Heights University Hospital

All Charges

Charge

Type

Setting

Price

EPISTAXIS WITHOUT MCC

Facility

$33,127.11

Service Code	MSDRG 151
Min. Negotiated Rate	$8,009.84
Max. Negotiated Rate	$33,127.11
Rate for Payer: Aetna Commercial	$24,750.41
Rate for Payer: Aetna Medicare Advantage	$8,009.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,226.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,226.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,042.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21,226.59
Rate for Payer: Cigna Commercial	$15,796.41
Rate for Payer: Cigna Medicare Advantage	$11,042.37
Rate for Payer: Clover Medicare Advantage	$10,490.25
Rate for Payer: EmblemHealth Commercial	$33,127.11
Rate for Payer: Humana Medicare Advantage	$11,373.64
Rate for Payer: Oxford Commercial	$9,872.30
Rate for Payer: UnitedHealthcare Commercial	$11,205.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,042.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11,704.91
Rate for Payer: Wellcare Medicare Advantage	$11,042.37

EPIVIR 150MG TAB

Facility

$24.00

Hospital Charge Code	60635066
Hospital Revenue Code	250
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

EPIVIR 150MG TAB

Facility

$24.00

Hospital Charge Code	60635066
Hospital Revenue Code	250
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$7.20
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.12
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$12.00

EPIVIR ORAL SOL 10MG/ML

Facility

$276.00

Hospital Charge Code	60635174
Hospital Revenue Code	250
Min. Negotiated Rate	$35.88
Max. Negotiated Rate	$138.00
Rate for Payer: Aetna Commercial	$82.80
Rate for Payer: Aetna Medicare Advantage	$82.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.38
Rate for Payer: Cigna Commercial	$138.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.88
Rate for Payer: Oxford Commercial	$138.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.40
Rate for Payer: UnitedHealthcare Commercial	$138.00

EPIVIR ORAL SOL 10MG/ML

Facility

$276.00

Hospital Charge Code	60635174
Hospital Revenue Code	250
Min. Negotiated Rate	$41.40
Max. Negotiated Rate	$41.40
Rate for Payer: Qualcare PPO/HMO/WC	$41.40

EPOETIN ALFA 10,000 UNIT/ML ML

Facility

$1,710.11

Service Code	NDC 59676031002
Hospital Charge Code	60635894
Hospital Revenue Code	635
Min. Negotiated Rate	$222.31
Max. Negotiated Rate	$855.05
Rate for Payer: Aetna Commercial	$513.03
Rate for Payer: Aetna Medicare Advantage	$513.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$436.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$436.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$436.08
Rate for Payer: Cigna Commercial	$855.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.31
Rate for Payer: Oxford Commercial	$855.05
Rate for Payer: Qualcare PPO/HMO/WC	$256.52
Rate for Payer: UnitedHealthcare Commercial	$855.05

EPOETIN ALFA 10,000 UNIT/ML ML

Facility

$1,710.11

Service Code	NDC 59676031002
Hospital Charge Code	60635894
Hospital Revenue Code	635
Min. Negotiated Rate	$256.52
Max. Negotiated Rate	$256.52
Rate for Payer: Qualcare PPO/HMO/WC	$256.52

EPOETIN ALFA 10,000 UNITS/1MLE

Facility

$1,710.11

Service Code	NDC 59676031002
Hospital Charge Code	606361051
Hospital Revenue Code	635
Min. Negotiated Rate	$256.52
Max. Negotiated Rate	$256.52
Rate for Payer: Qualcare PPO/HMO/WC	$256.52

EPOETIN ALFA 10,000 UNITS/1MLE

Facility

$1,710.11

Service Code	NDC 59676031002
Hospital Charge Code	606361051
Hospital Revenue Code	635
Min. Negotiated Rate	$222.31
Max. Negotiated Rate	$855.05
Rate for Payer: Aetna Commercial	$513.03
Rate for Payer: Aetna Medicare Advantage	$513.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$436.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$436.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$436.08
Rate for Payer: Cigna Commercial	$855.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.31
Rate for Payer: Oxford Commercial	$855.05
Rate for Payer: Qualcare PPO/HMO/WC	$256.52
Rate for Payer: UnitedHealthcare Commercial	$855.05

