Heights University Hospital

All Charges

Charge

Type

Setting

Price

CISATRACURIUM 10MG/5ML

Facility

$126.03

Service Code	NDC 74437805
Hospital Charge Code	60635765
Hospital Revenue Code	250
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

CISATRACURIUM INJ 20MG/10ML

Facility

$221.17

Service Code	NDC 74438010
Hospital Charge Code	6017636
Hospital Revenue Code	250
Min. Negotiated Rate	$28.75
Max. Negotiated Rate	$110.58
Rate for Payer: Aetna Commercial	$66.35
Rate for Payer: Aetna Medicare Advantage	$66.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.40
Rate for Payer: Cigna Commercial	$110.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.75
Rate for Payer: Oxford Commercial	$110.58
Rate for Payer: Qualcare PPO/HMO/WC	$33.18
Rate for Payer: UnitedHealthcare Commercial	$110.58

CISATRACURIUM INJ 20MG/10ML

Facility

$221.17

Service Code	NDC 74438010
Hospital Charge Code	6017636
Hospital Revenue Code	250
Min. Negotiated Rate	$33.18
Max. Negotiated Rate	$33.18
Rate for Payer: Qualcare PPO/HMO/WC	$33.18

CISCO CATAKYST 24 ETHERNET

Facility

$5,838.75

Hospital Charge Code	270659108
Hospital Revenue Code	278
Min. Negotiated Rate	$875.81
Max. Negotiated Rate	$2,919.38
Rate for Payer: Aetna Commercial	$1,751.62
Rate for Payer: Aetna Medicare Advantage	$1,751.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,488.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,488.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,167.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,488.88
Rate for Payer: Cigna Commercial	$2,919.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,412.98
Rate for Payer: Qualcare PPO/HMO/WC	$875.81

CISCO CATAKYST 24 ETHERNET

Facility

$5,838.75

Hospital Charge Code	270659108
Hospital Revenue Code	278
Min. Negotiated Rate	$875.81
Max. Negotiated Rate	$1,412.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,167.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,412.98
Rate for Payer: Qualcare PPO/HMO/WC	$875.81

CISPLATIN 100 MG/100ML INJ

Facility

$576.00

Hospital Charge Code	6001226
Hospital Revenue Code	636
Min. Negotiated Rate	$86.40
Max. Negotiated Rate	$139.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.39
Rate for Payer: Qualcare PPO/HMO/WC	$86.40

CISPLATIN 100 MG/100ML INJ

Facility

$576.00

Hospital Charge Code	6001226
Hospital Revenue Code	636
Min. Negotiated Rate	$86.40
Max. Negotiated Rate	$288.00
Rate for Payer: Aetna Commercial	$172.80
Rate for Payer: Aetna Medicare Advantage	$172.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.88
Rate for Payer: Cigna Commercial	$288.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.39
Rate for Payer: Qualcare PPO/HMO/WC	$86.40

CISPLATIN INJ 10 MG

Facility

$250.25

Hospital Charge Code	6001218
Hospital Revenue Code	250
Min. Negotiated Rate	$32.53
Max. Negotiated Rate	$125.12
Rate for Payer: Aetna Commercial	$75.08
Rate for Payer: Aetna Medicare Advantage	$75.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.81
Rate for Payer: Cigna Commercial	$125.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.53
Rate for Payer: Oxford Commercial	$125.12
Rate for Payer: Qualcare PPO/HMO/WC	$37.54
Rate for Payer: UnitedHealthcare Commercial	$125.12

CISPLATIN INJ 10 MG

Facility

$250.25

Hospital Charge Code	6001218
Hospital Revenue Code	250
Min. Negotiated Rate	$37.54
Max. Negotiated Rate	$37.54
Rate for Payer: Qualcare PPO/HMO/WC	$37.54

CITALOPRAM 20 MG TAB

Facility

$17.15

Service Code	NDC 65162005350
Hospital Charge Code	60628873
Hospital Revenue Code	250
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$2.57
Rate for Payer: Qualcare PPO/HMO/WC	$2.57

CITALOPRAM 20 MG TAB

Facility

$17.15

Service Code	NDC 65162005350
Hospital Charge Code	60628873
Hospital Revenue Code	250
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$8.57
Rate for Payer: Aetna Commercial	$5.14
Rate for Payer: Aetna Medicare Advantage	$5.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.37
Rate for Payer: Cigna Commercial	$8.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.23
Rate for Payer: Oxford Commercial	$8.57
Rate for Payer: Qualcare PPO/HMO/WC	$2.57
Rate for Payer: UnitedHealthcare Commercial	$8.57

