Heights University Hospital

All Charges

Charge

Type

Setting

Price

ALUMINUM HYDROXIDE GEL/40

Facility

$6.00

Hospital Charge Code	60632426
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

ALUMINUM HYDROXIDE GEL CO

Facility

$27.94

Service Code	NDC 17856009103
Hospital Charge Code	60632427
Hospital Revenue Code	250
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$13.97
Rate for Payer: Aetna Commercial	$8.38
Rate for Payer: Aetna Medicare Advantage	$8.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.12
Rate for Payer: Cigna Commercial	$13.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.63
Rate for Payer: Oxford Commercial	$13.97
Rate for Payer: Qualcare PPO/HMO/WC	$4.19
Rate for Payer: UnitedHealthcare Commercial	$13.97

ALUMINUM HYDROXIDE GEL CO

Facility

$27.94

Service Code	NDC 17856009103
Hospital Charge Code	60632427
Hospital Revenue Code	250
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.19

ALUMINUM HYDROXIDE GEL CO

Facility

$5.00

Hospital Charge Code	60632428
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

ALUMINUM HYDROXIDE GEL CO

Facility

$5.00

Hospital Charge Code	60632428
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

ALUMINUM SERUM

Facility

$231.25

Service Code	HCPCS 82108
Hospital Charge Code	8200301RS
Hospital Revenue Code	301
Min. Negotiated Rate	$34.69
Max. Negotiated Rate	$34.69
Rate for Payer: Qualcare PPO/HMO/WC	$34.69

ALUMINUM SERUM

Facility

$231.25

Service Code	HCPCS 82108
Hospital Charge Code	3006962
Hospital Revenue Code	301
Min. Negotiated Rate	$12.74
Max. Negotiated Rate	$114.00
Rate for Payer: Cigna Commercial	$25.48
Rate for Payer: Aetna Commercial	$82.56
Rate for Payer: Aetna Medicare Advantage	$25.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.48
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	$93.36
Rate for Payer: Cigna Medicare Advantage	$12.74
Rate for Payer: Clover Medicare Advantage	$24.21
Rate for Payer: EmblemHealth Commercial	$76.44
Rate for Payer: Humana Medicare Advantage	$26.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$27.01
Rate for Payer: Wellcare Medicare Advantage	$25.48

ALUMINUM SERUM

Facility

$231.25

Service Code	HCPCS 82108
Hospital Charge Code	3006962
Hospital Revenue Code	301
Min. Negotiated Rate	$34.69
Max. Negotiated Rate	$34.69
Rate for Payer: Qualcare PPO/HMO/WC	$34.69

ALUMINUM SERUM

Facility

$231.25

Service Code	HCPCS 82108
Hospital Charge Code	8200301RS
Hospital Revenue Code	301
Min. Negotiated Rate	$12.74
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$82.56
Rate for Payer: Aetna Medicare Advantage	$25.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.48
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	$93.36
Rate for Payer: Cigna Commercial	$25.48
Rate for Payer: Cigna Medicare Advantage	$12.74
Rate for Payer: Clover Medicare Advantage	$24.21
Rate for Payer: EmblemHealth Commercial	$76.44
Rate for Payer: Humana Medicare Advantage	$26.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$27.01
Rate for Payer: Wellcare Medicare Advantage	$25.48

ALUMINUM,SERUM

Facility

$390.00

Service Code	HCPCS 82108
Hospital Charge Code	39900040
Hospital Revenue Code	301
Min. Negotiated Rate	$12.74
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$82.56
Rate for Payer: Aetna Medicare Advantage	$25.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.48
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	$93.36
Rate for Payer: Cigna Commercial	$25.48
Rate for Payer: Cigna Medicare Advantage	$12.74
Rate for Payer: Clover Medicare Advantage	$24.21
Rate for Payer: EmblemHealth Commercial	$76.44
Rate for Payer: Humana Medicare Advantage	$26.24
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	$25.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$27.01
Rate for Payer: Wellcare Medicare Advantage	$25.48

ALUMINUM,SERUM

Facility

$390.00

Service Code	HCPCS 82108
Hospital Charge Code	39900040
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ALUMINUM, URINE I

