Heights University Hospital

All Charges

Charge

Type

Setting

Price

ACUTE MAJOR EYE INFECTIONS WITH CC/MCC

Facility

$45,587.85

Service Code	MSDRG 121
Min. Negotiated Rate	$12,694.61
Max. Negotiated Rate	$45,587.85
Rate for Payer: Aetna Commercial	$39,226.34
Rate for Payer: Aetna Medicare Advantage	$12,694.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,285.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,285.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,195.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,285.76
Rate for Payer: Cigna Commercial	$25,035.38
Rate for Payer: Cigna Medicare Advantage	$15,195.95
Rate for Payer: Clover Medicare Advantage	$14,436.15
Rate for Payer: EmblemHealth Commercial	$45,587.85
Rate for Payer: Humana Medicare Advantage	$15,651.83
Rate for Payer: Oxford Commercial	$15,646.39
Rate for Payer: UnitedHealthcare Commercial	$17,760.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,195.95
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16,107.71
Rate for Payer: Wellcare Medicare Advantage	$15,195.95

ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC

Facility

$34,630.65

Service Code	MSDRG 122
Min. Negotiated Rate	$8,575.11
Max. Negotiated Rate	$34,630.65
Rate for Payer: Aetna Commercial	$26,497.09
Rate for Payer: Aetna Medicare Advantage	$8,575.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,399.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,399.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,543.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20,399.58
Rate for Payer: Cigna Commercial	$16,911.20
Rate for Payer: Cigna Medicare Advantage	$11,543.55
Rate for Payer: Clover Medicare Advantage	$10,966.37
Rate for Payer: EmblemHealth Commercial	$34,630.65
Rate for Payer: Humana Medicare Advantage	$11,889.86
Rate for Payer: Oxford Commercial	$10,569.01
Rate for Payer: UnitedHealthcare Commercial	$11,996.81
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,543.55
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12,236.16
Rate for Payer: Wellcare Medicare Advantage	$11,543.55

ACUTE MYOCARDIAL INFARCTION

Facility

$23,631.48

Service Code	APR-DRG 1904
Min. Negotiated Rate	$21,437.42
Max. Negotiated Rate	$23,631.48
Rate for Payer: Aetna Better Health Medicaid	$23,168.12
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,631.48
Rate for Payer: Wellpoint Medicaid Managed Care	$21,437.42

ACUTE MYOCARDIAL INFARCTION

Facility

$10,697.16

Service Code	APR-DRG 1901
Min. Negotiated Rate	$7,704.63
Max. Negotiated Rate	$10,697.16
Rate for Payer: Aetna Better Health Medicaid	$10,487.41
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,697.16
Rate for Payer: Wellpoint Medicaid Managed Care	$7,704.63

ACUTE MYOCARDIAL INFARCTION

Facility

$15,064.78

Service Code	APR-DRG 1903
Min. Negotiated Rate	$11,574.58
Max. Negotiated Rate	$15,064.78
Rate for Payer: Aetna Better Health Medicaid	$14,769.39
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,064.78
Rate for Payer: Wellpoint Medicaid Managed Care	$11,574.58

ACUTE MYOCARDIAL INFARCTION

Facility

$11,569.26

Service Code	APR-DRG 1902
Min. Negotiated Rate	$8,495.34
Max. Negotiated Rate	$11,569.26
Rate for Payer: Aetna Better Health Medicaid	$11,342.41
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,569.26
Rate for Payer: Wellpoint Medicaid Managed Care	$8,495.34

ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC

Facility

$38,499.78

Service Code	MSDRG 281
Min. Negotiated Rate	$10,029.75
Max. Negotiated Rate	$38,499.78
Rate for Payer: Aetna Commercial	$30,991.93
Rate for Payer: Aetna Medicare Advantage	$10,029.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,085.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,085.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,833.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,085.97
Rate for Payer: Cigna Commercial	$19,779.95
Rate for Payer: Cigna Medicare Advantage	$12,833.26
Rate for Payer: Clover Medicare Advantage	$12,191.60
Rate for Payer: EmblemHealth Commercial	$38,499.78
Rate for Payer: Humana Medicare Advantage	$13,218.26
Rate for Payer: Oxford Commercial	$12,361.90
Rate for Payer: UnitedHealthcare Commercial	$14,031.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,833.26
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13,603.26
Rate for Payer: Wellcare Medicare Advantage	$12,833.26

ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC

Facility

$58,382.40

Service Code	MSDRG 280
Min. Negotiated Rate	$17,504.87
Max. Negotiated Rate	$58,382.40
Rate for Payer: Aetna Commercial	$54,090.05
Rate for Payer: Aetna Medicare Advantage	$17,504.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43,831.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43,831.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,460.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43,831.53
Rate for Payer: Cigna Commercial	$34,521.84
Rate for Payer: Cigna Medicare Advantage	$19,460.80
Rate for Payer: Clover Medicare Advantage	$18,487.76
Rate for Payer: EmblemHealth Commercial	$58,382.40
Rate for Payer: Humana Medicare Advantage	$20,044.62
Rate for Payer: Oxford Commercial	$21,575.15
Rate for Payer: UnitedHealthcare Commercial	$24,489.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,460.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20,628.45
Rate for Payer: Wellcare Medicare Advantage	$19,460.80

ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC

Facility

$32,810.73

Service Code	MSDRG 282
Min. Negotiated Rate	$7,890.89
Max. Negotiated Rate	$32,810.73
Rate for Payer: Aetna Commercial	$24,382.85
Rate for Payer: Aetna Medicare Advantage	$7,890.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,848.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,848.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10,936.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19,848.24
Rate for Payer: Cigna Commercial	$15,561.84
Rate for Payer: Cigna Medicare Advantage	$10,936.91
Rate for Payer: Clover Medicare Advantage	$10,390.06
Rate for Payer: EmblemHealth Commercial	$32,810.73
Rate for Payer: Humana Medicare Advantage	$11,265.02
Rate for Payer: Oxford Commercial	$9,725.69
Rate for Payer: UnitedHealthcare Commercial	$11,039.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$10,936.91
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11,593.12
Rate for Payer: Wellcare Medicare Advantage	$10,936.91

ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC

Facility

$31,913.85

Service Code	MSDRG 284
Min. Negotiated Rate	$7,553.69
Max. Negotiated Rate	$31,913.85
Rate for Payer: Aetna Commercial	$23,340.90
Rate for Payer: Aetna Medicare Advantage	$7,553.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,399.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,399.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10,637.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20,399.58
Rate for Payer: Cigna Commercial	$14,896.84
Rate for Payer: Cigna Medicare Advantage	$10,637.95
Rate for Payer: Clover Medicare Advantage	$10,106.05
Rate for Payer: EmblemHealth Commercial	$31,913.85
Rate for Payer: Humana Medicare Advantage	$10,957.09
Rate for Payer: Oxford Commercial	$9,310.09
Rate for Payer: UnitedHealthcare Commercial	$10,567.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$10,637.95
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11,276.23
Rate for Payer: Wellcare Medicare Advantage	$10,637.95

ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC

Facility

$69,316.41

Service Code	MSDRG 283
Min. Negotiated Rate	$21,615.64
Max. Negotiated Rate	$69,316.41
Rate for Payer: Aetna Commercial	$66,792.33
Rate for Payer: Aetna Medicare Advantage	$21,615.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54,306.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54,306.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,105.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54,306.99
Rate for Payer: Cigna Commercial	$42,628.80
Rate for Payer: Cigna Medicare Advantage	$23,105.47
Rate for Payer: Clover Medicare Advantage	$21,950.20
Rate for Payer: EmblemHealth Commercial	$69,316.41
Rate for Payer: Humana Medicare Advantage	$23,798.63
Rate for Payer: Oxford Commercial	$26,641.76
Rate for Payer: UnitedHealthcare Commercial	$30,240.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,105.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$24,491.80
Rate for Payer: Wellcare Medicare Advantage	$23,105.47

ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC

Facility

$29,205.75

Service Code	MSDRG 285
Min. Negotiated Rate	$6,535.55
Max. Negotiated Rate	$29,205.75
Rate for Payer: Aetna Commercial	$20,194.85
Rate for Payer: Aetna Medicare Advantage	$6,535.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,507.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,507.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,735.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,507.83
Rate for Payer: Cigna Commercial	$12,888.93
Rate for Payer: Cigna Medicare Advantage	$9,735.25
Rate for Payer: Clover Medicare Advantage	$9,248.49
Rate for Payer: EmblemHealth Commercial	$29,205.75
Rate for Payer: Humana Medicare Advantage	$10,027.31
Rate for Payer: Oxford Commercial	$8,055.20
Rate for Payer: UnitedHealthcare Commercial	$9,143.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,735.25
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$10,319.36
Rate for Payer: Wellcare Medicare Advantage	$9,735.25

ACYCLOVIR 200 MG CAP

Facility

$8.78

Service Code	HCPCS J8499
Hospital Charge Code	60627335
Hospital Revenue Code	636
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$2.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.12
Rate for Payer: Qualcare PPO/HMO/WC	$1.32