CITALOPRAM (CELEXA)10MG TAB

Facility

$16.42

Service Code	NDC 378623101
Hospital Charge Code	60630129
Hospital Revenue Code	250
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$2.46
Rate for Payer: Qualcare PPO/HMO/WC	$2.46

CITALOPRAM (CELEXA)10MG TAB

Facility

$16.42

Service Code	NDC 378623101
Hospital Charge Code	60630129
Hospital Revenue Code	250
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$8.21
Rate for Payer: Aetna Commercial	$4.93
Rate for Payer: Aetna Medicare Advantage	$4.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.19
Rate for Payer: Cigna Commercial	$8.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.13
Rate for Payer: Oxford Commercial	$8.21
Rate for Payer: Qualcare PPO/HMO/WC	$2.46
Rate for Payer: UnitedHealthcare Commercial	$8.21

CITRACAL D TAB

Facility

$4.00

Service Code	NDC 904546061
Hospital Charge Code	6063943080
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

CITRACAL D TAB

Facility

$4.00

Service Code	NDC 904546061
Hospital Charge Code	6063943080
Hospital Revenue Code	250
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

CITRATE

Facility

$390.00

Service Code	HCPCS 82507
Hospital Charge Code	39990241C
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CITRATE

Facility

$390.00

Service Code	HCPCS 82507
Hospital Charge Code	39990241C
Hospital Revenue Code	301
Min. Negotiated Rate	$13.90
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$90.07
Rate for Payer: Aetna Medicare Advantage	$27.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.86
Rate for Payer: Cigna Commercial	$27.80
Rate for Payer: Cigna Medicare Advantage	$13.90
Rate for Payer: Clover Medicare Advantage	$26.41
Rate for Payer: EmblemHealth Commercial	$83.40
Rate for Payer: Humana Medicare Advantage	$28.63
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	$27.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$29.47
Rate for Payer: Wellcare Medicare Advantage	$27.80

CITRATE,24HR URINE

Facility

$390.00

Service Code	HCPCS 82507
Hospital Charge Code	39900062
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CITRATE,24HR URINE

Facility

$390.00

Service Code	HCPCS 82507
Hospital Charge Code	39900062
Hospital Revenue Code	301
Min. Negotiated Rate	$13.90
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$90.07
Rate for Payer: Aetna Medicare Advantage	$27.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.86
Rate for Payer: Cigna Commercial	$27.80
Rate for Payer: Cigna Medicare Advantage	$13.90
Rate for Payer: Clover Medicare Advantage	$26.41
Rate for Payer: EmblemHealth Commercial	$83.40
Rate for Payer: Humana Medicare Advantage	$28.63
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	$27.80
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$29.47
Rate for Payer: Wellcare Medicare Advantage	$27.80

CITRATE DEXT SOL FORM A 500ML

Facility

$82.60

Hospital Charge Code	6010268
Hospital Revenue Code	250
Min. Negotiated Rate	$10.74
Max. Negotiated Rate	$41.30
Rate for Payer: Aetna Commercial	$24.78
Rate for Payer: Aetna Medicare Advantage	$24.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.06
Rate for Payer: Cigna Commercial	$41.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.74
Rate for Payer: Oxford Commercial	$41.30
Rate for Payer: Qualcare PPO/HMO/WC	$12.39
Rate for Payer: UnitedHealthcare Commercial	$41.30

CITRATE DEXT SOL FORM A 500ML

Facility

$82.60

Hospital Charge Code	6010268
Hospital Revenue Code	250
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$12.39
Rate for Payer: Qualcare PPO/HMO/WC	$12.39

CITRATE DEXT SOL FORM B 500ML

Facility

$82.60

Hospital Charge Code	6010250
Hospital Revenue Code	250
Min. Negotiated Rate	$10.74
Max. Negotiated Rate	$41.30
Rate for Payer: Aetna Commercial	$24.78
Rate for Payer: Aetna Medicare Advantage	$24.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.06
Rate for Payer: Cigna Commercial	$41.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.74
Rate for Payer: Oxford Commercial	$41.30
Rate for Payer: Qualcare PPO/HMO/WC	$12.39
Rate for Payer: UnitedHealthcare Commercial	$41.30

CITRATE DEXT SOL FORM B 500ML

Facility

$82.60

Hospital Charge Code	6010250
Hospital Revenue Code	250
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$12.39
Rate for Payer: Qualcare PPO/HMO/WC	$12.39

CITRATE OF MAGNESIA/296ML

Facility

$3.00

Hospital Charge Code	60632706
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

CITRATE OF MAGNESIA/296ML

Facility

$3.00

Hospital Charge Code	60632706
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

Know your out-of-pocket cost for care.

All Charges