Payer: EmblemHealth Commercial	$11.49
Rate for Payer: Humana Medicare Advantage	$3.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.83
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.06
Rate for Payer: Wellcare Medicare Advantage	$3.83

BLOOD TYPE RH

Facility

$71.25

Service Code	HCPCS 86901
Hospital Charge Code	3100617B
Hospital Revenue Code	300
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$10.69
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

BLOOD TYPE RH

Facility

$71.25

Service Code	HCPCS 86901
Hospital Charge Code	3100617B
Hospital Revenue Code	300
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$114.00
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	$88.94
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	$9.26
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
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

BLOOD TYPE & RH (CORD BLOOD)

Facility

$626.42

Service Code	HCPCS 86900
Hospital Charge Code	3100559
Hospital Revenue Code	300
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	$81.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.96
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

BLOOD TYPE & RH (CORD BLOOD)

Facility

$626.42

Service Code	HCPCS 86900
Hospital Charge Code	3100559
Hospital Revenue Code	300
Min. Negotiated Rate	$93.96
Max. Negotiated Rate	$93.96
Rate for Payer: Qualcare PPO/HMO/WC	$93.96

BLOOD TYPE & RH PANEL

Facility

$630.21

Service Code	HCPCS 86900
Hospital Charge Code	3100617
Hospital Revenue Code	309
Min. Negotiated Rate	$94.53
Max. Negotiated Rate	$94.53
Rate for Payer: Qualcare PPO/HMO/WC	$94.53

BLOOD TYPE & RH PANEL

Facility

$630.21

Service Code	HCPCS 86900
Hospital Charge Code	3100617
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	$81.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.53
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

BLOOD UREA NITROGEN, BUN

Facility

$390.00

Service Code	HCPCS 84520
Hospital Charge Code	3002664
Hospital Revenue Code	301
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$12.80
Rate for Payer: Aetna Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.47
Rate for Payer: Cigna Commercial	$3.95
Rate for Payer: Cigna Medicare Advantage	$1.98
Rate for Payer: Clover Medicare Advantage	$3.75
Rate for Payer: EmblemHealth Commercial	$11.85
Rate for Payer: Humana Medicare Advantage	$4.07
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	$3.95
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.19
Rate for Payer: Wellcare Medicare Advantage	$3.95

BLOOD UREA NITROGEN, BUN

Facility

$390.00

Service Code	HCPCS 84520
Hospital Charge Code	3002664
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BLOOD UREA NITROGEN PANEL

Facility

$21.00

Service Code	HCPCS 84520
Hospital Charge Code	3002664P
Hospital Revenue Code	301
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$12.80
Rate for Payer: Aetna Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.47
Rate for Payer: Cigna Commercial	$3.95
Rate for Payer: Cigna Medicare Advantage	$1.98
Rate for Payer: Clover Medicare Advantage	$3.75
Rate for Payer: EmblemHealth Commercial	$11.85
Rate for Payer: Humana Medicare Advantage	$4.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.95
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.19
Rate for Payer: Wellcare Medicare Advantage	$3.95

BLOOD UREA NITROGEN PANEL

Facility

$21.00

Service Code	HCPCS 84520
Hospital Charge Code	3002664P
Hospital Revenue Code	301
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

BLOOD URINE

Facility

$22.45

Service Code	HCPCS 81005
Hospital Charge Code	3003175
Hospital Revenue Code	307
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

BLOOD URINE

Facility

$22.45

Service Code	HCPCS 81005
Hospital Charge Code	3003175
Hospital Revenue Code	307
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.03
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.95
Rate for Payer: Cigna Commercial	$2.17
Rate for Payer: Cigna Medicare Advantage	$1.08
Rate for Payer: Clover Medicare Advantage	$2.06
Rate for Payer: EmblemHealth Commercial	$6.51
Rate for Payer: Humana Medicare Advantage	$2.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.17
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.30
Rate for Payer: Wellcare Medicare Advantage	$2.17

BLOOD WHOLE LEUKORED IRRAD

Facility

$1,022.00

Hospital Charge Code	38471213
Hospital Revenue Code	390
Min. Negotiated Rate	$153.30
Max. Negotiated Rate	$153.30
Rate for Payer: Qualcare PPO/HMO/WC	$153.30

BLOOD WHOLE LEUKORED IRRAD

Facility

$1,022.00

Hospital Charge Code	38471213
Hospital Revenue Code	390
Min. Negotiated Rate	$132.86
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$306.60
Rate for Payer: Aetna Medicare Advantage	$306.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.61
Rate for Payer: Cigna Commercial	$511.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.86
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$153.30
Rate for Payer: UnitedHealthcare Commercial	$756.00

BLOWFLY LARVAE

Facility

$247.70

Hospital Charge Code	6010300
Hospital Revenue Code	251
Min. Negotiated Rate	$37.16
Max. Negotiated Rate	$37.16
Rate for Payer: Qualcare PPO/HMO/WC	$37.16

BLOWFLY LARVAE

Facility

$247.70

Hospital Charge Code	6010300
Hospital Revenue Code	251
Min. Negotiated Rate	$32.20
Max. Negotiated Rate	$123.85
Rate for Payer: Aetna Commercial	$74.31
Rate for Payer: Aetna Medicare Advantage	$74.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.16
Rate for Payer: Cigna Commercial	$123.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.20
Rate for Payer: Oxford Commercial	$123.85
Rate for Payer: Qualcare PPO/HMO/WC	$37.16
Rate for Payer: UnitedHealthcare Commercial	$123.85

BLS/ALS MILEAGE

Facility

$22.00

Hospital Charge Code	26000510
Hospital Revenue Code	540
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

BLS/ALS MILEAGE

Facility

$22.00

Hospital Charge Code	26000510
Hospital Revenue Code	540
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$2,359.00
Rate for Payer: Aetna Commercial	$6.60
Rate for Payer: Aetna Medicare Advantage	$6.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.61
Rate for Payer: Cigna Commercial	$11.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.86
Rate for Payer: Oxford Commercial	$2,078.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$2,359.00

BLUEBOOST SUVMUCOSAL 10ML

Facility

$300.00

Hospital Charge Code	270700338
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

BLUEBOOST SUVMUCOSAL 10ML

Facility

$300.00

Hospital Charge Code	270700338
Hospital Revenue Code	272
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$150.00

BLUE MAX BALLOON DIALTION

Facility

$813.00

Hospital Charge Code	270332340
Hospital Revenue Code	272
Min. Negotiated Rate	$121.95
Max. Negotiated Rate	$121.95
Rate for Payer: Qualcare PPO/HMO/WC	$121.95

Know your out-of-pocket cost for care.

All Charges