Heights University Hospital

All Charges

Charge

Type

Setting

Price

HYOSCYAMINE INJ 0.5MG/ML

Facility

$66.60

Hospital Charge Code	60627435
Hospital Revenue Code	250
Min. Negotiated Rate	$8.66
Max. Negotiated Rate	$33.30
Rate for Payer: Aetna Commercial	$19.98
Rate for Payer: Aetna Medicare Advantage	$19.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.98
Rate for Payer: Cigna Commercial	$33.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.66
Rate for Payer: Oxford Commercial	$33.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.99
Rate for Payer: UnitedHealthcare Commercial	$33.30

HYOSCYAMINE INJ 0.5MG/ML

Facility

$66.60

Hospital Charge Code	60627435
Hospital Revenue Code	250
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$9.99
Rate for Payer: Qualcare PPO/HMO/WC	$9.99

HYOSCYAMINE SULFATE

Facility

$26.90

Hospital Charge Code	6010532
Hospital Revenue Code	250
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$4.04
Rate for Payer: Qualcare PPO/HMO/WC	$4.04

HYOSCYAMINE SULFATE

Facility

$26.90

Hospital Charge Code	6010532
Hospital Revenue Code	250
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$13.45
Rate for Payer: Aetna Commercial	$8.07
Rate for Payer: Aetna Medicare Advantage	$8.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.86
Rate for Payer: Cigna Commercial	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.50
Rate for Payer: Oxford Commercial	$13.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.04
Rate for Payer: UnitedHealthcare Commercial	$13.45

HYOSCYAMINE TAB 0.125MG

Facility

$5.70

Service Code	NDC 47781001301
Hospital Charge Code	60627433
Hospital Revenue Code	251
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$0.86
Rate for Payer: Qualcare PPO/HMO/WC	$0.86

HYOSCYAMINE TAB 0.125MG

Facility

$5.70

Service Code	NDC 47781001301
Hospital Charge Code	60627433
Hospital Revenue Code	251
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$2.85
Rate for Payer: Aetna Commercial	$1.71
Rate for Payer: Aetna Medicare Advantage	$1.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.45
Rate for Payer: Cigna Commercial	$2.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.74
Rate for Payer: Oxford Commercial	$2.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.86
Rate for Payer: UnitedHealthcare Commercial	$2.85

HYOSCYAMINE TAB SL 0.125MG

Facility

$4.00

Hospital Charge Code	60628914
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

HYOSCYAMINE TAB SL 0.125MG

Facility

$4.00

Hospital Charge Code	60628914
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

HYP-08

Facility

$7,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270666721
Hospital Revenue Code	278
Min. Negotiated Rate	$1,087.50
Max. Negotiated Rate	$3,625.00
Rate for Payer: Aetna Commercial	$2,175.00
Rate for Payer: Aetna Medicare Advantage	$2,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,848.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,848.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,848.75
Rate for Payer: Cigna Commercial	$3,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,087.50

HYP-08

Facility

$7,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270666721
Hospital Revenue Code	278
Min. Negotiated Rate	$1,087.50
Max. Negotiated Rate	$1,754.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,754.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,087.50

HYPAQUE

Facility

$41.60

Hospital Charge Code	6014054
Hospital Revenue Code	250
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$6.24
Rate for Payer: Qualcare PPO/HMO/WC	$6.24

HYPAQUE

Facility

$41.60

Hospital Charge Code	6014054
Hospital Revenue Code	250
Min. Negotiated Rate	$5.41
Max. Negotiated Rate	$20.80
Rate for Payer: Aetna Commercial	$12.48
Rate for Payer: Aetna Medicare Advantage	$12.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.61
Rate for Payer: Cigna Commercial	$20.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.41
Rate for Payer: Oxford Commercial	$20.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.24
Rate for Payer: UnitedHealthcare Commercial	$20.80

