Heights University Hospital

All Charges

Charge

Type

Setting

Price

KACTUSH .5x4.5PS.5x4.5 1156603

Facility

$980.00

Hospital Charge Code	270639233
Hospital Revenue Code	272
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$147.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.00

KACTUSH .5x4.5PS.5x4.5 1156603

Facility

$980.00

Hospital Charge Code	270639233
Hospital Revenue Code	272
Min. Negotiated Rate	$127.40
Max. Negotiated Rate	$490.00
Rate for Payer: Aetna Commercial	$294.00
Rate for Payer: Aetna Medicare Advantage	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.90
Rate for Payer: Cigna Commercial	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.40
Rate for Payer: Oxford Commercial	$490.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.00
Rate for Payer: UnitedHealthcare Commercial	$490.00

KACTUSH PTN.5x4 PR.5x4 1156601

Facility

$980.00

Hospital Charge Code	270639231
Hospital Revenue Code	272
Min. Negotiated Rate	$127.40
Max. Negotiated Rate	$490.00
Rate for Payer: Aetna Commercial	$294.00
Rate for Payer: Aetna Medicare Advantage	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.90
Rate for Payer: Cigna Commercial	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.40
Rate for Payer: Oxford Commercial	$490.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.00
Rate for Payer: UnitedHealthcare Commercial	$490.00

KACTUSH PTN.5x4 PR.5x4 1156601

Facility

$980.00

Hospital Charge Code	270639231
Hospital Revenue Code	272
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$147.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.00

KANAMYCIN INJ 1GM

Facility

$10.90

Hospital Charge Code	6009716
Hospital Revenue Code	250
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

KANAMYCIN INJ 1GM

Facility

$10.90

Hospital Charge Code	6009716
Hospital Revenue Code	250
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$5.45
Rate for Payer: Aetna Commercial	$3.27
Rate for Payer: Aetna Medicare Advantage	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.78
Rate for Payer: Cigna Commercial	$5.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.42
Rate for Payer: Oxford Commercial	$5.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Commercial	$5.45

KANAMYCIN SULF 3ML IN 5ML

Facility

$138.00

Hospital Charge Code	60633235
Hospital Revenue Code	250
Min. Negotiated Rate	$17.94
Max. Negotiated Rate	$69.00
Rate for Payer: Aetna Commercial	$41.40
Rate for Payer: Aetna Medicare Advantage	$41.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.19
Rate for Payer: Cigna Commercial	$69.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Oxford Commercial	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.70
Rate for Payer: UnitedHealthcare Commercial	$69.00

KANAMYCIN SULF 3ML IN 5ML

Facility

$138.00

Hospital Charge Code	60633235
Hospital Revenue Code	250
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$20.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.70

KANAMYCIN SULF VL 1GM

Facility

$90.65

Hospital Charge Code	6006530
Hospital Revenue Code	250
Min. Negotiated Rate	$13.60
Max. Negotiated Rate	$13.60
Rate for Payer: Qualcare PPO/HMO/WC	$13.60

KANAMYCIN SULF VL 1GM

Facility

$90.65

Hospital Charge Code	6006530
Hospital Revenue Code	250
Min. Negotiated Rate	$11.78
Max. Negotiated Rate	$45.33
Rate for Payer: Aetna Commercial	$27.20
Rate for Payer: Aetna Medicare Advantage	$27.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.12
Rate for Payer: Cigna Commercial	$45.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.78
Rate for Payer: Oxford Commercial	$45.33
Rate for Payer: Qualcare PPO/HMO/WC	$13.60
Rate for Payer: UnitedHealthcare Commercial	$45.33

KANTREX/500MG/CAP

Facility

$3.00

Hospital Charge Code	60634797
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

KANTREX/500MG/CAP

Facility

$3.00

Hospital Charge Code	60634797
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

KAOLIN 1GM/PECTIN 24MG/BELL.02

Facility

$19.85

Hospital Charge Code	6009732
Hospital Revenue Code	251
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$2.98
Rate for Payer: Qualcare PPO/HMO/WC	$2.98

KAOLIN 1GM/PECTIN 24MG/BELL.02

Facility

$19.85

Hospital Charge Code	6009732
Hospital Revenue Code	251
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$9.93
Rate for Payer: Aetna Commercial	$5.96
Rate for Payer: Aetna Medicare Advantage	$5.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.06
Rate for Payer: Cigna Commercial	$9.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.58
Rate for Payer: Oxford Commercial	$9.93
Rate for Payer: Qualcare PPO/HMO/WC	$2.98
Rate for Payer: UnitedHealthcare Commercial	$9.93

KAOLIN-PECTIN/30ML

Facility

$1.00

Hospital Charge Code	60633236
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

KAOLIN-PECTIN/30ML

Facility

$1.00

Hospital Charge Code	60633236
Hospital Revenue Code	250
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.30
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.13
Rate for Payer: Oxford Commercial	$0.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.50

KAOLIN PECTIN SSP

Facility

$5.00

Service Code	HCPCS A9150
Hospital Charge Code	60628114
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

KAOLIN PECTIN SSP

Facility

$5.00

Service Code	HCPCS A9150
Hospital Charge Code	60628114
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

KAOLIN PECTIN SSP 30ML

Facility

$1.95

Hospital Charge Code	6022602
Hospital Revenue Code	257
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

KAOLIN PECTIN SSP 30ML

Facility

$1.95

Hospital Charge Code	6022602
Hospital Revenue Code	257
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.98
Rate for Payer: Aetna Commercial	$0.59
Rate for Payer: Aetna Medicare Advantage	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.50
Rate for Payer: Cigna Commercial	$0.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.25
Rate for Payer: Oxford Commercial	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.29
Rate for Payer: UnitedHealthcare Commercial	$0.98

KAON ELIXIR/16OZ

Facility

$107.00

Hospital Charge Code	60634573
Hospital Revenue Code	250
Min. Negotiated Rate	$13.91
Max. Negotiated Rate	$53.50
Rate for Payer: Aetna Commercial	$32.10
Rate for Payer: Aetna Medicare Advantage	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.29
Rate for Payer: Cigna Commercial	$53.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.91
Rate for Payer: Oxford Commercial	$53.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Commercial	$53.50

KAON ELIXIR/16OZ

Facility

$107.00

Hospital Charge Code	60634573
Hospital Revenue Code	250
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

KAOPECTATE 262MG/15ML SUSPENS.

Facility

$0.15

Hospital Charge Code	60629838
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.02
Rate for Payer: Qualcare PPO/HMO/WC	$0.02

KAOPECTATE 262MG/15ML SUSPENS.

Facility

$0.15

Hospital Charge Code	60629838
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.08
Rate for Payer: Aetna Commercial	$0.05
Rate for Payer: Aetna Medicare Advantage	$0.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.04
Rate for Payer: Cigna Commercial	$0.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.02
Rate for Payer: Oxford Commercial	$0.08
Rate for Payer: Qualcare PPO/HMO/WC	$0.02
Rate for Payer: UnitedHealthcare Commercial	$0.08

KAPPA/LAMBDA,FREE W/REFL I

Facility

$93.45

Service Code	HCPCS 8388391
Hospital Charge Code	39990015A
Hospital Revenue Code	301
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$28.04
Rate for Payer: Aetna Medicare Advantage	$28.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.83
Rate for Payer: Cigna Commercial	$46.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.15
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.02
Rate for Payer: UnitedHealthcare Commercial	$114.00

Know your out-of-pocket cost for care.

All Charges