Heights University Hospital

All Charges

Charge

Type

Setting

Price

MEPERIDINE (DEMEROL)

Facility

$190.45

Service Code	HCPCS 80300
Hospital Charge Code	3000303
Hospital Revenue Code	301
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$57.13
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$114.00

MEPERIDINE (DEMEROL)

Facility

$190.45

Service Code	HCPCS 80300
Hospital Charge Code	3000303
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

MEPERIDINE HYDROCHLORIDE 50MG

Facility

$3.45

Hospital Charge Code	6024210
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$0.52
Rate for Payer: Qualcare PPO/HMO/WC	$0.52

MEPERIDINE HYDROCHLORIDE 50MG

Facility

$3.45

Hospital Charge Code	6024210
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$1.73
Rate for Payer: Aetna Commercial	$1.03
Rate for Payer: Aetna Medicare Advantage	$1.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.88
Rate for Payer: Cigna Commercial	$1.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.45
Rate for Payer: Oxford Commercial	$1.73
Rate for Payer: Qualcare PPO/HMO/WC	$0.52
Rate for Payer: UnitedHealthcare Commercial	$1.73

MEPERIDINE INJ PCA 1MG/ML

Facility

$50.45

Hospital Charge Code	6003495
Hospital Revenue Code	250
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$25.23
Rate for Payer: Cigna Commercial	$25.23
Rate for Payer: Aetna Commercial	$15.13
Rate for Payer: Aetna Medicare Advantage	$15.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.56
Rate for Payer: Oxford Commercial	$25.23
Rate for Payer: Qualcare PPO/HMO/WC	$7.57
Rate for Payer: UnitedHealthcare Commercial	$25.23

MEPERIDINE INJ PCA 1MG/ML

Facility

$50.45

Hospital Charge Code	6003495
Hospital Revenue Code	250
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$7.57
Rate for Payer: Qualcare PPO/HMO/WC	$7.57

MEPERIDINE/NORMEPERIDINE URINE

Facility

$390.00

Service Code	HCPCS 80362
Hospital Charge Code	401080362
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MEPERIDINE/NORMEPERIDINE URINE

Facility

$390.00

Service Code	HCPCS 80362
Hospital Charge Code	401080362
Hospital Revenue Code	301
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00

MEPERIDINE RANDOM URINE

Facility

$588.25

Service Code	HCPCS 80362
Hospital Charge Code	39708046
Hospital Revenue Code	306
Min. Negotiated Rate	$76.47
Max. Negotiated Rate	$294.12
Rate for Payer: Aetna Commercial	$176.47
Rate for Payer: Aetna Medicare Advantage	$176.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.00
Rate for Payer: Cigna Commercial	$294.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.47
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$88.24
Rate for Payer: UnitedHealthcare Commercial	$114.00

MEPERIDINE RANDOM URINE

Facility

$588.25

Service Code	HCPCS 80362
Hospital Charge Code	39708046
Hospital Revenue Code	306
Min. Negotiated Rate	$88.24
Max. Negotiated Rate	$88.24
Rate for Payer: Qualcare PPO/HMO/WC	$88.24

MEPHENYTOIN

Facility

$277.00

Service Code	HCPCS 82542
Hospital Charge Code	38472676
Hospital Revenue Code	301
Min. Negotiated Rate	$41.55
Max. Negotiated Rate	$41.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.55

MEPHENYTOIN

Facility

$277.00

Service Code	HCPCS 82542
Hospital Charge Code	38472676
Hospital Revenue Code	301
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$114.00
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: Aetna Commercial	$78.05
Rate for Payer: Aetna Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.27
Rate for Payer: Cigna Commercial	$24.09
Rate for Payer: Cigna Medicare Advantage	$12.04
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.01
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.54
Rate for Payer: Wellcare Medicare Advantage	$24.09

