Heights University Hospital

All Charges

Charge

Type

Setting

Price

ALBUTEROL INH SOL 0.83% 3ML

Facility

$4.85

Hospital Charge Code	6012199
Hospital Revenue Code	250
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$2.42
Rate for Payer: Aetna Commercial	$1.46
Rate for Payer: Aetna Medicare Advantage	$1.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.24
Rate for Payer: Cigna Commercial	$2.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.63
Rate for Payer: Oxford Commercial	$2.42
Rate for Payer: Qualcare PPO/HMO/WC	$0.73
Rate for Payer: UnitedHealthcare Commercial	$2.42

ALBUTEROL-IPRATROPIUM INHALER

Facility

$2,237.80

Service Code	NDC 597002402
Hospital Charge Code	60628929
Hospital Revenue Code	250
Min. Negotiated Rate	$290.91
Max. Negotiated Rate	$1,118.90
Rate for Payer: Aetna Commercial	$671.34
Rate for Payer: Aetna Medicare Advantage	$671.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.64
Rate for Payer: Cigna Commercial	$1,118.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.91
Rate for Payer: Oxford Commercial	$1,118.90
Rate for Payer: Qualcare PPO/HMO/WC	$335.67
Rate for Payer: UnitedHealthcare Commercial	$1,118.90

ALBUTEROL-IPRATROPIUM INHALER

Facility

$2,237.80

Service Code	NDC 597002402
Hospital Charge Code	60628929
Hospital Revenue Code	250
Min. Negotiated Rate	$335.67
Max. Negotiated Rate	$335.67
Rate for Payer: Qualcare PPO/HMO/WC	$335.67

ALBUTEROL RESP 5MG/ML 20ML

Facility

$82.60

Hospital Charge Code	6005888
Hospital Revenue Code	250
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$12.39
Rate for Payer: Qualcare PPO/HMO/WC	$12.39

ALBUTEROL RESP 5MG/ML 20ML

Facility

$82.60

Hospital Charge Code	6005888
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

ALBUTEROL SULFT 0.042% 3ML SOL

Facility

$10.65

Service Code	NDC 487990401
Hospital Charge Code	60630093
Hospital Revenue Code	250
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$5.33
Rate for Payer: Aetna Commercial	$3.19
Rate for Payer: Aetna Medicare Advantage	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.72
Rate for Payer: Cigna Commercial	$5.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.38
Rate for Payer: Oxford Commercial	$5.33
Rate for Payer: Qualcare PPO/HMO/WC	$1.60
Rate for Payer: UnitedHealthcare Commercial	$5.33

ALBUTEROL SULFT 0.042% 3ML SOL

Facility

$10.65

Service Code	NDC 487990401
Hospital Charge Code	60630093
Hospital Revenue Code	250
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.60

ALBUTEROL TAB 4MG

Facility

$4.50

Hospital Charge Code	60627442
Hospital Revenue Code	251
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$2.25
Rate for Payer: Aetna Commercial	$1.35
Rate for Payer: Aetna Medicare Advantage	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.15
Rate for Payer: Cigna Commercial	$2.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.59
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$0.68
Rate for Payer: UnitedHealthcare Commercial	$2.25

ALBUTEROL TAB 4MG

Facility

$4.50

Hospital Charge Code	60627442
Hospital Revenue Code	251
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$0.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.68

ALBUTEROL TAB CR 4MG

Facility

$8.35

Hospital Charge Code	60627443
Hospital Revenue Code	252
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$1.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.25

ALBUTEROL TAB CR 4MG

Facility

$8.35

Hospital Charge Code	60627443
Hospital Revenue Code	252
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$4.17
Rate for Payer: Aetna Commercial	$2.50
Rate for Payer: Aetna Medicare Advantage	$2.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.13
Rate for Payer: Cigna Commercial	$4.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.09
Rate for Payer: Oxford Commercial	$4.17
Rate for Payer: Qualcare PPO/HMO/WC	$1.25
Rate for Payer: UnitedHealthcare Commercial	$4.17

ALCHOHOL ETHYL 190 PROOF-5GAL

Facility

$251.25

Hospital Charge Code	270657896
Hospital Revenue Code	272
Min. Negotiated Rate	$32.66
Max. Negotiated Rate	$125.62
Rate for Payer: Aetna Commercial	$75.38
Rate for Payer: Aetna Medicare Advantage	$75.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.07
Rate for Payer: Cigna Commercial	$125.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.66
Rate for Payer: Oxford Commercial	$125.62
Rate for Payer: Qualcare PPO/HMO/WC	$37.69
Rate for Payer: UnitedHealthcare Commercial	$125.62

