Heights University Hospital

All Charges

Charge

Type

Setting

Price

CHLORIDE URINE, RANDOM

Facility

$71.25

Service Code	HCPCS 82436
Hospital Charge Code	3009084A
Hospital Revenue Code	301
Min. Negotiated Rate	$2.88
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.63
Rate for Payer: Aetna Medicare Advantage	$5.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.07
Rate for Payer: Cigna Commercial	$5.75
Rate for Payer: Cigna Medicare Advantage	$2.88
Rate for Payer: Clover Medicare Advantage	$5.46
Rate for Payer: EmblemHealth Commercial	$17.25
Rate for Payer: Humana Medicare Advantage	$5.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.26
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.75
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.09
Rate for Payer: Wellcare Medicare Advantage	$5.75

CHLORIDE URINE, RANDOM

Facility

$71.25

Service Code	HCPCS 82436
Hospital Charge Code	3009084A
Hospital Revenue Code	301
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$10.69
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

CHLORIDE, URINE, RANDOM

Facility

$71.25

Service Code	HCPCS 82436
Hospital Charge Code	3000759
Hospital Revenue Code	301
Min. Negotiated Rate	$2.88
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.63
Rate for Payer: Aetna Medicare Advantage	$5.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.07
Rate for Payer: Cigna Commercial	$5.75
Rate for Payer: Cigna Medicare Advantage	$2.88
Rate for Payer: Clover Medicare Advantage	$5.46
Rate for Payer: EmblemHealth Commercial	$17.25
Rate for Payer: Humana Medicare Advantage	$5.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.26
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.75
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.09
Rate for Payer: Wellcare Medicare Advantage	$5.75

CHLORIDE, URINE, RANDOM

Facility

$71.25

Service Code	HCPCS 82436
Hospital Charge Code	3000759
Hospital Revenue Code	301
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$10.69
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

CHLOROFLUOROMETHANE SPRY 120ML

Facility

$90.90

Hospital Charge Code	6001119
Hospital Revenue Code	251
Min. Negotiated Rate	$11.82
Max. Negotiated Rate	$45.45
Rate for Payer: Aetna Commercial	$27.27
Rate for Payer: Aetna Medicare Advantage	$27.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.18
Rate for Payer: Cigna Commercial	$45.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.82
Rate for Payer: Oxford Commercial	$45.45
Rate for Payer: Qualcare PPO/HMO/WC	$13.63
Rate for Payer: UnitedHealthcare Commercial	$45.45

CHLOROFLUOROMETHANE SPRY 120ML

Facility

$90.90

Hospital Charge Code	6001119
Hospital Revenue Code	251
Min. Negotiated Rate	$13.63
Max. Negotiated Rate	$13.63
Rate for Payer: Qualcare PPO/HMO/WC	$13.63

CHLOROMYCETIN OPHTH OINT

Facility

$49.00

Hospital Charge Code	60634568
Hospital Revenue Code	250
Min. Negotiated Rate	$6.37
Max. Negotiated Rate	$24.50
Rate for Payer: Aetna Commercial	$14.70
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.49
Rate for Payer: Cigna Commercial	$24.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.37
Rate for Payer: Oxford Commercial	$24.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.35
Rate for Payer: UnitedHealthcare Commercial	$24.50

CHLOROMYCETIN OPHTH OINT

Facility

$49.00

Hospital Charge Code	60634568
Hospital Revenue Code	250
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$7.35
Rate for Payer: Qualcare PPO/HMO/WC	$7.35

CHLOROMYCETIN OPHTH SOLN

Facility

$71.00

Hospital Charge Code	60634569
Hospital Revenue Code	250
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$35.50
Rate for Payer: Aetna Commercial	$21.30
Rate for Payer: Aetna Medicare Advantage	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.11
Rate for Payer: Cigna Commercial	$35.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.23
Rate for Payer: Oxford Commercial	$35.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$35.50

CHLOROMYCETIN OPHTH SOLN

Facility

$71.00

Hospital Charge Code	60634569
Hospital Revenue Code	250
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

