Heights University Hospital

All Charges

Charge

Type

Setting

Price

MONOLITH 1 MCV 1091

Facility

$2,222.45

Hospital Charge Code	270604775
Hospital Revenue Code	272
Min. Negotiated Rate	$333.37
Max. Negotiated Rate	$333.37
Rate for Payer: Qualcare PPO/HMO/WC	$333.37

MONOPRIL/10MG/TAB/U/D

Facility

$12.00

Hospital Charge Code	60634831
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

MONOPRIL/10MG/TAB/U/D

Facility

$12.00

Hospital Charge Code	60634831
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

MONOPRIL/20MG/TAB/U/D

Facility

$12.00

Hospital Charge Code	60634832
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

MONOPRIL/20MG/TAB/U/D

Facility

$12.00

Hospital Charge Code	60634832
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

MONO SCREEN,LA

Facility

$35.55

Service Code	HCPCS 86308
Hospital Charge Code	39900209
Hospital Revenue Code	302
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.78
Rate for Payer: Aetna Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.98
Rate for Payer: Cigna Commercial	$5.18
Rate for Payer: Cigna Medicare Advantage	$2.59
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.33
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.49
Rate for Payer: Wellcare Medicare Advantage	$5.18

MONO SCREEN,LA

Facility

$35.55

Service Code	HCPCS 86308
Hospital Charge Code	39900209
Hospital Revenue Code	302
Min. Negotiated Rate	$5.33
Max. Negotiated Rate	$5.33
Rate for Payer: Qualcare PPO/HMO/WC	$5.33

MONO TEST (SCREEN)***

Facility

$42.00

Hospital Charge Code	3011913
Hospital Revenue Code	309
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

MONO TEST (SCREEN)***

Facility

$42.00

Hospital Charge Code	3011913
Hospital Revenue Code	309
Min. Negotiated Rate	$5.46
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$12.60
Rate for Payer: Aetna Medicare Advantage	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.71
Rate for Payer: Cigna Commercial	$21.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Commercial	$114.00

MONO TITER

Facility

$77.65

Service Code	HCPCS 86309
Hospital Charge Code	3003464
Hospital Revenue Code	302
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$11.65
Rate for Payer: Qualcare PPO/HMO/WC	$11.65

MONO TITER

Facility

$77.65

Service Code	HCPCS 86309
Hospital Charge Code	3003464
Hospital Revenue Code	302
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$20.96
Rate for Payer: Aetna Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.71
Rate for Payer: Cigna Commercial	$6.47
Rate for Payer: Cigna Medicare Advantage	$3.23
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.86
Rate for Payer: Wellcare Medicare Advantage	$6.47

MONOTITER (MONOSPOT)

Facility

$63.25

Service Code	HCPCS 86308
Hospital Charge Code	3001914
Hospital Revenue Code	302
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.78
Rate for Payer: Aetna Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.98
Rate for Payer: Cigna Commercial	$5.18
Rate for Payer: Cigna Medicare Advantage	$2.59
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.22
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.49
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.49
Rate for Payer: Wellcare Medicare Advantage	$5.18

MONOTITER (MONOSPOT)

Facility

$63.25

Service Code	HCPCS 86308
Hospital Charge Code	3001914
Hospital Revenue Code	302
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$9.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

MONOTUBE RED 51500475

Facility

$11,990.00

Hospital Charge Code	270643410
Hospital Revenue Code	272
Min. Negotiated Rate	$1,798.50
Max. Negotiated Rate	$1,798.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,798.50

MONOTUBE RED 51500475

Facility

$11,990.00

Hospital Charge Code	270643410
Hospital Revenue Code	272
Min. Negotiated Rate	$1,558.70
Max. Negotiated Rate	$5,995.00
Rate for Payer: Aetna Commercial	$3,597.00
Rate for Payer: Aetna Medicare Advantage	$3,597.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,057.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,057.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,057.45
Rate for Payer: Cigna Commercial	$5,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,558.70
Rate for Payer: Oxford Commercial	$5,995.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,798.50
Rate for Payer: UnitedHealthcare Commercial	$5,995.00

