Heights University Hospital

All Charges

Charge

Type

Setting

Price

METHOCARBAMOL/750MG/TAB

Facility

$4.00

Hospital Charge Code	60633387
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

METHOCARBAMOL/750MG/TAB

Facility

$3.00

Hospital Charge Code	60633385
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

METHOCARBAMOL/750MG/TAB

Facility

$4.00

Hospital Charge Code	60633387
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

METHOCARBAMOL/750MG/TAB

Facility

$3.00

Hospital Charge Code	60633385
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

METHOCHOLINE CHALLENGE***

Facility

$283.00

Service Code	HCPCS 94070
Hospital Charge Code	9500139
Hospital Revenue Code	419
Min. Negotiated Rate	$36.79
Max. Negotiated Rate	$1,004.00
Rate for Payer: Aetna Commercial	$84.90
Rate for Payer: Aetna Medicare Advantage	$84.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$515.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.17
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.79
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.45
Rate for Payer: UnitedHealthcare Commercial	$1,004.00

METHOCHOLINE CHALLENGE***

Facility

$283.00

Service Code	HCPCS 94070
Hospital Charge Code	9500139
Hospital Revenue Code	419
Min. Negotiated Rate	$42.45
Max. Negotiated Rate	$42.45
Rate for Payer: Qualcare PPO/HMO/WC	$42.45

METHOHEXITAL NA 500MG INJ

Facility

$434.90

Service Code	NDC 54569391200
Hospital Charge Code	6063943065
Hospital Revenue Code	250
Min. Negotiated Rate	$65.23
Max. Negotiated Rate	$65.23
Rate for Payer: Qualcare PPO/HMO/WC	$65.23

METHOHEXITAL NA 500MG INJ

Facility

$434.90

Service Code	NDC 54569391200
Hospital Charge Code	6063943065
Hospital Revenue Code	250
Min. Negotiated Rate	$56.54
Max. Negotiated Rate	$217.45
Rate for Payer: Aetna Commercial	$130.47
Rate for Payer: Aetna Medicare Advantage	$130.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.90
Rate for Payer: Cigna Commercial	$217.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.54
Rate for Payer: Oxford Commercial	$217.45
Rate for Payer: Qualcare PPO/HMO/WC	$65.23
Rate for Payer: UnitedHealthcare Commercial	$217.45

METHOHEXITAL SOD INJ 500MG

Facility

$53.80

Hospital Charge Code	6003602
Hospital Revenue Code	250
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

METHOHEXITAL SOD INJ 500MG

Facility

$53.80

Hospital Charge Code	6003602
Hospital Revenue Code	250
Min. Negotiated Rate	$6.99
Max. Negotiated Rate	$26.90
Rate for Payer: Aetna Commercial	$16.14
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.99
Rate for Payer: Oxford Commercial	$26.90
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$26.90

METHOTREXATE

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3008233
Hospital Revenue Code	301
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

METHOTREXATE

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3008233
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

METHOTREXATE 2.5 MG TAB

Facility

$41.81

Service Code	NDC 378001401
Hospital Charge Code	60631731
Hospital Revenue Code	250
Min. Negotiated Rate	$5.44
Max. Negotiated Rate	$20.91
Rate for Payer: Aetna Commercial	$12.54
Rate for Payer: Aetna Medicare Advantage	$12.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.66
Rate for Payer: Cigna Commercial	$20.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.44
Rate for Payer: Oxford Commercial	$20.91
Rate for Payer: Qualcare PPO/HMO/WC	$6.27
Rate for Payer: UnitedHealthcare Commercial	$20.91

METHOTREXATE 2.5 MG TAB

Facility

$41.81

Service Code	NDC 378001401
Hospital Charge Code	60631731
Hospital Revenue Code	250
Min. Negotiated Rate	$6.27
Max. Negotiated Rate	$6.27
Rate for Payer: Qualcare PPO/HMO/WC	$6.27

METHOTREXATE/2.5MG/TAB

Facility

$13.00

Hospital Charge Code	60633388
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$3.90
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Oxford Commercial	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$6.50

METHOTREXATE/2.5MG/TAB

Facility

$18.00

Hospital Charge Code	60633389
Hospital Revenue Code	636
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$5.40
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.36
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

METHOTREXATE/2.5MG/TAB

Facility

$13.00

Hospital Charge Code	60633388
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

METHOTREXATE/2.5MG/TAB

Facility

$18.00

Hospital Charge Code	60633389
Hospital Revenue Code	636
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$4.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.36
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

METHOTREXATE 50 MG/2 ML INJ

Facility

$169.51

Service Code	HCPCS J9260
Hospital Charge Code	60627400
Hospital Revenue Code	636
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$50.85
Rate for Payer: Aetna Commercial	$50.85
Rate for Payer: Aetna Medicare Advantage	$50.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.23
Rate for Payer: Cigna Commercial	$2.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.02
Rate for Payer: Qualcare PPO/HMO/WC	$25.43

METHOTREXATE 50 MG/2 ML INJ

Facility

$169.51

Service Code	HCPCS J9260
Hospital Charge Code	60627400
Hospital Revenue Code	636
Min. Negotiated Rate	$25.43
Max. Negotiated Rate	$41.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.02
Rate for Payer: Qualcare PPO/HMO/WC	$25.43

METHOTREXATE INJ 100MG

Facility

$15.40

Hospital Charge Code	6017164
Hospital Revenue Code	250
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$7.70
Rate for Payer: Aetna Commercial	$4.62
Rate for Payer: Aetna Medicare Advantage	$4.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.93
Rate for Payer: Cigna Commercial	$7.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.00
Rate for Payer: Oxford Commercial	$7.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.31
Rate for Payer: UnitedHealthcare Commercial	$7.70

METHOTREXATE INJ 100MG

Facility

$15.40

Hospital Charge Code	6017164
Hospital Revenue Code	250
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$2.31
Rate for Payer: Qualcare PPO/HMO/WC	$2.31

METHOTREXATE INJ 1GM

Facility

$105.00

Hospital Charge Code	6017172
Hospital Revenue Code	250
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$15.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

METHOTREXATE INJ 1GM

Facility

$105.00

Hospital Charge Code	6017172
Hospital Revenue Code	250
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$31.50
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.65
Rate for Payer: Oxford Commercial	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$52.50

METHOTREXATE INJ 200MG

Facility

$19.85

Hospital Charge Code	6017156
Hospital Revenue Code	250
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$9.93
Rate for Payer: Aetna Commercial	$5.96
Rate for Payer: Aetna Medicare Advantage	$5.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.06
Rate for Payer: Cigna Commercial	$9.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.58
Rate for Payer: Oxford Commercial	$9.93
Rate for Payer: Qualcare PPO/HMO/WC	$2.98
Rate for Payer: UnitedHealthcare Commercial	$9.93

Know your out-of-pocket cost for care.

All Charges