Heights University Hospital

All Charges

Charge

Type

Setting

Price

MOMETASONE FUROATE 220MCG

Facility

$355.00

Hospital Charge Code	60635780
Hospital Revenue Code	250
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$53.25
Rate for Payer: Qualcare PPO/HMO/WC	$53.25

MOMETASONE OINT 0.1%

Facility

$234.90

Hospital Charge Code	60628401
Hospital Revenue Code	250
Min. Negotiated Rate	$30.54
Max. Negotiated Rate	$117.45
Rate for Payer: Aetna Commercial	$70.47
Rate for Payer: Aetna Medicare Advantage	$70.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.90
Rate for Payer: Cigna Commercial	$117.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.54
Rate for Payer: Oxford Commercial	$117.45
Rate for Payer: Qualcare PPO/HMO/WC	$35.23
Rate for Payer: UnitedHealthcare Commercial	$117.45

MOMETASONE OINT 0.1%

Facility

$234.90

Hospital Charge Code	60628401
Hospital Revenue Code	250
Min. Negotiated Rate	$35.23
Max. Negotiated Rate	$35.23
Rate for Payer: Qualcare PPO/HMO/WC	$35.23

MONBLK CR NEX TRAB MTL58864410

Facility

$15,118.20

Hospital Charge Code	2709639087
Hospital Revenue Code	278
Min. Negotiated Rate	$2,267.73
Max. Negotiated Rate	$3,658.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,023.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,658.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,267.73

MONBLK CR NEX TRAB MTL58864410

Facility

$18,897.75

Hospital Charge Code	270639087
Hospital Revenue Code	278
Min. Negotiated Rate	$2,834.66
Max. Negotiated Rate	$9,448.88
Rate for Payer: Aetna Commercial	$5,669.32
Rate for Payer: Aetna Medicare Advantage	$5,669.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,818.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,818.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,779.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,818.93
Rate for Payer: Cigna Commercial	$9,448.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,573.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,834.66

MONBLK CR NEX TRAB MTL58864410

Facility

$18,897.75

Hospital Charge Code	270639087
Hospital Revenue Code	278
Min. Negotiated Rate	$2,834.66
Max. Negotiated Rate	$4,573.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,779.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,573.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,834.66

MONBLK CR NEX TRAB MTL58864410

Facility

$15,118.20

Hospital Charge Code	2709639087
Hospital Revenue Code	278
Min. Negotiated Rate	$2,267.73
Max. Negotiated Rate	$7,559.10
Rate for Payer: Aetna Commercial	$4,535.46
Rate for Payer: Aetna Medicare Advantage	$4,535.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,855.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,855.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,023.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,855.14
Rate for Payer: Cigna Commercial	$7,559.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,658.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,267.73

MONILLA SMEAR***

Facility

$14.00

Hospital Charge Code	3010238
Hospital Revenue Code	306
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

MONILLA SMEAR***

Facility

$14.00

Hospital Charge Code	3010238
Hospital Revenue Code	306
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$4.20
Rate for Payer: Aetna Medicare Advantage	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.57
Rate for Payer: Cigna Commercial	$7.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$114.00

MONISTAT 3/200MG/EACH

Facility

$127.97

Service Code	NDC 472173803
Hospital Charge Code	60633443
Hospital Revenue Code	250
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

MONISTAT 3/200MG/EACH

Facility

$127.97

Service Code	NDC 472173803
Hospital Charge Code	60633443
Hospital Revenue Code	250
Min. Negotiated Rate	$16.64
Max. Negotiated Rate	$63.98
Rate for Payer: Aetna Commercial	$38.39
Rate for Payer: Aetna Medicare Advantage	$38.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.63
Rate for Payer: Cigna Commercial	$63.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$63.98
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$63.98

MONISTAT 7/100MG/EACH

Facility

$18.00

Hospital Charge Code	60633444
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

