Heights University Hospital

All Charges

Charge

Type

Setting

Price

GEN LAP KIT

Facility

$352.00

Hospital Charge Code	270338736
Hospital Revenue Code	272
Min. Negotiated Rate	$52.80
Max. Negotiated Rate	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$52.80

GENOPTIC OPHTH/5ML

Facility

$53.00

Hospital Charge Code	60633039
Hospital Revenue Code	250
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$7.95
Rate for Payer: Qualcare PPO/HMO/WC	$7.95

GENOPTIC OPHTH/5ML

Facility

$53.00

Hospital Charge Code	60633039
Hospital Revenue Code	250
Min. Negotiated Rate	$6.89
Max. Negotiated Rate	$26.50
Rate for Payer: Aetna Commercial	$15.90
Rate for Payer: Aetna Medicare Advantage	$15.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.52
Rate for Payer: Cigna Commercial	$26.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.89
Rate for Payer: Oxford Commercial	$26.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.95
Rate for Payer: UnitedHealthcare Commercial	$26.50

GENOPTIC SOLUTION

Facility

$43.55

Hospital Charge Code	6008452
Hospital Revenue Code	252
Min. Negotiated Rate	$5.66
Max. Negotiated Rate	$21.77
Rate for Payer: Aetna Commercial	$13.06
Rate for Payer: Aetna Medicare Advantage	$13.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.11
Rate for Payer: Cigna Commercial	$21.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.66
Rate for Payer: Oxford Commercial	$21.77
Rate for Payer: Qualcare PPO/HMO/WC	$6.53
Rate for Payer: UnitedHealthcare Commercial	$21.77

GENOPTIC SOLUTION

Facility

$43.55

Hospital Charge Code	6008452
Hospital Revenue Code	252
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$6.53
Rate for Payer: Qualcare PPO/HMO/WC	$6.53

GENTACIDIN OPHTH/3MG/1ML

Facility

$41.00

Hospital Charge Code	60633040
Hospital Revenue Code	250
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$6.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.15

GENTACIDIN OPHTH/3MG/1ML

Facility

$41.00

Hospital Charge Code	60633040
Hospital Revenue Code	250
Min. Negotiated Rate	$5.33
Max. Negotiated Rate	$20.50
Rate for Payer: Aetna Commercial	$12.30
Rate for Payer: Aetna Medicare Advantage	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.46
Rate for Payer: Cigna Commercial	$20.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.33
Rate for Payer: Oxford Commercial	$20.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.15
Rate for Payer: UnitedHealthcare Commercial	$20.50

GENTAMICIN 0.3% OPHTH OINT

Facility

$28.10

Hospital Charge Code	6002562
Hospital Revenue Code	251
Min. Negotiated Rate	$4.21
Max. Negotiated Rate	$4.21
Rate for Payer: Qualcare PPO/HMO/WC	$4.21

GENTAMICIN 0.3% OPHTH OINT

Facility

$28.10

Hospital Charge Code	6002562
Hospital Revenue Code	251
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$14.05
Rate for Payer: Aetna Commercial	$8.43
Rate for Payer: Aetna Medicare Advantage	$8.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.17
Rate for Payer: Cigna Commercial	$14.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.65
Rate for Payer: Oxford Commercial	$14.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.21
Rate for Payer: UnitedHealthcare Commercial	$14.05

GENTAMICIN 0.3% OPHTH SOLN

Facility

$32.00

Hospital Charge Code	60628013
Hospital Revenue Code	250
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

GENTAMICIN 0.3% OPHTH SOLN

Facility

$32.00

Hospital Charge Code	60628013
Hospital Revenue Code	250
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$9.60
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$16.00

GENTAMICIN 0.3%/PREDN 0.6% UNG

Facility

$472.25

Hospital Charge Code	606390043
Hospital Revenue Code	250
Min. Negotiated Rate	$61.39
Max. Negotiated Rate	$236.12
Rate for Payer: Aetna Commercial	$141.68
Rate for Payer: Aetna Medicare Advantage	$141.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.42
Rate for Payer: Cigna Commercial	$236.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.39
Rate for Payer: Oxford Commercial	$236.12
Rate for Payer: Qualcare PPO/HMO/WC	$70.84
Rate for Payer: UnitedHealthcare Commercial	$236.12

GENTAMICIN 0.3%/PREDN 0.6% UNG

Facility

$472.25

Hospital Charge Code	606390043
Hospital Revenue Code	250
Min. Negotiated Rate	$70.84
Max. Negotiated Rate	$70.84
Rate for Payer: Qualcare PPO/HMO/WC	$70.84

GENTAMICIN 60MG/50ML NS IVPB**

Facility

$27.90

Service Code	HCPCS J1580
Hospital Charge Code	606272236
Hospital Revenue Code	259
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$4.18
Rate for Payer: Qualcare PPO/HMO/WC	$4.18

GENTAMICIN 60MG/50ML NS IVPB**

Facility

$27.90

Service Code	HCPCS J1580
Hospital Charge Code	606272236
Hospital Revenue Code	259
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$13.95
Rate for Payer: Aetna Commercial	$8.37
Rate for Payer: Aetna Medicare Advantage	$8.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.11
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.63
Rate for Payer: Oxford Commercial	$13.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.18
Rate for Payer: UnitedHealthcare Commercial	$13.95

GENTAMICIN 80 MG/2ML INJ.

