Heights University Hospital

All Charges

Charge

Type

Setting

Price

CEPHALEXIN SSP 250MG/5ML 100ML

Facility

$4.00

Service Code	NDC 93417773
Hospital Charge Code	6009302
Hospital Revenue Code	251
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

CEPHALEXIN SSP 250MG/5ML 100ML

Facility

$4.00

Service Code	NDC 93417773
Hospital Charge Code	6009302
Hospital Revenue Code	251
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

CEPHEID RNA RESP 4PLEX PANEL

Facility

$713.00

Service Code	HCPCS 0241U
Hospital Charge Code	40110241U
Hospital Revenue Code	300
Min. Negotiated Rate	$92.69
Max. Negotiated Rate	$356.50
Rate for Payer: Aetna Commercial	$213.90
Rate for Payer: Aetna Medicare Advantage	$213.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.81
Rate for Payer: Cigna Commercial	$356.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.69
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$106.95
Rate for Payer: UnitedHealthcare Commercial	$114.00

CEPHEID RNA RESP 4PLEX PANEL

Facility

$713.00

Service Code	HCPCS 0241U
Hospital Charge Code	40110241U
Hospital Revenue Code	300
Min. Negotiated Rate	$106.95
Max. Negotiated Rate	$106.95
Rate for Payer: Qualcare PPO/HMO/WC	$106.95

CEPHEID RNA RESP 4PLEX PANEL

Facility

$713.00

Service Code	HCPCS 0241U
Hospital Charge Code	40130241U
Hospital Revenue Code	300
Min. Negotiated Rate	$92.69
Max. Negotiated Rate	$356.50
Rate for Payer: Aetna Commercial	$213.90
Rate for Payer: Aetna Medicare Advantage	$213.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.81
Rate for Payer: Cigna Commercial	$356.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.69
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$106.95
Rate for Payer: UnitedHealthcare Commercial	$114.00

CEPHEID RNA RESP 4PLEX PANEL

Facility

$713.00

Service Code	HCPCS 0241U
Hospital Charge Code	40130241U
Hospital Revenue Code	300
Min. Negotiated Rate	$106.95
Max. Negotiated Rate	$106.95
Rate for Payer: Qualcare PPO/HMO/WC	$106.95

CEPHRADINE CAP 250MG

Facility

$1.95

Hospital Charge Code	6012348
Hospital Revenue Code	251
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

CEPHRADINE CAP 250MG

Facility

$1.95

Hospital Charge Code	6012348
Hospital Revenue Code	251
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.98
Rate for Payer: Aetna Commercial	$0.59
Rate for Payer: Aetna Medicare Advantage	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.50
Rate for Payer: Cigna Commercial	$0.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.25
Rate for Payer: Oxford Commercial	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.29
Rate for Payer: UnitedHealthcare Commercial	$0.98

CEPHRADRINE 250MG/5ML 100ML SU

Facility

$62.10

Hospital Charge Code	6009310
Hospital Revenue Code	251
Min. Negotiated Rate	$9.31
Max. Negotiated Rate	$9.31
Rate for Payer: Qualcare PPO/HMO/WC	$9.31

CEPHRADRINE 250MG/5ML 100ML SU

Facility

$62.10

Hospital Charge Code	6009310
Hospital Revenue Code	251
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$31.05
Rate for Payer: Aetna Commercial	$18.63
Rate for Payer: Aetna Medicare Advantage	$18.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.84
Rate for Payer: Cigna Commercial	$31.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.07
Rate for Payer: Oxford Commercial	$31.05
Rate for Payer: Qualcare PPO/HMO/WC	$9.31
Rate for Payer: UnitedHealthcare Commercial	$31.05

CEPHULAC/10GM/15ML

Facility

$24.00

Hospital Charge Code	60632669
Hospital Revenue Code	250
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$7.20
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.12
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$12.00

CEPHULAC/10GM/15ML

Facility

$24.00

Hospital Charge Code	60632669
Hospital Revenue Code	250
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

CEPTAZ/10GM/VIAL

Facility

$181.00

Hospital Charge Code	60634644
Hospital Revenue Code	250
Min. Negotiated Rate	$27.15
Max. Negotiated Rate	$27.15
Rate for Payer: Qualcare PPO/HMO/WC	$27.15