MONISTAT 7/100MG/EACH

Facility

$18.00

Hospital Charge Code	60633444
Hospital Revenue Code	250
Min. Negotiated Rate	$2.34
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	$2.34
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$9.00

MONISTAT 7 2%/45GM

Facility

$15.00

Hospital Charge Code	60633445
Hospital Revenue Code	250
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

MONISTAT 7 2%/45GM

Facility

$15.00

Hospital Charge Code	60633445
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

MONISTAT-DERM 2%/30GM

Facility

$110.00

Hospital Charge Code	60633446
Hospital Revenue Code	250
Min. Negotiated Rate	$14.30
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$33.00
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$55.00

MONISTAT-DERM 2%/30GM

Facility

$110.00

Hospital Charge Code	60633446
Hospital Revenue Code	250
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

MONISTAT IV

Facility

$122.00

Hospital Charge Code	60634505
Hospital Revenue Code	250
Min. Negotiated Rate	$15.86
Max. Negotiated Rate	$61.00
Rate for Payer: Aetna Commercial	$36.60
Rate for Payer: Aetna Medicare Advantage	$36.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.11
Rate for Payer: Cigna Commercial	$61.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.86
Rate for Payer: Oxford Commercial	$61.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.30
Rate for Payer: UnitedHealthcare Commercial	$61.00

MONISTAT IV

Facility

$122.00

Hospital Charge Code	60634505
Hospital Revenue Code	250
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$18.30
Rate for Payer: Qualcare PPO/HMO/WC	$18.30

MONITOR BELT DISPOSABLE

Facility

$14.10

Hospital Charge Code	270664965
Hospital Revenue Code	270
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$7.05
Rate for Payer: Aetna Commercial	$4.23
Rate for Payer: Aetna Medicare Advantage	$4.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.60
Rate for Payer: Cigna Commercial	$7.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.83
Rate for Payer: Oxford Commercial	$7.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.12
Rate for Payer: UnitedHealthcare Commercial	$7.05

MONITOR BELT DISPOSABLE

Facility

$14.10

Hospital Charge Code	270664965
Hospital Revenue Code	270
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$2.12
Rate for Payer: Qualcare PPO/HMO/WC	$2.12

MONITOR CARDIAC AF REVEAL LINQ

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270698999S
Hospital Revenue Code	278
Min. Negotiated Rate	$3,746.25
Max. Negotiated Rate	$6,043.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25

MONITOR CARDIAC AF REVEAL LINQ

Facility

$24,975.00

Service Code	HCPCS C1764
Hospital Charge Code	270698999S
Hospital Revenue Code	278
Min. Negotiated Rate	$3,746.25
Max. Negotiated Rate	$12,487.50
Rate for Payer: Aetna Commercial	$7,492.50
Rate for Payer: Aetna Medicare Advantage	$7,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,368.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,368.62
Rate for Payer: Cigna Commercial	$12,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,043.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,746.25

MONITOR CO2 LNG TERM ORAL/NASL

Facility

$87.04

Hospital Charge Code	270652786
Hospital Revenue Code	270
Min. Negotiated Rate	$13.06
Max. Negotiated Rate	$13.06
Rate for Payer: Qualcare PPO/HMO/WC	$13.06

MONITOR CO2 LNG TERM ORAL/NASL

Facility

$87.04

Hospital Charge Code	270652786
Hospital Revenue Code	270
Min. Negotiated Rate	$11.32
Max. Negotiated Rate	$43.52
Rate for Payer: Aetna Commercial	$26.11
Rate for Payer: Aetna Medicare Advantage	$26.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.20
Rate for Payer: Cigna Commercial	$43.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.32
Rate for Payer: Oxford Commercial	$43.52
Rate for Payer: Qualcare PPO/HMO/WC	$13.06
Rate for Payer: UnitedHealthcare Commercial	$43.52

Know your out-of-pocket cost for care.

All Charges