Heights University Hospital

All Charges

Charge

Type

Setting

Price

METHYLENE BLUE 1%/10ML

Facility

$51.00

Hospital Charge Code	60633406
Hospital Revenue Code	250
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$25.50
Rate for Payer: Aetna Commercial	$15.30
Rate for Payer: Aetna Medicare Advantage	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.01
Rate for Payer: Cigna Commercial	$25.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.63
Rate for Payer: Oxford Commercial	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$25.50

METHYLENE BLUE 1%/10ML

Facility

$51.00

Hospital Charge Code	60633406
Hospital Revenue Code	250
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

METHYLENE BLUE INJ 10MG/ML 10M

Facility

$43.55

Hospital Charge Code	6003628
Hospital Revenue Code	250
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$6.53
Rate for Payer: Qualcare PPO/HMO/WC	$6.53

METHYLENE BLUE INJ 10MG/ML 10M

Facility

$43.55

Hospital Charge Code	6003628
Hospital Revenue Code	250
Min. Negotiated Rate	$5.66
Max. Negotiated Rate	$21.77
Rate for Payer: Aetna Commercial	$13.06
Rate for Payer: Aetna Medicare Advantage	$13.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.11
Rate for Payer: Cigna Commercial	$21.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.66
Rate for Payer: Oxford Commercial	$21.77
Rate for Payer: Qualcare PPO/HMO/WC	$6.53
Rate for Payer: UnitedHealthcare Commercial	$21.77

METHYLENE TETRA HYDRFOLATE 1

Facility

$111.00

Hospital Charge Code	3036050A
Hospital Revenue Code	301
Min. Negotiated Rate	$16.65
Max. Negotiated Rate	$16.65
Rate for Payer: Qualcare PPO/HMO/WC	$16.65

METHYLENE TETRA HYDRFOLATE 1

Facility

$111.00

Hospital Charge Code	3036050A
Hospital Revenue Code	301
Min. Negotiated Rate	$14.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$33.30
Rate for Payer: Aetna Medicare Advantage	$33.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.30
Rate for Payer: Cigna Commercial	$55.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.65
Rate for Payer: UnitedHealthcare Commercial	$114.00

METHYLENE TETRA HYDRFOLATE 2

Facility

$163.60

Hospital Charge Code	3036050B
Hospital Revenue Code	301
Min. Negotiated Rate	$24.54
Max. Negotiated Rate	$24.54
Rate for Payer: Qualcare PPO/HMO/WC	$24.54

METHYLENE TETRA HYDRFOLATE 2

Facility

$163.60

Hospital Charge Code	3036050B
Hospital Revenue Code	301
Min. Negotiated Rate	$21.27
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$49.08
Rate for Payer: Aetna Medicare Advantage	$49.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.72
Rate for Payer: Cigna Commercial	$81.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.27
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.54
Rate for Payer: UnitedHealthcare Commercial	$114.00

METHYLENE TETRA HYDRFOLATE 3

Facility

$204.00

Hospital Charge Code	3036050C
Hospital Revenue Code	301
Min. Negotiated Rate	$26.52
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$61.20
Rate for Payer: Aetna Medicare Advantage	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.02
Rate for Payer: Cigna Commercial	$102.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.52
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.60
Rate for Payer: UnitedHealthcare Commercial	$114.00

METHYLENE TETRA HYDRFOLATE 3

Facility

$204.00

Hospital Charge Code	3036050C
Hospital Revenue Code	301
Min. Negotiated Rate	$30.60
Max. Negotiated Rate	$30.60
Rate for Payer: Qualcare PPO/HMO/WC	$30.60

METHYLENE TETRA HYDRFOLATE 4

Facility

$128.00

Hospital Charge Code	3036050D
Hospital Revenue Code	301
Min. Negotiated Rate	$16.64
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$38.40
Rate for Payer: Aetna Medicare Advantage	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.64
Rate for Payer: Cigna Commercial	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$114.00

METHYLENE TETRA HYDRFOLATE 4

Facility

$128.00

Hospital Charge Code	3036050D
Hospital Revenue Code	301
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

METHYLENE TETRA HYDRFOLATE 5

Facility

$111.00

Hospital Charge Code	3036050E
Hospital Revenue Code	301
Min. Negotiated Rate	$16.65
Max. Negotiated Rate	$16.65
Rate for Payer: Qualcare PPO/HMO/WC	$16.65

METHYLENE TETRA HYDRFOLATE 5

Facility

$111.00

Hospital Charge Code	3036050E
Hospital Revenue Code	301
Min. Negotiated Rate	$14.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$33.30
Rate for Payer: Aetna Medicare Advantage	$33.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.30
Rate for Payer: Cigna Commercial	$55.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.65
Rate for Payer: UnitedHealthcare Commercial	$114.00

