Heights University Hospital

All Charges

Charge

Type

Setting

Price

ATOMOXETINE HYDROCHLORIDE 80 M

Facility

$87.57

Service Code	NDC 2325030
Hospital Charge Code	6063943183
Hospital Revenue Code	250
Min. Negotiated Rate	$13.14
Max. Negotiated Rate	$13.14
Rate for Payer: Qualcare PPO/HMO/WC	$13.14

ATORVASTATIN 10 MG TAB

Facility

$51.12

Service Code	NDC 71015540
Hospital Charge Code	60627618
Hospital Revenue Code	250
Min. Negotiated Rate	$6.65
Max. Negotiated Rate	$25.56
Rate for Payer: Aetna Commercial	$15.34
Rate for Payer: Aetna Medicare Advantage	$15.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.04
Rate for Payer: Cigna Commercial	$25.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.65
Rate for Payer: Oxford Commercial	$25.56
Rate for Payer: Qualcare PPO/HMO/WC	$7.67
Rate for Payer: UnitedHealthcare Commercial	$25.56

ATORVASTATIN 10 MG TAB

Facility

$51.12

Service Code	NDC 71015540
Hospital Charge Code	60627618
Hospital Revenue Code	250
Min. Negotiated Rate	$7.67
Max. Negotiated Rate	$7.67
Rate for Payer: Qualcare PPO/HMO/WC	$7.67

ATORVASTATIN 20 MG TAB

Facility

$72.90

Service Code	NDC 71015640
Hospital Charge Code	60628829
Hospital Revenue Code	250
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$36.45
Rate for Payer: Aetna Commercial	$21.87
Rate for Payer: Aetna Medicare Advantage	$21.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.59
Rate for Payer: Cigna Commercial	$36.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.48
Rate for Payer: Oxford Commercial	$36.45
Rate for Payer: Qualcare PPO/HMO/WC	$10.94
Rate for Payer: UnitedHealthcare Commercial	$36.45

ATORVASTATIN 20 MG TAB

Facility

$72.90

Service Code	NDC 71015640
Hospital Charge Code	60628829
Hospital Revenue Code	250
Min. Negotiated Rate	$10.94
Max. Negotiated Rate	$10.94
Rate for Payer: Qualcare PPO/HMO/WC	$10.94

ATORVASTATIN 40MG TAB

Facility

$72.90

Service Code	NDC 71015740
Hospital Charge Code	60630070
Hospital Revenue Code	250
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$36.45
Rate for Payer: Aetna Commercial	$21.87
Rate for Payer: Aetna Medicare Advantage	$21.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.59
Rate for Payer: Cigna Commercial	$36.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.48
Rate for Payer: Oxford Commercial	$36.45
Rate for Payer: Qualcare PPO/HMO/WC	$10.94
Rate for Payer: UnitedHealthcare Commercial	$36.45

ATORVASTATIN 40MG TAB

Facility

$72.90

Service Code	NDC 71015740
Hospital Charge Code	60630070
Hospital Revenue Code	250
Min. Negotiated Rate	$10.94
Max. Negotiated Rate	$10.94
Rate for Payer: Qualcare PPO/HMO/WC	$10.94

ATORVASTATIN CALCIUM TAB 10MG

Facility

$13.45

Hospital Charge Code	6020002
Hospital Revenue Code	252
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$6.72
Rate for Payer: Aetna Commercial	$4.04
Rate for Payer: Aetna Medicare Advantage	$4.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.43
Rate for Payer: Cigna Commercial	$6.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.75
Rate for Payer: Oxford Commercial	$6.72
Rate for Payer: Qualcare PPO/HMO/WC	$2.02
Rate for Payer: UnitedHealthcare Commercial	$6.72

ATORVASTATIN CALCIUM TAB 10MG

Facility

$13.45

Hospital Charge Code	6020002
Hospital Revenue Code	252
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$2.02
Rate for Payer: Qualcare PPO/HMO/WC	$2.02

