Heights University Hospital

All Charges

Charge

Type

Setting

Price

HYDROCORT SOD SUC INJ 250MG

Facility

$51.20

Hospital Charge Code	60628197
Hospital Revenue Code	250
Min. Negotiated Rate	$7.68
Max. Negotiated Rate	$7.68
Rate for Payer: Qualcare PPO/HMO/WC	$7.68

HYDROCORT SOD SUC INJ 250MG

Facility

$51.20

Hospital Charge Code	60628197
Hospital Revenue Code	250
Min. Negotiated Rate	$6.66
Max. Negotiated Rate	$25.60
Rate for Payer: Aetna Commercial	$15.36
Rate for Payer: Aetna Medicare Advantage	$15.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.06
Rate for Payer: Cigna Commercial	$25.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.66
Rate for Payer: Oxford Commercial	$25.60
Rate for Payer: Qualcare PPO/HMO/WC	$7.68
Rate for Payer: UnitedHealthcare Commercial	$25.60

HYDROCORT SOD SUC INJ 500MG

Facility

$121.00

Hospital Charge Code	60628198
Hospital Revenue Code	250
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

HYDROCORT SOD SUC INJ 500MG

Facility

$121.00

Hospital Charge Code	60628198
Hospital Revenue Code	250
Min. Negotiated Rate	$15.73
Max. Negotiated Rate	$60.50
Rate for Payer: Aetna Commercial	$36.30
Rate for Payer: Aetna Medicare Advantage	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.86
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.73
Rate for Payer: Oxford Commercial	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$60.50

HYDROCORT VALERATE .2% 60GM

Facility

$215.05

Hospital Charge Code	6008650
Hospital Revenue Code	251
Min. Negotiated Rate	$27.96
Max. Negotiated Rate	$107.53
Rate for Payer: Aetna Commercial	$64.52
Rate for Payer: Aetna Medicare Advantage	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.84
Rate for Payer: Cigna Commercial	$107.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.96
Rate for Payer: Oxford Commercial	$107.53
Rate for Payer: Qualcare PPO/HMO/WC	$32.26
Rate for Payer: UnitedHealthcare Commercial	$107.53

HYDROCORT VALERATE .2% 60GM

Facility

$215.05

Hospital Charge Code	6008650
Hospital Revenue Code	251
Min. Negotiated Rate	$32.26
Max. Negotiated Rate	$32.26
Rate for Payer: Qualcare PPO/HMO/WC	$32.26

HYDRO DISSECTION SUCTION

Facility

$372.52

Hospital Charge Code	270650793
Hospital Revenue Code	272
Min. Negotiated Rate	$55.88
Max. Negotiated Rate	$55.88
Rate for Payer: Qualcare PPO/HMO/WC	$55.88

HYDRO DISSECTION SUCTION

Facility

$372.52

Hospital Charge Code	270650793
Hospital Revenue Code	272
Min. Negotiated Rate	$48.43
Max. Negotiated Rate	$186.26
Rate for Payer: Aetna Commercial	$111.76
Rate for Payer: Aetna Medicare Advantage	$111.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.99
Rate for Payer: Cigna Commercial	$186.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.43
Rate for Payer: Oxford Commercial	$186.26
Rate for Payer: Qualcare PPO/HMO/WC	$55.88
Rate for Payer: UnitedHealthcare Commercial	$186.26

HYDROFLEX HD HYSTER DIST TUBIN

Facility

$125.00

Hospital Charge Code	270339089
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

HYDROFLEX HD HYSTER DIST TUBIN

Facility

$125.00

Hospital Charge Code	270339089
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

HYDROGEL SKINTEGRITY 1 OZ

Facility

$5.19

Hospital Charge Code	270350290
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$2.60
Rate for Payer: Aetna Commercial	$1.56
Rate for Payer: Aetna Medicare Advantage	$1.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.32
Rate for Payer: Cigna Commercial	$2.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.67
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.78
Rate for Payer: UnitedHealthcare Commercial	$2.60

HYDROGEL SKINTEGRITY 1 OZ

Facility

$5.19

Hospital Charge Code	270350290
Hospital Revenue Code	272
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$0.78
Rate for Payer: Qualcare PPO/HMO/WC	$0.78

HYDROGEL WOUND DRESSING 8G

Facility

$30.10

Hospital Charge Code	60628890
Hospital Revenue Code	250
Min. Negotiated Rate	$3.91
Max. Negotiated Rate	$15.05
Rate for Payer: Aetna Commercial	$9.03
Rate for Payer: Aetna Medicare Advantage	$9.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.68
Rate for Payer: Cigna Commercial	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.91
Rate for Payer: Oxford Commercial	$15.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.51
Rate for Payer: UnitedHealthcare Commercial	$15.05

