Heights University Hospital

All Charges

Charge

Type

Setting

Price

CEFIZOX 1GM/50ML

Facility

$63.00

Hospital Charge Code	60635024
Hospital Revenue Code	250
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna Commercial	$18.90
Rate for Payer: Aetna Medicare Advantage	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.07
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.19
Rate for Payer: Oxford Commercial	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$31.50

CEFIZOX 1GM ADDVANT

Facility

$63.00

Hospital Charge Code	60635386
Hospital Revenue Code	250
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna Commercial	$18.90
Rate for Payer: Aetna Medicare Advantage	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.07
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.19
Rate for Payer: Oxford Commercial	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$31.50

CEFIZOX 1GM ADDVANT

Facility

$63.00

Hospital Charge Code	60635386
Hospital Revenue Code	250
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

CEFIZOX/2GM

Facility

$127.00

Hospital Charge Code	60632659
Hospital Revenue Code	250
Min. Negotiated Rate	$19.05
Max. Negotiated Rate	$19.05
Rate for Payer: Qualcare PPO/HMO/WC	$19.05

CEFIZOX/2GM

Facility

$90.00

Hospital Charge Code	60632656
Hospital Revenue Code	250
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$45.00
Rate for Payer: Aetna Commercial	$27.00
Rate for Payer: Aetna Medicare Advantage	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.95
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$45.00

CEFIZOX/2GM

Facility

$90.00

Hospital Charge Code	60632656
Hospital Revenue Code	250
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

CEFIZOX/2GM

Facility

$127.00

Hospital Charge Code	60632659
Hospital Revenue Code	250
Min. Negotiated Rate	$16.51
Max. Negotiated Rate	$63.50
Rate for Payer: Aetna Commercial	$38.10
Rate for Payer: Aetna Medicare Advantage	$38.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.38
Rate for Payer: Cigna Commercial	$63.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.51
Rate for Payer: Oxford Commercial	$63.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.05
Rate for Payer: UnitedHealthcare Commercial	$63.50

CEFIZOX 2GM/50ML

Facility

$97.00

Hospital Charge Code	60635025
Hospital Revenue Code	250
Min. Negotiated Rate	$12.61
Max. Negotiated Rate	$48.50
Rate for Payer: Aetna Commercial	$29.10
Rate for Payer: Aetna Medicare Advantage	$29.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.73
Rate for Payer: Cigna Commercial	$48.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.61
Rate for Payer: Oxford Commercial	$48.50
Rate for Payer: Qualcare PPO/HMO/WC	$14.55
Rate for Payer: UnitedHealthcare Commercial	$48.50

CEFIZOX 2GM/50ML

Facility

$97.00

Hospital Charge Code	60635025
Hospital Revenue Code	250
Min. Negotiated Rate	$14.55
Max. Negotiated Rate	$14.55
Rate for Payer: Qualcare PPO/HMO/WC	$14.55

CEFOL/TAB

Facility

$3.00

Hospital Charge Code	60632660
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

CEFOL/TAB

Facility

$3.00

Hospital Charge Code	60632660
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

CEFOTETAN DISODIUM 1 GM VIAL

Facility

$91.25

Hospital Charge Code	6006506
Hospital Revenue Code	250
Min. Negotiated Rate	$11.86
Max. Negotiated Rate	$45.62
Rate for Payer: Aetna Commercial	$27.38
Rate for Payer: Aetna Medicare Advantage	$27.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.27
Rate for Payer: Cigna Commercial	$45.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.86
Rate for Payer: Oxford Commercial	$45.62
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$45.62

CEFOTETAN DISODIUM 1 GM VIAL

Facility

$91.25

Hospital Charge Code	6006506
Hospital Revenue Code	250
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

CEFOTETAN DISODIUM 2 GM VIAL

Facility

$168.00

Hospital Charge Code	6006894
Hospital Revenue Code	250
Min. Negotiated Rate	$25.20
Max. Negotiated Rate	$25.20
Rate for Payer: Qualcare PPO/HMO/WC	$25.20

CEFOTETAN DISODIUM 2 GM VIAL

Facility

$168.00

Hospital Charge Code	6006894
Hospital Revenue Code	250
Min. Negotiated Rate	$21.84
Max. Negotiated Rate	$84.00
Rate for Payer: Aetna Commercial	$50.40
Rate for Payer: Aetna Medicare Advantage	$50.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.84
Rate for Payer: Cigna Commercial	$84.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.84
Rate for Payer: Oxford Commercial	$84.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.20
Rate for Payer: UnitedHealthcare Commercial	$84.00