Facility

$293.00

Service Code	HCPCS 82108
Hospital Charge Code	3006970A
Hospital Revenue Code	301
Min. Negotiated Rate	$12.74
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$82.56
Rate for Payer: Aetna Medicare Advantage	$25.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.48
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	$93.36
Rate for Payer: Cigna Commercial	$25.48
Rate for Payer: Cigna Medicare Advantage	$12.74
Rate for Payer: Clover Medicare Advantage	$24.21
Rate for Payer: EmblemHealth Commercial	$76.44
Rate for Payer: Humana Medicare Advantage	$26.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$27.01
Rate for Payer: Wellcare Medicare Advantage	$25.48

ALUMINUM, URINE I

Facility

$293.00

Service Code	HCPCS 82108
Hospital Charge Code	3006970A
Hospital Revenue Code	301
Min. Negotiated Rate	$43.95
Max. Negotiated Rate	$43.95
Rate for Payer: Qualcare PPO/HMO/WC	$43.95

ALUMINUM, URINE II

Facility

$107.00

Service Code	HCPCS 82570
Hospital Charge Code	3006970B
Hospital Revenue Code	301
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.78
Rate for Payer: Aetna Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.98
Rate for Payer: Cigna Commercial	$5.18
Rate for Payer: Cigna Medicare Advantage	$2.59
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.49
Rate for Payer: Wellcare Medicare Advantage	$5.18

ALUMINUM, URINE II

Facility

$107.00

Service Code	HCPCS 82570
Hospital Charge Code	3006970B
Hospital Revenue Code	301
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

ALUM-MAG HYDROXIDE/SIMETHICONE

Facility

$25.39

Service Code	NDC 121176130
Hospital Charge Code	60629303
Hospital Revenue Code	250
Min. Negotiated Rate	$3.81
Max. Negotiated Rate	$3.81
Rate for Payer: Qualcare PPO/HMO/WC	$3.81

ALUM-MAG HYDROXIDE/SIMETHICONE

Facility

$25.39

Service Code	NDC 121176130
Hospital Charge Code	60629303
Hospital Revenue Code	250
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$12.70
Rate for Payer: Aetna Commercial	$7.62
Rate for Payer: Aetna Medicare Advantage	$7.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.47
Rate for Payer: Cigna Commercial	$12.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.30
Rate for Payer: Oxford Commercial	$12.70
Rate for Payer: Qualcare PPO/HMO/WC	$3.81
Rate for Payer: UnitedHealthcare Commercial	$12.70

ALUM MAG HYDROX SIMETHICONESUS

Facility

$32.85

Hospital Charge Code	60628103
Hospital Revenue Code	250
Min. Negotiated Rate	$4.93
Max. Negotiated Rate	$4.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.93

ALUM MAG HYDROX SIMETHICONESUS

Facility

$32.85

Hospital Charge Code	60628103
Hospital Revenue Code	250
Min. Negotiated Rate	$4.27
Max. Negotiated Rate	$16.43
Rate for Payer: Aetna Commercial	$9.86
Rate for Payer: Aetna Medicare Advantage	$9.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.38
Rate for Payer: Cigna Commercial	$16.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.27
Rate for Payer: Oxford Commercial	$16.43
Rate for Payer: Qualcare PPO/HMO/WC	$4.93
Rate for Payer: UnitedHealthcare Commercial	$16.43

ALUM MAGNESIUM HYDROX SSP

Facility

$30.10

Hospital Charge Code	6005979
Hospital Revenue Code	251
Min. Negotiated Rate	$3.91
Max. Negotiated Rate	$15.05
Rate for Payer: Aetna Commercial	$9.03
Rate for Payer: Aetna Medicare Advantage	$9.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.68
Rate for Payer: Cigna Commercial	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.91
Rate for Payer: Oxford Commercial	$15.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.51
Rate for Payer: UnitedHealthcare Commercial	$15.05

ALUM MAGNESIUM HYDROX SSP

Facility

$30.10

Hospital Charge Code	6005979
Hospital Revenue Code	251
Min. Negotiated Rate	$4.51
Max. Negotiated Rate	$4.51
Rate for Payer: Qualcare PPO/HMO/WC	$4.51

ALUM SSP 600MG/5ML

Facility

$7.70

Hospital Charge Code	60628106
Hospital Revenue Code	250
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$3.85
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.96
Rate for Payer: Cigna Commercial	$3.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.00
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$3.85

ALUM SSP 600MG/5ML

Facility

$7.70

Hospital Charge Code	60628106
Hospital Revenue Code	250
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

ALUPENT/10MG/5ML

Facility

$8.00

Hospital Charge Code	60632429
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

ALUPENT/10MG/5ML

Facility

$8.00

Hospital Charge Code	60632429
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

Know your out-of-pocket cost for care.

All Charges