ATOVAQUONE 750 MG/5 ML SUSP

Facility

$232.89

Service Code	NDC 173054700
Hospital Charge Code	60628939
Hospital Revenue Code	250
Min. Negotiated Rate	$34.93
Max. Negotiated Rate	$34.93
Rate for Payer: Qualcare PPO/HMO/WC	$34.93

ATOVAQUONE 750 MG/5 ML SUSP

Facility

$232.89

Service Code	NDC 173054700
Hospital Charge Code	60628939
Hospital Revenue Code	250
Min. Negotiated Rate	$30.28
Max. Negotiated Rate	$116.44
Rate for Payer: Aetna Commercial	$69.87
Rate for Payer: Aetna Medicare Advantage	$69.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.39
Rate for Payer: Cigna Commercial	$116.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.28
Rate for Payer: Oxford Commercial	$116.44
Rate for Payer: Qualcare PPO/HMO/WC	$34.93
Rate for Payer: UnitedHealthcare Commercial	$116.44

AT PROCEDURE UNSCHEDULE

Facility

$3,240.00

Hospital Charge Code	270605797
Hospital Revenue Code	272
Min. Negotiated Rate	$486.00
Max. Negotiated Rate	$486.00
Rate for Payer: Qualcare PPO/HMO/WC	$486.00

AT PROCEDURE UNSCHEDULE

Facility

$3,240.00

Hospital Charge Code	270605797
Hospital Revenue Code	272
Min. Negotiated Rate	$421.20
Max. Negotiated Rate	$1,620.00
Rate for Payer: Aetna Commercial	$972.00
Rate for Payer: Aetna Medicare Advantage	$972.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$826.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$826.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$826.20
Rate for Payer: Cigna Commercial	$1,620.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$421.20
Rate for Payer: Oxford Commercial	$1,620.00
Rate for Payer: Qualcare PPO/HMO/WC	$486.00
Rate for Payer: UnitedHealthcare Commercial	$1,620.00

ATRACURIUM 50 MG/5ML INJ

Facility

$66.33

Service Code	NDC 25021065905
Hospital Charge Code	6012223
Hospital Revenue Code	250
Min. Negotiated Rate	$9.95
Max. Negotiated Rate	$9.95
Rate for Payer: Qualcare PPO/HMO/WC	$9.95

ATRACURIUM 50 MG/5ML INJ

Facility

$66.33

Service Code	NDC 25021065905
Hospital Charge Code	6012223
Hospital Revenue Code	250
Min. Negotiated Rate	$8.62
Max. Negotiated Rate	$33.16
Rate for Payer: Aetna Commercial	$19.90
Rate for Payer: Aetna Medicare Advantage	$19.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.91
Rate for Payer: Cigna Commercial	$33.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.62
Rate for Payer: Oxford Commercial	$33.16
Rate for Payer: Qualcare PPO/HMO/WC	$9.95
Rate for Payer: UnitedHealthcare Commercial	$33.16

ATRACURIUM BES INJ 10MG/ML

Facility

$104.52

Service Code	NDC 409110502
Hospital Charge Code	606390317
Hospital Revenue Code	250
Min. Negotiated Rate	$13.59
Max. Negotiated Rate	$52.26
Rate for Payer: Aetna Commercial	$31.36
Rate for Payer: Aetna Medicare Advantage	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.65
Rate for Payer: Cigna Commercial	$52.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.59
Rate for Payer: Oxford Commercial	$52.26
Rate for Payer: Qualcare PPO/HMO/WC	$15.68
Rate for Payer: UnitedHealthcare Commercial	$52.26

ATRACURIUM BES INJ 10MG/ML

Facility

$104.52

Service Code	NDC 409110502
Hospital Charge Code	606390317
Hospital Revenue Code	250
Min. Negotiated Rate	$15.68
Max. Negotiated Rate	$15.68
Rate for Payer: Qualcare PPO/HMO/WC	$15.68

