Heights University Hospital

All Charges

Charge

Type

Setting

Price

KEFZOL 1GM ADVANTAGE 50ML

Facility

$24.00

Hospital Charge Code	60635535
Hospital Revenue Code	250
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

KEFZOL/500MG

Facility

$13.00

Hospital Charge Code	60633245
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$3.90
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Oxford Commercial	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$6.50

KEFZOL/500MG

Facility

$13.00

Hospital Charge Code	60633245
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

KENALOG-40/40MG/1ML

Facility

$32.00

Hospital Charge Code	60633246
Hospital Revenue Code	250
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$9.60
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$16.00

KENALOG-40/40MG/1ML

Facility

$32.00

Hospital Charge Code	60633246
Hospital Revenue Code	250
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

KENALOG 40MG/ML VIAL 1ML

Facility

$11.00

Hospital Charge Code	83652571
Hospital Revenue Code	636
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$5.50
Rate for Payer: Aetna Commercial	$3.30
Rate for Payer: Aetna Medicare Advantage	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.81
Rate for Payer: Cigna Commercial	$5.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.66
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

KENALOG 40MG/ML VIAL 1ML

Facility

$11.00

Hospital Charge Code	83652571
Hospital Revenue Code	636
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$2.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.66
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

KEOTCONAZOLE 2% CREAM (15GM)

Facility

$879.91

Service Code	NDC 51672129801
Hospital Charge Code	606350980
Hospital Revenue Code	250
Min. Negotiated Rate	$131.99
Max. Negotiated Rate	$131.99
Rate for Payer: Qualcare PPO/HMO/WC	$131.99

KEOTCONAZOLE 2% CREAM (15GM)

Facility

$879.91

Service Code	NDC 51672129801
Hospital Charge Code	606350980
Hospital Revenue Code	250
Min. Negotiated Rate	$114.39
Max. Negotiated Rate	$439.95
Rate for Payer: Aetna Commercial	$263.97
Rate for Payer: Aetna Medicare Advantage	$263.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.38
Rate for Payer: Cigna Commercial	$439.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.39
Rate for Payer: Oxford Commercial	$439.95
Rate for Payer: Qualcare PPO/HMO/WC	$131.99
Rate for Payer: UnitedHealthcare Commercial	$439.95

KEPPRA

Facility

$181.65

Service Code	HCPCS 82542
Hospital Charge Code	3038088
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

KEPPRA

Facility

$181.65

Service Code	HCPCS 82542
Hospital Charge Code	3038088
Hospital Revenue Code	301
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.05
Rate for Payer: Aetna Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.27
Rate for Payer: Cigna Commercial	$24.09
Rate for Payer: Cigna Medicare Advantage	$12.04
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.54
Rate for Payer: Wellcare Medicare Advantage	$24.09

KEPPRA 250MG TAB

Facility

$3.00

Hospital Charge Code	60635431
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

KEPPRA 250MG TAB

Facility

$3.00

Hospital Charge Code	60635431
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

KEPPRA 500MG TAB

Facility

$3.00

Hospital Charge Code	60635432
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

KEPPRA 500MG TAB

Facility

$3.00

Hospital Charge Code	60635432
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

KEPPRA S/F LIQUID 473 ML

Facility

$22.71

Service Code	NDC 781614116
Hospital Charge Code	606350948
Hospital Revenue Code	250
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$11.36
Rate for Payer: Aetna Commercial	$6.81
Rate for Payer: Aetna Medicare Advantage	$6.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.79
Rate for Payer: Cigna Commercial	$11.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.95
Rate for Payer: Oxford Commercial	$11.36
Rate for Payer: Qualcare PPO/HMO/WC	$3.41
Rate for Payer: UnitedHealthcare Commercial	$11.36

KEPPRA S/F LIQUID 473 ML

Facility

$22.71

Service Code	NDC 781614116
Hospital Charge Code	606350948
Hospital Revenue Code	250
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$3.41
Rate for Payer: Qualcare PPO/HMO/WC	$3.41

KERALYT/28GM

Facility

$75.00

Hospital Charge Code	60633247
Hospital Revenue Code	250
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$37.50

KERALYT/28GM

Facility

$75.00

Hospital Charge Code	60633247
Hospital Revenue Code	250
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

KERI SCENTED/390ML

Facility

$38.00

Hospital Charge Code	60633248
Hospital Revenue Code	250
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$19.00
Rate for Payer: Aetna Commercial	$11.40
Rate for Payer: Aetna Medicare Advantage	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.69
Rate for Payer: Cigna Commercial	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.94
Rate for Payer: Oxford Commercial	$19.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$19.00

KERI SCENTED/390ML

Facility

$38.00

Hospital Charge Code	60633248
Hospital Revenue Code	250
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

KERI SKIN OIL

Facility

$21.15

Hospital Charge Code	60628429
Hospital Revenue Code	250
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$10.57
Rate for Payer: Aetna Commercial	$6.34
Rate for Payer: Aetna Medicare Advantage	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.39
Rate for Payer: Cigna Commercial	$10.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.75
Rate for Payer: Oxford Commercial	$10.57
Rate for Payer: Qualcare PPO/HMO/WC	$3.17
Rate for Payer: UnitedHealthcare Commercial	$10.57

KERI SKIN OIL

Facility

$21.15

Hospital Charge Code	60628429
Hospital Revenue Code	250
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

KETALAR 50ML 10/ML VIAL

Facility

$38.00

Hospital Charge Code	60635179
Hospital Revenue Code	250
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$19.00
Rate for Payer: Aetna Commercial	$11.40
Rate for Payer: Aetna Medicare Advantage	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.69
Rate for Payer: Cigna Commercial	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.94
Rate for Payer: Oxford Commercial	$19.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$19.00

KETALAR 50ML 10/ML VIAL

Facility

$38.00

Hospital Charge Code	60635179
Hospital Revenue Code	250
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

Know your out-of-pocket cost for care.

All Charges