Heights University Hospital

All Charges

Charge

Type

Setting

Price

MECHANICAL CHEST WALL OSCILL

Facility

$676.95

Service Code	HCPCS 94669
Hospital Charge Code	317094669
Hospital Revenue Code	410
Min. Negotiated Rate	$18.35
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$203.09
Rate for Payer: Aetna Medicare Advantage	$203.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.62
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.00
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$101.54
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

MECHANICAL VENTILATOR INITIAL

Facility

$1,411.65

Service Code	HCPCS 94002
Hospital Charge Code	9500422
Hospital Revenue Code	410
Min. Negotiated Rate	$211.75
Max. Negotiated Rate	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$211.75

MECHANICAL VENTILATOR INITIAL

Facility

$1,411.65

Service Code	HCPCS 94002
Hospital Charge Code	9500422
Hospital Revenue Code	410
Min. Negotiated Rate	$56.48
Max. Negotiated Rate	$1,471.21
Rate for Payer: Aetna Commercial	$423.50
Rate for Payer: Aetna Medicare Advantage	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$359.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$359.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$359.97
Rate for Payer: Cigna Commercial	$1,471.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.51
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$211.75
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

MECHLORETHAMINE 10MG

Facility

$117.00

Hospital Charge Code	6000178
Hospital Revenue Code	250
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$17.55
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

MECHLORETHAMINE 10MG

Facility

$117.00

Hospital Charge Code	6000178
Hospital Revenue Code	250
Min. Negotiated Rate	$15.21
Max. Negotiated Rate	$58.50
Rate for Payer: Aetna Commercial	$35.10
Rate for Payer: Aetna Medicare Advantage	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.84
Rate for Payer: Cigna Commercial	$58.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.21
Rate for Payer: Oxford Commercial	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$17.55
Rate for Payer: UnitedHealthcare Commercial	$58.50

MECHLORETHAMINE INJ 10ML

Facility

$705.36

Hospital Charge Code	6003420
Hospital Revenue Code	636
Min. Negotiated Rate	$105.80
Max. Negotiated Rate	$170.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.70
Rate for Payer: Qualcare PPO/HMO/WC	$105.80

MECHLORETHAMINE INJ 10ML

Facility

$705.36

Hospital Charge Code	6003420
Hospital Revenue Code	636
Min. Negotiated Rate	$105.80
Max. Negotiated Rate	$352.68
Rate for Payer: Aetna Commercial	$211.61
Rate for Payer: Aetna Medicare Advantage	$211.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.87
Rate for Payer: Cigna Commercial	$352.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.70
Rate for Payer: Qualcare PPO/HMO/WC	$105.80

MECH SML MODUL C/D 0-5 02185

Facility

$2,366.00

Hospital Charge Code	270634999
Hospital Revenue Code	272
Min. Negotiated Rate	$354.90
Max. Negotiated Rate	$354.90
Rate for Payer: Qualcare PPO/HMO/WC	$354.90

MECH SML MODUL C/D 0-5 02185

Facility

$2,366.00

Hospital Charge Code	270634999
Hospital Revenue Code	272
Min. Negotiated Rate	$307.58
Max. Negotiated Rate	$1,183.00
Rate for Payer: Aetna Commercial	$709.80
Rate for Payer: Aetna Medicare Advantage	$709.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$603.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$603.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$603.33
Rate for Payer: Cigna Commercial	$1,183.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.58
Rate for Payer: Oxford Commercial	$1,183.00
Rate for Payer: Qualcare PPO/HMO/WC	$354.90
Rate for Payer: UnitedHealthcare Commercial	$1,183.00

MECH VENT EA ADDL DAY

Facility

$689.00

Service Code	HCPCS 94003
Hospital Charge Code	9501148
Hospital Revenue Code	410
Min. Negotiated Rate	$103.35
Max. Negotiated Rate	$103.35
Rate for Payer: Qualcare PPO/HMO/WC	$103.35

MECH VENT EA ADDL DAY

Facility

$689.00

Service Code	HCPCS 94003
Hospital Charge Code	9501148
Hospital Revenue Code	410
Min. Negotiated Rate	$40.72
Max. Negotiated Rate	$1,471.21
Rate for Payer: Aetna Commercial	$206.70
Rate for Payer: Aetna Medicare Advantage	$206.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.69
Rate for Payer: Cigna Commercial	$1,471.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.57
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$103.35
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

MECH VENT - SUBSEQ W/SUPPL****

Facility

$258.00

Service Code	HCPCS 94657
Hospital Charge Code	9501150
Hospital Revenue Code	469
Min. Negotiated Rate	$38.70
Max. Negotiated Rate	$38.70
Rate for Payer: Qualcare PPO/HMO/WC	$38.70

MECH VENT - SUBSEQ W/SUPPL****

Facility

$258.00

Service Code	HCPCS 94657
Hospital Charge Code	9501150
Hospital Revenue Code	469
Min. Negotiated Rate	$33.54
Max. Negotiated Rate	$1,793.00
Rate for Payer: Aetna Commercial	$77.40
Rate for Payer: Aetna Medicare Advantage	$77.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.79
Rate for Payer: Cigna Commercial	$129.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.54
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.70
Rate for Payer: UnitedHealthcare Commercial	$1,793.00

MECLIZINE 12.5MG

Facility

$4.76

Service Code	NDC 49210066
Hospital Charge Code	6022677
Hospital Revenue Code	250
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$2.38
Rate for Payer: Aetna Commercial	$1.43
Rate for Payer: Aetna Medicare Advantage	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.21
Rate for Payer: Cigna Commercial	$2.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.62
Rate for Payer: Oxford Commercial	$2.38
Rate for Payer: Qualcare PPO/HMO/WC	$0.71
Rate for Payer: UnitedHealthcare Commercial	$2.38

MECLIZINE 12.5MG

Facility

$4.76

Service Code	NDC 49210066
Hospital Charge Code	6022677
Hospital Revenue Code	250
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$0.71
Rate for Payer: Qualcare PPO/HMO/WC	$0.71

MECLIZINE/25MG/TAB

Facility

$4.00

Hospital Charge Code	60633360
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

MECLIZINE/25MG/TAB

Facility

$3.00

Hospital Charge Code	60633362
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

MECLIZINE/25MG/TAB

Facility

$4.00

Hospital Charge Code	60633360
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MECLIZINE/25MG/TAB

Facility

$3.00

Hospital Charge Code	60633362
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

MECLIZINE/25MG/TAB

Facility

$3.00

Hospital Charge Code	60633361
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

MECLIZINE/25MG/TAB

Facility

$3.00

Hospital Charge Code	60633361
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

MECLIZINE TAB 25MG

Facility

$4.00

Service Code	NDC 65162044210
Hospital Charge Code	60628143
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

MECLIZINE TAB 25MG

Facility

$4.00

Service Code	NDC 65162044210
Hospital Charge Code	60628143
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MECLOFENAMATE CAP 50MG

Facility

$3.85

Hospital Charge Code	60628644
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

MECLOFENAMATE CAP 50MG

Facility

$3.85

Hospital Charge Code	60628644
Hospital Revenue Code	250
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.16
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.50
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$1.93

Know your out-of-pocket cost for care.

All Charges