Heights University Hospital

All Charges

Charge

Type

Setting

Price

KETOROLAC 30 MG/ML INJ

Facility

$40.20

Service Code	HCPCS J1885
Hospital Charge Code	6006225
Hospital Revenue Code	636
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$12.06
Rate for Payer: Aetna Commercial	$12.06
Rate for Payer: Aetna Medicare Advantage	$12.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.73
Rate for Payer: Qualcare PPO/HMO/WC	$6.03

KETOROLAC 30 MG/ML INJ

Facility

$40.20

Service Code	HCPCS J1885
Hospital Charge Code	6006225
Hospital Revenue Code	636
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$9.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.73
Rate for Payer: Qualcare PPO/HMO/WC	$6.03

KETOROLAC 30MG (TORADOL) VIAL

Facility

$7.00

Hospital Charge Code	83652573
Hospital Revenue Code	636
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.10
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

KETOROLAC 30MG (TORADOL) VIAL

Facility

$7.00

Hospital Charge Code	83652573
Hospital Revenue Code	636
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

KETOROLAC 60MG(TORADOL)VIAL

Facility

$15.00

Hospital Charge Code	83652575
Hospital Revenue Code	636
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$3.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.63
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

KETOROLAC 60MG(TORADOL)VIAL

Facility

$15.00

Hospital Charge Code	83652575
Hospital Revenue Code	636
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.63
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

KETOROLAC INJ 60MG/2ML

Facility

$50.25

Service Code	HCPCS J1885
Hospital Charge Code	60627689
Hospital Revenue Code	636
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$15.07
Rate for Payer: Aetna Commercial	$15.07
Rate for Payer: Aetna Medicare Advantage	$15.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.16
Rate for Payer: Qualcare PPO/HMO/WC	$7.54

KETOROLAC INJ 60MG/2ML

Facility

$50.25

Service Code	HCPCS J1885
Hospital Charge Code	60627689
Hospital Revenue Code	636
Min. Negotiated Rate	$7.54
Max. Negotiated Rate	$12.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.16
Rate for Payer: Qualcare PPO/HMO/WC	$7.54

KETOROLAC TAB 10MG

Facility

$11.25

Hospital Charge Code	60628862
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

KETOROLAC TAB 10MG

Facility

$11.25

Hospital Charge Code	60628862
Hospital Revenue Code	250
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$5.62
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: Aetna Commercial	$3.38
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$5.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$5.62

KETOROLAC TROM 0.5% OPTH

Facility

$326.49

Service Code	NDC 17478020919
Hospital Charge Code	60635778
Hospital Revenue Code	250
Min. Negotiated Rate	$48.97
Max. Negotiated Rate	$48.97
Rate for Payer: Qualcare PPO/HMO/WC	$48.97

KETOROLAC TROM 0.5% OPTH

Facility

$326.49

Service Code	NDC 17478020919
Hospital Charge Code	60635778
Hospital Revenue Code	250
Min. Negotiated Rate	$42.44
Max. Negotiated Rate	$163.25
Rate for Payer: Aetna Commercial	$97.95
Rate for Payer: Aetna Medicare Advantage	$97.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.25
Rate for Payer: Cigna Commercial	$163.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.44
Rate for Payer: Oxford Commercial	$163.25
Rate for Payer: Qualcare PPO/HMO/WC	$48.97
Rate for Payer: UnitedHealthcare Commercial	$163.25

KETOSTEROIDS,17(17 KS)FRACTION

Facility

$303.00

Service Code	HCPCS 83593
Hospital Charge Code	38472110
Hospital Revenue Code	301
Min. Negotiated Rate	$12.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$92.34
Rate for Payer: Aetna Medicare Advantage	$28.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$28.50
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	$104.42
Rate for Payer: Cigna Commercial	$28.50
Rate for Payer: Cigna Medicare Advantage	$14.25
Rate for Payer: Clover Medicare Advantage	$27.07
Rate for Payer: EmblemHealth Commercial	$85.50
Rate for Payer: Humana Medicare Advantage	$29.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.39
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$28.50
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$30.21
Rate for Payer: Wellcare Medicare Advantage	$28.50

KETOSTEROIDS,17(17 KS)FRACTION

Facility

$303.00

Service Code	HCPCS 83593
Hospital Charge Code	38472110
Hospital Revenue Code	301
Min. Negotiated Rate	$45.45
Max. Negotiated Rate	$45.45
Rate for Payer: Qualcare PPO/HMO/WC	$45.45

KETROLAC 0.5% OPTHA SOLN

Facility

$66.10

Hospital Charge Code	60628893
Hospital Revenue Code	250
Min. Negotiated Rate	$9.91
Max. Negotiated Rate	$9.91
Rate for Payer: Qualcare PPO/HMO/WC	$9.91

