Heights University Hospital

All Charges

Charge

Type

Setting

Price

MONTELUSKAST 4MG (SINGULAR)

Facility

$37.92

Service Code	NDC 93742456
Hospital Charge Code	6000385
Hospital Revenue Code	250
Min. Negotiated Rate	$5.69
Max. Negotiated Rate	$5.69
Rate for Payer: Qualcare PPO/HMO/WC	$5.69

MONTELUSKAST 4MG (SINGULAR)

Facility

$37.92

Service Code	NDC 93742456
Hospital Charge Code	6000385
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

MONTIOR HANDSET COMMUNICATOR

Facility

$5,975.00

Service Code	HCPCS C1787
Hospital Charge Code	270691736
Hospital Revenue Code	270
Min. Negotiated Rate	$776.75
Max. Negotiated Rate	$2,987.50
Rate for Payer: Aetna Commercial	$1,792.50
Rate for Payer: Aetna Medicare Advantage	$1,792.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,523.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,523.62
Rate for Payer: Cigna Commercial	$2,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$776.75
Rate for Payer: Oxford Commercial	$2,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$896.25
Rate for Payer: UnitedHealthcare Commercial	$2,987.50

MONTIOR HANDSET COMMUNICATOR

Facility

$5,975.00

Service Code	HCPCS C1787
Hospital Charge Code	270691736
Hospital Revenue Code	270
Min. Negotiated Rate	$896.25
Max. Negotiated Rate	$896.25
Rate for Payer: Qualcare PPO/HMO/WC	$896.25

MOPATH PROCEDURE LVL 7

Facility

$1,414.40

Service Code	HCPCS 81406
Hospital Charge Code	401181406A
Hospital Revenue Code	306
Min. Negotiated Rate	$212.16
Max. Negotiated Rate	$212.16
Rate for Payer: Qualcare PPO/HMO/WC	$212.16

MOPATH PROCEDURE LVL 7

Facility

$1,414.40

Service Code	HCPCS 81406
Hospital Charge Code	401181406A
Hospital Revenue Code	306
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$1,036.47
Rate for Payer: Aetna Commercial	$916.53
Rate for Payer: Aetna Medicare Advantage	$282.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,036.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,036.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$282.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,036.47
Rate for Payer: Cigna Commercial	$282.88
Rate for Payer: Cigna Medicare Advantage	$141.44
Rate for Payer: Clover Medicare Advantage	$268.74
Rate for Payer: EmblemHealth Commercial	$848.64
Rate for Payer: Humana Medicare Advantage	$291.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.87
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$212.16
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$282.88
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$299.85
Rate for Payer: Wellcare Medicare Advantage	$282.88

MOPS FEMORA CONDYLE MED

Facility

$59,800.00

Hospital Charge Code	270688279
Hospital Revenue Code	278
Min. Negotiated Rate	$8,970.00
Max. Negotiated Rate	$14,471.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,471.60
Rate for Payer: Qualcare PPO/HMO/WC	$8,970.00

MOPS FEMORA CONDYLE MED

Facility

$59,800.00

Hospital Charge Code	270688279
Hospital Revenue Code	278
Min. Negotiated Rate	$8,970.00
Max. Negotiated Rate	$29,900.00
Rate for Payer: Aetna Commercial	$17,940.00
Rate for Payer: Aetna Medicare Advantage	$17,940.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,249.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,249.00
Rate for Payer: Cigna Commercial	$29,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,471.60
Rate for Payer: Qualcare PPO/HMO/WC	$8,970.00

MORCELLATOR GYN DISP 15 MX0100

Facility

$2,945.00

Hospital Charge Code	270638551
Hospital Revenue Code	270
Min. Negotiated Rate	$441.75
Max. Negotiated Rate	$441.75
Rate for Payer: Qualcare PPO/HMO/WC	$441.75

MORCELLATOR GYN DISP 15 MX0100

Facility

$2,945.00

Hospital Charge Code	270638551
Hospital Revenue Code	270
Min. Negotiated Rate	$382.85
Max. Negotiated Rate	$1,472.50
Rate for Payer: Aetna Commercial	$883.50
Rate for Payer: Aetna Medicare Advantage	$883.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$750.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$750.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$750.98
Rate for Payer: Cigna Commercial	$1,472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$382.85
Rate for Payer: Oxford Commercial	$1,472.50
Rate for Payer: Qualcare PPO/HMO/WC	$441.75
Rate for Payer: UnitedHealthcare Commercial	$1,472.50

MORCELLATOR TIS 15 DISP DV0015

Facility

$2,624.00

Hospital Charge Code	270637619
Hospital Revenue Code	272
Min. Negotiated Rate	$341.12
Max. Negotiated Rate	$1,312.00
Rate for Payer: Aetna Commercial	$787.20
Rate for Payer: Aetna Medicare Advantage	$787.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.12
Rate for Payer: Cigna Commercial	$1,312.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.12
Rate for Payer: Oxford Commercial	$1,312.00
Rate for Payer: Qualcare PPO/HMO/WC	$393.60
Rate for Payer: UnitedHealthcare Commercial	$1,312.00