HYDROGEL WOUND DRESSING 8G

Facility

$30.10

Hospital Charge Code	60628890
Hospital Revenue Code	250
Min. Negotiated Rate	$4.51
Max. Negotiated Rate	$4.51
Rate for Payer: Qualcare PPO/HMO/WC	$4.51

HYDROGEN PEROXIDE 3% PINT

Facility

$3.85

Hospital Charge Code	6014096
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

HYDROGEN PEROXIDE 3% PINT

Facility

$3.85

Hospital Charge Code	6014096
Hospital Revenue Code	250
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.16
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.50
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$1.93

HYDROGEN PEROXIDE 3% SOLN

Facility

$105.26

Service Code	NDC 49348003138
Hospital Charge Code	60628351
Hospital Revenue Code	250
Min. Negotiated Rate	$13.68
Max. Negotiated Rate	$52.63
Rate for Payer: Aetna Commercial	$31.58
Rate for Payer: Aetna Medicare Advantage	$31.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.84
Rate for Payer: Cigna Commercial	$52.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.68
Rate for Payer: Oxford Commercial	$52.63
Rate for Payer: Qualcare PPO/HMO/WC	$15.79
Rate for Payer: UnitedHealthcare Commercial	$52.63

HYDROGEN PEROXIDE 3% SOLN

Facility

$105.26

Service Code	NDC 49348003138
Hospital Charge Code	60628351
Hospital Revenue Code	250
Min. Negotiated Rate	$15.79
Max. Negotiated Rate	$15.79
Rate for Payer: Qualcare PPO/HMO/WC	$15.79

HYDROGLIDE WIRE

Facility

$73.50

Hospital Charge Code	270702095
Hospital Revenue Code	278
Min. Negotiated Rate	$11.03
Max. Negotiated Rate	$36.75
Rate for Payer: Aetna Commercial	$22.05
Rate for Payer: Aetna Medicare Advantage	$22.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.74
Rate for Payer: Cigna Commercial	$36.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.79
Rate for Payer: Qualcare PPO/HMO/WC	$11.03

HYDROGLIDE WIRE

Facility

$73.50

Hospital Charge Code	270702095
Hospital Revenue Code	278
Min. Negotiated Rate	$11.03
Max. Negotiated Rate	$17.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.79
Rate for Payer: Qualcare PPO/HMO/WC	$11.03

HYDROLYSATE COLLAGEN WND FILL

Facility

$4,251.25

Service Code	HCPCS A6010
Hospital Charge Code	270695509
Hospital Revenue Code	272
Min. Negotiated Rate	$637.69
Max. Negotiated Rate	$637.69
Rate for Payer: Qualcare PPO/HMO/WC	$637.69

HYDROLYSATE COLLAGEN WND FILL

Facility

$4,251.25

Service Code	HCPCS A6010
Hospital Charge Code	270695509
Hospital Revenue Code	272
Min. Negotiated Rate	$26.48
Max. Negotiated Rate	$2,125.62
Rate for Payer: Aetna Commercial	$1,275.38
Rate for Payer: Aetna Medicare Advantage	$1,275.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,084.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,084.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,084.07
Rate for Payer: Cigna Commercial	$44.14
Rate for Payer: Cigna Medicare Advantage	$26.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.66
Rate for Payer: Oxford Commercial	$2,125.62
Rate for Payer: Qualcare PPO/HMO/WC	$637.69
Rate for Payer: UnitedHealthcare Commercial	$2,125.62

HYDROMORPHONE 0.2 MG/ML (25ML)

Facility

$84.82

Service Code	HCPCS J1171
Hospital Charge Code	60629207
Hospital Revenue Code	636
Min. Negotiated Rate	$12.72
Max. Negotiated Rate	$20.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.53
Rate for Payer: Qualcare PPO/HMO/WC	$12.72

HYDROMORPHONE 0.2 MG/ML (25ML)

Facility

$84.82

Service Code	HCPCS J1171
Hospital Charge Code	60629207
Hospital Revenue Code	636
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$25.45
Rate for Payer: Aetna Commercial	$25.45
Rate for Payer: Aetna Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.63
Rate for Payer: Cigna Commercial	$0.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.53
Rate for Payer: Qualcare PPO/HMO/WC	$12.72

HYDROMORPHONE 0.2 MG/ML PCA

Facility

$67.00

Service Code	HCPCS J1171
Hospital Charge Code	6063943360
Hospital Revenue Code	636
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$20.10
Rate for Payer: Aetna Commercial	$20.10
Rate for Payer: Aetna Medicare Advantage	$20.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.09
Rate for Payer: Cigna Commercial	$0.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.21
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

Know your out-of-pocket cost for care.

All Charges