Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH WESTNILE VIRUS IGG AB CSF

Facility

$565.60

Service Code	HCPCS 86789
Hospital Charge Code	397040006
Hospital Revenue Code	302
Min. Negotiated Rate	$84.84
Max. Negotiated Rate	$84.84
Rate for Payer: Qualcare PPO/HMO/WC	$84.84

CH WESTNILE VIRUS IGG AB CSF

Facility

$565.60

Service Code	HCPCS 86789
Hospital Charge Code	397040006
Hospital Revenue Code	302
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.62
Rate for Payer: Aetna Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.72
Rate for Payer: Cigna Commercial	$14.39
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.84
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.25
Rate for Payer: Wellcare Medicare Advantage	$14.39

CH WESTNILE VIRUS IGM AB CSF

Facility

$565.60

Service Code	HCPCS 86788
Hospital Charge Code	397040007
Hospital Revenue Code	302
Min. Negotiated Rate	$84.84
Max. Negotiated Rate	$84.84
Rate for Payer: Qualcare PPO/HMO/WC	$84.84

CH WESTNILE VIRUS IGM AB CSF

Facility

$565.60

Service Code	HCPCS 86788
Hospital Charge Code	397040007
Hospital Revenue Code	302
Min. Negotiated Rate	$8.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.59
Rate for Payer: Aetna Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.74
Rate for Payer: Cigna Commercial	$16.85
Rate for Payer: Cigna Medicare Advantage	$8.43
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.84
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.85
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.86
Rate for Payer: Wellcare Medicare Advantage	$16.85

CH WHOLE BLD 48H

Facility

$585.00

Service Code	HCPCS P9010
Hospital Charge Code	397031035
Hospital Revenue Code	390
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$87.75
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

CH WHOLE BLD 48H

Facility

$585.00

Service Code	HCPCS P9010
Hospital Charge Code	397031035
Hospital Revenue Code	390
Min. Negotiated Rate	$76.05
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$175.50
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$442.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.05
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH WHOLE BLOOD

Facility

$585.00

Service Code	HCPCS P9010
Hospital Charge Code	397031004
Hospital Revenue Code	390
Min. Negotiated Rate	$76.05
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$175.50
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$442.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.05
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.75
Rate for Payer: UnitedHealthcare Commercial	$756.00

CH WHOLE BLOOD

Facility

$585.00

Service Code	HCPCS P9010
Hospital Charge Code	397031004
Hospital Revenue Code	390
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$87.75
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

CHYLMD TRACH DNA AMP PROBE

Facility

$390.00

Service Code	HCPCS 87491
Hospital Charge Code	3990245A
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CHYLMD TRACH DNA AMP PROBE

Facility

$390.00

Service Code	HCPCS 87491
Hospital Charge Code	3990245A
Hospital Revenue Code	306
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$128.57
Rate for Payer: Aetna Commercial	$113.69
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.57
Rate for Payer: Cigna Commercial	$35.09
Rate for Payer: Cigna Medicare Advantage	$17.55
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

CH ZINC

Facility

$134.00

Service Code	HCPCS 84630
Hospital Charge Code	397072142
Hospital Revenue Code	301
Min. Negotiated Rate	$20.10
Max. Negotiated Rate	$20.10
Rate for Payer: Qualcare PPO/HMO/WC	$20.10

CH ZINC

Facility

$134.00

Service Code	HCPCS 84630
Hospital Charge Code	397072142
Hospital Revenue Code	301
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$36.90
Rate for Payer: Aetna Medicare Advantage	$11.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.73
Rate for Payer: Cigna Commercial	$11.39
Rate for Payer: Cigna Medicare Advantage	$5.70
Rate for Payer: Clover Medicare Advantage	$10.82
Rate for Payer: EmblemHealth Commercial	$34.17
Rate for Payer: Humana Medicare Advantage	$11.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.42
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.07
Rate for Payer: Wellcare Medicare Advantage	$11.39

CH ZOLOFT/SERTALINE

Facility

$85.00

Service Code	HCPCS 80299
Hospital Charge Code	397073138
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	$11.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
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