EPOETIN ALFA 20000 UNIT/ML INJ

Facility

$3,420.22

Service Code	NDC 59676032004
Hospital Charge Code	60632231
Hospital Revenue Code	634
Min. Negotiated Rate	$444.63
Max. Negotiated Rate	$1,710.11
Rate for Payer: Aetna Commercial	$1,026.07
Rate for Payer: Aetna Medicare Advantage	$1,026.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$872.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$872.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$872.16
Rate for Payer: Cigna Commercial	$1,710.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$444.63
Rate for Payer: Oxford Commercial	$1,710.11
Rate for Payer: Qualcare PPO/HMO/WC	$513.03
Rate for Payer: UnitedHealthcare Commercial	$1,710.11

EPOETIN ALFA 20000 UNIT/ML INJ

Facility

$3,420.22

Service Code	NDC 59676032004
Hospital Charge Code	60632231
Hospital Revenue Code	634
Min. Negotiated Rate	$513.03
Max. Negotiated Rate	$513.03
Rate for Payer: Qualcare PPO/HMO/WC	$513.03

EPOETIN ALFA 2000 U/ML INJ

Facility

$310.81

Service Code	NDC 59676030200
Hospital Charge Code	60635891
Hospital Revenue Code	634
Min. Negotiated Rate	$40.41
Max. Negotiated Rate	$155.41
Rate for Payer: Aetna Commercial	$93.24
Rate for Payer: Aetna Medicare Advantage	$93.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.26
Rate for Payer: Cigna Commercial	$155.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.41
Rate for Payer: Oxford Commercial	$155.41
Rate for Payer: Qualcare PPO/HMO/WC	$46.62
Rate for Payer: UnitedHealthcare Commercial	$155.41

EPOETIN ALFA 2000 U/ML INJ

Facility

$310.81

Service Code	NDC 59676030200
Hospital Charge Code	60635891
Hospital Revenue Code	634
Min. Negotiated Rate	$46.62
Max. Negotiated Rate	$46.62
Rate for Payer: Qualcare PPO/HMO/WC	$46.62

EPOETINALFA 3000 U/ML INJ

Facility

$466.25

Service Code	NDC 59676030300
Hospital Charge Code	60635892
Hospital Revenue Code	634
Min. Negotiated Rate	$69.94
Max. Negotiated Rate	$69.94
Rate for Payer: Qualcare PPO/HMO/WC	$69.94

EPOETINALFA 3000 U/ML INJ

Facility

$466.25

Service Code	NDC 59676030300
Hospital Charge Code	60635892
Hospital Revenue Code	634
Min. Negotiated Rate	$60.61
Max. Negotiated Rate	$233.12
Rate for Payer: Aetna Commercial	$139.88
Rate for Payer: Aetna Medicare Advantage	$139.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.89
Rate for Payer: Cigna Commercial	$233.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.61
Rate for Payer: Oxford Commercial	$233.12
Rate for Payer: Qualcare PPO/HMO/WC	$69.94
Rate for Payer: UnitedHealthcare Commercial	$233.12

EPOETIN ALFA 40000 UNIT/ML INJ

Facility

$6,840.43

Service Code	NDC 59676034001
Hospital Charge Code	60632230
Hospital Revenue Code	635
Min. Negotiated Rate	$889.26
Max. Negotiated Rate	$3,420.22
Rate for Payer: Aetna Commercial	$2,052.13
Rate for Payer: Aetna Medicare Advantage	$2,052.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,744.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,744.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,744.31
Rate for Payer: Cigna Commercial	$3,420.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$889.26
Rate for Payer: Oxford Commercial	$3,420.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,026.06
Rate for Payer: UnitedHealthcare Commercial	$3,420.22

EPOETIN ALFA 40000 UNIT/ML INJ

Facility

$6,840.43

Service Code	NDC 59676034001
Hospital Charge Code	60632230
Hospital Revenue Code	635
Min. Negotiated Rate	$1,026.06
Max. Negotiated Rate	$1,026.06
Rate for Payer: Qualcare PPO/HMO/WC	$1,026.06

