Heights University Hospital

All Charges

Charge

Type

Setting

Price

FLUOCINONIDE/0.05% SOL

Facility

$385.72

Service Code	NDC 51672127302
Hospital Charge Code	60634870
Hospital Revenue Code	250
Min. Negotiated Rate	$50.14
Max. Negotiated Rate	$192.86
Rate for Payer: Aetna Commercial	$115.72
Rate for Payer: Aetna Medicare Advantage	$115.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.36
Rate for Payer: Cigna Commercial	$192.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.14
Rate for Payer: Oxford Commercial	$192.86
Rate for Payer: Qualcare PPO/HMO/WC	$57.86
Rate for Payer: UnitedHealthcare Commercial	$192.86

FLUOCINONIDE/0.05% SOL

Facility

$385.72

Service Code	NDC 51672127302
Hospital Charge Code	60634870
Hospital Revenue Code	250
Min. Negotiated Rate	$57.86
Max. Negotiated Rate	$57.86
Rate for Payer: Qualcare PPO/HMO/WC	$57.86

FLUOCINONIDE CRM 15GM

Facility

$48.00

Hospital Charge Code	6002422
Hospital Revenue Code	251
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

FLUOCINONIDE CRM 15GM

Facility

$48.00

Hospital Charge Code	6002422
Hospital Revenue Code	251
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

FLUOCINONIDE CRM 60GM

Facility

$97.30

Hospital Charge Code	6002455
Hospital Revenue Code	251
Min. Negotiated Rate	$14.60
Max. Negotiated Rate	$14.60
Rate for Payer: Qualcare PPO/HMO/WC	$14.60

FLUOCINONIDE CRM 60GM

Facility

$97.30

Hospital Charge Code	6002455
Hospital Revenue Code	251
Min. Negotiated Rate	$12.65
Max. Negotiated Rate	$48.65
Rate for Payer: Aetna Commercial	$29.19
Rate for Payer: Aetna Medicare Advantage	$29.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.81
Rate for Payer: Cigna Commercial	$48.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.65
Rate for Payer: Oxford Commercial	$48.65
Rate for Payer: Qualcare PPO/HMO/WC	$14.60
Rate for Payer: UnitedHealthcare Commercial	$48.65

FLUOCINONIDE GEL 15GM

Facility

$70.40

Hospital Charge Code	6002430
Hospital Revenue Code	251
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$35.20
Rate for Payer: Aetna Commercial	$21.12
Rate for Payer: Aetna Medicare Advantage	$21.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.95
Rate for Payer: Cigna Commercial	$35.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.15
Rate for Payer: Oxford Commercial	$35.20
Rate for Payer: Qualcare PPO/HMO/WC	$10.56
Rate for Payer: UnitedHealthcare Commercial	$35.20

FLUOCINONIDE GEL 15GM

Facility

$70.40

Hospital Charge Code	6002430
Hospital Revenue Code	251
Min. Negotiated Rate	$10.56
Max. Negotiated Rate	$10.56
Rate for Payer: Qualcare PPO/HMO/WC	$10.56

FLUOCINONIDE SOL 60ML

Facility

$154.25

Hospital Charge Code	6002448
Hospital Revenue Code	251
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$77.12
Rate for Payer: Aetna Commercial	$46.27
Rate for Payer: Aetna Medicare Advantage	$46.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.33
Rate for Payer: Cigna Commercial	$77.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.05
Rate for Payer: Oxford Commercial	$77.12
Rate for Payer: Qualcare PPO/HMO/WC	$23.14
Rate for Payer: UnitedHealthcare Commercial	$77.12

FLUOCINONIDE SOL 60ML

Facility

$154.25

Hospital Charge Code	6002448
Hospital Revenue Code	251
Min. Negotiated Rate	$23.14
Max. Negotiated Rate	$23.14
Rate for Payer: Qualcare PPO/HMO/WC	$23.14

FLUORESCEIN 2% OPHTH SOLN

Facility

$9.65

Hospital Charge Code	6002463
Hospital Revenue Code	250
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

FLUORESCEIN 2% OPHTH SOLN

Facility

$9.65

Hospital Charge Code	6002463
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

