Heights University Hospital

All Charges

Charge

Type

Setting

Price

MEZLOCILLIN OPH DROPS 100MG/ML

Facility

$946.60

Hospital Charge Code	6003719
Hospital Revenue Code	252
Min. Negotiated Rate	$123.06
Max. Negotiated Rate	$473.30
Rate for Payer: Aetna Commercial	$283.98
Rate for Payer: Aetna Medicare Advantage	$283.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.38
Rate for Payer: Cigna Commercial	$473.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.06
Rate for Payer: Oxford Commercial	$473.30
Rate for Payer: Qualcare PPO/HMO/WC	$141.99
Rate for Payer: UnitedHealthcare Commercial	$473.30

MEZLOCILLIN OPH SBCN 100MG/ML

Facility

$485.80

Hospital Charge Code	6003701
Hospital Revenue Code	252
Min. Negotiated Rate	$63.15
Max. Negotiated Rate	$242.90
Rate for Payer: Aetna Commercial	$145.74
Rate for Payer: Aetna Medicare Advantage	$145.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.88
Rate for Payer: Cigna Commercial	$242.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.15
Rate for Payer: Oxford Commercial	$242.90
Rate for Payer: Qualcare PPO/HMO/WC	$72.87
Rate for Payer: UnitedHealthcare Commercial	$242.90

MEZLOCILLIN OPH SBCN 100MG/ML

Facility

$485.80

Hospital Charge Code	6003701
Hospital Revenue Code	252
Min. Negotiated Rate	$72.87
Max. Negotiated Rate	$72.87
Rate for Payer: Qualcare PPO/HMO/WC	$72.87

MG-ALUM/SIMETH SUSP 30ML(MYLAN

Facility

$2.00

Hospital Charge Code	83652577
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.60
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$1.00

MG-ALUM/SIMETH SUSP 30ML(MYLAN

Facility

$2.00

Hospital Charge Code	83652577
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

M.GENITALIUM AMP PROBE URINE V

Facility

$173.23

Service Code	HCPCS 87563
Hospital Charge Code	401387563
Hospital Revenue Code	306
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$128.57
Rate for Payer: Aetna Commercial	$113.69
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.57
Rate for Payer: Cigna Commercial	$35.09
Rate for Payer: Cigna Medicare Advantage	$17.55
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.52
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.98
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

M.GENITALIUM AMP PROBE URINE V

Facility

$173.23

Service Code	HCPCS 87563
Hospital Charge Code	401387563
Hospital Revenue Code	306
Min. Negotiated Rate	$25.98
Max. Negotiated Rate	$25.98
Rate for Payer: Qualcare PPO/HMO/WC	$25.98

MHA-TP

Facility

$141.65

Service Code	HCPCS 86780
Hospital Charge Code	3001350
Hospital Revenue Code	302
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.90
Rate for Payer: Aetna Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.51
Rate for Payer: Cigna Commercial	$13.24
Rate for Payer: Cigna Medicare Advantage	$6.62
Rate for Payer: Clover Medicare Advantage	$12.58
Rate for Payer: EmblemHealth Commercial	$39.72
Rate for Payer: Humana Medicare Advantage	$13.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.24
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.03
Rate for Payer: Wellcare Medicare Advantage	$13.24

MHA-TP

Facility

$141.65

Service Code	HCPCS 86780
Hospital Charge Code	3001350
Hospital Revenue Code	302
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

M.HOMINIS/UREAPLASMA CULT

Facility

$105.75

Service Code	HCPCS 87109
Hospital Charge Code	39900268
Hospital Revenue Code	309
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$49.86
Rate for Payer: Aetna Medicare Advantage	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.39
Rate for Payer: Cigna Commercial	$15.39
Rate for Payer: Cigna Medicare Advantage	$7.70
Rate for Payer: Clover Medicare Advantage	$14.62
Rate for Payer: EmblemHealth Commercial	$46.17
Rate for Payer: Humana Medicare Advantage	$15.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.86
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.31
Rate for Payer: Wellcare Medicare Advantage	$15.39

M.HOMINIS/UREAPLASMA CULT

Facility

$390.00

Service Code	HCPCS 87109
Hospital Charge Code	39900490
Hospital Revenue Code	309
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$49.86
Rate for Payer: Aetna Medicare Advantage	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.39
Rate for Payer: Cigna Commercial	$15.39
Rate for Payer: Cigna Medicare Advantage	$7.70
Rate for Payer: Clover Medicare Advantage	$14.62
Rate for Payer: EmblemHealth Commercial	$46.17
Rate for Payer: Humana Medicare Advantage	$15.85
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
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.39
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.31
Rate for Payer: Wellcare Medicare Advantage	$15.39

M.HOMINIS/UREAPLASMA CULT

Facility

$390.00

Service Code	HCPCS 87109
Hospital Charge Code	39900490
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

M.HOMINIS/UREAPLASMA CULT

Facility

$105.75

Service Code	HCPCS 87109
Hospital Charge Code	39900268
Hospital Revenue Code	309
Min. Negotiated Rate	$15.86
Max. Negotiated Rate	$15.86
Rate for Payer: Qualcare PPO/HMO/WC	$15.86