CEFOXITIN 1G PREMIX

Facility

$82.41

Service Code	HCPCS J0694
Hospital Charge Code	60635576
Hospital Revenue Code	636
Min. Negotiated Rate	$12.36
Max. Negotiated Rate	$19.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.94
Rate for Payer: Qualcare PPO/HMO/WC	$12.36

CEFOXITIN 1G PREMIX

Facility

$82.41

Service Code	HCPCS J0694
Hospital Charge Code	60635576
Hospital Revenue Code	636
Min. Negotiated Rate	$3.56
Max. Negotiated Rate	$24.72
Rate for Payer: Aetna Commercial	$24.72
Rate for Payer: Aetna Medicare Advantage	$24.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.01
Rate for Payer: Cigna Commercial	$3.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.94
Rate for Payer: Qualcare PPO/HMO/WC	$12.36

CEFOXITIN 2GM VIAL

Facility

$150.75

Service Code	HCPCS J0694
Hospital Charge Code	60632211
Hospital Revenue Code	636
Min. Negotiated Rate	$3.56
Max. Negotiated Rate	$45.23
Rate for Payer: Aetna Commercial	$45.23
Rate for Payer: Aetna Medicare Advantage	$45.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.44
Rate for Payer: Cigna Commercial	$3.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.48
Rate for Payer: Qualcare PPO/HMO/WC	$22.61

CEFOXITIN 2GM VIAL

Facility

$150.75

Service Code	HCPCS J0694
Hospital Charge Code	60632211
Hospital Revenue Code	636
Min. Negotiated Rate	$22.61
Max. Negotiated Rate	$36.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.48
Rate for Payer: Qualcare PPO/HMO/WC	$22.61

CEFOXITIN 2G PREMIX

Facility

$164.89

Service Code	HCPCS J0694
Hospital Charge Code	60635575
Hospital Revenue Code	636
Min. Negotiated Rate	$3.56
Max. Negotiated Rate	$49.47
Rate for Payer: Aetna Commercial	$49.47
Rate for Payer: Aetna Medicare Advantage	$49.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.05
Rate for Payer: Cigna Commercial	$3.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.90
Rate for Payer: Qualcare PPO/HMO/WC	$24.73

CEFOXITIN 2G PREMIX

Facility

$164.89

Service Code	HCPCS J0694
Hospital Charge Code	60635575
Hospital Revenue Code	636
Min. Negotiated Rate	$24.73
Max. Negotiated Rate	$39.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.90
Rate for Payer: Qualcare PPO/HMO/WC	$24.73

CEFOXITIN INJ 1GM

Facility

$113.30

Hospital Charge Code	6001002
Hospital Revenue Code	250
Min. Negotiated Rate	$17.00
Max. Negotiated Rate	$17.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.00

CEFOXITIN INJ 1GM

Facility

$113.30

Hospital Charge Code	6001002
Hospital Revenue Code	250
Min. Negotiated Rate	$14.73
Max. Negotiated Rate	$56.65
Rate for Payer: Aetna Commercial	$33.99
Rate for Payer: Aetna Medicare Advantage	$33.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.89
Rate for Payer: Cigna Commercial	$56.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.73
Rate for Payer: Oxford Commercial	$56.65
Rate for Payer: Qualcare PPO/HMO/WC	$17.00
Rate for Payer: UnitedHealthcare Commercial	$56.65

CEFOXITIN INJ 2GM

Facility

$185.00

Hospital Charge Code	6001010
Hospital Revenue Code	250
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

CEFOXITIN INJ 2GM

Facility

$185.00

Hospital Charge Code	6001010
Hospital Revenue Code	250
Min. Negotiated Rate	$24.05
Max. Negotiated Rate	$92.50
Rate for Payer: Aetna Commercial	$55.50
Rate for Payer: Aetna Medicare Advantage	$55.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.17
Rate for Payer: Cigna Commercial	$92.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.05
Rate for Payer: Oxford Commercial	$92.50
Rate for Payer: Qualcare PPO/HMO/WC	$27.75
Rate for Payer: UnitedHealthcare Commercial	$92.50

Know your out-of-pocket cost for care.

All Charges