Heights University Hospital

All Charges

Charge

Type

Setting

Price

HYDROCORTISONE 1% OIN

Facility

$32.16

Service Code	NDC 168018131
Hospital Charge Code	60628392
Hospital Revenue Code	250
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$16.08
Rate for Payer: Aetna Commercial	$9.65
Rate for Payer: Aetna Medicare Advantage	$9.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.20
Rate for Payer: Cigna Commercial	$16.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.18
Rate for Payer: Oxford Commercial	$16.08
Rate for Payer: Qualcare PPO/HMO/WC	$4.82
Rate for Payer: UnitedHealthcare Commercial	$16.08

HYDROCORTISONE 1% OIN

Facility

$32.16

Service Code	NDC 168018131
Hospital Charge Code	60628392
Hospital Revenue Code	250
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$4.82
Rate for Payer: Qualcare PPO/HMO/WC	$4.82

HYDROCORTISONE 1% PACKETS

Facility

$3.00

Hospital Charge Code	60634961
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

HYDROCORTISONE 1% PACKETS

Facility

$3.00

Hospital Charge Code	60634961
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

HYDROCORTISONE 20 MG TAB

Facility

$7.30

Service Code	NDC 54505033310
Hospital Charge Code	60628813
Hospital Revenue Code	250
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

HYDROCORTISONE 20 MG TAB

Facility

$7.30

Service Code	NDC 54505033310
Hospital Charge Code	60628813
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/20MG/TAB

Facility

$3.00

Hospital Charge Code	60633117
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

HYDROCORTISONE/20MG/TAB

Facility

$3.00

Hospital Charge Code	60633117
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

HYDROCORTISONE 2.5%/20GM

Facility

$23.00

Hospital Charge Code	60633120
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

HYDROCORTISONE 2.5%/20GM

Facility

$23.00

Hospital Charge Code	60633120
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

HYDROCORTISONE 2.5%/30GM

Facility

$27.00

Hospital Charge Code	60633121
Hospital Revenue Code	250
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$8.10
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.51
Rate for Payer: Oxford Commercial	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$13.50

HYDROCORTISONE 2.5%/30GM

Facility

$27.00

Hospital Charge Code	60633121
Hospital Revenue Code	250
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

HYDROCORTISONE 2.5% CREAM

Facility

$32.83

Service Code	NDC 45802000402
Hospital Charge Code	6063943316
Hospital Revenue Code	250
Min. Negotiated Rate	$4.92
Max. Negotiated Rate	$4.92
Rate for Payer: Qualcare PPO/HMO/WC	$4.92

HYDROCORTISONE 2.5% CREAM

Facility

$32.83

Service Code	NDC 45802000402
Hospital Charge Code	6063943316
Hospital Revenue Code	250
Min. Negotiated Rate	$4.27
Max. Negotiated Rate	$16.41
Rate for Payer: Aetna Commercial	$9.85
Rate for Payer: Aetna Medicare Advantage	$9.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.37
Rate for Payer: Cigna Commercial	$16.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.27
Rate for Payer: Oxford Commercial	$16.41
Rate for Payer: Qualcare PPO/HMO/WC	$4.92
Rate for Payer: UnitedHealthcare Commercial	$16.41

HYDROCORTISONE 2.5% LOTION

Facility

$348.60

Service Code	NDC 168028802
Hospital Charge Code	6063943112
Hospital Revenue Code	250
Min. Negotiated Rate	$52.29
Max. Negotiated Rate	$52.29
Rate for Payer: Qualcare PPO/HMO/WC	$52.29

HYDROCORTISONE 2.5% LOTION

Facility

$348.60

Service Code	NDC 168028802
Hospital Charge Code	6063943112
Hospital Revenue Code	250
Min. Negotiated Rate	$45.32
Max. Negotiated Rate	$174.30
Rate for Payer: Aetna Commercial	$104.58
Rate for Payer: Aetna Medicare Advantage	$104.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.89
Rate for Payer: Cigna Commercial	$174.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.32
Rate for Payer: Oxford Commercial	$174.30
Rate for Payer: Qualcare PPO/HMO/WC	$52.29
Rate for Payer: UnitedHealthcare Commercial	$174.30

