Heights University Hospital

All Charges

Charge

Type

Setting

Price

CARDIOLIPIN AB (IGM)

Facility

$390.00

Service Code	HCPCS 86147
Hospital Charge Code	39900359
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CARDIOLIPIN IGA

Facility

$358.45

Service Code	HCPCS 86147
Hospital Charge Code	3004855
Hospital Revenue Code	302
Min. Negotiated Rate	$53.77
Max. Negotiated Rate	$53.77
Rate for Payer: Qualcare PPO/HMO/WC	$53.77

CARDIOLIPIN IGA

Facility

$358.45

Service Code	HCPCS 86147
Hospital Charge Code	3004855
Hospital Revenue Code	302
Min. Negotiated Rate	$12.72
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$82.46
Rate for Payer: Aetna Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.25
Rate for Payer: Cigna Commercial	$25.45
Rate for Payer: Cigna Medicare Advantage	$12.72
Rate for Payer: Clover Medicare Advantage	$24.18
Rate for Payer: EmblemHealth Commercial	$76.35
Rate for Payer: Humana Medicare Advantage	$26.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.77
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$26.98
Rate for Payer: Wellcare Medicare Advantage	$25.45

CARDIOLIPIN PANEL COMP***

Facility

$291.00

Service Code	HCPCS 86147
Hospital Charge Code	3032224
Hospital Revenue Code	302
Min. Negotiated Rate	$12.72
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$82.46
Rate for Payer: Aetna Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.25
Rate for Payer: Cigna Commercial	$25.45
Rate for Payer: Cigna Medicare Advantage	$12.72
Rate for Payer: Clover Medicare Advantage	$24.18
Rate for Payer: EmblemHealth Commercial	$76.35
Rate for Payer: Humana Medicare Advantage	$26.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$26.98
Rate for Payer: Wellcare Medicare Advantage	$25.45

CARDIOLIPIN PANEL COMP***

Facility

$291.00

Service Code	HCPCS 86147
Hospital Charge Code	3032224
Hospital Revenue Code	302
Min. Negotiated Rate	$43.65
Max. Negotiated Rate	$43.65
Rate for Payer: Qualcare PPO/HMO/WC	$43.65

CARDIOMYOPATHY

Facility

$26,077.94

Service Code	APR-DRG 2054
Min. Negotiated Rate	$22,609.21
Max. Negotiated Rate	$26,077.94
Rate for Payer: Aetna Better Health Medicaid	$25,566.61
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,077.94
Rate for Payer: Wellpoint Medicaid Managed Care	$22,609.21

CARDIOMYOPATHY

Facility

$12,295.32

Service Code	APR-DRG 2053
Min. Negotiated Rate	$9,214.12
Max. Negotiated Rate	$12,295.32
Rate for Payer: Aetna Better Health Medicaid	$12,054.24
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,295.32
Rate for Payer: Wellpoint Medicaid Managed Care	$9,214.12

CARDIOMYOPATHY

Facility

$6,606.24

Service Code	APR-DRG 2051
Min. Negotiated Rate	$5,013.55
Max. Negotiated Rate	$6,606.24
Rate for Payer: Aetna Better Health Medicaid	$6,476.71
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,606.24
Rate for Payer: Wellpoint Medicaid Managed Care	$5,013.55

CARDIOMYOPATHY

Facility

$8,271.81

Service Code	APR-DRG 2052
Min. Negotiated Rate	$6,382.74
Max. Negotiated Rate	$8,271.81
Rate for Payer: Aetna Better Health Medicaid	$8,109.62
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,271.81
Rate for Payer: Wellpoint Medicaid Managed Care	$6,382.74

CARDIOVERSION

Facility

$1,760.00

Service Code	HCPCS 92960
Hospital Charge Code	366892960
Hospital Revenue Code	480
Min. Negotiated Rate	$228.80
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$528.00
Rate for Payer: Aetna Medicare Advantage	$528.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.80
Rate for Payer: Cigna Commercial	$1,573.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.80
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$264.00
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

CARDIOVERSION

Facility

$1,760.00

Service Code	HCPCS 92960
Hospital Charge Code	7411181
Hospital Revenue Code	480
Min. Negotiated Rate	$264.00
Max. Negotiated Rate	$264.00
Rate for Payer: Qualcare PPO/HMO/WC	$264.00

CARDIOVERSION

Facility

$1,760.00

Service Code	HCPCS 92960
Hospital Charge Code	7411181
Hospital Revenue Code	480
Min. Negotiated Rate	$228.80
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$528.00
Rate for Payer: Aetna Medicare Advantage	$528.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.80
Rate for Payer: Cigna Commercial	$1,573.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.80
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$264.00
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