ALCHOHOL ETHYL 190 PROOF-5GAL

Facility

$251.25

Hospital Charge Code	270657896
Hospital Revenue Code	272
Min. Negotiated Rate	$37.69
Max. Negotiated Rate	$37.69
Rate for Payer: Qualcare PPO/HMO/WC	$37.69

ALCIAN BLUE STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005251
Hospital Revenue Code	310
Min. Negotiated Rate	$46.48
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$201.60
Rate for Payer: Aetna Medicare Advantage	$201.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$46.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.80
Rate for Payer: UnitedHealthcare Commercial	$114.00

ALCIAN BLUE STAIN

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	3005251
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

ALCOHOL 70%

Facility

$6.88

Hospital Charge Code	270650527
Hospital Revenue Code	272
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$3.44
Rate for Payer: Aetna Commercial	$2.06
Rate for Payer: Aetna Medicare Advantage	$2.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.75
Rate for Payer: Cigna Commercial	$3.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.89
Rate for Payer: Oxford Commercial	$3.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.03
Rate for Payer: UnitedHealthcare Commercial	$3.44

ALCOHOL 70%

Facility

$6.88

Hospital Charge Code	270650527
Hospital Revenue Code	272
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$1.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.03

ALCOHOL 70% BOTTLE

Facility

$4.50

Hospital Charge Code	6012207
Hospital Revenue Code	250
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$2.25
Rate for Payer: Aetna Commercial	$1.35
Rate for Payer: Aetna Medicare Advantage	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.15
Rate for Payer: Cigna Commercial	$2.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.59
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$0.68
Rate for Payer: UnitedHealthcare Commercial	$2.25

ALCOHOL 70% BOTTLE

Facility

$4.50

Hospital Charge Code	6012207
Hospital Revenue Code	250
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$0.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.68

ALCOHOL ABUSE AND DEPENDENCE

Facility

$7,086.47

Service Code	APR-DRG 7752
Min. Negotiated Rate	$4,688.91
Max. Negotiated Rate	$7,086.47
Rate for Payer: Aetna Better Health Medicaid	$6,947.52
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,086.47
Rate for Payer: Wellpoint Medicaid Managed Care	$4,688.91

ALCOHOL ABUSE AND DEPENDENCE

Facility

$5,246.78

Service Code	APR-DRG 7751
Min. Negotiated Rate	$3,288.80
Max. Negotiated Rate	$5,246.78
Rate for Payer: Aetna Better Health Medicaid	$5,143.90
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,246.78
Rate for Payer: Wellpoint Medicaid Managed Care	$3,288.80

ALCOHOL ABUSE AND DEPENDENCE

Facility

$12,185.84

Service Code	APR-DRG 7753
Min. Negotiated Rate	$8,927.54
Max. Negotiated Rate	$12,185.84
Rate for Payer: Aetna Better Health Medicaid	$11,946.90
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,185.84
Rate for Payer: Wellpoint Medicaid Managed Care	$8,927.54

ALCOHOL ABUSE AND DEPENDENCE

Facility

$28,104.52

Service Code	APR-DRG 7754
Min. Negotiated Rate	$25,578.15
Max. Negotiated Rate	$28,104.52
Rate for Payer: Aetna Better Health Medicaid	$27,553.45
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$28,104.52
Rate for Payer: Wellpoint Medicaid Managed Care	$25,578.15

ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY

Facility

$6,354.80

Service Code	APR-DRG 7721
Min. Negotiated Rate	$5,662.87
Max. Negotiated Rate	$6,354.80
Rate for Payer: Aetna Better Health Medicaid	$6,230.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,354.80
Rate for Payer: Wellpoint Medicaid Managed Care	$5,662.87

ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY

Facility

$7,762.03

Service Code	APR-DRG 7722
Min. Negotiated Rate	$6,648.63
Max. Negotiated Rate	$7,762.03
Rate for Payer: Aetna Better Health Medicaid	$7,609.83
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,762.03
Rate for Payer: Wellpoint Medicaid Managed Care	$6,648.63

Know your out-of-pocket cost for care.

All Charges