Facility

$5.43

Service Code	HCPCS J1580
Hospital Charge Code	60627238
Hospital Revenue Code	636
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$1.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$0.81

GENTAMICIN 80 MG/2ML INJ.

Facility

$5.43

Service Code	HCPCS J1580
Hospital Charge Code	60627238
Hospital Revenue Code	636
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.63
Rate for Payer: Aetna Medicare Advantage	$1.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.38
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$0.81

GENTAMICIN FORTIFIED 13.6MG/ML

Facility

$62.10

Hospital Charge Code	60629022
Hospital Revenue Code	250
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$31.05
Rate for Payer: Aetna Commercial	$18.63
Rate for Payer: Aetna Medicare Advantage	$18.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.84
Rate for Payer: Cigna Commercial	$31.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.07
Rate for Payer: Oxford Commercial	$31.05
Rate for Payer: Qualcare PPO/HMO/WC	$9.31
Rate for Payer: UnitedHealthcare Commercial	$31.05

GENTAMICIN FORTIFIED 13.6MG/ML

Facility

$62.10

Hospital Charge Code	60629022
Hospital Revenue Code	250
Min. Negotiated Rate	$9.31
Max. Negotiated Rate	$9.31
Rate for Payer: Qualcare PPO/HMO/WC	$9.31

GENTAMICIN (GARAMYCIN)

Facility

$179.00

Service Code	HCPCS 80170
Hospital Charge Code	38472296
Hospital Revenue Code	301
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$53.07
Rate for Payer: Aetna Medicare Advantage	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.02
Rate for Payer: Cigna Commercial	$16.38
Rate for Payer: Cigna Medicare Advantage	$8.19
Rate for Payer: Clover Medicare Advantage	$15.56
Rate for Payer: EmblemHealth Commercial	$49.14
Rate for Payer: Humana Medicare Advantage	$16.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.27
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.38
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.36
Rate for Payer: Wellcare Medicare Advantage	$16.38

GENTAMICIN (GARAMYCIN)

Facility

$179.00

Service Code	HCPCS 80170
Hospital Charge Code	38472296
Hospital Revenue Code	301
Min. Negotiated Rate	$26.85
Max. Negotiated Rate	$26.85
Rate for Payer: Qualcare PPO/HMO/WC	$26.85

GENTAMICIN IV 100MG/100ML NS

Facility

$28.07

Service Code	HCPCS J1580
Hospital Charge Code	60629864
Hospital Revenue Code	636
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$8.42
Rate for Payer: Aetna Commercial	$8.42
Rate for Payer: Aetna Medicare Advantage	$8.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.16
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.79
Rate for Payer: Qualcare PPO/HMO/WC	$4.21

GENTAMICIN IV 100MG/100ML NS

Facility

$28.07

Service Code	HCPCS J1580
Hospital Charge Code	60629864
Hospital Revenue Code	636
Min. Negotiated Rate	$4.21
Max. Negotiated Rate	$6.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.79
Rate for Payer: Qualcare PPO/HMO/WC	$4.21

GENTAMICIN PEAK

Facility

$170.45

Service Code	HCPCS 80170
Hospital Charge Code	3004016
Hospital Revenue Code	301
Min. Negotiated Rate	$25.57
Max. Negotiated Rate	$25.57
Rate for Payer: Qualcare PPO/HMO/WC	$25.57

GENTAMICIN PEAK

Facility

$170.45

Service Code	HCPCS 80170
Hospital Charge Code	3004016
Hospital Revenue Code	301
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$53.07
Rate for Payer: Aetna Medicare Advantage	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.02
Rate for Payer: Cigna Commercial	$16.38
Rate for Payer: Cigna Medicare Advantage	$8.19
Rate for Payer: Clover Medicare Advantage	$15.56
Rate for Payer: EmblemHealth Commercial	$49.14
Rate for Payer: Humana Medicare Advantage	$16.87
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	$16.38
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.36
Rate for Payer: Wellcare Medicare Advantage	$16.38

Know your out-of-pocket cost for care.

All Charges