Heights University Hospital

All Charges

Charge

Type

Setting

Price

HALOPERIDOL INTENSOL ORAL120ML

Facility

$131.85

Hospital Charge Code	6016190
Hospital Revenue Code	251
Min. Negotiated Rate	$17.14
Max. Negotiated Rate	$65.92
Rate for Payer: Aetna Commercial	$39.55
Rate for Payer: Aetna Medicare Advantage	$39.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.62
Rate for Payer: Cigna Commercial	$65.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.14
Rate for Payer: Oxford Commercial	$65.92
Rate for Payer: Qualcare PPO/HMO/WC	$19.78
Rate for Payer: UnitedHealthcare Commercial	$65.92

HALOPERIDOL INTENSOL ORAL120ML

Facility

$131.85

Hospital Charge Code	6016190
Hospital Revenue Code	251
Min. Negotiated Rate	$19.78
Max. Negotiated Rate	$19.78
Rate for Payer: Qualcare PPO/HMO/WC	$19.78

HALOPERIDOL (QUANT SERUM)

Facility

$244.85

Service Code	HCPCS 80173
Hospital Charge Code	3007424
Hospital Revenue Code	301
Min. Negotiated Rate	$7.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$51.13
Rate for Payer: Aetna Medicare Advantage	$15.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.82
Rate for Payer: Cigna Commercial	$15.78
Rate for Payer: Cigna Medicare Advantage	$7.89
Rate for Payer: Clover Medicare Advantage	$14.99
Rate for Payer: EmblemHealth Commercial	$47.34
Rate for Payer: Humana Medicare Advantage	$16.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.73
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.73
Rate for Payer: Wellcare Medicare Advantage	$15.78

HALOPERIDOL (QUANT SERUM)

Facility

$244.85

Service Code	HCPCS 80173
Hospital Charge Code	3007424
Hospital Revenue Code	301
Min. Negotiated Rate	$36.73
Max. Negotiated Rate	$36.73
Rate for Payer: Qualcare PPO/HMO/WC	$36.73

HALOPERIDOL TAB 2MG

Facility

$1.95

Hospital Charge Code	6022511
Hospital Revenue Code	251
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

HALOPERIDOL TAB 2MG

Facility

$1.95

Hospital Charge Code	6022511
Hospital Revenue Code	251
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.98
Rate for Payer: Aetna Commercial	$0.59
Rate for Payer: Aetna Medicare Advantage	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.50
Rate for Payer: Cigna Commercial	$0.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.25
Rate for Payer: Oxford Commercial	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.29
Rate for Payer: UnitedHealthcare Commercial	$0.98

HALOPERIDOL VIAL 5MG

Facility

$37.80

Hospital Charge Code	6012587
Hospital Revenue Code	250
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$5.67
Rate for Payer: Qualcare PPO/HMO/WC	$5.67

HALOPERIDOL VIAL 5MG

Facility

$37.80

Hospital Charge Code	6012587
Hospital Revenue Code	250
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$18.90
Rate for Payer: Aetna Commercial	$11.34
Rate for Payer: Aetna Medicare Advantage	$11.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.64
Rate for Payer: Cigna Commercial	$18.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.91
Rate for Payer: Oxford Commercial	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$5.67
Rate for Payer: UnitedHealthcare Commercial	$18.90

HALOTESTIN/10MG/TAB

Facility

$8.00

Hospital Charge Code	60633078
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

HALOTESTIN/10MG/TAB

Facility

$8.00

Hospital Charge Code	60633078
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

HALOTHANE 100% GAS

Facility

$446.45

Hospital Charge Code	60627668
Hospital Revenue Code	250
Min. Negotiated Rate	$58.04
Max. Negotiated Rate	$223.22
Rate for Payer: Aetna Commercial	$133.94
Rate for Payer: Aetna Medicare Advantage	$133.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.84
Rate for Payer: Cigna Commercial	$223.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.04
Rate for Payer: Oxford Commercial	$223.22
Rate for Payer: Qualcare PPO/HMO/WC	$66.97
Rate for Payer: UnitedHealthcare Commercial	$223.22

HALOTHANE 100% GAS

Facility

$446.45

Hospital Charge Code	60627668
Hospital Revenue Code	250
Min. Negotiated Rate	$66.97
Max. Negotiated Rate	$66.97
Rate for Payer: Qualcare PPO/HMO/WC	$66.97

HALOTHANE/125ML

Facility

$122.00

Hospital Charge Code	60634824
Hospital Revenue Code	250
Min. Negotiated Rate	$15.86
Max. Negotiated Rate	$61.00
Rate for Payer: Aetna Commercial	$36.60
Rate for Payer: Aetna Medicare Advantage	$36.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.11
Rate for Payer: Cigna Commercial	$61.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.86
Rate for Payer: Oxford Commercial	$61.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.30
Rate for Payer: UnitedHealthcare Commercial	$61.00