KETROLAC 0.5% OPTHA SOLN

Facility

$66.10

Hospital Charge Code	60628893
Hospital Revenue Code	250
Min. Negotiated Rate	$8.59
Max. Negotiated Rate	$33.05
Rate for Payer: Aetna Commercial	$19.83
Rate for Payer: Aetna Medicare Advantage	$19.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.86
Rate for Payer: Cigna Commercial	$33.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.59
Rate for Payer: Oxford Commercial	$33.05
Rate for Payer: Qualcare PPO/HMO/WC	$9.91
Rate for Payer: UnitedHealthcare Commercial	$33.05

KEVZARA PFS 200MG/1.14ML

Facility

$13,989.60

Service Code	HCPCS C9399
Hospital Charge Code	606390315
Hospital Revenue Code	636
Min. Negotiated Rate	$2,098.44
Max. Negotiated Rate	$3,385.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,385.48
Rate for Payer: Qualcare PPO/HMO/WC	$2,098.44

KEVZARA PFS 200MG/1.14ML

Facility

$13,989.60

Service Code	HCPCS C9399
Hospital Charge Code	606390315
Hospital Revenue Code	636
Min. Negotiated Rate	$2,098.44
Max. Negotiated Rate	$6,994.80
Rate for Payer: Aetna Commercial	$4,196.88
Rate for Payer: Aetna Medicare Advantage	$4,196.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,567.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,567.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,567.35
Rate for Payer: Cigna Commercial	$6,994.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,385.48
Rate for Payer: Qualcare PPO/HMO/WC	$2,098.44

KEY DILATOR TD-8/38

Facility

$336.00

Hospital Charge Code	270331220
Hospital Revenue Code	272
Min. Negotiated Rate	$43.68
Max. Negotiated Rate	$168.00
Rate for Payer: Aetna Commercial	$100.80
Rate for Payer: Aetna Medicare Advantage	$100.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.68
Rate for Payer: Cigna Commercial	$168.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.68
Rate for Payer: Oxford Commercial	$168.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.40
Rate for Payer: UnitedHealthcare Commercial	$168.00

KEY DILATOR TD-8/38

Facility

$336.00

Hospital Charge Code	270331220
Hospital Revenue Code	272
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$50.40
Rate for Payer: Qualcare PPO/HMO/WC	$50.40

KEYSTONE MULTI-STATE ECMO PACK

Facility

$1,127.95

Hospital Charge Code	2703110B
Hospital Revenue Code	272
Min. Negotiated Rate	$146.63
Max. Negotiated Rate	$563.98
Rate for Payer: Aetna Commercial	$338.38
Rate for Payer: Aetna Medicare Advantage	$338.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$287.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$287.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$287.63
Rate for Payer: Cigna Commercial	$563.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.63
Rate for Payer: Oxford Commercial	$563.98
Rate for Payer: Qualcare PPO/HMO/WC	$169.19
Rate for Payer: UnitedHealthcare Commercial	$563.98

KEYSTONE MULTI-STATE ECMO PACK

Facility

$1,127.95

Hospital Charge Code	2703110B
Hospital Revenue Code	272
Min. Negotiated Rate	$169.19
Max. Negotiated Rate	$169.19
Rate for Payer: Qualcare PPO/HMO/WC	$169.19

KI-67 IHC

Facility

$1,082.30

Service Code	HCPCS 88360
Hospital Charge Code	401688360
Hospital Revenue Code	310
Min. Negotiated Rate	$68.36
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$324.69
Rate for Payer: Aetna Medicare Advantage	$324.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.99
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$68.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.34
Rate for Payer: UnitedHealthcare Commercial	$114.00

KI-67 IHC

Facility

$1,082.30

Service Code	HCPCS 88360
Hospital Charge Code	401688360
Hospital Revenue Code	310
Min. Negotiated Rate	$162.34
Max. Negotiated Rate	$162.34
Rate for Payer: Qualcare PPO/HMO/WC	$162.34

KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC

Facility

$64,939.32

Service Code	MSDRG 657
Min. Negotiated Rate	$19,970.03
Max. Negotiated Rate	$64,939.32
Rate for Payer: Aetna Commercial	$61,707.39
Rate for Payer: Aetna Medicare Advantage	$19,970.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50,723.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50,723.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,646.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50,723.28
Rate for Payer: Cigna Commercial	$39,383.43
Rate for Payer: Cigna Medicare Advantage	$21,646.44
Rate for Payer: Clover Medicare Advantage	$20,564.12
Rate for Payer: EmblemHealth Commercial	$64,939.32
Rate for Payer: Humana Medicare Advantage	$22,295.83
Rate for Payer: Oxford Commercial	$24,613.50
Rate for Payer: UnitedHealthcare Commercial	$27,938.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,646.44
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22,945.23
Rate for Payer: Wellcare Medicare Advantage	$21,646.44

Know your out-of-pocket cost for care.

All Charges