CHLOROMYCETIN STERI-VIAL

Facility

$19.00

Hospital Charge Code	60632684
Hospital Revenue Code	250
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$9.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$5.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.84
Rate for Payer: Cigna Commercial	$9.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.47
Rate for Payer: Oxford Commercial	$9.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.85
Rate for Payer: UnitedHealthcare Commercial	$9.50

CHLOROMYCETIN STERI-VIAL

Facility

$19.00

Hospital Charge Code	60632684
Hospital Revenue Code	250
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$2.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.85

CHLOROPHYLL TAB 100MG

Facility

$3.20

Hospital Charge Code	60628591
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

CHLOROPHYLL TAB 100MG

Facility

$3.20

Hospital Charge Code	60628591
Hospital Revenue Code	250
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$1.60
Rate for Payer: Aetna Commercial	$0.96
Rate for Payer: Aetna Medicare Advantage	$0.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.82
Rate for Payer: Cigna Commercial	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.42
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.48
Rate for Payer: UnitedHealthcare Commercial	$1.60

CHLOROPROCAINE 3% PF INJ

Facility

$64.00

Hospital Charge Code	6001135
Hospital Revenue Code	250
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$19.20
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.32
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$32.00

CHLOROPROCAINE 3% PF INJ

Facility

$64.00

Hospital Charge Code	6001135
Hospital Revenue Code	250
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

CHLOROPROCAINE INJ 1%

Facility

$48.00

Hospital Charge Code	6001143
Hospital Revenue Code	250
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna Commercial	$14.40
Rate for Payer: Aetna Medicare Advantage	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.24
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.24
Rate for Payer: Oxford Commercial	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$24.00

CHLOROPROCAINE INJ 1%

Facility

$48.00

Hospital Charge Code	6001143
Hospital Revenue Code	250
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

CHLOROPROCAINE INJ 2%

Facility

$53.80

Hospital Charge Code	6001127
Hospital Revenue Code	250
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

CHLOROPROCAINE INJ 2%

Facility

$53.80

Hospital Charge Code	6001127
Hospital Revenue Code	250
Min. Negotiated Rate	$6.99
Max. Negotiated Rate	$26.90
Rate for Payer: Aetna Commercial	$16.14
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.99
Rate for Payer: Oxford Commercial	$26.90
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$26.90

CHLOROPTIC 0.5% OPHTH/7.5

Facility

$71.00

Hospital Charge Code	60632685
Hospital Revenue Code	250
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

CHLOROPTIC 0.5% OPHTH/7.5

Facility

$71.00

Hospital Charge Code	60632685
Hospital Revenue Code	250
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$35.50
Rate for Payer: Aetna Commercial	$21.30
Rate for Payer: Aetna Medicare Advantage	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.11
Rate for Payer: Cigna Commercial	$35.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.23
Rate for Payer: Oxford Commercial	$35.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$35.50

CHLOROQUINE 500MG TAB

Facility

$116.25

Hospital Charge Code	6063943079
Hospital Revenue Code	250
Min. Negotiated Rate	$17.44
Max. Negotiated Rate	$17.44
Rate for Payer: Qualcare PPO/HMO/WC	$17.44

CHLOROQUINE 500MG TAB

Facility

$116.25

Hospital Charge Code	6063943079
Hospital Revenue Code	250
Min. Negotiated Rate	$15.11
Max. Negotiated Rate	$58.12
Rate for Payer: Aetna Commercial	$34.88
Rate for Payer: Aetna Medicare Advantage	$34.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.64
Rate for Payer: Cigna Commercial	$58.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.11
Rate for Payer: Oxford Commercial	$58.12
Rate for Payer: Qualcare PPO/HMO/WC	$17.44
Rate for Payer: UnitedHealthcare Commercial	$58.12

CHLOROQUINE PHOSPHATE 500 MG TAB

Facility

$36.18

Service Code	NDC 63304046126
Hospital Charge Code	6063943189
Hospital Revenue Code	250
Min. Negotiated Rate	$4.70
Max. Negotiated Rate	$18.09
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	$18.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.70
Rate for Payer: Oxford Commercial	$18.09
Rate for Payer: Qualcare PPO/HMO/WC	$5.43
Rate for Payer: UnitedHealthcare Commercial	$18.09

Know your out-of-pocket cost for care.

All Charges