Heights University Hospital

All Charges

Charge

Type

Setting

Price

ETHANOLAMINEOLEATE 50MG/ML 2ML

Facility

$1,563.78

Service Code	HCPCS J1430
Hospital Charge Code	60632280
Hospital Revenue Code	636
Min. Negotiated Rate	$234.57
Max. Negotiated Rate	$469.13
Rate for Payer: Aetna Commercial	$469.13
Rate for Payer: Aetna Medicare Advantage	$469.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$398.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$398.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$398.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$378.43
Rate for Payer: Qualcare PPO/HMO/WC	$234.57

ETHICON CAP(384.75)+RETRACTOR

Facility

$707.00

Hospital Charge Code	270335972
Hospital Revenue Code	272
Min. Negotiated Rate	$106.05
Max. Negotiated Rate	$106.05
Rate for Payer: Qualcare PPO/HMO/WC	$106.05

ETHICON CAP(384.75)+RETRACTOR

Facility

$707.00

Hospital Charge Code	270335972
Hospital Revenue Code	272
Min. Negotiated Rate	$91.91
Max. Negotiated Rate	$353.50
Rate for Payer: Aetna Commercial	$212.10
Rate for Payer: Aetna Medicare Advantage	$212.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$180.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$180.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$180.28
Rate for Payer: Cigna Commercial	$353.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.91
Rate for Payer: Oxford Commercial	$353.50
Rate for Payer: Qualcare PPO/HMO/WC	$106.05
Rate for Payer: UnitedHealthcare Commercial	$353.50

ETHICON PHYSIOMESH

Facility

$345.00

Hospital Charge Code	270335977
Hospital Revenue Code	278
Min. Negotiated Rate	$51.75
Max. Negotiated Rate	$83.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.49
Rate for Payer: Qualcare PPO/HMO/WC	$51.75

ETHICON PHYSIOMESH

Facility

$345.00

Hospital Charge Code	270335977
Hospital Revenue Code	278
Min. Negotiated Rate	$51.75
Max. Negotiated Rate	$172.50
Rate for Payer: Aetna Commercial	$103.50
Rate for Payer: Aetna Medicare Advantage	$103.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.97
Rate for Payer: Cigna Commercial	$172.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.49
Rate for Payer: Qualcare PPO/HMO/WC	$51.75

ETHICON P MESH-PHY151V 15X15CM

Facility

$843.00

Hospital Charge Code	270335978
Hospital Revenue Code	278
Min. Negotiated Rate	$126.45
Max. Negotiated Rate	$204.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$168.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$204.01
Rate for Payer: Qualcare PPO/HMO/WC	$126.45

ETHICON P MESH-PHY151V 15X15CM

Facility

$843.00

Hospital Charge Code	270335978
Hospital Revenue Code	278
Min. Negotiated Rate	$126.45
Max. Negotiated Rate	$421.50
Rate for Payer: Aetna Commercial	$252.90
Rate for Payer: Aetna Medicare Advantage	$252.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$168.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.97
Rate for Payer: Cigna Commercial	$421.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$204.01
Rate for Payer: Qualcare PPO/HMO/WC	$126.45

ETHIPACK STEEL 2-0 18 STRANDS

Facility

$56.75

Hospital Charge Code	270625530
Hospital Revenue Code	272
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$28.38
Rate for Payer: Aetna Commercial	$17.02
Rate for Payer: Aetna Medicare Advantage	$17.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.47
Rate for Payer: Cigna Commercial	$28.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.38
Rate for Payer: Oxford Commercial	$28.38
Rate for Payer: Qualcare PPO/HMO/WC	$8.51
Rate for Payer: UnitedHealthcare Commercial	$28.38

ETHIPACK STEEL 2-0 18 STRANDS

Facility

$56.75

Hospital Charge Code	270625530
Hospital Revenue Code	272
Min. Negotiated Rate	$8.51
Max. Negotiated Rate	$8.51
Rate for Payer: Qualcare PPO/HMO/WC	$8.51

ETHIPACK STEEL 3-0 18 STR DS30

Facility

$59.60

Hospital Charge Code	270625531
Hospital Revenue Code	272
Min. Negotiated Rate	$7.75
Max. Negotiated Rate	$29.80
Rate for Payer: Aetna Commercial	$17.88
Rate for Payer: Aetna Medicare Advantage	$17.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.20
Rate for Payer: Cigna Commercial	$29.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.75
Rate for Payer: Oxford Commercial	$29.80
Rate for Payer: Qualcare PPO/HMO/WC	$8.94
Rate for Payer: UnitedHealthcare Commercial	$29.80