METHYLERGONOVINE MAL INJ .2MG

Facility

$57.49

Service Code	HCPCS J2210
Hospital Charge Code	6009161
Hospital Revenue Code	636
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$21.61
Rate for Payer: Aetna Commercial	$17.25
Rate for Payer: Aetna Medicare Advantage	$17.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.66
Rate for Payer: Cigna Commercial	$21.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.91
Rate for Payer: Qualcare PPO/HMO/WC	$8.62

METHYLERGONOVINE MAL INJ .2MG

Facility

$57.49

Service Code	HCPCS J2210
Hospital Charge Code	6009161
Hospital Revenue Code	636
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$13.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.91
Rate for Payer: Qualcare PPO/HMO/WC	$8.62

METHYLERGONOVINE TAB 0.2MG

Facility

$187.20

Service Code	NDC 43386014007
Hospital Charge Code	60628283
Hospital Revenue Code	250
Min. Negotiated Rate	$28.08
Max. Negotiated Rate	$28.08
Rate for Payer: Qualcare PPO/HMO/WC	$28.08

METHYLERGONOVINE TAB 0.2MG

Facility

$187.20

Service Code	NDC 43386014007
Hospital Charge Code	60628283
Hospital Revenue Code	250
Min. Negotiated Rate	$24.34
Max. Negotiated Rate	$93.60
Rate for Payer: Aetna Commercial	$56.16
Rate for Payer: Aetna Medicare Advantage	$56.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.74
Rate for Payer: Cigna Commercial	$93.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.34
Rate for Payer: Oxford Commercial	$93.60
Rate for Payer: Qualcare PPO/HMO/WC	$28.08
Rate for Payer: UnitedHealthcare Commercial	$93.60

METHYLMALONIC ACID

Facility

$641.00

Service Code	HCPCS 82542
Hospital Charge Code	38472012
Hospital Revenue Code	301
Min. Negotiated Rate	$96.15
Max. Negotiated Rate	$96.15
Rate for Payer: Qualcare PPO/HMO/WC	$96.15

METHYLMALONIC ACID

Facility

$641.00

Service Code	HCPCS 82542
Hospital Charge Code	38472012
Hospital Revenue Code	301
Min. Negotiated Rate	$12.04
Max. Negotiated Rate	$114.00
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: Humana Medicare Advantage	$24.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.33
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.15
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

METHYLMALONIC ACID

Facility

$509.00

Service Code	HCPCS 83921
Hospital Charge Code	38473073
Hospital Revenue Code	301
Min. Negotiated Rate	$76.35
Max. Negotiated Rate	$76.35
Rate for Payer: Qualcare PPO/HMO/WC	$76.35

METHYLMALONIC ACID

Facility

$509.00

Service Code	HCPCS 83921
Hospital Charge Code	38473073
Hospital Revenue Code	301
Min. Negotiated Rate	$10.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$68.72
Rate for Payer: Aetna Medicare Advantage	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.71
Rate for Payer: Cigna Commercial	$21.21
Rate for Payer: Cigna Medicare Advantage	$10.61
Rate for Payer: Clover Medicare Advantage	$20.15
Rate for Payer: EmblemHealth Commercial	$63.63
Rate for Payer: Humana Medicare Advantage	$21.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$76.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.21
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.48
Rate for Payer: Wellcare Medicare Advantage	$21.21

METHYLMALONIC ACID,SERUM

Facility

$667.59

Service Code	HCPCS 83921
Hospital Charge Code	39990016EX
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

METHYLMALONIC ACID,SERUM

Facility

$667.59

Service Code	HCPCS 83921
Hospital Charge Code	39990016EX
Hospital Revenue Code	301
Min. Negotiated Rate	$10.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$68.72
Rate for Payer: Aetna Medicare Advantage	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.71
Rate for Payer: Cigna Commercial	$21.21
Rate for Payer: Cigna Medicare Advantage	$10.61
Rate for Payer: Clover Medicare Advantage	$20.15
Rate for Payer: EmblemHealth Commercial	$63.63
Rate for Payer: Humana Medicare Advantage	$21.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.21
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.48
Rate for Payer: Wellcare Medicare Advantage	$21.21

METHYLMALONIC ACID,SERUM I

Facility

$113.10

Service Code	HCPCS 83918
Hospital Charge Code	39990016A
Hospital Revenue Code	301
Min. Negotiated Rate	$16.96
Max. Negotiated Rate	$16.96
Rate for Payer: Qualcare PPO/HMO/WC	$16.96

Know your out-of-pocket cost for care.

All Charges