Heights University Hospital

All Charges

Charge

Type

Setting

Price

CADIUM,URINE

Facility

$372.00

Service Code	HCPCS 82300
Hospital Charge Code	38472144
Hospital Revenue Code	301
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

CADIUM,URINE

Facility

$372.00

Service Code	HCPCS 82300
Hospital Charge Code	38472144
Hospital Revenue Code	301
Min. Negotiated Rate	$11.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$76.59
Rate for Payer: Aetna Medicare Advantage	$23.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.64
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	$86.62
Rate for Payer: Cigna Commercial	$23.64
Rate for Payer: Cigna Medicare Advantage	$11.82
Rate for Payer: Clover Medicare Advantage	$22.46
Rate for Payer: EmblemHealth Commercial	$70.92
Rate for Payer: Humana Medicare Advantage	$24.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.06
Rate for Payer: Wellcare Medicare Advantage	$23.64

CADMIUM

Facility

$372.00

Service Code	HCPCS 82300
Hospital Charge Code	38473062
Hospital Revenue Code	301
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

CADMIUM

Facility

$157.60

Hospital Charge Code	39990166B
Hospital Revenue Code	301
Min. Negotiated Rate	$20.49
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.28
Rate for Payer: Aetna Medicare Advantage	$47.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.19
Rate for Payer: Cigna Commercial	$78.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.64
Rate for Payer: UnitedHealthcare Commercial	$114.00

CADMIUM

Facility

$390.00

Service Code	HCPCS 82300
Hospital Charge Code	401083018B
Hospital Revenue Code	301
Min. Negotiated Rate	$11.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$76.59
Rate for Payer: Aetna Medicare Advantage	$23.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.64
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	$86.62
Rate for Payer: Cigna Commercial	$23.64
Rate for Payer: Cigna Medicare Advantage	$11.82
Rate for Payer: Clover Medicare Advantage	$22.46
Rate for Payer: EmblemHealth Commercial	$70.92
Rate for Payer: Humana Medicare Advantage	$24.35
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	$23.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.06
Rate for Payer: Wellcare Medicare Advantage	$23.64

CADMIUM

Facility

$390.00

Service Code	HCPCS 82300
Hospital Charge Code	401083018B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CADMIUM

Facility

$372.00

Service Code	HCPCS 82300
Hospital Charge Code	38473062
Hospital Revenue Code	301
Min. Negotiated Rate	$11.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$76.59
Rate for Payer: Aetna Medicare Advantage	$23.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.64
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	$86.62
Rate for Payer: Cigna Commercial	$23.64
Rate for Payer: Cigna Medicare Advantage	$11.82
Rate for Payer: Clover Medicare Advantage	$22.46
Rate for Payer: EmblemHealth Commercial	$70.92
Rate for Payer: Humana Medicare Advantage	$24.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.06
Rate for Payer: Wellcare Medicare Advantage	$23.64

CADMIUM

Facility

$200.85

Service Code	HCPCS 82300
Hospital Charge Code	3007259
Hospital Revenue Code	301
Min. Negotiated Rate	$30.13
Max. Negotiated Rate	$30.13
Rate for Payer: Qualcare PPO/HMO/WC	$30.13

CADMIUM

Facility

$157.60

Hospital Charge Code	39990166B
Hospital Revenue Code	301
Min. Negotiated Rate	$23.64
Max. Negotiated Rate	$23.64
Rate for Payer: Qualcare PPO/HMO/WC	$23.64

CADMIUM

Facility

$200.85

Service Code	HCPCS 82300
Hospital Charge Code	3007259
Hospital Revenue Code	301
Min. Negotiated Rate	$11.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$76.59
Rate for Payer: Aetna Medicare Advantage	$23.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.64
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	$86.62
Rate for Payer: Cigna Commercial	$23.64
Rate for Payer: Cigna Medicare Advantage	$11.82
Rate for Payer: Clover Medicare Advantage	$22.46
Rate for Payer: EmblemHealth Commercial	$70.92
Rate for Payer: Humana Medicare Advantage	$24.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.13
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.06
Rate for Payer: Wellcare Medicare Advantage	$23.64

CADMIUM URINE

Facility

$608.00

Service Code	HCPCS 82300
Hospital Charge Code	3031070B
Hospital Revenue Code	301
Min. Negotiated Rate	$91.20
Max. Negotiated Rate	$91.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.20