MIC

Facility

$160.00

Service Code	HCPCS 87186
Hospital Charge Code	38475074
Hospital Revenue Code	309
Min. Negotiated Rate	$4.33
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$28.03
Rate for Payer: Aetna Medicare Advantage	$8.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.69
Rate for Payer: Cigna Commercial	$8.65
Rate for Payer: Cigna Medicare Advantage	$4.33
Rate for Payer: Clover Medicare Advantage	$8.22
Rate for Payer: EmblemHealth Commercial	$25.95
Rate for Payer: Humana Medicare Advantage	$8.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.17
Rate for Payer: Wellcare Medicare Advantage	$8.65

MIC

Facility

$160.00

Service Code	HCPCS 87186
Hospital Charge Code	38475074
Hospital Revenue Code	309
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

MICA DEPTH GAUGE 150 STER MICA

Facility

$558.00

Service Code	HCPCS C1713
Hospital Charge Code	270702606
Hospital Revenue Code	278
Min. Negotiated Rate	$83.70
Max. Negotiated Rate	$135.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.04
Rate for Payer: Qualcare PPO/HMO/WC	$83.70

MICA DEPTH GAUGE 150 STER MICA

Facility

$558.00

Service Code	HCPCS C1713
Hospital Charge Code	270702606
Hospital Revenue Code	278
Min. Negotiated Rate	$83.70
Max. Negotiated Rate	$279.00
Rate for Payer: Aetna Commercial	$167.40
Rate for Payer: Aetna Medicare Advantage	$167.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.29
Rate for Payer: Cigna Commercial	$279.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.04
Rate for Payer: Qualcare PPO/HMO/WC	$83.70

MICA FIRST MET TRANSL STER MIC

Facility

$567.00

Service Code	HCPCS C1713
Hospital Charge Code	270702610
Hospital Revenue Code	278
Min. Negotiated Rate	$85.05
Max. Negotiated Rate	$137.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.21
Rate for Payer: Qualcare PPO/HMO/WC	$85.05

MICA FIRST MET TRANSL STER MIC

Facility

$567.00

Service Code	HCPCS C1713
Hospital Charge Code	270702610
Hospital Revenue Code	278
Min. Negotiated Rate	$85.05
Max. Negotiated Rate	$283.50
Rate for Payer: Aetna Commercial	$170.10
Rate for Payer: Aetna Medicare Advantage	$170.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.59
Rate for Payer: Cigna Commercial	$283.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.21
Rate for Payer: Qualcare PPO/HMO/WC	$85.05

MICAFUNGIN 100 MG IV

Facility

$1,503.48

Service Code	HCPCS J2248
Hospital Charge Code	60629929
Hospital Revenue Code	636
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$451.04
Rate for Payer: Aetna Commercial	$451.04
Rate for Payer: Aetna Medicare Advantage	$451.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$383.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$383.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$383.39
Rate for Payer: Cigna Commercial	$0.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.84
Rate for Payer: Qualcare PPO/HMO/WC	$225.52

MICAFUNGIN 100 MG IV

Facility

$1,503.48

Service Code	HCPCS J2248
Hospital Charge Code	60629929
Hospital Revenue Code	636
Min. Negotiated Rate	$225.52
Max. Negotiated Rate	$363.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.84
Rate for Payer: Qualcare PPO/HMO/WC	$225.52

MICAFUNGIN SODIUM 50 MG VIAL

Facility

$751.74

Service Code	HCPCS J2248
Hospital Charge Code	60629930
Hospital Revenue Code	636
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$225.52
Rate for Payer: Aetna Commercial	$225.52
Rate for Payer: Aetna Medicare Advantage	$225.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.69
Rate for Payer: Cigna Commercial	$0.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.92
Rate for Payer: Qualcare PPO/HMO/WC	$112.76

MICAFUNGIN SODIUM 50 MG VIAL

Facility

$751.74

Service Code	HCPCS J2248
Hospital Charge Code	60629930
Hospital Revenue Code	636
Min. Negotiated Rate	$112.76
Max. Negotiated Rate	$181.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.92
Rate for Payer: Qualcare PPO/HMO/WC	$112.76

MICA PROSTEP SOLO GUIDE

Facility

$9,656.25

Hospital Charge Code	270703201
Hospital Revenue Code	270
Min. Negotiated Rate	$1,255.31
Max. Negotiated Rate	$4,828.12
Rate for Payer: Aetna Commercial	$2,896.88
Rate for Payer: Aetna Medicare Advantage	$2,896.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,462.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,462.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,462.34
Rate for Payer: Cigna Commercial	$4,828.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,255.31
Rate for Payer: Oxford Commercial	$4,828.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,448.44
Rate for Payer: UnitedHealthcare Commercial	$4,828.12

MICA PROSTEP SOLO GUIDE

Facility

$9,656.25

Hospital Charge Code	270703201
Hospital Revenue Code	270
Min. Negotiated Rate	$1,448.44
Max. Negotiated Rate	$1,448.44
Rate for Payer: Qualcare PPO/HMO/WC	$1,448.44

Know your out-of-pocket cost for care.

All Charges