EPOETINALFA 4000 U/ML ML

Facility

$621.63

Service Code	NDC 59676030401
Hospital Charge Code	60635893
Hospital Revenue Code	634
Min. Negotiated Rate	$93.24
Max. Negotiated Rate	$93.24
Rate for Payer: Qualcare PPO/HMO/WC	$93.24

EPOETINALFA 4000 U/ML ML

Facility

$621.63

Service Code	NDC 59676030401
Hospital Charge Code	60635893
Hospital Revenue Code	634
Min. Negotiated Rate	$80.81
Max. Negotiated Rate	$310.81
Rate for Payer: Aetna Commercial	$186.49
Rate for Payer: Aetna Medicare Advantage	$186.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.52
Rate for Payer: Cigna Commercial	$310.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.81
Rate for Payer: Oxford Commercial	$310.81
Rate for Payer: Qualcare PPO/HMO/WC	$93.24
Rate for Payer: UnitedHealthcare Commercial	$310.81

EPOETIN ALFA-EPBX 40000IU VIAL

Facility

$3,048.50

Service Code	NDC 69130904
Hospital Charge Code	606390476
Hospital Revenue Code	635
Min. Negotiated Rate	$396.31
Max. Negotiated Rate	$1,524.25
Rate for Payer: Aetna Commercial	$914.55
Rate for Payer: Aetna Medicare Advantage	$914.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$777.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$777.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$777.37
Rate for Payer: Cigna Commercial	$1,524.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.31
Rate for Payer: Oxford Commercial	$1,524.25
Rate for Payer: Qualcare PPO/HMO/WC	$457.27
Rate for Payer: UnitedHealthcare Commercial	$1,524.25

EPOETIN ALFA-EPBX 40000IU VIAL

Facility

$3,048.50

Service Code	NDC 69130904
Hospital Charge Code	606390476
Hospital Revenue Code	635
Min. Negotiated Rate	$457.27
Max. Negotiated Rate	$457.27
Rate for Payer: Qualcare PPO/HMO/WC	$457.27

EPOETIN ALFAEPFX20000U/ML ESRD

Facility

$1,768.80

Service Code	NDC 69131110
Hospital Charge Code	606390457
Hospital Revenue Code	635
Min. Negotiated Rate	$229.94
Max. Negotiated Rate	$884.40
Rate for Payer: Aetna Commercial	$530.64
Rate for Payer: Aetna Medicare Advantage	$530.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$451.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$451.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$451.04
Rate for Payer: Cigna Commercial	$884.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.94
Rate for Payer: Oxford Commercial	$884.40
Rate for Payer: Qualcare PPO/HMO/WC	$265.32
Rate for Payer: UnitedHealthcare Commercial	$884.40

EPOETIN ALFAEPFX20000U/ML ESRD

Facility

$1,768.80

Service Code	NDC 69131110
Hospital Charge Code	606390457
Hospital Revenue Code	635
Min. Negotiated Rate	$265.32
Max. Negotiated Rate	$265.32
Rate for Payer: Qualcare PPO/HMO/WC	$265.32

EPOETIN INJ 10,000U/1ML

Facility

$981.15

Hospital Charge Code	60627530
Hospital Revenue Code	250
Min. Negotiated Rate	$147.17
Max. Negotiated Rate	$147.17
Rate for Payer: Qualcare PPO/HMO/WC	$147.17

EPOETIN INJ 10,000U/1ML

Facility

$981.15

Hospital Charge Code	60627530
Hospital Revenue Code	250
Min. Negotiated Rate	$127.55
Max. Negotiated Rate	$490.57
Rate for Payer: Aetna Commercial	$294.35
Rate for Payer: Aetna Medicare Advantage	$294.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.19
Rate for Payer: Cigna Commercial	$490.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.55
Rate for Payer: Oxford Commercial	$490.57
Rate for Payer: Qualcare PPO/HMO/WC	$147.17
Rate for Payer: UnitedHealthcare Commercial	$490.57

Know your out-of-pocket cost for care.

All Charges