HALOTHANE/125ML

Facility

$122.00

Hospital Charge Code	60634824
Hospital Revenue Code	250
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$18.30
Rate for Payer: Qualcare PPO/HMO/WC	$18.30

HALOTHANE GAS INTERMED 3-6HRS

Facility

$268.20

Hospital Charge Code	6010425
Hospital Revenue Code	250
Min. Negotiated Rate	$34.87
Max. Negotiated Rate	$134.10
Rate for Payer: Aetna Commercial	$80.46
Rate for Payer: Aetna Medicare Advantage	$80.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.39
Rate for Payer: Cigna Commercial	$134.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.87
Rate for Payer: Oxford Commercial	$134.10
Rate for Payer: Qualcare PPO/HMO/WC	$40.23
Rate for Payer: UnitedHealthcare Commercial	$134.10

HALOTHANE GAS INTERMED 3-6HRS

Facility

$268.20

Hospital Charge Code	6010425
Hospital Revenue Code	250
Min. Negotiated Rate	$40.23
Max. Negotiated Rate	$40.23
Rate for Payer: Qualcare PPO/HMO/WC	$40.23

HALOTHANE GAS LONG 250ML 6+HRS

Facility

$718.10

Hospital Charge Code	6009385
Hospital Revenue Code	250
Min. Negotiated Rate	$93.35
Max. Negotiated Rate	$359.05
Rate for Payer: Aetna Commercial	$215.43
Rate for Payer: Aetna Medicare Advantage	$215.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.12
Rate for Payer: Cigna Commercial	$359.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.35
Rate for Payer: Oxford Commercial	$359.05
Rate for Payer: Qualcare PPO/HMO/WC	$107.72
Rate for Payer: UnitedHealthcare Commercial	$359.05

HALOTHANE GAS LONG 250ML 6+HRS

Facility

$718.10

Hospital Charge Code	6009385
Hospital Revenue Code	250
Min. Negotiated Rate	$107.72
Max. Negotiated Rate	$107.72
Rate for Payer: Qualcare PPO/HMO/WC	$107.72

HALOTHANE GAS SHORT 0-3 HOURS

Facility

$136.35

Hospital Charge Code	6010433
Hospital Revenue Code	250
Min. Negotiated Rate	$17.73
Max. Negotiated Rate	$68.17
Rate for Payer: Aetna Commercial	$40.91
Rate for Payer: Aetna Medicare Advantage	$40.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.77
Rate for Payer: Cigna Commercial	$68.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.73
Rate for Payer: Oxford Commercial	$68.17
Rate for Payer: Qualcare PPO/HMO/WC	$20.45
Rate for Payer: UnitedHealthcare Commercial	$68.17

HALOTHANE GAS SHORT 0-3 HOURS

Facility

$136.35

Hospital Charge Code	6010433
Hospital Revenue Code	250
Min. Negotiated Rate	$20.45
Max. Negotiated Rate	$20.45
Rate for Payer: Qualcare PPO/HMO/WC	$20.45

HALOTHANE INJ 125MG

Facility

$141.00

Hospital Charge Code	60635256
Hospital Revenue Code	250
Min. Negotiated Rate	$21.15
Max. Negotiated Rate	$21.15
Rate for Payer: Qualcare PPO/HMO/WC	$21.15

HALOTHANE INJ 125MG

Facility

$141.00

Hospital Charge Code	60635256
Hospital Revenue Code	250
Min. Negotiated Rate	$18.33
Max. Negotiated Rate	$70.50
Rate for Payer: Aetna Commercial	$42.30
Rate for Payer: Aetna Medicare Advantage	$42.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.95
Rate for Payer: Cigna Commercial	$70.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.33
Rate for Payer: Oxford Commercial	$70.50
Rate for Payer: Qualcare PPO/HMO/WC	$21.15
Rate for Payer: UnitedHealthcare Commercial	$70.50

HALTER CERVICAL HEAD*****

Facility

$11.00

Hospital Charge Code	8004285
Hospital Revenue Code	279
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

HALTER CERVICAL HEAD*****

Facility

$11.00

Hospital Charge Code	8004285
Hospital Revenue Code	279
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$5.50
Rate for Payer: Aetna Commercial	$3.30
Rate for Payer: Aetna Medicare Advantage	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.81
Rate for Payer: Cigna Commercial	$5.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.43
Rate for Payer: Oxford Commercial	$5.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.65
Rate for Payer: UnitedHealthcare Commercial	$5.50

HALTER CHIN

Facility

$16.85

Hospital Charge Code	270606680
Hospital Revenue Code	270
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$5.05
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.19
Rate for Payer: Oxford Commercial	$8.43
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$8.43

Know your out-of-pocket cost for care.

All Charges