ATRACURIUM INJ 50MG, 10ML

Facility

$419.85

Hospital Charge Code	6000475
Hospital Revenue Code	250
Min. Negotiated Rate	$62.98
Max. Negotiated Rate	$62.98
Rate for Payer: Qualcare PPO/HMO/WC	$62.98

ATRACURIUM INJ 50MG, 10ML

Facility

$419.85

Hospital Charge Code	6000475
Hospital Revenue Code	250
Min. Negotiated Rate	$54.58
Max. Negotiated Rate	$209.93
Rate for Payer: Aetna Commercial	$125.95
Rate for Payer: Aetna Medicare Advantage	$125.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.06
Rate for Payer: Cigna Commercial	$209.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.58
Rate for Payer: Oxford Commercial	$209.93
Rate for Payer: Qualcare PPO/HMO/WC	$62.98
Rate for Payer: UnitedHealthcare Commercial	$209.93

ATRACURIUM INJ 50MG, 10ML****

Facility

$205.00

Hospital Charge Code	600475
Hospital Revenue Code	259
Min. Negotiated Rate	$30.75
Max. Negotiated Rate	$30.75
Rate for Payer: Qualcare PPO/HMO/WC	$30.75

ATRACURIUM INJ 50MG, 10ML****

Facility

$205.00

Hospital Charge Code	600475
Hospital Revenue Code	259
Min. Negotiated Rate	$26.65
Max. Negotiated Rate	$102.50
Rate for Payer: Aetna Commercial	$61.50
Rate for Payer: Aetna Medicare Advantage	$61.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.27
Rate for Payer: Cigna Commercial	$102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.65
Rate for Payer: Oxford Commercial	$102.50
Rate for Payer: Qualcare PPO/HMO/WC	$30.75
Rate for Payer: UnitedHealthcare Commercial	$102.50

ATRIUM CHEST DRAINAGE DUAL

Facility

$189.63

Hospital Charge Code	270650496
Hospital Revenue Code	272
Min. Negotiated Rate	$24.65
Max. Negotiated Rate	$94.81
Rate for Payer: Aetna Commercial	$56.89
Rate for Payer: Aetna Medicare Advantage	$56.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.36
Rate for Payer: Cigna Commercial	$94.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.65
Rate for Payer: Oxford Commercial	$94.81
Rate for Payer: Qualcare PPO/HMO/WC	$28.44
Rate for Payer: UnitedHealthcare Commercial	$94.81

ATRIUM CHEST DRAINAGE DUAL

Facility

$189.63

Hospital Charge Code	270650496
Hospital Revenue Code	272
Min. Negotiated Rate	$28.44
Max. Negotiated Rate	$28.44
Rate for Payer: Qualcare PPO/HMO/WC	$28.44

ATRIUM CHESTDRAINAGE UNITSINGL

Facility

$102.50

Hospital Charge Code	270650497R
Hospital Revenue Code	272
Min. Negotiated Rate	$13.32
Max. Negotiated Rate	$51.25
Rate for Payer: Aetna Commercial	$30.75
Rate for Payer: Aetna Medicare Advantage	$30.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.14
Rate for Payer: Cigna Commercial	$51.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.32
Rate for Payer: Oxford Commercial	$51.25
Rate for Payer: Qualcare PPO/HMO/WC	$15.38
Rate for Payer: UnitedHealthcare Commercial	$51.25

ATRIUM CHESTDRAINAGE UNITSINGL

Facility

$24.72

Service Code	HCPCS C1729
Hospital Charge Code	270650497N
Hospital Revenue Code	278
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$12.36
Rate for Payer: Aetna Commercial	$7.42
Rate for Payer: Aetna Medicare Advantage	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.30
Rate for Payer: Cigna Commercial	$12.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.98
Rate for Payer: Qualcare PPO/HMO/WC	$3.71

Know your out-of-pocket cost for care.

All Charges