CEPTAZ/10GM/VIAL

Facility

$181.00

Hospital Charge Code	60634644
Hospital Revenue Code	250
Min. Negotiated Rate	$23.53
Max. Negotiated Rate	$90.50
Rate for Payer: Aetna Commercial	$54.30
Rate for Payer: Aetna Medicare Advantage	$54.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.16
Rate for Payer: Cigna Commercial	$90.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.53
Rate for Payer: Oxford Commercial	$90.50
Rate for Payer: Qualcare PPO/HMO/WC	$27.15
Rate for Payer: UnitedHealthcare Commercial	$90.50

CERACELL ORTHO MOLDABE FOAM 10

Facility

$18,250.00

Service Code	HCPCS C1765
Hospital Charge Code	270704181
Hospital Revenue Code	278
Min. Negotiated Rate	$2,737.50
Max. Negotiated Rate	$9,125.00
Rate for Payer: Aetna Commercial	$5,475.00
Rate for Payer: Aetna Medicare Advantage	$5,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,653.75
Rate for Payer: Cigna Commercial	$9,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50

CERACELL ORTHO MOLDABE FOAM 10

Facility

$18,250.00

Service Code	HCPCS C1765
Hospital Charge Code	270704181
Hospital Revenue Code	278
Min. Negotiated Rate	$2,737.50
Max. Negotiated Rate	$4,416.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50

CERAMENT 10cc

Facility

$19,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270664901
Hospital Revenue Code	278
Min. Negotiated Rate	$2,970.00
Max. Negotiated Rate	$9,900.00
Rate for Payer: Aetna Commercial	$5,940.00
Rate for Payer: Aetna Medicare Advantage	$5,940.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,049.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,049.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,049.00
Rate for Payer: Cigna Commercial	$9,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,791.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,970.00

CERAMENT 10cc

Facility

$19,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270664901
Hospital Revenue Code	278
Min. Negotiated Rate	$2,970.00
Max. Negotiated Rate	$4,791.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,791.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,970.00

CERAMENT BONE VOID 18ml

Facility

$23,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270690954
Hospital Revenue Code	278
Min. Negotiated Rate	$3,506.25
Max. Negotiated Rate	$11,687.50
Rate for Payer: Aetna Commercial	$7,012.50
Rate for Payer: Aetna Medicare Advantage	$7,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,960.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,960.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,960.62
Rate for Payer: Cigna Commercial	$11,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,656.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,506.25

CERAMENT BONE VOID 18ml

Facility

$23,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270690954
Hospital Revenue Code	278
Min. Negotiated Rate	$3,506.25
Max. Negotiated Rate	$5,656.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,656.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,506.25

CERCLAGE 1.0MM W/EYE 280MM

Facility

$336.00

Hospital Charge Code	270672158
Hospital Revenue Code	272
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$50.40
Rate for Payer: Qualcare PPO/HMO/WC	$50.40

CERCLAGE 1.0MM W/EYE 280MM

Facility

$336.00

Hospital Charge Code	270672158
Hospital Revenue Code	272
Min. Negotiated Rate	$43.68
Max. Negotiated Rate	$168.00
Rate for Payer: Aetna Commercial	$100.80
Rate for Payer: Aetna Medicare Advantage	$100.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.68
Rate for Payer: Cigna Commercial	$168.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.68
Rate for Payer: Oxford Commercial	$168.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.40
Rate for Payer: UnitedHealthcare Commercial	$168.00

CERCLAGE CERVIX PREGNANT VAG

Facility

$16,333.80

Service Code	HCPCS 59320
Hospital Charge Code	73190165
Hospital Revenue Code	720
Min. Negotiated Rate	$2,450.07
Max. Negotiated Rate	$2,450.07
Rate for Payer: Qualcare PPO/HMO/WC	$2,450.07

CERCLAGE CERVIX PREGNANT VAG

Facility

$16,333.80

Service Code	HCPCS 59320
Hospital Charge Code	73190165
Hospital Revenue Code	720
Min. Negotiated Rate	$97.75
Max. Negotiated Rate	$7,708.87
Rate for Payer: Aetna Commercial	$4,900.14
Rate for Payer: Aetna Medicare Advantage	$4,900.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,165.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,165.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$97.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,165.12
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,123.39
Rate for Payer: Oxford Commercial	$2,624.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,450.07
Rate for Payer: UnitedHealthcare Commercial	$2,979.00

CERCLAGE CERVIX PREGNANT,VAG

Facility

$16,333.80

Service Code	HCPCS 59320
Hospital Charge Code	1600000486
Hospital Revenue Code	360
Min. Negotiated Rate	$2,450.07
Max. Negotiated Rate	$2,450.07
Rate for Payer: Qualcare PPO/HMO/WC	$2,450.07

Know your out-of-pocket cost for care.

All Charges