CADMIUM URINE

Facility

$608.00

Service Code	HCPCS 82300
Hospital Charge Code	3031070B
Hospital Revenue Code	301
Min. Negotiated Rate	$11.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$76.59
Rate for Payer: Aetna Medicare Advantage	$23.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.64
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	$86.62
Rate for Payer: Cigna Commercial	$23.64
Rate for Payer: Cigna Medicare Advantage	$11.82
Rate for Payer: Clover Medicare Advantage	$22.46
Rate for Payer: EmblemHealth Commercial	$70.92
Rate for Payer: Humana Medicare Advantage	$24.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.04
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.06
Rate for Payer: Wellcare Medicare Advantage	$23.64

CAD-SCREENING MAMMOGRAPHY

Facility

$1,097.60

Service Code	HCPCS 77052
Hospital Charge Code	2008050
Hospital Revenue Code	403
Min. Negotiated Rate	$142.69
Max. Negotiated Rate	$1,240.00
Rate for Payer: Aetna Commercial	$329.28
Rate for Payer: Aetna Medicare Advantage	$329.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$279.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$279.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$279.89
Rate for Payer: Cigna Commercial	$548.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.69
Rate for Payer: Oxford Commercial	$1,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$164.64
Rate for Payer: UnitedHealthcare Commercial	$1,240.00

CAD-SCREENING MAMMOGRAPHY

Facility

$1,097.60

Service Code	HCPCS 77052
Hospital Charge Code	2008050
Hospital Revenue Code	403
Min. Negotiated Rate	$164.64
Max. Negotiated Rate	$164.64
Rate for Payer: Qualcare PPO/HMO/WC	$164.64

CAFERGOT/TAB

Facility

$6.00

Hospital Charge Code	60632596
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

CAFERGOT/TAB

Facility

$6.00

Hospital Charge Code	60632596
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

CAFFEINE

Facility

$272.00

Service Code	HCPCS 80299
Hospital Charge Code	38472922
Hospital Revenue Code	301
Min. Negotiated Rate	$40.80
Max. Negotiated Rate	$40.80
Rate for Payer: Qualcare PPO/HMO/WC	$40.80

CAFFEINE

Facility

$272.00

Service Code	HCPCS 80299
Hospital Charge Code	38472922
Hospital Revenue Code	301
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

CAFFEINE CITRATE 20MG/ML INJ

Facility

$93.80

Service Code	HCPCS J0706
Hospital Charge Code	6063943068
Hospital Revenue Code	636
Min. Negotiated Rate	$14.07
Max. Negotiated Rate	$46.90
Rate for Payer: Aetna Commercial	$28.14
Rate for Payer: Aetna Medicare Advantage	$28.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.92
Rate for Payer: Cigna Commercial	$46.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.70
Rate for Payer: Qualcare PPO/HMO/WC	$14.07

CAFFEINE CITRATE 20MG/ML INJ

Facility

$93.80

Service Code	HCPCS J0706
Hospital Charge Code	6063943068
Hospital Revenue Code	636
Min. Negotiated Rate	$14.07
Max. Negotiated Rate	$22.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.70
Rate for Payer: Qualcare PPO/HMO/WC	$14.07

CAFFEINE (QUANT SERUM)

Facility

$181.65

Service Code	HCPCS 82542
Hospital Charge Code	3007267
Hospital Revenue Code	301
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.05
Rate for Payer: Aetna Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.27
Rate for Payer: Cigna Commercial	$24.09
Rate for Payer: Cigna Medicare Advantage	$12.04
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.54
Rate for Payer: Wellcare Medicare Advantage	$24.09

CAFFEINE (QUANT SERUM)

Facility

$181.65

Service Code	HCPCS 82542
Hospital Charge Code	3007267
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

CAFFEINE (QUANT URINE)

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3031572
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

CAFFEINE (QUANT URINE)

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3031572
Hospital Revenue Code	301
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

CAFFEINE-SODIUM 250MG/ML 2ML I

Facility

$144.85

Hospital Charge Code	60628780
Hospital Revenue Code	250
Min. Negotiated Rate	$21.73
Max. Negotiated Rate	$21.73
Rate for Payer: Qualcare PPO/HMO/WC	$21.73

Know your out-of-pocket cost for care.

All Charges