Heights University Hospital

All Charges

Charge

Type

Setting

Price

HYDROCORT DIBUCNE REC CRM 28GM

Facility

$53.80

Hospital Charge Code	6002968
Hospital Revenue Code	251
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

HYDROCORT ENEMA 100MG/60ML

Facility

$48.00

Hospital Charge Code	6002927
Hospital Revenue Code	251
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

HYDROCORT ENEMA 100MG/60ML

Facility

$81.20

Service Code	NDC 51991072867
Hospital Charge Code	60628393
Hospital Revenue Code	250
Min. Negotiated Rate	$12.18
Max. Negotiated Rate	$12.18
Rate for Payer: Qualcare PPO/HMO/WC	$12.18

HYDROCORT ENEMA 100MG/60ML

Facility

$81.20

Service Code	NDC 51991072867
Hospital Charge Code	60628393
Hospital Revenue Code	250
Min. Negotiated Rate	$10.56
Max. Negotiated Rate	$40.60
Rate for Payer: Aetna Commercial	$24.36
Rate for Payer: Aetna Medicare Advantage	$24.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.71
Rate for Payer: Cigna Commercial	$40.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.56
Rate for Payer: Oxford Commercial	$40.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.18
Rate for Payer: UnitedHealthcare Commercial	$40.60

HYDROCORT ENEMA 100MG/60ML

Facility

$48.00

Hospital Charge Code	6002927
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

HYDROCORT HEMORR CRM 28GM

Facility

$64.00

Hospital Charge Code	6002844
Hospital Revenue Code	251
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

HYDROCORT HEMORR CRM 28GM

Facility

$64.00

Hospital Charge Code	6002844
Hospital Revenue Code	251
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

HYDROCORT INJ 125MG/ML

Facility

$10.90

Hospital Charge Code	6002919
Hospital Revenue Code	250
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

HYDROCORT INJ 125MG/ML

Facility

$10.90

Hospital Charge Code	6002919
Hospital Revenue Code	250
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$5.45
Rate for Payer: Aetna Commercial	$3.27
Rate for Payer: Aetna Medicare Advantage	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.78
Rate for Payer: Cigna Commercial	$5.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.42
Rate for Payer: Oxford Commercial	$5.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Commercial	$5.45

HYDROCORT INJ 50MG/ML 2ML

Facility

$15.40

Hospital Charge Code	6002901
Hospital Revenue Code	250
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$7.70
Rate for Payer: Aetna Commercial	$4.62
Rate for Payer: Aetna Medicare Advantage	$4.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.93
Rate for Payer: Cigna Commercial	$7.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.00
Rate for Payer: Oxford Commercial	$7.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.31
Rate for Payer: UnitedHealthcare Commercial	$7.70

HYDROCORT INJ 50MG/ML 2ML

Facility

$15.40

Hospital Charge Code	6002901
Hospital Revenue Code	250
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$2.31
Rate for Payer: Qualcare PPO/HMO/WC	$2.31

HYDROCORT IODOQUINOL CRM

Facility

$136.85

Hospital Charge Code	6002976
Hospital Revenue Code	252
Min. Negotiated Rate	$17.79
Max. Negotiated Rate	$68.42
Rate for Payer: Aetna Commercial	$41.05
Rate for Payer: Aetna Medicare Advantage	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.90
Rate for Payer: Cigna Commercial	$68.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.79
Rate for Payer: Oxford Commercial	$68.42
Rate for Payer: Qualcare PPO/HMO/WC	$20.53
Rate for Payer: UnitedHealthcare Commercial	$68.42

HYDROCORT IODOQUINOL CRM

Facility

$136.85

Hospital Charge Code	6002976
Hospital Revenue Code	252
Min. Negotiated Rate	$20.53
Max. Negotiated Rate	$20.53
Rate for Payer: Qualcare PPO/HMO/WC	$20.53

HYDROCORTISONE 0.5%/30GM

Facility

$9.00

Hospital Charge Code	60633118
Hospital Revenue Code	250
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

HYDROCORTISONE 0.5%/30GM

Facility

$9.00

Hospital Charge Code	60633118
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

HYDROCORTISONE 0.5 % OIN

Facility

$26.53

Service Code	NDC 168001631
Hospital Charge Code	60628389
Hospital Revenue Code	250
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$3.98
Rate for Payer: Qualcare PPO/HMO/WC	$3.98

HYDROCORTISONE 0.5 % OIN

Facility

$26.53

Service Code	NDC 168001631
Hospital Charge Code	60628389
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$13.27
Rate for Payer: Aetna Commercial	$7.96
Rate for Payer: Aetna Medicare Advantage	$7.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.77
Rate for Payer: Cigna Commercial	$13.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.45
Rate for Payer: Oxford Commercial	$13.27
Rate for Payer: Qualcare PPO/HMO/WC	$3.98
Rate for Payer: UnitedHealthcare Commercial	$13.27

HYDROCORTISONE 100 MG INJ

Facility

$59.97

Service Code	HCPCS J1720
Hospital Charge Code	60628196
Hospital Revenue Code	636
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$22.14
Rate for Payer: Aetna Commercial	$17.99
Rate for Payer: Aetna Medicare Advantage	$17.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.29
Rate for Payer: Cigna Commercial	$22.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.51
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

HYDROCORTISONE 100 MG INJ

Facility

$59.97

Service Code	HCPCS J1720
Hospital Charge Code	60628196
Hospital Revenue Code	636
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$14.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.51
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

HYDROCORTISONE 10 MG TAB

Facility

$7.30

Service Code	NDC 9003101
Hospital Charge Code	60628194
Hospital Revenue Code	250
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$3.65
Rate for Payer: Aetna Commercial	$2.19
Rate for Payer: Aetna Medicare Advantage	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.86
Rate for Payer: Cigna Commercial	$3.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.95
Rate for Payer: Oxford Commercial	$3.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$3.65

HYDROCORTISONE 10 MG TAB

Facility

$7.30

Service Code	NDC 9003101
Hospital Charge Code	60628194
Hospital Revenue Code	250
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

HYDROCORTISONE 1%/30GM

Facility

$12.00

Hospital Charge Code	60633119
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

HYDROCORTISONE 1%/30GM

Facility

$12.00

Hospital Charge Code	60633119
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

HYDROCORTISONE 1% CREAM

Facility

$45.76

Service Code	NDC 472032126
Hospital Charge Code	60628390
Hospital Revenue Code	250
Min. Negotiated Rate	$6.86
Max. Negotiated Rate	$6.86
Rate for Payer: Qualcare PPO/HMO/WC	$6.86

HYDROCORTISONE 1% CREAM

Facility

$45.76

Service Code	NDC 472032126
Hospital Charge Code	60628390
Hospital Revenue Code	250
Min. Negotiated Rate	$5.95
Max. Negotiated Rate	$22.88
Rate for Payer: Aetna Commercial	$13.73
Rate for Payer: Aetna Medicare Advantage	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.67
Rate for Payer: Cigna Commercial	$22.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.95
Rate for Payer: Oxford Commercial	$22.88
Rate for Payer: Qualcare PPO/HMO/WC	$6.86
Rate for Payer: UnitedHealthcare Commercial	$22.88

Know your out-of-pocket cost for care.

All Charges