ETHIPACK STEEL 3-0 18 STR DS30

Facility

$59.60

Hospital Charge Code	270625531
Hospital Revenue Code	272
Min. Negotiated Rate	$8.94
Max. Negotiated Rate	$8.94
Rate for Payer: Qualcare PPO/HMO/WC	$8.94

ETHMOZINE/200MG/TAB

Facility

$6.00

Hospital Charge Code	60632962
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

ETHMOZINE/200MG/TAB

Facility

$6.00

Hospital Charge Code	60632962
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

ETHMOZINE/250MG/TAB

Facility

$6.00

Hospital Charge Code	60632963
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

ETHMOZINE/250MG/TAB

Facility

$6.00

Hospital Charge Code	60632963
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

ETHMOZINE/300MG/TAB

Facility

$8.00

Hospital Charge Code	60632964
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

ETHMOZINE/300MG/TAB

Facility

$8.00

Hospital Charge Code	60632964
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

ETHOSUXIMIDE, SERUM

Facility

$170.45

Service Code	HCPCS 80168
Hospital Charge Code	3003993
Hospital Revenue Code	301
Min. Negotiated Rate	$25.57
Max. Negotiated Rate	$25.57
Rate for Payer: Qualcare PPO/HMO/WC	$25.57

ETHOSUXIMIDE, SERUM

Facility

$170.45

Service Code	HCPCS 80168
Hospital Charge Code	3003993
Hospital Revenue Code	301
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.94
Rate for Payer: Aetna Medicare Advantage	$16.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.87
Rate for Payer: Cigna Commercial	$16.34
Rate for Payer: Cigna Medicare Advantage	$8.17
Rate for Payer: Clover Medicare Advantage	$15.52
Rate for Payer: EmblemHealth Commercial	$49.02
Rate for Payer: Humana Medicare Advantage	$16.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.16
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.57
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.34
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.32
Rate for Payer: Wellcare Medicare Advantage	$16.34

ETHRANE/125ML

Facility

$533.00

Hospital Charge Code	60634425
Hospital Revenue Code	250
Min. Negotiated Rate	$69.29
Max. Negotiated Rate	$266.50
Rate for Payer: Aetna Commercial	$159.90
Rate for Payer: Aetna Medicare Advantage	$159.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.91
Rate for Payer: Cigna Commercial	$266.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.29
Rate for Payer: Oxford Commercial	$266.50
Rate for Payer: Qualcare PPO/HMO/WC	$79.95
Rate for Payer: UnitedHealthcare Commercial	$266.50

ETHRANE/125ML

Facility

$533.00

Hospital Charge Code	60634425
Hospital Revenue Code	250
Min. Negotiated Rate	$79.95
Max. Negotiated Rate	$79.95
Rate for Payer: Qualcare PPO/HMO/WC	$79.95

ETHRANE/250ML

Facility

$806.00

Hospital Charge Code	60634426
Hospital Revenue Code	250
Min. Negotiated Rate	$120.90
Max. Negotiated Rate	$120.90
Rate for Payer: Qualcare PPO/HMO/WC	$120.90

ETHRANE/250ML

Facility

$806.00

Hospital Charge Code	60634426
Hospital Revenue Code	250
Min. Negotiated Rate	$104.78
Max. Negotiated Rate	$403.00
Rate for Payer: Aetna Commercial	$241.80
Rate for Payer: Aetna Medicare Advantage	$241.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.53
Rate for Payer: Cigna Commercial	$403.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.78
Rate for Payer: Oxford Commercial	$403.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.90
Rate for Payer: UnitedHealthcare Commercial	$403.00

ETHYL ALCOHOL

Facility

$662.29

Service Code	HCPCS 80320
Hospital Charge Code	3000411
Hospital Revenue Code	301
Min. Negotiated Rate	$86.10
Max. Negotiated Rate	$331.14
Rate for Payer: Aetna Commercial	$198.69
Rate for Payer: Aetna Medicare Advantage	$198.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.88
Rate for Payer: Cigna Commercial	$331.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.34
Rate for Payer: UnitedHealthcare Commercial	$114.00

ETHYL ALCOHOL

Facility

$662.29

Service Code	HCPCS 80320
Hospital Charge Code	3000411
Hospital Revenue Code	301
Min. Negotiated Rate	$99.34
Max. Negotiated Rate	$99.34
Rate for Payer: Qualcare PPO/HMO/WC	$99.34

Know your out-of-pocket cost for care.

All Charges