Heights University Hospital

All Charges

Charge

Type

Setting

Price

IV PUSH EA ADDL DRUG SAME

Facility

$633.74

Service Code	HCPCS 96376
Hospital Charge Code	5700444
Hospital Revenue Code	450
Min. Negotiated Rate	$95.06
Max. Negotiated Rate	$95.06
Rate for Payer: Qualcare PPO/HMO/WC	$95.06

IV PUSH EA ADDL DRUG SAME

Facility

$440.91

Service Code	HCPCS 96376
Hospital Charge Code	4501034
Hospital Revenue Code	260
Min. Negotiated Rate	$9.25
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$132.27
Rate for Payer: Aetna Medicare Advantage	$132.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.43
Rate for Payer: Cigna Commercial	$220.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.32
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.14
Rate for Payer: UnitedHealthcare Commercial	$802.00

IV PUSH EA ADDL DRUG SAME

Facility

$440.91

Service Code	HCPCS 96376
Hospital Charge Code	5100781
Hospital Revenue Code	260
Min. Negotiated Rate	$9.25
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$132.27
Rate for Payer: Aetna Medicare Advantage	$132.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.43
Rate for Payer: Cigna Commercial	$220.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.32
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.14
Rate for Payer: UnitedHealthcare Commercial	$802.00

IV PUSH EA ADDL DRUG SAME

Facility

$440.91

Service Code	HCPCS 96376
Hospital Charge Code	411096376
Hospital Revenue Code	260
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$66.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.14

IV PUSH EA ADDL DRUG SAME

Facility

$440.91

Service Code	HCPCS 96376
Hospital Charge Code	395096376
Hospital Revenue Code	260
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$66.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.14

IV PUSH EA ADDL DRUG SAME

Facility

$440.91

Service Code	HCPCS 96376
Hospital Charge Code	1600525
Hospital Revenue Code	260
Min. Negotiated Rate	$9.25
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$132.27
Rate for Payer: Aetna Medicare Advantage	$132.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.43
Rate for Payer: Cigna Commercial	$220.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.32
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.14
Rate for Payer: UnitedHealthcare Commercial	$802.00

IV PUSH EA ADDL DRUG SAME

Facility

$440.91

Service Code	HCPCS 96376
Hospital Charge Code	93500077
Hospital Revenue Code	260
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$66.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.14

IV PUSH EA ADDL DRUG SAME

Facility

$2,800.00

Service Code	HCPCS 96375
Hospital Charge Code	321796376
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

IV PUSH EA ADDL DRUG SAME

Facility

$440.91

Service Code	HCPCS 96376
Hospital Charge Code	5100781
Hospital Revenue Code	260
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$66.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.14

IV PUSH EA ADDL DRUG SAME

Facility

$440.91

Service Code	HCPCS 96376
Hospital Charge Code	100116
Hospital Revenue Code	260
Min. Negotiated Rate	$9.25
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$132.27
Rate for Payer: Aetna Medicare Advantage	$132.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.43
Rate for Payer: Cigna Commercial	$220.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.32
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.14
Rate for Payer: UnitedHealthcare Commercial	$802.00

IV PUSH EA ADDL DRUG SAME

Facility

$440.91

Service Code	HCPCS 96376
Hospital Charge Code	8200514
Hospital Revenue Code	260
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$66.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.14

IV PUSH EA ADDL DRUG SAME

Facility

$440.91

Service Code	HCPCS 96376
Hospital Charge Code	73050960
Hospital Revenue Code	260
Min. Negotiated Rate	$9.25
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$132.27
Rate for Payer: Aetna Medicare Advantage	$132.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.43
Rate for Payer: Cigna Commercial	$220.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.32
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.14
Rate for Payer: UnitedHealthcare Commercial	$802.00

IV PUSH EA ADDL DRUG SAME

Facility

$440.91

Service Code	HCPCS 96376
Hospital Charge Code	4501034
Hospital Revenue Code	260
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$66.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.14