CH ZOLOFT/SERTALINE

Facility

$85.00

Service Code	HCPCS 80299
Hospital Charge Code	397073138
Hospital Revenue Code	301
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

CH ZONEGRAN

Facility

$154.00

Service Code	HCPCS 80299
Hospital Charge Code	397071085
Hospital Revenue Code	301
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

CH ZONEGRAN

Facility

$154.00

Service Code	HCPCS 80299
Hospital Charge Code	397071085
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	$20.02
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
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

CIBALITH-S/480ML

Facility

$21.00

Hospital Charge Code	60634583
Hospital Revenue Code	250
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$10.50
Rate for Payer: Aetna Commercial	$6.30
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$10.50

CIBALITH-S/480ML

Facility

$21.00

Hospital Charge Code	60634583
Hospital Revenue Code	250
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

CICLOPIROX 0.77% CRE

Facility

$113.00

Hospital Charge Code	60629288
Hospital Revenue Code	250
Min. Negotiated Rate	$16.95
Max. Negotiated Rate	$16.95
Rate for Payer: Qualcare PPO/HMO/WC	$16.95

CICLOPIROX 0.77% CRE

Facility

$113.00

Hospital Charge Code	60629288
Hospital Revenue Code	250
Min. Negotiated Rate	$14.69
Max. Negotiated Rate	$56.50
Rate for Payer: Aetna Commercial	$33.90
Rate for Payer: Aetna Medicare Advantage	$33.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.82
Rate for Payer: Cigna Commercial	$56.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.69
Rate for Payer: Oxford Commercial	$56.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.95
Rate for Payer: UnitedHealthcare Commercial	$56.50

CICLOPIROXOLAMINE TOP 90 GM

Facility

$192.65

Hospital Charge Code	6001192
Hospital Revenue Code	252
Min. Negotiated Rate	$25.04
Max. Negotiated Rate	$96.33
Rate for Payer: Aetna Commercial	$57.80
Rate for Payer: Aetna Medicare Advantage	$57.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.13
Rate for Payer: Cigna Commercial	$96.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.04
Rate for Payer: Oxford Commercial	$96.33
Rate for Payer: Qualcare PPO/HMO/WC	$28.90
Rate for Payer: UnitedHealthcare Commercial	$96.33

CICLOPIROXOLAMINE TOP 90 GM

Facility

$192.65

Hospital Charge Code	6001192
Hospital Revenue Code	252
Min. Negotiated Rate	$28.90
Max. Negotiated Rate	$28.90
Rate for Payer: Qualcare PPO/HMO/WC	$28.90

CIDEX OPA SOLUTION

Facility

$124.45

Hospital Charge Code	270625194
Hospital Revenue Code	272
Min. Negotiated Rate	$18.67
Max. Negotiated Rate	$18.67
Rate for Payer: Qualcare PPO/HMO/WC	$18.67

CIDEX OPA SOLUTION

Facility

$124.45

Hospital Charge Code	270625194
Hospital Revenue Code	272
Min. Negotiated Rate	$16.18
Max. Negotiated Rate	$62.23
Rate for Payer: Aetna Commercial	$37.34
Rate for Payer: Aetna Medicare Advantage	$37.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.73
Rate for Payer: Cigna Commercial	$62.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.18
Rate for Payer: Oxford Commercial	$62.23
Rate for Payer: Qualcare PPO/HMO/WC	$18.67
Rate for Payer: UnitedHealthcare Commercial	$62.23

CIDOFOVIR 375 MG 5ML VIAL

Facility

$24,083.49

Service Code	HCPCS J0740
Hospital Charge Code	60630119
Hospital Revenue Code	636
Min. Negotiated Rate	$3,612.52
Max. Negotiated Rate	$7,225.05
Rate for Payer: Aetna Commercial	$7,225.05
Rate for Payer: Aetna Medicare Advantage	$7,225.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,141.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,141.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,141.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,828.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,612.52

Know your out-of-pocket cost for care.

All Charges