Heights University Hospital

All Charges

Charge

Type

Setting

Price

MICA SCREW

Facility

$2,860.00

Hospital Charge Code	270703200
Hospital Revenue Code	278
Min. Negotiated Rate	$429.00
Max. Negotiated Rate	$692.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.12
Rate for Payer: Qualcare PPO/HMO/WC	$429.00

MICA SCREW

Facility

$2,860.00

Hospital Charge Code	270703200
Hospital Revenue Code	278
Min. Negotiated Rate	$429.00
Max. Negotiated Rate	$1,430.00
Rate for Payer: Aetna Commercial	$858.00
Rate for Payer: Aetna Medicare Advantage	$858.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$729.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$729.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$572.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$729.30
Rate for Payer: Cigna Commercial	$1,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$692.12
Rate for Payer: Qualcare PPO/HMO/WC	$429.00

MICA SCREW 4X60MM

Facility

$2,845.25

Hospital Charge Code	270702620
Hospital Revenue Code	278
Min. Negotiated Rate	$426.79
Max. Negotiated Rate	$688.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79

MICA SCREW 4X60MM

Facility

$2,845.25

Hospital Charge Code	270702620
Hospital Revenue Code	278
Min. Negotiated Rate	$426.79
Max. Negotiated Rate	$1,422.62
Rate for Payer: Aetna Commercial	$853.58
Rate for Payer: Aetna Medicare Advantage	$853.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$725.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$725.54
Rate for Payer: Cigna Commercial	$1,422.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.55
Rate for Payer: Qualcare PPO/HMO/WC	$426.79

MICONAZALE CRM TOP 2% 15GM

Facility

$109.45

Hospital Charge Code	6009187
Hospital Revenue Code	251
Min. Negotiated Rate	$14.23
Max. Negotiated Rate	$54.73
Rate for Payer: Aetna Commercial	$32.84
Rate for Payer: Aetna Medicare Advantage	$32.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.91
Rate for Payer: Cigna Commercial	$54.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.23
Rate for Payer: Oxford Commercial	$54.73
Rate for Payer: Qualcare PPO/HMO/WC	$16.42
Rate for Payer: UnitedHealthcare Commercial	$54.73

MICONAZALE CRM TOP 2% 15GM

Facility

$109.45

Hospital Charge Code	6009187
Hospital Revenue Code	251
Min. Negotiated Rate	$16.42
Max. Negotiated Rate	$16.42
Rate for Payer: Qualcare PPO/HMO/WC	$16.42

MICONAZOLE CRM 2% 28GM

Facility

$136.35

Hospital Charge Code	6003727
Hospital Revenue Code	251
Min. Negotiated Rate	$17.73
Max. Negotiated Rate	$68.17
Rate for Payer: Aetna Commercial	$40.91
Rate for Payer: Aetna Medicare Advantage	$40.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.77
Rate for Payer: Cigna Commercial	$68.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.73
Rate for Payer: Oxford Commercial	$68.17
Rate for Payer: Qualcare PPO/HMO/WC	$20.45
Rate for Payer: UnitedHealthcare Commercial	$68.17

MICONAZOLE CRM 2% 28GM

Facility

$136.35

Hospital Charge Code	6003727
Hospital Revenue Code	251
Min. Negotiated Rate	$20.45
Max. Negotiated Rate	$20.45
Rate for Payer: Qualcare PPO/HMO/WC	$20.45

MICONAZOLE NITRATE 100 MG SUP

Facility

$6.23

Service Code	NDC 713019757
Hospital Charge Code	60628340
Hospital Revenue Code	250
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$3.12
Rate for Payer: Aetna Commercial	$1.87
Rate for Payer: Aetna Medicare Advantage	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.59
Rate for Payer: Cigna Commercial	$3.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.81
Rate for Payer: Oxford Commercial	$3.12
Rate for Payer: Qualcare PPO/HMO/WC	$0.93
Rate for Payer: UnitedHealthcare Commercial	$3.12

MICONAZOLE NITRATE 100 MG SUP

Facility

$6.23

Service Code	NDC 713019757
Hospital Charge Code	60628340
Hospital Revenue Code	250
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$0.93
Rate for Payer: Qualcare PPO/HMO/WC	$0.93

MICONAZOLE NITRATE 2% CREAM

Facility

$49.18

Service Code	NDC 603780550
Hospital Charge Code	60628341
Hospital Revenue Code	250
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$7.38
Rate for Payer: Qualcare PPO/HMO/WC	$7.38

MICONAZOLE NITRATE 2% CREAM

Facility

$49.18

Service Code	NDC 603780550
Hospital Charge Code	60628341
Hospital Revenue Code	250
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$24.59
Rate for Payer: Aetna Commercial	$14.75
Rate for Payer: Aetna Medicare Advantage	$14.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.54
Rate for Payer: Cigna Commercial	$24.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.39
Rate for Payer: Oxford Commercial	$24.59
Rate for Payer: Qualcare PPO/HMO/WC	$7.38
Rate for Payer: UnitedHealthcare Commercial	$24.59