CARDIOVERSION

Facility

$1,760.00

Service Code	HCPCS 92960
Hospital Charge Code	366892960
Hospital Revenue Code	480
Min. Negotiated Rate	$264.00
Max. Negotiated Rate	$264.00
Rate for Payer: Qualcare PPO/HMO/WC	$264.00

CARDIOVERSION (ELECTIVE)

Facility

$6,070.00

Service Code	HCPCS 92960
Hospital Charge Code	5100078
Hospital Revenue Code	480
Min. Negotiated Rate	$910.50
Max. Negotiated Rate	$910.50
Rate for Payer: Qualcare PPO/HMO/WC	$910.50

CARDIOVERSION (ELECTIVE)

Facility

$6,070.00

Service Code	HCPCS 92960
Hospital Charge Code	5100078
Hospital Revenue Code	480
Min. Negotiated Rate	$595.70
Max. Negotiated Rate	$1,821.00
Rate for Payer: Aetna Commercial	$1,821.00
Rate for Payer: Aetna Medicare Advantage	$1,821.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,547.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,547.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,547.85
Rate for Payer: Cigna Commercial	$1,573.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$789.10
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$910.50
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

CARDIOVERSION (ELECTIVE)

Facility

$2,190.00

Service Code	HCPCS 92960
Hospital Charge Code	5309040
Hospital Revenue Code	480
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$657.00
Rate for Payer: Aetna Medicare Advantage	$657.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$558.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$558.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$558.45
Rate for Payer: Cigna Commercial	$1,573.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.70
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$328.50
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

CARDIOVERSION (ELECTIVE)

Facility

$2,190.00

Service Code	HCPCS 92960
Hospital Charge Code	74110012
Hospital Revenue Code	480
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$657.00
Rate for Payer: Aetna Medicare Advantage	$657.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$558.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$558.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$558.45
Rate for Payer: Cigna Commercial	$1,573.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.70
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$328.50
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

CARDIOVERSION (ELECTIVE)

Facility

$2,190.00

Service Code	HCPCS 92960
Hospital Charge Code	74110012
Hospital Revenue Code	480
Min. Negotiated Rate	$328.50
Max. Negotiated Rate	$328.50
Rate for Payer: Qualcare PPO/HMO/WC	$328.50

CARDIOVERSION (ELECTIVE)

Facility

$2,190.00

Service Code	HCPCS 92960
Hospital Charge Code	5309040
Hospital Revenue Code	480
Min. Negotiated Rate	$328.50
Max. Negotiated Rate	$328.50
Rate for Payer: Qualcare PPO/HMO/WC	$328.50

CARDIOVERSION-INTERNAL

Facility

$1,760.00

Service Code	HCPCS 92961
Hospital Charge Code	7411183
Hospital Revenue Code	480
Min. Negotiated Rate	$131.58
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$528.00
Rate for Payer: Aetna Medicare Advantage	$528.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.80
Rate for Payer: Cigna Commercial	$1,573.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.80
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$264.00
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

CARDIOVERSION-INTERNAL

Facility

$1,760.00

Service Code	HCPCS 92961
Hospital Charge Code	7411183
Hospital Revenue Code	480
Min. Negotiated Rate	$264.00
Max. Negotiated Rate	$264.00
Rate for Payer: Qualcare PPO/HMO/WC	$264.00

CARDIZEM/120MG/TAB

Facility

$19.30

Service Code	NDC 93032101
Hospital Charge Code	60632635
Hospital Revenue Code	250
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$9.65
Rate for Payer: Aetna Commercial	$5.79
Rate for Payer: Aetna Medicare Advantage	$5.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.92
Rate for Payer: Cigna Commercial	$9.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.51
Rate for Payer: Oxford Commercial	$9.65
Rate for Payer: Qualcare PPO/HMO/WC	$2.90
Rate for Payer: UnitedHealthcare Commercial	$9.65

CARDIZEM/120MG/TAB

Facility

$8.00

Hospital Charge Code	60632634
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

CARDIZEM/120MG/TAB

Facility

$8.00

Hospital Charge Code	60632634
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

CARDIZEM/120MG/TAB

Facility

$19.30

Service Code	NDC 93032101
Hospital Charge Code	60632635
Hospital Revenue Code	250
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$2.90
Rate for Payer: Qualcare PPO/HMO/WC	$2.90

Know your out-of-pocket cost for care.

All Charges