MONOTUBETRIAX STERILE WRIS.KIT

Facility

$11,075.00

Hospital Charge Code	270656538
Hospital Revenue Code	272
Min. Negotiated Rate	$1,439.75
Max. Negotiated Rate	$5,537.50
Rate for Payer: Aetna Commercial	$3,322.50
Rate for Payer: Aetna Medicare Advantage	$3,322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,824.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,824.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,824.12
Rate for Payer: Cigna Commercial	$5,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,439.75
Rate for Payer: Oxford Commercial	$5,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,661.25
Rate for Payer: UnitedHealthcare Commercial	$5,537.50

MONOTUBETRIAX STERILE WRIS.KIT

Facility

$11,075.00

Hospital Charge Code	270656538
Hospital Revenue Code	272
Min. Negotiated Rate	$1,661.25
Max. Negotiated Rate	$1,661.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,661.25

MONOTUBE TRIAX-STERILEWRISTKIT

Facility

$11,075.00

Hospital Charge Code	270663134
Hospital Revenue Code	270
Min. Negotiated Rate	$1,439.75
Max. Negotiated Rate	$5,537.50
Rate for Payer: Aetna Commercial	$3,322.50
Rate for Payer: Aetna Medicare Advantage	$3,322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,824.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,824.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,824.12
Rate for Payer: Cigna Commercial	$5,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,439.75
Rate for Payer: Oxford Commercial	$5,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,661.25
Rate for Payer: UnitedHealthcare Commercial	$5,537.50

MONOTUBE TRIAX-STERILEWRISTKIT

Facility

$11,075.00

Hospital Charge Code	270663134
Hospital Revenue Code	270
Min. Negotiated Rate	$1,661.25
Max. Negotiated Rate	$1,661.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,661.25

MONOTUBE TRIAX WRIST KIT

Facility

$8,771.40

Hospital Charge Code	270660594
Hospital Revenue Code	272
Min. Negotiated Rate	$1,140.28
Max. Negotiated Rate	$4,385.70
Rate for Payer: Aetna Commercial	$2,631.42
Rate for Payer: Aetna Medicare Advantage	$2,631.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,236.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,236.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,236.71
Rate for Payer: Cigna Commercial	$4,385.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,140.28
Rate for Payer: Oxford Commercial	$4,385.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,315.71
Rate for Payer: UnitedHealthcare Commercial	$4,385.70

MONOTUBE TRIAX WRIST KIT

Facility

$8,771.40

Hospital Charge Code	270660594
Hospital Revenue Code	272
Min. Negotiated Rate	$1,315.71
Max. Negotiated Rate	$1,315.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,315.71

MONSELS 8ML SOLUTION

Facility

$2.50

Hospital Charge Code	60629843
Hospital Revenue Code	250
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$0.38
Rate for Payer: Qualcare PPO/HMO/WC	$0.38

MONSELS 8ML SOLUTION

Facility

$2.50

Hospital Charge Code	60629843
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$1.25
Rate for Payer: Aetna Commercial	$0.75
Rate for Payer: Aetna Medicare Advantage	$0.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.64
Rate for Payer: Cigna Commercial	$1.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.33
Rate for Payer: Oxford Commercial	$1.25
Rate for Payer: Qualcare PPO/HMO/WC	$0.38
Rate for Payer: UnitedHealthcare Commercial	$1.25

MONTELUKAST 10 MG TAB

Facility

$37.92

Service Code	NDC 54025913
Hospital Charge Code	60629041
Hospital Revenue Code	250
Min. Negotiated Rate	$5.69
Max. Negotiated Rate	$5.69
Rate for Payer: Qualcare PPO/HMO/WC	$5.69

MONTELUKAST 10 MG TAB

Facility

$37.92

Service Code	NDC 54025913
Hospital Charge Code	60629041
Hospital Revenue Code	250
Min. Negotiated Rate	$4.93
Max. Negotiated Rate	$18.96
Rate for Payer: Aetna Commercial	$11.38
Rate for Payer: Aetna Medicare Advantage	$11.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.67
Rate for Payer: Cigna Commercial	$18.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.93
Rate for Payer: Oxford Commercial	$18.96
Rate for Payer: Qualcare PPO/HMO/WC	$5.69
Rate for Payer: UnitedHealthcare Commercial	$18.96

Know your out-of-pocket cost for care.

All Charges