Heights University Hospital

All Charges

Charge

Type

Setting

Price

METFORMIN HCL TAB 500MG

Facility

$4.50

Hospital Charge Code	6017966
Hospital Revenue Code	252
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$2.25
Rate for Payer: Aetna Commercial	$1.35
Rate for Payer: Aetna Medicare Advantage	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.15
Rate for Payer: Cigna Commercial	$2.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.59
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$0.68
Rate for Payer: UnitedHealthcare Commercial	$2.25

METFORMIN TAB 500MG

Facility

$5.23

Service Code	NDC 51079017220
Hospital Charge Code	60628240
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$0.78
Rate for Payer: Qualcare PPO/HMO/WC	$0.78

METFORMIN TAB 500MG

Facility

$5.23

Service Code	NDC 51079017220
Hospital Charge Code	60628240
Hospital Revenue Code	250
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$2.62
Rate for Payer: Aetna Commercial	$1.57
Rate for Payer: Aetna Medicare Advantage	$1.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.33
Rate for Payer: Cigna Commercial	$2.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.68
Rate for Payer: Oxford Commercial	$2.62
Rate for Payer: Qualcare PPO/HMO/WC	$0.78
Rate for Payer: UnitedHealthcare Commercial	$2.62

METFORMIN TAB 850MG

Facility

$8.04

Service Code	NDC 23155010301
Hospital Charge Code	60628879
Hospital Revenue Code	250
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$1.21

METFORMIN TAB 850MG

Facility

$8.04

Service Code	NDC 23155010301
Hospital Charge Code	60628879
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$4.02
Rate for Payer: Aetna Commercial	$2.41
Rate for Payer: Aetna Medicare Advantage	$2.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.05
Rate for Payer: Cigna Commercial	$4.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.05
Rate for Payer: Oxford Commercial	$4.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.21
Rate for Payer: UnitedHealthcare Commercial	$4.02

METFROMIN ER 750

Facility

$8.04

Service Code	NDC 53746017901
Hospital Charge Code	60635579
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$4.02
Rate for Payer: Aetna Commercial	$2.41
Rate for Payer: Aetna Medicare Advantage	$2.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.05
Rate for Payer: Cigna Commercial	$4.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.05
Rate for Payer: Oxford Commercial	$4.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.21
Rate for Payer: UnitedHealthcare Commercial	$4.02

METFROMIN ER 750

Facility

$8.04

Service Code	NDC 53746017901
Hospital Charge Code	60635579
Hospital Revenue Code	250
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$1.21

METHADONE

Facility

$259.00

Service Code	HCPCS 80358
Hospital Charge Code	38472497
Hospital Revenue Code	301
Min. Negotiated Rate	$38.85
Max. Negotiated Rate	$38.85
Rate for Payer: Qualcare PPO/HMO/WC	$38.85

METHADONE

Facility

$259.00

Service Code	HCPCS 80358
Hospital Charge Code	38472497
Hospital Revenue Code	301
Min. Negotiated Rate	$33.67
Max. Negotiated Rate	$129.50
Rate for Payer: Aetna Commercial	$77.70
Rate for Payer: Aetna Medicare Advantage	$77.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.05
Rate for Payer: Cigna Commercial	$129.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.85
Rate for Payer: UnitedHealthcare Commercial	$114.00

METHADONE 10 MG TABLET

Facility

$4.00

Service Code	NDC 54855424
Hospital Charge Code	60629336
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

METHADONE 10 MG TABLET

Facility

$4.00

Service Code	NDC 54855424
Hospital Charge Code	60629336
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

METHADONE,40MG

Facility

$4.00

Service Code	NDC 406054034
Hospital Charge Code	60635464
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

METHADONE,40MG

Facility

$4.00

Service Code	NDC 406054034
Hospital Charge Code	60635464
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

METHADONE 5 MG TABLET

Facility

$4.00

Service Code	NDC 54855324
Hospital Charge Code	60629335
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

METHADONE 5 MG TABLET

Facility

$4.00

Service Code	NDC 54855324
Hospital Charge Code	60629335
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

METHADONE INJ 10MG/1ML

Facility

$117.80

Hospital Charge Code	60627711
Hospital Revenue Code	250
Min. Negotiated Rate	$15.31
Max. Negotiated Rate	$58.90
Rate for Payer: Aetna Commercial	$35.34
Rate for Payer: Aetna Medicare Advantage	$35.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.04
Rate for Payer: Cigna Commercial	$58.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.31
Rate for Payer: Oxford Commercial	$58.90
Rate for Payer: Qualcare PPO/HMO/WC	$17.67
Rate for Payer: UnitedHealthcare Commercial	$58.90

METHADONE INJ 10MG/1ML

Facility

$117.80

Hospital Charge Code	60627711
Hospital Revenue Code	250
Min. Negotiated Rate	$17.67
Max. Negotiated Rate	$17.67
Rate for Payer: Qualcare PPO/HMO/WC	$17.67

METHADONE LIQ 1MG/ML QT

Facility

$2.45

Hospital Charge Code	6003560
Hospital Revenue Code	251
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

METHADONE LIQ 1MG/ML QT

Facility

$2.45

Hospital Charge Code	6003560
Hospital Revenue Code	251
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$1.23
Rate for Payer: Oxford Commercial	$1.23
Rate for Payer: Aetna Commercial	$0.74
Rate for Payer: Aetna Medicare Advantage	$0.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.62
Rate for Payer: Cigna Commercial	$1.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.32
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$1.23

METHADONE (QUANT URINE)

Facility

$153.65

Service Code	HCPCS 80358
Hospital Charge Code	3007630
Hospital Revenue Code	301
Min. Negotiated Rate	$19.97
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$46.09
Rate for Payer: Aetna Medicare Advantage	$46.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.18
Rate for Payer: Cigna Commercial	$76.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Commercial	$114.00

METHADONE (QUANT URINE)

Facility

$153.65

Service Code	HCPCS 80358
Hospital Charge Code	3007630
Hospital Revenue Code	301
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$23.05
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

METHADONE,UR COMFIR

Facility

$115.64

Service Code	HCPCS 80358
Hospital Charge Code	38479120
Hospital Revenue Code	301
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$17.35
Rate for Payer: Qualcare PPO/HMO/WC	$17.35

METHADONE,UR COMFIR

Facility

$115.64

Service Code	HCPCS 80358
Hospital Charge Code	38479120
Hospital Revenue Code	301
Min. Negotiated Rate	$15.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$34.69
Rate for Payer: Aetna Medicare Advantage	$34.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.49
Rate for Payer: Cigna Commercial	$57.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.35
Rate for Payer: UnitedHealthcare Commercial	$114.00

METHADONE,URINE

Facility

$115.64

Service Code	HCPCS 80358
Hospital Charge Code	38472500
Hospital Revenue Code	301
Min. Negotiated Rate	$15.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$34.69
Rate for Payer: Aetna Medicare Advantage	$34.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.49
Rate for Payer: Cigna Commercial	$57.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.35
Rate for Payer: UnitedHealthcare Commercial	$114.00

METHADONE,URINE

Facility

$115.64

Service Code	HCPCS 80358
Hospital Charge Code	38472500
Hospital Revenue Code	301
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$17.35
Rate for Payer: Qualcare PPO/HMO/WC	$17.35

Know your out-of-pocket cost for care.

All Charges