MICONAZOLE NITRATE 45 GM CRE

Facility

$78.99

Service Code	NDC 904773445
Hospital Charge Code	6009179
Hospital Revenue Code	251
Min. Negotiated Rate	$11.85
Max. Negotiated Rate	$11.85
Rate for Payer: Qualcare PPO/HMO/WC	$11.85

MICONAZOLE NITRATE 45 GM CRE

Facility

$78.99

Service Code	NDC 904773445
Hospital Charge Code	6009179
Hospital Revenue Code	251
Min. Negotiated Rate	$10.27
Max. Negotiated Rate	$39.49
Rate for Payer: Aetna Commercial	$23.70
Rate for Payer: Aetna Medicare Advantage	$23.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.14
Rate for Payer: Cigna Commercial	$39.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.27
Rate for Payer: Oxford Commercial	$39.49
Rate for Payer: Qualcare PPO/HMO/WC	$11.85
Rate for Payer: UnitedHealthcare Commercial	$39.49

MICONAZOLE VAG CRM 2% 45GM

Facility

$142.75

Hospital Charge Code	6003743
Hospital Revenue Code	251
Min. Negotiated Rate	$21.41
Max. Negotiated Rate	$21.41
Rate for Payer: Qualcare PPO/HMO/WC	$21.41

MICONAZOLE VAG CRM 2% 45GM

Facility

$142.75

Hospital Charge Code	6003743
Hospital Revenue Code	251
Min. Negotiated Rate	$18.56
Max. Negotiated Rate	$71.38
Rate for Payer: Aetna Commercial	$42.83
Rate for Payer: Aetna Medicare Advantage	$42.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.40
Rate for Payer: Cigna Commercial	$71.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.56
Rate for Payer: Oxford Commercial	$71.38
Rate for Payer: Qualcare PPO/HMO/WC	$21.41
Rate for Payer: UnitedHealthcare Commercial	$71.38

MICONAZOLE VAG SUPP

Facility

$152.35

Hospital Charge Code	6003735
Hospital Revenue Code	251
Min. Negotiated Rate	$22.85
Max. Negotiated Rate	$22.85
Rate for Payer: Qualcare PPO/HMO/WC	$22.85

MICONAZOLE VAG SUPP

Facility

$152.35

Hospital Charge Code	6003735
Hospital Revenue Code	251
Min. Negotiated Rate	$19.81
Max. Negotiated Rate	$76.17
Rate for Payer: Aetna Commercial	$45.70
Rate for Payer: Aetna Medicare Advantage	$45.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.85
Rate for Payer: Cigna Commercial	$76.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.81
Rate for Payer: Oxford Commercial	$76.17
Rate for Payer: Qualcare PPO/HMO/WC	$22.85
Rate for Payer: UnitedHealthcare Commercial	$76.17

MICONAZOLE VAG SUPP 100MG

Facility

$19.85

Hospital Charge Code	6008957
Hospital Revenue Code	251
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

MICONAZOLE VAG SUPP 100MG

Facility

$19.85

Hospital Charge Code	6008957
Hospital Revenue Code	251
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$2.98
Rate for Payer: Qualcare PPO/HMO/WC	$2.98

MIC PLUS STREP PANEL

Facility

$66.25

Service Code	HCPCS 87184
Hospital Charge Code	3008747
Hospital Revenue Code	309
Min. Negotiated Rate	$9.94
Max. Negotiated Rate	$9.94
Rate for Payer: Qualcare PPO/HMO/WC	$9.94

MIC PLUS STREP PANEL

Facility

$66.25

Service Code	HCPCS 87184
Hospital Charge Code	3008747
Hospital Revenue Code	309
Min. Negotiated Rate	$3.74
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$24.24
Rate for Payer: Aetna Medicare Advantage	$7.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.41
Rate for Payer: Cigna Commercial	$7.48
Rate for Payer: Cigna Medicare Advantage	$3.74
Rate for Payer: Clover Medicare Advantage	$7.11
Rate for Payer: EmblemHealth Commercial	$22.44
Rate for Payer: Humana Medicare Advantage	$7.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.94
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.48
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.93
Rate for Payer: Wellcare Medicare Advantage	$7.48

MICR INTROD KIT 5FR UNIV SAFTY

Facility

$220.00

Hospital Charge Code	270649243
Hospital Revenue Code	272
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

MICR INTROD KIT 5FR UNIV SAFTY

Facility

$220.00

Hospital Charge Code	270649243
Hospital Revenue Code	272
Min. Negotiated Rate	$28.60
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$66.00
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.60
Rate for Payer: Oxford Commercial	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Commercial	$110.00

MICROALBUMIN,24HU(W/O CR)

Facility

$390.00

Service Code	HCPCS 82043
Hospital Charge Code	39900034
Hospital Revenue Code	307
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.73
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.18
Rate for Payer: Cigna Commercial	$5.78
Rate for Payer: Cigna Medicare Advantage	$2.89
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
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	$5.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.13
Rate for Payer: Wellcare Medicare Advantage	$5.78

Know your out-of-pocket cost for care.

All Charges