Heights University Hospital

All Charges

Charge

Type

Setting

Price

IBD SEROLOGY 7

Facility

$556.25

Hospital Charge Code	3035157
Hospital Revenue Code	301
Min. Negotiated Rate	$72.31
Max. Negotiated Rate	$278.12
Rate for Payer: Aetna Commercial	$166.88
Rate for Payer: Aetna Medicare Advantage	$166.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.84
Rate for Payer: Cigna Commercial	$278.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.31
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$83.44
Rate for Payer: UnitedHealthcare Commercial	$114.00

IBD SYST 7 IMMUNOFLOR ASSAY

Facility

$531.00

Service Code	HCPCS 88346
Hospital Charge Code	3035158A
Hospital Revenue Code	312
Min. Negotiated Rate	$79.65
Max. Negotiated Rate	$79.65
Rate for Payer: Qualcare PPO/HMO/WC	$79.65

IBD SYST 7 IMMUNOFLOR ASSAY

Facility

$531.00

Service Code	HCPCS 88346
Hospital Charge Code	3035158A
Hospital Revenue Code	312
Min. Negotiated Rate	$69.03
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$159.30
Rate for Payer: Aetna Medicare Advantage	$159.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.41
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$78.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$79.65
Rate for Payer: UnitedHealthcare Commercial	$114.00

IBD SYST 7 IMMUNOFLOR ASSAY

Facility

$531.00

Service Code	HCPCS 88350
Hospital Charge Code	3035158B
Hospital Revenue Code	312
Min. Negotiated Rate	$79.65
Max. Negotiated Rate	$79.65
Rate for Payer: Qualcare PPO/HMO/WC	$79.65

IBD SYST 7 IMMUNOFLOR ASSAY

Facility

$531.00

Service Code	HCPCS 88350
Hospital Charge Code	3035158B
Hospital Revenue Code	312
Min. Negotiated Rate	$61.02
Max. Negotiated Rate	$159.30
Rate for Payer: Aetna Commercial	$159.30
Rate for Payer: Aetna Medicare Advantage	$159.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.41
Rate for Payer: Cigna Commercial	$122.04
Rate for Payer: Cigna Medicare Advantage	$61.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$79.65
Rate for Payer: UnitedHealthcare Commercial	$114.00

IBERET/240ML

Facility

$71.00

Hospital Charge Code	60633145
Hospital Revenue Code	250
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$35.50
Rate for Payer: Aetna Commercial	$21.30
Rate for Payer: Aetna Medicare Advantage	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.11
Rate for Payer: Cigna Commercial	$35.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.23
Rate for Payer: Oxford Commercial	$35.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$35.50

IBERET/240ML

Facility

$71.00

Hospital Charge Code	60633145
Hospital Revenue Code	250
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

IBERET-500/240ML

Facility

$14.00

Hospital Charge Code	60633147
Hospital Revenue Code	250
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$7.00
Rate for Payer: Aetna Commercial	$4.20
Rate for Payer: Aetna Medicare Advantage	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.57
Rate for Payer: Cigna Commercial	$7.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.82
Rate for Payer: Oxford Commercial	$7.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$7.00

IBERET-500/240ML

Facility

$14.00

Hospital Charge Code	60633147
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

IBERET-500/500MG/TAB

Facility

$3.00

Hospital Charge Code	60633148
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

IBERET-500/500MG/TAB

Facility

$3.00

Hospital Charge Code	60633148
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

IB KIT MINI PEEK FT JUMPSTART

Facility

$14,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270696137
Hospital Revenue Code	278
Min. Negotiated Rate	$2,242.50
Max. Negotiated Rate	$3,617.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,617.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,242.50

IB KIT MINI PEEK FT JUMPSTART

Facility

$14,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270696137
Hospital Revenue Code	278
Min. Negotiated Rate	$2,242.50
Max. Negotiated Rate	$7,475.00
Rate for Payer: Aetna Commercial	$4,485.00
Rate for Payer: Aetna Medicare Advantage	$4,485.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,812.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,812.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,990.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,812.25
Rate for Payer: Cigna Commercial	$7,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,617.90
Rate for Payer: Qualcare PPO/HMO/WC	$2,242.50

IBUPROFEN

Facility

$324.00

Service Code	HCPCS 80299
Hospital Charge Code	38472482
Hospital Revenue Code	301
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

IBUPROFEN

Facility

$324.00

Service Code	HCPCS 80299
Hospital Charge Code	38472482
Hospital Revenue Code	301
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

IBUPROFEN 100MG/5ML 120ML SUSP

Facility

$14.95

Hospital Charge Code	6063943356
Hospital Revenue Code	250
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$2.24
Rate for Payer: Qualcare PPO/HMO/WC	$2.24

IBUPROFEN 100MG/5ML 120ML SUSP

Facility

$14.95

Hospital Charge Code	6063943356
Hospital Revenue Code	250
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$7.47
Rate for Payer: Aetna Commercial	$4.49
Rate for Payer: Aetna Medicare Advantage	$4.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.81
Rate for Payer: Cigna Commercial	$7.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.94
Rate for Payer: Oxford Commercial	$7.47
Rate for Payer: Qualcare PPO/HMO/WC	$2.24
Rate for Payer: UnitedHealthcare Commercial	$7.47

IBUPROFEN 100 MG/5 ML SUS

Facility

$18.63

Service Code	NDC 68094049458
Hospital Charge Code	6009666
Hospital Revenue Code	250
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$9.31
Rate for Payer: Aetna Commercial	$5.59
Rate for Payer: Aetna Medicare Advantage	$5.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.75
Rate for Payer: Cigna Commercial	$9.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.42
Rate for Payer: Oxford Commercial	$9.31
Rate for Payer: Qualcare PPO/HMO/WC	$2.79
Rate for Payer: UnitedHealthcare Commercial	$9.31

IBUPROFEN 100 MG/5 ML SUS

Facility

$18.63

Service Code	NDC 68094049458
Hospital Charge Code	6009666
Hospital Revenue Code	250
Min. Negotiated Rate	$2.79
Max. Negotiated Rate	$2.79
Rate for Payer: Qualcare PPO/HMO/WC	$2.79

IBUPROFEN 100MG/5ML SUSP

Facility

$28.00

Hospital Charge Code	60635508
Hospital Revenue Code	250
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$14.00

IBUPROFEN 100MG/5ML SUSP

Facility

$28.00

Hospital Charge Code	60635508
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

IBUPROFEN/300MG

Facility

$3.00

Hospital Charge Code	60634447
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

IBUPROFEN/300MG

Facility

$3.00

Hospital Charge Code	60634447
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

IBUPROFEN/400MG

Facility

$3.00

Hospital Charge Code	60634448
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

IBUPROFEN/400MG

Facility

$3.00

Hospital Charge Code	60634448
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

Know your out-of-pocket cost for care.

All Charges