Heights University Hospital

All Charges

Charge

Type

Setting

Price

HABITROL/14MG/24H

Facility

$23.00

Hospital Charge Code	60634728
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

HABITROL/14MG/24H

Facility

$23.00

Hospital Charge Code	60634728
Hospital Revenue Code	250
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$6.90
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Oxford Commercial	$11.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$11.50

HABITROL 14 PATCH

Facility

$5.00

Hospital Charge Code	60635181
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

HABITROL 14 PATCH

Facility

$5.00

Hospital Charge Code	60635181
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

HABITROL/21MG/24H

Facility

$23.00

Hospital Charge Code	60634729
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

HABITROL/21MG/24H

Facility

$23.00

Hospital Charge Code	60634729
Hospital Revenue Code	250
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$6.90
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Oxford Commercial	$11.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$11.50

HABITROL 21 PATCH

Facility

$5.00

Hospital Charge Code	60635182
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

HABITROL 21 PATCH

Facility

$5.00

Hospital Charge Code	60635182
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

HABITROL/7MG/24H

Facility

$23.00

Hospital Charge Code	60634730
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

HABITROL/7MG/24H

Facility

$23.00

Hospital Charge Code	60634730
Hospital Revenue Code	250
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$6.90
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Oxford Commercial	$11.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$11.50

HABITROL 7 PATCH

Facility

$5.00

Hospital Charge Code	60635180
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

HABITROL 7 PATCH

Facility

$5.00

Hospital Charge Code	60635180
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

HAEMOP FLUB PRP-T CONJ VAC 4DS

Facility

$72.03

Service Code	HCPCS 90648
Hospital Charge Code	606390467
Hospital Revenue Code	636
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$36.02
Rate for Payer: Aetna Commercial	$21.61
Rate for Payer: Aetna Medicare Advantage	$21.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.37
Rate for Payer: Cigna Commercial	$36.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.43
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

HAEMOP FLUB PRP-T CONJ VAC 4DS

Facility

$72.03

Service Code	HCPCS 90648
Hospital Charge Code	606390467
Hospital Revenue Code	636
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$17.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.43
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

HAEMOPHILS INFL-TYPE B 0.5ML**

Facility

$64.00

Service Code	HCPCS 90721
Hospital Charge Code	6017727
Hospital Revenue Code	259
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

HAEMOPHILS INFL-TYPE B 0.5ML**

Facility

$64.00

Service Code	HCPCS 90721
Hospital Charge Code	6017727
Hospital Revenue Code	259
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$19.20
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.32
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$32.00

HAEMOPHILUS B CONJUGATE VACCIN

Facility

$714.10

Service Code	HCPCS 90645
Hospital Charge Code	60630032
Hospital Revenue Code	636
Min. Negotiated Rate	$107.11
Max. Negotiated Rate	$172.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.81
Rate for Payer: Qualcare PPO/HMO/WC	$107.11

HAEMOPHILUS B CONJUGATE VACCIN

Facility

$714.10

Service Code	HCPCS 90645
Hospital Charge Code	60630032
Hospital Revenue Code	636
Min. Negotiated Rate	$107.11
Max. Negotiated Rate	$357.05
Rate for Payer: Aetna Commercial	$214.23
Rate for Payer: Aetna Medicare Advantage	$214.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.10
Rate for Payer: Cigna Commercial	$357.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.81
Rate for Payer: Qualcare PPO/HMO/WC	$107.11

HAEMOPHILUS B (PEDVAXHIB) 7.5

Facility

$105.36

Service Code	HCPCS 90647
Hospital Charge Code	60630158
Hospital Revenue Code	636
Min. Negotiated Rate	$15.80
Max. Negotiated Rate	$25.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$15.80

HAEMOPHILUS B (PEDVAXHIB) 7.5

Facility

$105.36

Service Code	HCPCS 90647
Hospital Charge Code	60630158
Hospital Revenue Code	636
Min. Negotiated Rate	$15.80
Max. Negotiated Rate	$52.68
Rate for Payer: Aetna Commercial	$31.61
Rate for Payer: Aetna Medicare Advantage	$31.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.87
Rate for Payer: Cigna Commercial	$52.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$15.80

HAEMOPHILUS B VACCINE

Facility

$273.00

Service Code	HCPCS 90737
Hospital Charge Code	60628302
Hospital Revenue Code	259
Min. Negotiated Rate	$35.49
Max. Negotiated Rate	$136.50
Rate for Payer: Aetna Commercial	$81.90
Rate for Payer: Aetna Medicare Advantage	$81.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.61
Rate for Payer: Cigna Commercial	$136.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.49
Rate for Payer: Oxford Commercial	$136.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.95
Rate for Payer: UnitedHealthcare Commercial	$136.50

HAEMOPHILUS B VACCINE

Facility

$273.00

Service Code	HCPCS 90737
Hospital Charge Code	60628302
Hospital Revenue Code	259
Min. Negotiated Rate	$40.95
Max. Negotiated Rate	$40.95
Rate for Payer: Qualcare PPO/HMO/WC	$40.95

HAIR REDCN LIP,CHIN,NECK,CHEEK

Facility

$623.14

Service Code	HCPCS 17380
Hospital Charge Code	75190095
Hospital Revenue Code	510
Min. Negotiated Rate	$93.47
Max. Negotiated Rate	$93.47
Rate for Payer: Qualcare PPO/HMO/WC	$93.47

HAIR REDCN LIP,CHIN,NECK,CHEEK

Facility

$623.14

Service Code	HCPCS 17380
Hospital Charge Code	75190095
Hospital Revenue Code	510
Min. Negotiated Rate	$16.70
Max. Negotiated Rate	$1,760.02
Rate for Payer: Aetna Commercial	$186.94
Rate for Payer: Aetna Medicare Advantage	$186.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$158.90
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.01
Rate for Payer: Qualcare PPO/HMO/WC	$93.47

HALCION

Facility

$181.65

Service Code	HCPCS 80346
Hospital Charge Code	3031507
Hospital Revenue Code	301
Min. Negotiated Rate	$23.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.49
Rate for Payer: Aetna Medicare Advantage	$54.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.32
Rate for Payer: Cigna Commercial	$90.83
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

Know your out-of-pocket cost for care.

All Charges