MEPHOBARBITAL TAB 50MG

Facility

$3.20

Hospital Charge Code	60628834
Hospital Revenue Code	250
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

MEPHOBARBITAL TAB 50MG

Facility

$3.20

Hospital Charge Code	60628834
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

MEPIVACAINE HCL 1% 50ML VIAL

Facility

$54.67

Service Code	HCPCS J0670
Hospital Charge Code	606390196
Hospital Revenue Code	636
Min. Negotiated Rate	$8.20
Max. Negotiated Rate	$13.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.23
Rate for Payer: Qualcare PPO/HMO/WC	$8.20

MEPIVACAINE HCL 1% 50ML VIAL

Facility

$54.67

Service Code	HCPCS J0670
Hospital Charge Code	606390196
Hospital Revenue Code	636
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$16.40
Rate for Payer: Aetna Commercial	$16.40
Rate for Payer: Aetna Medicare Advantage	$16.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.94
Rate for Payer: Cigna Commercial	$3.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.23
Rate for Payer: Qualcare PPO/HMO/WC	$8.20

MEPIVACAINE HCL 3% DENTAL1.8ML

Facility

$161.65

Hospital Charge Code	60628278
Hospital Revenue Code	250
Min. Negotiated Rate	$24.25
Max. Negotiated Rate	$24.25
Rate for Payer: Qualcare PPO/HMO/WC	$24.25

MEPIVACAINE HCL 3% DENTAL1.8ML

Facility

$161.65

Hospital Charge Code	60628278
Hospital Revenue Code	250
Min. Negotiated Rate	$21.01
Max. Negotiated Rate	$80.83
Rate for Payer: Aetna Commercial	$48.49
Rate for Payer: Aetna Medicare Advantage	$48.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.22
Rate for Payer: Cigna Commercial	$80.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.01
Rate for Payer: Oxford Commercial	$80.83
Rate for Payer: Qualcare PPO/HMO/WC	$24.25
Rate for Payer: UnitedHealthcare Commercial	$80.83

MEPIVACAINE INJ 3% 1.8ML

Facility

$129.30

Hospital Charge Code	6003503
Hospital Revenue Code	250
Min. Negotiated Rate	$16.81
Max. Negotiated Rate	$64.65
Rate for Payer: Aetna Commercial	$38.79
Rate for Payer: Aetna Medicare Advantage	$38.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.97
Rate for Payer: Cigna Commercial	$64.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.81
Rate for Payer: Oxford Commercial	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.39
Rate for Payer: UnitedHealthcare Commercial	$64.65

MEPIVACAINE INJ 3% 1.8ML

Facility

$129.30

Hospital Charge Code	6003503
Hospital Revenue Code	250
Min. Negotiated Rate	$19.39
Max. Negotiated Rate	$19.39
Rate for Payer: Qualcare PPO/HMO/WC	$19.39

MEPROBAMATE

Facility

$124.84

Service Code	HCPCS 80339
Hospital Charge Code	38477146
Hospital Revenue Code	301
Min. Negotiated Rate	$18.73
Max. Negotiated Rate	$18.73
Rate for Payer: Qualcare PPO/HMO/WC	$18.73

MEPROBAMATE

Facility

$124.84

Service Code	HCPCS 80339
Hospital Charge Code	38477146
Hospital Revenue Code	301
Min. Negotiated Rate	$16.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.45
Rate for Payer: Aetna Medicare Advantage	$37.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.83
Rate for Payer: Cigna Commercial	$62.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.23
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.73
Rate for Payer: UnitedHealthcare Commercial	$114.00

MEPROBAMATE/400MG/TAB

Facility

$3.00

Hospital Charge Code	60633377
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

MEPROBAMATE/400MG/TAB

Facility

$3.00

Hospital Charge Code	60633377
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

MEPRON/250MG/TAB

Facility

$8.00

Hospital Charge Code	60634884
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

Know your out-of-pocket cost for care.

All Charges