Heights University Hospital

All Charges

Charge

Type

Setting

Price

KETOCONAZOLE CRM 30GM

Facility

$185.00

Hospital Charge Code	6007363
Hospital Revenue Code	252
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

KETOCONAZOLE TAB 200MG

Facility

$19.85

Hospital Charge Code	6003206
Hospital Revenue Code	252
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$2.98
Rate for Payer: Qualcare PPO/HMO/WC	$2.98

KETOCONAZOLE TAB 200MG

Facility

$19.85

Hospital Charge Code	6003206
Hospital Revenue Code	252
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

KETO-DIASTIX 50 TEST BOTTLE

Facility

$7.70

Hospital Charge Code	6009740
Hospital Revenue Code	259
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$3.85
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.96
Rate for Payer: Cigna Commercial	$3.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.00
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$3.85

KETO-DIASTIX 50 TEST BOTTLE

Facility

$7.70

Hospital Charge Code	6009740
Hospital Revenue Code	259
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

KETOGENIC STEROIDS,URINE

Facility

$207.00

Service Code	HCPCS 83582
Hospital Charge Code	38472431
Hospital Revenue Code	301
Min. Negotiated Rate	$7.74
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$50.12
Rate for Payer: Aetna Medicare Advantage	$15.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.68
Rate for Payer: Cigna Commercial	$15.47
Rate for Payer: Cigna Medicare Advantage	$7.74
Rate for Payer: Clover Medicare Advantage	$14.70
Rate for Payer: EmblemHealth Commercial	$46.41
Rate for Payer: Humana Medicare Advantage	$15.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.40
Rate for Payer: Wellcare Medicare Advantage	$15.47

KETOGENIC STEROIDS,URINE

Facility

$207.00

Service Code	HCPCS 83582
Hospital Charge Code	38472431
Hospital Revenue Code	301
Min. Negotiated Rate	$31.05
Max. Negotiated Rate	$31.05
Rate for Payer: Qualcare PPO/HMO/WC	$31.05

KETONE BODIES, PLASMA

Facility

$56.00

Service Code	HCPCS 82010
Hospital Charge Code	3035123C
Hospital Revenue Code	307
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.47
Rate for Payer: Aetna Medicare Advantage	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.93
Rate for Payer: Cigna Commercial	$8.17
Rate for Payer: Cigna Medicare Advantage	$4.08
Rate for Payer: Clover Medicare Advantage	$7.76
Rate for Payer: EmblemHealth Commercial	$24.51
Rate for Payer: Humana Medicare Advantage	$8.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.17
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.66
Rate for Payer: Wellcare Medicare Advantage	$8.17

KETONE BODIES, PLASMA

Facility

$56.00

Service Code	HCPCS 82010
Hospital Charge Code	3035123C
Hospital Revenue Code	307
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

KETONE BODIES, PLASMA

Facility

$56.00

Service Code	HCPCS 82010
Hospital Charge Code	3035123B
Hospital Revenue Code	307
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.47
Rate for Payer: Aetna Medicare Advantage	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.93
Rate for Payer: Cigna Commercial	$8.17
Rate for Payer: Cigna Medicare Advantage	$4.08
Rate for Payer: Clover Medicare Advantage	$7.76
Rate for Payer: EmblemHealth Commercial	$24.51
Rate for Payer: Humana Medicare Advantage	$8.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.17
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.66
Rate for Payer: Wellcare Medicare Advantage	$8.17

KETONE BODIES, PLASMA

Facility

$56.00

Service Code	HCPCS 82010
Hospital Charge Code	3035123A
Hospital Revenue Code	307
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.47
Rate for Payer: Aetna Medicare Advantage	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.93
Rate for Payer: Cigna Commercial	$8.17
Rate for Payer: Cigna Medicare Advantage	$4.08
Rate for Payer: Clover Medicare Advantage	$7.76
Rate for Payer: EmblemHealth Commercial	$24.51
Rate for Payer: Humana Medicare Advantage	$8.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.17
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.66
Rate for Payer: Wellcare Medicare Advantage	$8.17

KETONE BODIES, PLASMA

Facility

$56.00

Service Code	HCPCS 82010
Hospital Charge Code	3035123A
Hospital Revenue Code	307
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

KETONE BODIES, PLASMA

Facility

$56.00

Service Code	HCPCS 82010
Hospital Charge Code	3035123B
Hospital Revenue Code	307
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

KETONES -ACETONES

Facility

$667.59

Service Code	HCPCS 82009
Hospital Charge Code	38472434
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

KETONES -ACETONES

Facility

$667.59

Service Code	HCPCS 82009
Hospital Charge Code	38472434
Hospital Revenue Code	301
Min. Negotiated Rate	$2.26
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$14.64
Rate for Payer: Aetna Medicare Advantage	$4.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.56
Rate for Payer: Cigna Commercial	$4.52
Rate for Payer: Cigna Medicare Advantage	$2.26
Rate for Payer: Clover Medicare Advantage	$4.29
Rate for Payer: EmblemHealth Commercial	$13.56
Rate for Payer: Humana Medicare Advantage	$4.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.52
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.79
Rate for Payer: Wellcare Medicare Advantage	$4.52

KETONES URINE

Facility

$22.45

Service Code	HCPCS 81005
Hospital Charge Code	3000049
Hospital Revenue Code	307
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

KETONES URINE

Facility

$22.45

Service Code	HCPCS 81005
Hospital Charge Code	3000049
Hospital Revenue Code	307
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$7.03
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.95
Rate for Payer: Cigna Commercial	$2.17
Rate for Payer: Cigna Medicare Advantage	$1.08
Rate for Payer: Clover Medicare Advantage	$2.06
Rate for Payer: EmblemHealth Commercial	$6.51
Rate for Payer: Humana Medicare Advantage	$2.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.17
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$2.30
Rate for Payer: Wellcare Medicare Advantage	$2.17

KETONES (URINE)****

Facility

$21.00

Hospital Charge Code	3010048
Hospital Revenue Code	301
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

KETONES (URINE)****

Facility

$21.00

Hospital Charge Code	3010048
Hospital Revenue Code	301
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$6.30
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$114.00

KETOPROFEN CAP 25MG

Facility

$7.70

Hospital Charge Code	60627687
Hospital Revenue Code	250
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

KETOPROFEN CAP 25MG

Facility

$7.70

Hospital Charge Code	60627687
Hospital Revenue Code	250
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$3.85
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.96
Rate for Payer: Cigna Commercial	$3.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.00
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$3.85

KETOPROFEN CAP 75MG

Facility

$9.00

Hospital Charge Code	60627688
Hospital Revenue Code	250
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

KETOPROFEN CAP 75MG

Facility

$9.00

Hospital Charge Code	60627688
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

KETOROLAC 15 MG/ML INJ

Facility

$30.15

Service Code	HCPCS J1885
Hospital Charge Code	6006217
Hospital Revenue Code	636
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$9.04
Rate for Payer: Aetna Commercial	$9.04
Rate for Payer: Aetna Medicare Advantage	$9.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.30
Rate for Payer: Qualcare PPO/HMO/WC	$4.52

KETOROLAC 15 MG/ML INJ

Facility

$30.15

Service Code	HCPCS J1885
Hospital Charge Code	6006217
Hospital Revenue Code	636
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$7.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.30
Rate for Payer: Qualcare PPO/HMO/WC	$4.52

Know your out-of-pocket cost for care.

All Charges