Heights University Hospital

All Charges

Charge

Type

Setting

Price

FLAT WIRE 3FR 18MM 115CM

Facility

$602.40

Hospital Charge Code	270682478
Hospital Revenue Code	272
Min. Negotiated Rate	$78.31
Max. Negotiated Rate	$301.20
Rate for Payer: Aetna Commercial	$180.72
Rate for Payer: Aetna Medicare Advantage	$180.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.61
Rate for Payer: Cigna Commercial	$301.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.31
Rate for Payer: Oxford Commercial	$301.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.36
Rate for Payer: UnitedHealthcare Commercial	$301.20

FLAT WIRE 3FR 18MM 115CM

Facility

$602.40

Hospital Charge Code	270682478
Hospital Revenue Code	272
Min. Negotiated Rate	$90.36
Max. Negotiated Rate	$90.36
Rate for Payer: Qualcare PPO/HMO/WC	$90.36

FLAVOXATE TAB 100MG

Facility

$9.65

Hospital Charge Code	60628467
Hospital Revenue Code	250
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

FLAVOXATE TAB 100MG

Facility

$9.65

Hospital Charge Code	60628467
Hospital Revenue Code	250
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$2.90
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.25
Rate for Payer: Oxford Commercial	$4.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$4.83

FLEBOGAMMA 5% 5G/100ML

Facility

$2,223.00

Hospital Charge Code	60635614
Hospital Revenue Code	636
Min. Negotiated Rate	$333.45
Max. Negotiated Rate	$1,111.50
Rate for Payer: Aetna Commercial	$666.90
Rate for Payer: Aetna Medicare Advantage	$666.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$566.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$566.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$566.87
Rate for Payer: Cigna Commercial	$1,111.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$537.97
Rate for Payer: Qualcare PPO/HMO/WC	$333.45

FLEBOGAMMA 5% 5G/100ML

Facility

$2,223.00

Hospital Charge Code	60635614
Hospital Revenue Code	636
Min. Negotiated Rate	$333.45
Max. Negotiated Rate	$537.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$537.97
Rate for Payer: Qualcare PPO/HMO/WC	$333.45

FLECAINIDE

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3000924
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

FLECAINIDE

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3000924
Hospital Revenue Code	301
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

FLECAINIDE***

Facility

$28.00

Hospital Charge Code	3010923
Hospital Revenue Code	301
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$114.00

FLECAINIDE***

Facility

$28.00

Hospital Charge Code	3010923
Hospital Revenue Code	301
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

FLECAINIDE 100MG TAB

Facility

$8.52

Hospital Charge Code	60635781
Hospital Revenue Code	250
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$1.28
Rate for Payer: Qualcare PPO/HMO/WC	$1.28

FLECAINIDE 100MG TAB

Facility

$8.52

Hospital Charge Code	60635781
Hospital Revenue Code	250
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$4.26
Rate for Payer: Aetna Commercial	$2.56
Rate for Payer: Aetna Medicare Advantage	$2.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.17
Rate for Payer: Cigna Commercial	$4.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.11
Rate for Payer: Oxford Commercial	$4.26
Rate for Payer: Qualcare PPO/HMO/WC	$1.28
Rate for Payer: UnitedHealthcare Commercial	$4.26

FLECAINIDE ACETATE

Facility

$324.00

Service Code	HCPCS 80299
Hospital Charge Code	38472670
Hospital Revenue Code	301
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

FLECAINIDE ACETATE

Facility

$324.00

Service Code	HCPCS 80299
Hospital Charge Code	38472670
Hospital Revenue Code	301
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

FLEET CASTOR OIL LAXATIVE

Facility

$5.00

Hospital Charge Code	60634770
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

FLEET CASTOR OIL LAXATIVE

Facility

$5.00

Hospital Charge Code	60634770
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

FLEET ENEMA

Facility

$13.20

Service Code	NDC 132020140
Hospital Charge Code	60628138
Hospital Revenue Code	250
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$6.60
Rate for Payer: Aetna Commercial	$3.96
Rate for Payer: Aetna Medicare Advantage	$3.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.37
Rate for Payer: Cigna Commercial	$6.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.72
Rate for Payer: Oxford Commercial	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.98
Rate for Payer: UnitedHealthcare Commercial	$6.60

FLEET ENEMA

Facility

$13.20

Service Code	NDC 132020140
Hospital Charge Code	60628138
Hospital Revenue Code	250
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$1.98
Rate for Payer: Qualcare PPO/HMO/WC	$1.98

FLEET ENEMA (PED )

Facility

$16.42

Service Code	NDC 132020220
Hospital Charge Code	60628750
Hospital Revenue Code	250
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$2.46
Rate for Payer: Qualcare PPO/HMO/WC	$2.46

FLEET ENEMA (PED )

Facility

$16.42

Service Code	NDC 132020220
Hospital Charge Code	60628750
Hospital Revenue Code	250
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$8.21
Rate for Payer: Aetna Commercial	$4.93
Rate for Payer: Aetna Medicare Advantage	$4.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.19
Rate for Payer: Cigna Commercial	$8.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.13
Rate for Payer: Oxford Commercial	$8.21
Rate for Payer: Qualcare PPO/HMO/WC	$2.46
Rate for Payer: UnitedHealthcare Commercial	$8.21

FLEET PEDIATRIC/66.6ML

Facility

$6.00

Hospital Charge Code	60632994
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

FLEET PEDIATRIC/66.6ML

Facility

$6.00

Hospital Charge Code	60632994
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

FLEET PHOSPHO-SODA 45ML

Facility

$15.00

Hospital Charge Code	60635638
Hospital Revenue Code	250
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

FLEET PHOSPHO-SODA 45ML

Facility

$15.00

Hospital Charge Code	60635638
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

FLEET PHOSPHO SODA 90ML

Facility

$18.00

Hospital Charge Code	60634769
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

Know your out-of-pocket cost for care.

All Charges