ACYCLOVIR 200 MG CAP

Facility

$8.78

Service Code	HCPCS J8499
Hospital Charge Code	60627335
Hospital Revenue Code	636
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$4.39
Rate for Payer: Aetna Commercial	$2.63
Rate for Payer: Aetna Medicare Advantage	$2.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.24
Rate for Payer: Cigna Commercial	$4.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.12
Rate for Payer: Qualcare PPO/HMO/WC	$1.32

ACYCLOVIR 500 MG INJ

Facility

$36.18

Service Code	HCPCS J0133
Hospital Charge Code	6007652
Hospital Revenue Code	636
Min. Negotiated Rate	$5.43
Max. Negotiated Rate	$8.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.76
Rate for Payer: Qualcare PPO/HMO/WC	$5.43

ACYCLOVIR 500 MG INJ

Facility

$36.18

Service Code	HCPCS J0133
Hospital Charge Code	6007652
Hospital Revenue Code	636
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$10.85
Rate for Payer: Aetna Commercial	$10.85
Rate for Payer: Aetna Medicare Advantage	$10.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.23
Rate for Payer: Cigna Commercial	$0.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.76
Rate for Payer: Qualcare PPO/HMO/WC	$5.43

ACYCLOVIR 5% 3GM

Facility

$468.85

Hospital Charge Code	60628332
Hospital Revenue Code	250
Min. Negotiated Rate	$70.33
Max. Negotiated Rate	$70.33
Rate for Payer: Qualcare PPO/HMO/WC	$70.33

ACYCLOVIR 5% 3GM

Facility

$468.85

Hospital Charge Code	60628332
Hospital Revenue Code	250
Min. Negotiated Rate	$60.95
Max. Negotiated Rate	$234.43
Rate for Payer: Aetna Commercial	$140.66
Rate for Payer: Aetna Medicare Advantage	$140.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.56
Rate for Payer: Cigna Commercial	$234.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.95
Rate for Payer: Oxford Commercial	$234.43
Rate for Payer: Qualcare PPO/HMO/WC	$70.33
Rate for Payer: UnitedHealthcare Commercial	$234.43

ACYCLOVIR 5% OINT 15GM

Facility

$2,671.96

Service Code	NDC 51079055067
Hospital Charge Code	6005854
Hospital Revenue Code	250
Min. Negotiated Rate	$347.35
Max. Negotiated Rate	$1,335.98
Rate for Payer: Aetna Commercial	$801.59
Rate for Payer: Aetna Medicare Advantage	$801.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$681.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$681.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$681.35
Rate for Payer: Cigna Commercial	$1,335.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.35
Rate for Payer: Oxford Commercial	$1,335.98
Rate for Payer: Qualcare PPO/HMO/WC	$400.79
Rate for Payer: UnitedHealthcare Commercial	$1,335.98

ACYCLOVIR 5% OINT 15GM

Facility

$2,671.96

Service Code	NDC 51079055067
Hospital Charge Code	6005854
Hospital Revenue Code	250
Min. Negotiated Rate	$400.79
Max. Negotiated Rate	$400.79
Rate for Payer: Qualcare PPO/HMO/WC	$400.79

ACYCLOVIR 800 MG TAB

Facility

$28.27

Service Code	NDC 63304050501
Hospital Charge Code	6010631
Hospital Revenue Code	251
Min. Negotiated Rate	$4.24
Max. Negotiated Rate	$4.24
Rate for Payer: Qualcare PPO/HMO/WC	$4.24

ACYCLOVIR 800 MG TAB

Facility

$28.27

Service Code	NDC 63304050501
Hospital Charge Code	6010631
Hospital Revenue Code	251
Min. Negotiated Rate	$3.68
Max. Negotiated Rate	$14.13
Rate for Payer: Aetna Commercial	$8.48
Rate for Payer: Aetna Medicare Advantage	$8.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.21
Rate for Payer: Cigna Commercial	$14.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.68
Rate for Payer: Oxford Commercial	$14.13
Rate for Payer: Qualcare PPO/HMO/WC	$4.24
Rate for Payer: UnitedHealthcare Commercial	$14.13

ACYCLOVIR BY HPLC QUANTIT ASSA

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3035121
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

ACYCLOVIR BY HPLC QUANTIT ASSA

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3035121
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

ACYCLOVIR ODD DOSE IVPB

Facility

$301.45

Hospital Charge Code	60627336
Hospital Revenue Code	250
Min. Negotiated Rate	$45.22
Max. Negotiated Rate	$45.22
Rate for Payer: Qualcare PPO/HMO/WC	$45.22

Know your out-of-pocket cost for care.

All Charges