HYPERALIMENTATION ADMIN *****

Facility

$643.00

Hospital Charge Code	3400066
Hospital Revenue Code	289
Min. Negotiated Rate	$83.59
Max. Negotiated Rate	$1,805.00
Rate for Payer: UnitedHealthcare Commercial	$1,805.00
Rate for Payer: Aetna Commercial	$192.90
Rate for Payer: Aetna Medicare Advantage	$192.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$163.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$163.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$163.97
Rate for Payer: Cigna Commercial	$321.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.59
Rate for Payer: Oxford Commercial	$1,591.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.45

HYPERALIMENTATION ADMIN *****

Facility

$643.00

Hospital Charge Code	3400066
Hospital Revenue Code	289
Min. Negotiated Rate	$96.45
Max. Negotiated Rate	$96.45
Rate for Payer: Qualcare PPO/HMO/WC	$96.45

HYPERBARIC CHAMBER DOUBLE****

Facility

$600.00

Service Code	HCPCS 99183
Hospital Charge Code	9000373
Hospital Revenue Code	413
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

HYPERBARIC CHAMBER DOUBLE****

Facility

$600.00

Service Code	HCPCS 99183
Hospital Charge Code	9000373
Hospital Revenue Code	413
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$2,300.00
Rate for Payer: Aetna Commercial	$180.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$119.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.00
Rate for Payer: Oxford Commercial	$2,027.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Commercial	$2,300.00

HYPERBARIC CHAMBER SGL****

Facility

$300.00

Service Code	HCPCS 99183
Hospital Charge Code	9000365
Hospital Revenue Code	413
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$2,300.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$119.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$2,027.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$2,300.00

HYPERBARIC CHAMBER SGL****

Facility

$300.00

Service Code	HCPCS 99183
Hospital Charge Code	9000365
Hospital Revenue Code	413
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

HYPERBARIC CHAMBER SUPERVISION

Facility

$300.00

Service Code	HCPCS 99183
Hospital Charge Code	9808275
Hospital Revenue Code	413
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$2,300.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$119.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$2,027.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$2,300.00

HYPERBARIC CHAMBER SUPERVISION

Facility

$300.00

Service Code	HCPCS 99183
Hospital Charge Code	9808275
Hospital Revenue Code	413
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

HYPERHEP

Facility

$711.14

Service Code	NDC 13533063603
Hospital Charge Code	6063943285
Hospital Revenue Code	250
Min. Negotiated Rate	$106.67
Max. Negotiated Rate	$106.67
Rate for Payer: Qualcare PPO/HMO/WC	$106.67

HYPERHEP

Facility

$711.14

Service Code	NDC 13533063603
Hospital Charge Code	6063943285
Hospital Revenue Code	250
Min. Negotiated Rate	$92.45
Max. Negotiated Rate	$355.57
Rate for Payer: Aetna Commercial	$213.34
Rate for Payer: Aetna Medicare Advantage	$213.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.34
Rate for Payer: Cigna Commercial	$355.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.45
Rate for Payer: Oxford Commercial	$355.57
Rate for Payer: Qualcare PPO/HMO/WC	$106.67
Rate for Payer: UnitedHealthcare Commercial	$355.57

HYPERHEP/1ML

Facility

$322.00

Hospital Charge Code	60633140
Hospital Revenue Code	250
Min. Negotiated Rate	$41.86
Max. Negotiated Rate	$161.00
Rate for Payer: Aetna Commercial	$96.60
Rate for Payer: Aetna Medicare Advantage	$96.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.11
Rate for Payer: Cigna Commercial	$161.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.86
Rate for Payer: Oxford Commercial	$161.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.30
Rate for Payer: UnitedHealthcare Commercial	$161.00

HYPERHEP/1ML

Facility

$322.00

Hospital Charge Code	60633140
Hospital Revenue Code	250
Min. Negotiated Rate	$48.30
Max. Negotiated Rate	$48.30
Rate for Payer: Qualcare PPO/HMO/WC	$48.30

HYPERHEP/5ML

Facility

$1,095.00

Hospital Charge Code	60633139
Hospital Revenue Code	250
Min. Negotiated Rate	$164.25
Max. Negotiated Rate	$164.25
Rate for Payer: Qualcare PPO/HMO/WC	$164.25

Know your out-of-pocket cost for care.

All Charges