HYDROCORTISONE 25 MG SUPP

Facility

$64.72

Service Code	NDC 65649041124
Hospital Charge Code	60628397
Hospital Revenue Code	250
Min. Negotiated Rate	$9.71
Max. Negotiated Rate	$9.71
Rate for Payer: Qualcare PPO/HMO/WC	$9.71

HYDROCORTISONE 25 MG SUPP

Facility

$64.72

Service Code	NDC 65649041124
Hospital Charge Code	60628397
Hospital Revenue Code	250
Min. Negotiated Rate	$8.41
Max. Negotiated Rate	$32.36
Rate for Payer: Aetna Commercial	$19.42
Rate for Payer: Aetna Medicare Advantage	$19.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.50
Rate for Payer: Cigna Commercial	$32.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.41
Rate for Payer: Oxford Commercial	$32.36
Rate for Payer: Qualcare PPO/HMO/WC	$9.71
Rate for Payer: UnitedHealthcare Commercial	$32.36

HYDROCORTISONE 2.5% OIN

Facility

$77.99

Service Code	NDC 168014630
Hospital Charge Code	60628396
Hospital Revenue Code	250
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$11.70
Rate for Payer: Qualcare PPO/HMO/WC	$11.70

HYDROCORTISONE 2.5% OIN

Facility

$77.99

Service Code	NDC 168014630
Hospital Charge Code	60628396
Hospital Revenue Code	250
Min. Negotiated Rate	$10.14
Max. Negotiated Rate	$38.99
Rate for Payer: Aetna Commercial	$23.40
Rate for Payer: Aetna Medicare Advantage	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.89
Rate for Payer: Cigna Commercial	$38.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.14
Rate for Payer: Oxford Commercial	$38.99
Rate for Payer: Qualcare PPO/HMO/WC	$11.70
Rate for Payer: UnitedHealthcare Commercial	$38.99

HYDROCORTISONE 2.5% OINT

Facility

$33.23

Service Code	NDC 45802001402
Hospital Charge Code	60635805
Hospital Revenue Code	250
Min. Negotiated Rate	$4.98
Max. Negotiated Rate	$4.98
Rate for Payer: Qualcare PPO/HMO/WC	$4.98

HYDROCORTISONE 2.5% OINT

Facility

$33.23

Service Code	NDC 45802001402
Hospital Charge Code	60635805
Hospital Revenue Code	250
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$16.61
Rate for Payer: Aetna Commercial	$9.97
Rate for Payer: Aetna Medicare Advantage	$9.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.47
Rate for Payer: Cigna Commercial	$16.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.32
Rate for Payer: Oxford Commercial	$16.61
Rate for Payer: Qualcare PPO/HMO/WC	$4.98
Rate for Payer: UnitedHealthcare Commercial	$16.61

HYDROCORTISONE 5 MG TAB

Facility

$4.36

Service Code	NDC 9001201
Hospital Charge Code	60628195
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$0.65
Rate for Payer: Qualcare PPO/HMO/WC	$0.65

HYDROCORTISONE 5 MG TAB

Facility

$4.36

Service Code	NDC 9001201
Hospital Charge Code	60628195
Hospital Revenue Code	250
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$2.18
Rate for Payer: Aetna Commercial	$1.31
Rate for Payer: Aetna Medicare Advantage	$1.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.11
Rate for Payer: Cigna Commercial	$2.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.57
Rate for Payer: Oxford Commercial	$2.18
Rate for Payer: Qualcare PPO/HMO/WC	$0.65
Rate for Payer: UnitedHealthcare Commercial	$2.18

HYDROCORTISONE OINT 0.2%/15GM

Facility

$659.28

Service Code	NDC 45802045535
Hospital Charge Code	60628866
Hospital Revenue Code	250
Min. Negotiated Rate	$98.89
Max. Negotiated Rate	$98.89
Rate for Payer: Qualcare PPO/HMO/WC	$98.89

Know your out-of-pocket cost for care.

All Charges