Heights University Hospital

All Charges

Charge

Type

Setting

Price

IV PUSH FIRST DRUG

Facility

$440.91

Service Code	HCPCS 96374
Hospital Charge Code	2011449
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

$394.88

Service Code	HCPCS 96374
Hospital Charge Code	93082030
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	74308255
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

$440.91

Service Code	HCPCS 96374
Hospital Charge Code	74117057
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

$440.91

Service Code	HCPCS 96374
Hospital Charge Code	2400612
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

$440.91

Service Code	HCPCS 96374
Hospital Charge Code	74116057
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

$2,800.00

Service Code	HCPCS 96374
Hospital Charge Code	94053140
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 FIRST DRUG

Facility

$394.88

Service Code	HCPCS 96374
Hospital Charge Code	73050985
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

$2,800.00

Service Code	HCPCS 96374
Hospital Charge Code	1500104
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 FIRST DRUG

Facility

$394.88

Service Code	HCPCS 96374
Hospital Charge Code	93500065
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

$2,800.00

Service Code	HCPCS 96374
Hospital Charge Code	5300145
Hospital Revenue Code	260
Min. Negotiated Rate	$36.51
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Commercial	$840.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
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	$714.00
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$802.00

IV PUSH FIRST DRUG

Facility

$2,800.00

Service Code	HCPCS 96374
Hospital Charge Code	73050940
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 FIRST DRUG

Facility

$2,800.00

Service Code	HCPCS 96374
Hospital Charge Code	1600515
Hospital Revenue Code	260
Min. Negotiated Rate	$36.51
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Commercial	$840.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
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	$714.00
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$802.00

IV PUSH FIRST DRUG

Facility

$2,800.00

Service Code	HCPCS 96374
Hospital Charge Code	73190107
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 FIRST DRUG

Facility

$2,800.00

Service Code	HCPCS 96374
Hospital Charge Code	5300145
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 FIRST DRUG

Facility

$440.91

Service Code	HCPCS 96374
Hospital Charge Code	2301092
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

$440.91

Service Code	HCPCS 96374
Hospital Charge Code	2301092
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

$2,800.00

Service Code	HCPCS 96374
Hospital Charge Code	93500061
Hospital Revenue Code	260
Min. Negotiated Rate	$36.51
Max. Negotiated Rate	$840.00
Rate for Payer: Aetna Commercial	$840.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
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	$714.00
Rate for Payer: Cigna Commercial	$506.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.00
Rate for Payer: Oxford Commercial	$707.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.00
Rate for Payer: UnitedHealthcare Commercial	$802.00

IV PUSH FIRST DRUG

Facility

$440.91

Service Code	HCPCS 96374
Hospital Charge Code	73237025
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	1600515
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 FIRST DRUG

Facility

$2,800.00

Service Code	HCPCS 96374
Hospital Charge Code	5100779
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 FIRST DRUG

Facility

$440.91

Service Code	HCPCS 96374
Hospital Charge Code	5700256
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 (NON-CHEMO)***

Facility

$60.00

Hospital Charge Code	3401010
Hospital Revenue Code	289
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

IV PUSH (NON-CHEMO)***

Facility

$60.00

Hospital Charge Code	3401010
Hospital Revenue Code	289
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$1,805.00
Rate for Payer: Aetna Commercial	$18.00
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$1,591.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$1,805.00

IV SET PUSH BUTTON W/LUER 25GX

Facility

$321.90

Hospital Charge Code	270664447
Hospital Revenue Code	270
Min. Negotiated Rate	$48.28
Max. Negotiated Rate	$48.28
Rate for Payer: Qualcare PPO/HMO/WC	$48.28

Know your out-of-pocket cost for care.

All Charges