FLUORESCEIN BENOXINATE SOL OPH

Facility

$94.10

Hospital Charge Code	60628050
Hospital Revenue Code	250
Min. Negotiated Rate	$12.23
Max. Negotiated Rate	$47.05
Rate for Payer: Aetna Commercial	$28.23
Rate for Payer: Aetna Medicare Advantage	$28.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.00
Rate for Payer: Cigna Commercial	$47.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.23
Rate for Payer: Oxford Commercial	$47.05
Rate for Payer: Qualcare PPO/HMO/WC	$14.12
Rate for Payer: UnitedHealthcare Commercial	$47.05

FLUORESCEIN BENOXINATE SOL OPH

Facility

$94.10

Hospital Charge Code	60628050
Hospital Revenue Code	250
Min. Negotiated Rate	$14.12
Max. Negotiated Rate	$14.12
Rate for Payer: Qualcare PPO/HMO/WC	$14.12

FLUORESCEIN OPTHALM STRIP

Facility

$11.40

Hospital Charge Code	270658298
Hospital Revenue Code	250
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$1.71
Rate for Payer: Qualcare PPO/HMO/WC	$1.71

FLUORESCEIN OPTHALM STRIP

Facility

$11.40

Hospital Charge Code	270658298
Hospital Revenue Code	250
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$5.70
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$3.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.91
Rate for Payer: Cigna Commercial	$5.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.48
Rate for Payer: Oxford Commercial	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$1.71
Rate for Payer: UnitedHealthcare Commercial	$5.70

FLUORESCEIN OPTH SOL/ML

Facility

$296.14

Service Code	NDC 54799050721
Hospital Charge Code	606390178
Hospital Revenue Code	250
Min. Negotiated Rate	$38.50
Max. Negotiated Rate	$148.07
Rate for Payer: Aetna Commercial	$88.84
Rate for Payer: Aetna Medicare Advantage	$88.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.52
Rate for Payer: Cigna Commercial	$148.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.50
Rate for Payer: Oxford Commercial	$148.07
Rate for Payer: Qualcare PPO/HMO/WC	$44.42
Rate for Payer: UnitedHealthcare Commercial	$148.07

FLUORESCEIN OPTH SOL/ML

Facility

$296.14

Service Code	NDC 54799050721
Hospital Charge Code	606390178
Hospital Revenue Code	250
Min. Negotiated Rate	$44.42
Max. Negotiated Rate	$44.42
Rate for Payer: Qualcare PPO/HMO/WC	$44.42

FLUORESCEIN O.S. 2%

Facility

$73.00

Hospital Charge Code	6012579
Hospital Revenue Code	252
Min. Negotiated Rate	$10.95
Max. Negotiated Rate	$10.95
Rate for Payer: Qualcare PPO/HMO/WC	$10.95

FLUORESCEIN O.S. 2%

Facility

$73.00

Hospital Charge Code	6012579
Hospital Revenue Code	252
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$36.50
Rate for Payer: Aetna Commercial	$21.90
Rate for Payer: Aetna Medicare Advantage	$21.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.61
Rate for Payer: Cigna Commercial	$36.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.49
Rate for Payer: Oxford Commercial	$36.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.95
Rate for Payer: UnitedHealthcare Commercial	$36.50

FLUORESCEIN SODIUM STRIP

Facility

$4.00

Service Code	NDC 17238090011
Hospital Charge Code	6022453
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

FLUORESCEIN SODIUM STRIP

Facility

$4.00

Service Code	NDC 17238090011
Hospital Charge Code	6022453
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

FLUORESCENCE IMAGING PACK

Facility

$975.00

Hospital Charge Code	270663998
Hospital Revenue Code	270
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$146.25
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

FLUORESCENCE IMAGING PACK

Facility

$975.00

Hospital Charge Code	270663998
Hospital Revenue Code	270
Min. Negotiated Rate	$126.75
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$292.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.75
Rate for Payer: Oxford Commercial	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$146.25
Rate for Payer: UnitedHealthcare Commercial	$487.50

FLUORESCENT NONINFECT ANTIBODY

Facility

$77.00

Service Code	HCPCS 86255
Hospital Charge Code	3035001A
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.01
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

Know your out-of-pocket cost for care.

All Charges