Heights University Hospital

All Charges

Charge

Type

Setting

Price

MENTHOL CAM EUCALYP OINT 45GM

Facility

$21.15

Hospital Charge Code	6003461
Hospital Revenue Code	251
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

MENTHOL CAM METHYLSA LOT 60ML

Facility

$327.05

Hospital Charge Code	6003479
Hospital Revenue Code	251
Min. Negotiated Rate	$42.52
Max. Negotiated Rate	$163.53
Rate for Payer: Aetna Commercial	$98.11
Rate for Payer: Aetna Medicare Advantage	$98.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.40
Rate for Payer: Cigna Commercial	$163.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.52
Rate for Payer: Oxford Commercial	$163.53
Rate for Payer: Qualcare PPO/HMO/WC	$49.06
Rate for Payer: UnitedHealthcare Commercial	$163.53

MENTHOL CAM METHYLSA LOT 60ML

Facility

$327.05

Hospital Charge Code	6003479
Hospital Revenue Code	251
Min. Negotiated Rate	$49.06
Max. Negotiated Rate	$49.06
Rate for Payer: Qualcare PPO/HMO/WC	$49.06

MENTHOL CREAM

Facility

$28.48

Service Code	NDC 41167000885
Hospital Charge Code	606390512
Hospital Revenue Code	250
Min. Negotiated Rate	$4.27
Max. Negotiated Rate	$4.27
Rate for Payer: Qualcare PPO/HMO/WC	$4.27

MENTHOL CREAM

Facility

$28.48

Service Code	NDC 41167000885
Hospital Charge Code	606390512
Hospital Revenue Code	250
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$14.24
Rate for Payer: Aetna Commercial	$8.54
Rate for Payer: Aetna Medicare Advantage	$8.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.26
Rate for Payer: Cigna Commercial	$14.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.70
Rate for Payer: Oxford Commercial	$14.24
Rate for Payer: Qualcare PPO/HMO/WC	$4.27
Rate for Payer: UnitedHealthcare Commercial	$14.24

MENTHOL GEL

Facility

$20.00

Hospital Charge Code	60628645
Hospital Revenue Code	250
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

MENTHOL GEL

Facility

$20.00

Hospital Charge Code	60628645
Hospital Revenue Code	250
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$6.00
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$10.00

MENTHOL METHYL OINT

Facility

$12.73

Service Code	NDC 54162055501
Hospital Charge Code	60628451
Hospital Revenue Code	250
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$1.91
Rate for Payer: Qualcare PPO/HMO/WC	$1.91

MENTHOL METHYL OINT

Facility

$12.73

Service Code	NDC 54162055501
Hospital Charge Code	60628451
Hospital Revenue Code	250
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$6.37
Rate for Payer: Aetna Commercial	$3.82
Rate for Payer: Aetna Medicare Advantage	$3.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.25
Rate for Payer: Cigna Commercial	$6.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.65
Rate for Payer: Oxford Commercial	$6.37
Rate for Payer: Qualcare PPO/HMO/WC	$1.91
Rate for Payer: UnitedHealthcare Commercial	$6.37

MENTHOL METHYLSALIE CRM 35GM

Facility

$21.15

Hospital Charge Code	6003487
Hospital Revenue Code	251
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

MENTHOL METHYLSALIE CRM 35GM

Facility

$21.15

Hospital Charge Code	6003487
Hospital Revenue Code	251
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

MENTHOL OINT 2%

Facility

$25.60

Hospital Charge Code	60628466
Hospital Revenue Code	250
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$12.80
Rate for Payer: Aetna Commercial	$7.68
Rate for Payer: Aetna Medicare Advantage	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.53
Rate for Payer: Cigna Commercial	$12.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.33
Rate for Payer: Oxford Commercial	$12.80
Rate for Payer: Qualcare PPO/HMO/WC	$3.84
Rate for Payer: UnitedHealthcare Commercial	$12.80

MENTHOL OINT 2%

Facility

$25.60

Hospital Charge Code	60628466
Hospital Revenue Code	250
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$3.84
Rate for Payer: Qualcare PPO/HMO/WC	$3.84

MEPERIDINE 100MG/ML

Facility

$5.65

Hospital Charge Code	6012058
Hospital Revenue Code	250
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$1.70
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.73
Rate for Payer: Oxford Commercial	$2.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$2.83

MEPERIDINE 100MG/ML

Facility

$5.65

Hospital Charge Code	6012058
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

MEPERIDINE 25MG/ML

Facility

$6.77

Service Code	HCPCS J2175
Hospital Charge Code	6012025
Hospital Revenue Code	636
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.02

MEPERIDINE 25MG/ML

Facility

$6.77

Service Code	HCPCS J2175
Hospital Charge Code	6012025
Hospital Revenue Code	636
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$8.82
Rate for Payer: Aetna Commercial	$2.03
Rate for Payer: Aetna Medicare Advantage	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.73
Rate for Payer: Cigna Commercial	$8.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.02

MEPERIDINE/300MG FOR PCA

Facility

$63.00

Hospital Charge Code	60634944
Hospital Revenue Code	250
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

MEPERIDINE/300MG FOR PCA

Facility

$63.00

Hospital Charge Code	60634944
Hospital Revenue Code	250
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna Commercial	$18.90
Rate for Payer: Aetna Medicare Advantage	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.07
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.19
Rate for Payer: Oxford Commercial	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$31.50

MEPERIDINE 50MG

Facility

$3.20

Hospital Charge Code	6022081
Hospital Revenue Code	251
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

MEPERIDINE 50MG

Facility

$3.20

Hospital Charge Code	6022081
Hospital Revenue Code	251
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$1.60
Rate for Payer: Aetna Commercial	$0.96
Rate for Payer: Aetna Medicare Advantage	$0.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.82
Rate for Payer: Cigna Commercial	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.42
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.48
Rate for Payer: UnitedHealthcare Commercial	$1.60

MEPERIDINE 50MG/ML

Facility

$5.30

Hospital Charge Code	6012033
Hospital Revenue Code	250
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$2.65
Rate for Payer: Aetna Commercial	$1.59
Rate for Payer: Aetna Medicare Advantage	$1.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.35
Rate for Payer: Cigna Commercial	$2.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.69
Rate for Payer: Oxford Commercial	$2.65
Rate for Payer: Qualcare PPO/HMO/WC	$0.80
Rate for Payer: UnitedHealthcare Commercial	$2.65

MEPERIDINE 50MG/ML

Facility

$5.30

Hospital Charge Code	6012033
Hospital Revenue Code	250
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.80

MEPERIDINE 75MG/ML

Facility

$5.65

Hospital Charge Code	6012041
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

MEPERIDINE 75MG/ML

Facility

$5.65

Hospital Charge Code	6012041
Hospital Revenue Code	250
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$1.70
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.73
Rate for Payer: Oxford Commercial	$2.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$2.83

Know your out-of-pocket cost for care.

All Charges