Heights University Hospital

All Charges

Charge

Type

Setting

Price

ER-VENT MGMT INIT DAY

Facility

$903.00

Service Code	HCPCS 94002
Hospital Charge Code	5790240
Hospital Revenue Code	410
Min. Negotiated Rate	$135.45
Max. Negotiated Rate	$135.45
Rate for Payer: Qualcare PPO/HMO/WC	$135.45

ER VUNIPNCTE CUTDOWN <AGE 5

Facility

$68.75

Service Code	HCPCS 36420
Hospital Charge Code	5700635
Hospital Revenue Code	450
Min. Negotiated Rate	$10.31
Max. Negotiated Rate	$10.31
Rate for Payer: Qualcare PPO/HMO/WC	$10.31

ER VUNIPNCTE CUTDOWN <AGE 5

Facility

$68.75

Service Code	HCPCS 36420
Hospital Charge Code	5700635
Hospital Revenue Code	450
Min. Negotiated Rate	$8.94
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$20.62
Rate for Payer: Aetna Medicare Advantage	$20.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.53
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.94
Rate for Payer: Qualcare PPO/HMO/WC	$10.31

ER WOUND EXPLORATION OF EXTREM

Facility

$3,068.75

Service Code	HCPCS 20103
Hospital Charge Code	5700545
Hospital Revenue Code	450
Min. Negotiated Rate	$139.87
Max. Negotiated Rate	$3,933.12
Rate for Payer: Aetna Better Health Medicaid	$1,912.33
Rate for Payer: Aetna Commercial	$920.62
Rate for Payer: Aetna Medicare Advantage	$920.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$782.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$782.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$782.53
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$398.94
Rate for Payer: Qualcare PPO/HMO/WC	$460.31
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,950.58

ER WOUND EXPLORATION OF EXTREM

Facility

$3,068.75

Service Code	HCPCS 20103
Hospital Charge Code	5700545
Hospital Revenue Code	450
Min. Negotiated Rate	$460.31
Max. Negotiated Rate	$460.31
Rate for Payer: Qualcare PPO/HMO/WC	$460.31

ER-WOUND PREP TRK/ARM/LEG

Facility

$1,343.00

Service Code	HCPCS 15002
Hospital Charge Code	5790025
Hospital Revenue Code	450
Min. Negotiated Rate	$174.59
Max. Negotiated Rate	$5,165.88
Rate for Payer: Aetna Better Health Medicaid	$5,064.59
Rate for Payer: Aetna Commercial	$402.90
Rate for Payer: Aetna Medicare Advantage	$402.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$342.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$342.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$222.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$342.46
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.59
Rate for Payer: Qualcare PPO/HMO/WC	$201.45
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,165.88

ER-WOUND PREP TRK/ARM/LEG

Facility

$1,343.00

Service Code	HCPCS 15002
Hospital Charge Code	5790025
Hospital Revenue Code	450
Min. Negotiated Rate	$201.45
Max. Negotiated Rate	$201.45
Rate for Payer: Qualcare PPO/HMO/WC	$201.45

ERYDERM 2%/60ML

Facility

$84.00

Hospital Charge Code	60632945
Hospital Revenue Code	250
Min. Negotiated Rate	$10.92
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$25.20
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.92
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$42.00

ERYDERM 2%/60ML

Facility

$84.00

Hospital Charge Code	60632945
Hospital Revenue Code	250
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

ERYPED/100MG/2.5ML

Facility

$39.00

Hospital Charge Code	60632948
Hospital Revenue Code	250
Min. Negotiated Rate	$5.07
Max. Negotiated Rate	$19.50
Rate for Payer: Aetna Commercial	$11.70
Rate for Payer: Aetna Medicare Advantage	$11.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.95
Rate for Payer: Cigna Commercial	$19.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.07
Rate for Payer: Oxford Commercial	$19.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.85
Rate for Payer: UnitedHealthcare Commercial	$19.50

ERYPED/100MG/2.5ML

Facility

$39.00

Hospital Charge Code	60632948
Hospital Revenue Code	250
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$5.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.85

ERYPED-200/200MG/5ML

Facility

$43.00

Hospital Charge Code	60632949
Hospital Revenue Code	250
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$21.50

ERYPED-200/200MG/5ML

Facility

$43.00

Hospital Charge Code	60632949
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

ERYPED/400MG/5ML

Facility

$118.00

Hospital Charge Code	60632947
Hospital Revenue Code	250
Min. Negotiated Rate	$17.70
Max. Negotiated Rate	$17.70
Rate for Payer: Qualcare PPO/HMO/WC	$17.70

ERYPED/400MG/5ML

Facility

$18.00

Hospital Charge Code	60632946
Hospital Revenue Code	250
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$5.40
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$9.00

ERYPED/400MG/5ML

Facility

$18.00

Hospital Charge Code	60632946
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

ERYPED/400MG/5ML

Facility

$118.00

Hospital Charge Code	60632947
Hospital Revenue Code	250
Min. Negotiated Rate	$15.34
Max. Negotiated Rate	$59.00
Rate for Payer: Aetna Commercial	$35.40
Rate for Payer: Aetna Medicare Advantage	$35.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.09
Rate for Payer: Cigna Commercial	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.34
Rate for Payer: Oxford Commercial	$59.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.70
Rate for Payer: UnitedHealthcare Commercial	$59.00

ERY-TAB/333MG/TAB

Facility

$3.00

Hospital Charge Code	60632944
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

ERY-TAB/333MG/TAB

Facility

$3.00

Hospital Charge Code	60632944
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ERYTHROCIN LACTOBIONATE/5

Facility

$48.00

Hospital Charge Code	60632950
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

ERYTHROCIN LACTOBIONATE/5

Facility

$48.00

Hospital Charge Code	60632950
Hospital Revenue Code	250
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

ERYTHROCIN LACTOBIONATE-I

Facility

$131.00

Hospital Charge Code	60632951
Hospital Revenue Code	250
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$19.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

ERYTHROCIN LACTOBIONATE-I

Facility

$131.00

Hospital Charge Code	60632951
Hospital Revenue Code	250
Min. Negotiated Rate	$17.03
Max. Negotiated Rate	$65.50
Rate for Payer: Aetna Commercial	$39.30
Rate for Payer: Aetna Medicare Advantage	$39.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.41
Rate for Payer: Cigna Commercial	$65.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.03
Rate for Payer: Oxford Commercial	$65.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.65
Rate for Payer: UnitedHealthcare Commercial	$65.50

ERYTHROCIN STEARATE/250MG

Facility

$4.00

Hospital Charge Code	60632953
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

ERYTHROCIN STEARATE/250MG

Facility

$4.00

Hospital Charge Code	60632952
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

Know your out-of-pocket cost for care.

All Charges