Heights University Hospital

All Charges

Charge

Type

Setting

Price

LANOXIN/0.125MG/TAB

Facility

$3.00

Hospital Charge Code	60633265
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

LANOXIN/0.25MG/1ML

Facility

$3.00

Hospital Charge Code	60633267
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

LANOXIN/0.25MG/1ML

Facility

$3.00

Hospital Charge Code	60633267
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

LANOXIN/0.25MG/TAB

Facility

$3.00

Hospital Charge Code	60633266
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

LANOXIN/0.25MG/TAB

Facility

$3.00

Hospital Charge Code	60633266
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

LANOXIN/0.25MG/TAB

Facility

$3.00

Hospital Charge Code	60633268
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

LANOXIN/0.25MG/TAB

Facility

$3.00

Hospital Charge Code	60633268
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

LANOXIN PEDIATRIC/0.05MG

Facility

$61.00

Hospital Charge Code	60633269
Hospital Revenue Code	250
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$9.15
Rate for Payer: Qualcare PPO/HMO/WC	$9.15

LANOXIN PEDIATRIC/0.05MG

Facility

$61.00

Hospital Charge Code	60633269
Hospital Revenue Code	250
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$30.50
Rate for Payer: Aetna Commercial	$18.30
Rate for Payer: Aetna Medicare Advantage	$18.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.55
Rate for Payer: Cigna Commercial	$30.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.93
Rate for Payer: Oxford Commercial	$30.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.15
Rate for Payer: UnitedHealthcare Commercial	$30.50

LANOXIN PEDIATRIC/0.1MG/1

Facility

$481.60

Service Code	NDC 70515026210
Hospital Charge Code	60633270
Hospital Revenue Code	250
Min. Negotiated Rate	$62.61
Max. Negotiated Rate	$240.80
Rate for Payer: Aetna Commercial	$144.48
Rate for Payer: Aetna Medicare Advantage	$144.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.81
Rate for Payer: Cigna Commercial	$240.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.61
Rate for Payer: Oxford Commercial	$240.80
Rate for Payer: Qualcare PPO/HMO/WC	$72.24
Rate for Payer: UnitedHealthcare Commercial	$240.80

LANOXIN PEDIATRIC/0.1MG/1

Facility

$481.60

Service Code	NDC 70515026210
Hospital Charge Code	60633270
Hospital Revenue Code	250
Min. Negotiated Rate	$72.24
Max. Negotiated Rate	$72.24
Rate for Payer: Qualcare PPO/HMO/WC	$72.24

LANSINOH OINTMENT

Facility

$4.00

Service Code	NDC 12090000091
Hospital Charge Code	6063943123
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

LANSINOH OINTMENT

Facility

$4.00

Service Code	NDC 12090000091
Hospital Charge Code	6063943123
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

LANSOPRAZOLE CAP 15MG

Facility

$21.15

Hospital Charge Code	6016430
Hospital Revenue Code	252
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

LANSOPRAZOLE CAP 15MG

Facility

$21.15

Hospital Charge Code	6016430
Hospital Revenue Code	252
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

LANSOPRAZOLE CAP 30MG

Facility

$21.15

Hospital Charge Code	6016489
Hospital Revenue Code	252
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

LANSOPRAZOLE CAP 30MG

Facility

$21.15

Hospital Charge Code	6016489
Hospital Revenue Code	252
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

LANSOPRAZOLE CAP EC 15MG

Facility

$21.80

Hospital Charge Code	60628159
Hospital Revenue Code	250
Min. Negotiated Rate	$2.83
Max. Negotiated Rate	$10.90
Rate for Payer: Aetna Commercial	$6.54
Rate for Payer: Aetna Medicare Advantage	$6.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.56
Rate for Payer: Cigna Commercial	$10.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.83
Rate for Payer: Oxford Commercial	$10.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.27
Rate for Payer: UnitedHealthcare Commercial	$10.90

LANSOPRAZOLE CAP EC 15MG

Facility

$21.80

Hospital Charge Code	60628159
Hospital Revenue Code	250
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$3.27
Rate for Payer: Qualcare PPO/HMO/WC	$3.27

LANSOPRAZOLE CAP EC 30MG

Facility

$27.25

Hospital Charge Code	60628160
Hospital Revenue Code	250
Min. Negotiated Rate	$3.54
Max. Negotiated Rate	$13.62
Rate for Payer: Aetna Commercial	$8.18
Rate for Payer: Aetna Medicare Advantage	$8.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.95
Rate for Payer: Cigna Commercial	$13.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.54
Rate for Payer: Oxford Commercial	$13.62
Rate for Payer: Qualcare PPO/HMO/WC	$4.09
Rate for Payer: UnitedHealthcare Commercial	$13.62

LANSOPRAZOLE CAP EC 30MG

Facility

$27.25

Hospital Charge Code	60628160
Hospital Revenue Code	250
Min. Negotiated Rate	$4.09
Max. Negotiated Rate	$4.09
Rate for Payer: Qualcare PPO/HMO/WC	$4.09

LANTHANUM CARBONATE1000MG CTAB

Facility

$75.17

Service Code	NDC 54092025490
Hospital Charge Code	60630028
Hospital Revenue Code	250
Min. Negotiated Rate	$11.28
Max. Negotiated Rate	$11.28
Rate for Payer: Qualcare PPO/HMO/WC	$11.28

LANTHANUM CARBONATE1000MG CTAB

Facility

$75.17

Service Code	NDC 54092025490
Hospital Charge Code	60630028
Hospital Revenue Code	250
Min. Negotiated Rate	$9.77
Max. Negotiated Rate	$37.59
Rate for Payer: Aetna Commercial	$22.55
Rate for Payer: Aetna Medicare Advantage	$22.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.17
Rate for Payer: Cigna Commercial	$37.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.77
Rate for Payer: Oxford Commercial	$37.59
Rate for Payer: Qualcare PPO/HMO/WC	$11.28
Rate for Payer: UnitedHealthcare Commercial	$37.59

LANTHANUM CARBONATE 500MG CTAB

Facility

$75.17

Service Code	NDC 54092025290
Hospital Charge Code	60630026
Hospital Revenue Code	250
Min. Negotiated Rate	$9.77
Max. Negotiated Rate	$37.59
Rate for Payer: Aetna Commercial	$22.55
Rate for Payer: Aetna Medicare Advantage	$22.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.17
Rate for Payer: Cigna Commercial	$37.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.77
Rate for Payer: Oxford Commercial	$37.59
Rate for Payer: Qualcare PPO/HMO/WC	$11.28
Rate for Payer: UnitedHealthcare Commercial	$37.59

LANTHANUM CARBONATE 500MG CTAB

Facility

$75.17

Service Code	NDC 54092025290
Hospital Charge Code	60630026
Hospital Revenue Code	250
Min. Negotiated Rate	$11.28
Max. Negotiated Rate	$11.28
Rate for Payer: Qualcare PPO/HMO/WC	$11.28

Know your out-of-pocket cost for care.

All Charges