IV PUSH EA ADDL DRUG SAME

Facility

$440.91

Service Code	HCPCS 96376
Hospital Charge Code	73237027
Hospital Revenue Code	260
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$66.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.14

IV PUSH EA ADDL DRUG SAME

Facility

$440.91

Service Code	HCPCS 96376
Hospital Charge Code	73050960
Hospital Revenue Code	260
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$66.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.14

IV PUSH EA ADDL DRUG SAME

Facility

$440.91

Service Code	HCPCS 96376
Hospital Charge Code	270339106
Hospital Revenue Code	260
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$66.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.14

IV PUSH EA ADDL DRUG SAME

Facility

$440.91

Service Code	HCPCS 96376
Hospital Charge Code	1500106
Hospital Revenue Code	260
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$66.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.14

IV PUSH-EA ADDTL NEW MED

Facility

$465.14

Service Code	HCPCS 96375
Hospital Charge Code	93500073
Hospital Revenue Code	260
Min. Negotiated Rate	$60.47
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$139.54
Rate for Payer: Aetna Medicare Advantage	$139.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$118.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$118.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$118.61
Rate for Payer: Cigna Commercial	$111.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.47
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.77
Rate for Payer: UnitedHealthcare Commercial	$802.00

IV PUSH-EA ADDTL NEW MED

Facility

$465.14

Service Code	HCPCS 96375
Hospital Charge Code	93500073
Hospital Revenue Code	260
Min. Negotiated Rate	$69.77
Max. Negotiated Rate	$69.77
Rate for Payer: Qualcare PPO/HMO/WC	$69.77

IV PUSH FIRST DRUG

Facility

$394.88

Service Code	HCPCS 96374
Hospital Charge Code	73050980
Hospital Revenue Code	260
Min. Negotiated Rate	$36.51
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$118.46
Rate for Payer: Aetna Medicare Advantage	$118.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.69
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.33
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.23
Rate for Payer: UnitedHealthcare Commercial	$802.00

IV PUSH FIRST DRUG

Facility

$440.91

Service Code	HCPCS 96374
Hospital Charge Code	73050945
Hospital Revenue Code	260
Min. Negotiated Rate	$66.14
Max. Negotiated Rate	$66.14
Rate for Payer: Qualcare PPO/HMO/WC	$66.14

IV PUSH FIRST DRUG

Facility

$1,738.06

Service Code	HCPCS 96374
Hospital Charge Code	5700245
Hospital Revenue Code	450
Min. Negotiated Rate	$36.51
Max. Negotiated Rate	$521.42
Rate for Payer: Aetna Commercial	$521.42
Rate for Payer: Aetna Medicare Advantage	$521.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$443.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$443.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$443.21
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.95
Rate for Payer: Qualcare PPO/HMO/WC	$260.71

IV PUSH FIRST DRUG

Facility

$394.88

Service Code	HCPCS 96374
Hospital Charge Code	73050985
Hospital Revenue Code	260
Min. Negotiated Rate	$59.23
Max. Negotiated Rate	$59.23
Rate for Payer: Qualcare PPO/HMO/WC	$59.23

IV PUSH FIRST DRUG

Facility

$440.91

Service Code	HCPCS 96374
Hospital Charge Code	74116057
Hospital Revenue Code	260
Min. Negotiated Rate	$36.51
Max. Negotiated Rate	$802.00
Rate for Payer: Aetna Commercial	$132.27
Rate for Payer: Aetna Medicare Advantage	$132.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.43
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.32
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.14
Rate for Payer: UnitedHealthcare Commercial	$802.00

IV PUSH FIRST DRUG

Facility

$2,800.00

Service Code	HCPCS 96374
Hospital Charge Code	73092070
Hospital Revenue Code	260
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

Know your out-of-pocket cost for care.

All Charges