MORCELLATOR TIS 15 DISP DV0015

Facility

$2,624.00

Hospital Charge Code	270637619
Hospital Revenue Code	272
Min. Negotiated Rate	$393.60
Max. Negotiated Rate	$393.60
Rate for Payer: Qualcare PPO/HMO/WC	$393.60

MORICIZINE 300 MG TAB

Facility

$11.25

Hospital Charge Code	60628656
Hospital Revenue Code	250
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$3.38
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$5.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$5.62

MORICIZINE 300 MG TAB

Facility

$11.25

Hospital Charge Code	60628656
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

MORPHINE

Facility

$291.00

Service Code	HCPCS 80361
Hospital Charge Code	38472512
Hospital Revenue Code	301
Min. Negotiated Rate	$43.65
Max. Negotiated Rate	$43.65
Rate for Payer: Qualcare PPO/HMO/WC	$43.65

MORPHINE

Facility

$291.00

Service Code	HCPCS 80361
Hospital Charge Code	38472512
Hospital Revenue Code	301
Min. Negotiated Rate	$37.83
Max. Negotiated Rate	$145.50
Rate for Payer: Aetna Commercial	$87.30
Rate for Payer: Aetna Medicare Advantage	$87.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.20
Rate for Payer: Cigna Commercial	$145.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.65
Rate for Payer: UnitedHealthcare Commercial	$114.00

MORPHINE 100 MG/4 ML

Facility

$85.56

Service Code	HCPCS J2270
Hospital Charge Code	60630077
Hospital Revenue Code	636
Min. Negotiated Rate	$12.83
Max. Negotiated Rate	$20.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.71
Rate for Payer: Qualcare PPO/HMO/WC	$12.83

MORPHINE 100 MG/4 ML

Facility

$85.56

Service Code	HCPCS J2270
Hospital Charge Code	60630077
Hospital Revenue Code	636
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$25.67
Rate for Payer: Aetna Commercial	$25.67
Rate for Payer: Aetna Medicare Advantage	$25.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.82
Rate for Payer: Cigna Commercial	$4.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.71
Rate for Payer: Qualcare PPO/HMO/WC	$12.83

MORPHINE 100 MG/4 ML INJ

Facility

$69.00

Hospital Charge Code	60634956
Hospital Revenue Code	636
Min. Negotiated Rate	$10.35
Max. Negotiated Rate	$16.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.70
Rate for Payer: Qualcare PPO/HMO/WC	$10.35

MORPHINE 100 MG/4 ML INJ

Facility

$69.00

Hospital Charge Code	60634956
Hospital Revenue Code	636
Min. Negotiated Rate	$10.35
Max. Negotiated Rate	$34.50
Rate for Payer: Aetna Commercial	$20.70
Rate for Payer: Aetna Medicare Advantage	$20.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.59
Rate for Payer: Cigna Commercial	$34.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.70
Rate for Payer: Qualcare PPO/HMO/WC	$10.35

MORPHINE 10MG/0.5ML ORAL SYR

Facility

$16.82

Service Code	NDC 68094075401
Hospital Charge Code	606390135
Hospital Revenue Code	250
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$2.52
Rate for Payer: Qualcare PPO/HMO/WC	$2.52

MORPHINE 10MG/0.5ML ORAL SYR

Facility

$16.82

Service Code	NDC 68094075401
Hospital Charge Code	606390135
Hospital Revenue Code	250
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$8.41
Rate for Payer: Aetna Commercial	$5.05
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.29
Rate for Payer: Cigna Commercial	$8.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.19
Rate for Payer: Oxford Commercial	$8.41
Rate for Payer: Qualcare PPO/HMO/WC	$2.52
Rate for Payer: UnitedHealthcare Commercial	$8.41

MORPHINE 10MG/10ML

Facility

$15.40

Hospital Charge Code	6012108
Hospital Revenue Code	250
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$2.31
Rate for Payer: Qualcare PPO/HMO/WC	$2.31

MORPHINE 10MG/10ML

Facility

$15.40

Hospital Charge Code	6012108
Hospital Revenue Code	250
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$7.70
Rate for Payer: Aetna Commercial	$4.62
Rate for Payer: Aetna Medicare Advantage	$4.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.93
Rate for Payer: Cigna Commercial	$7.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.00
Rate for Payer: Oxford Commercial	$7.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.31
Rate for Payer: UnitedHealthcare Commercial	$7.70

MORPHINE 10 MG/5 ML ORAL SOLN

Facility

$4.09

Service Code	NDC 54023749
Hospital Charge Code	60627714
Hospital Revenue Code	250
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$2.04
Rate for Payer: Aetna Commercial	$1.23
Rate for Payer: Aetna Medicare Advantage	$1.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.04
Rate for Payer: Cigna Commercial	$2.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.53
Rate for Payer: Oxford Commercial	$2.04
Rate for Payer: Qualcare PPO/HMO/WC	$0.61
Rate for Payer: UnitedHealthcare Commercial	$2.04

Know your out-of-pocket cost for care.

All Charges