Heights University Hospital

All Charges

Charge

Type

Setting

Price

ATRIUM CHESTDRAINAGE UNITSINGL

Facility

$102.50

Service Code	HCPCS C1729
Hospital Charge Code	270650497
Hospital Revenue Code	278
Min. Negotiated Rate	$15.38
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) NJ Health	$20.50
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	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$15.38

ATRIUM CHESTDRAINAGE UNITSINGL

Facility

$102.50

Service Code	HCPCS C1729
Hospital Charge Code	270650497S
Hospital Revenue Code	278
Min. Negotiated Rate	$15.38
Max. Negotiated Rate	$24.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$15.38

ATRIUM CHESTDRAINAGE UNITSINGL

Facility

$102.50

Service Code	HCPCS C1729
Hospital Charge Code	270650497S
Hospital Revenue Code	278
Min. Negotiated Rate	$15.38
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) NJ Health	$20.50
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	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$15.38

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

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	$5.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.98
Rate for Payer: Qualcare PPO/HMO/WC	$3.71

ATRIUM CHESTDRAIN UNIT2002-000

Facility

$123.60

Hospital Charge Code	270100638
Hospital Revenue Code	272
Min. Negotiated Rate	$18.54
Max. Negotiated Rate	$18.54
Rate for Payer: Qualcare PPO/HMO/WC	$18.54

ATRIUM CHESTDRAIN UNIT2002-000

Facility

$123.60

Hospital Charge Code	270100638
Hospital Revenue Code	272
Min. Negotiated Rate	$16.07
Max. Negotiated Rate	$61.80
Rate for Payer: Aetna Commercial	$37.08
Rate for Payer: Aetna Medicare Advantage	$37.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.52
Rate for Payer: Cigna Commercial	$61.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.07
Rate for Payer: Oxford Commercial	$61.80
Rate for Payer: Qualcare PPO/HMO/WC	$18.54
Rate for Payer: UnitedHealthcare Commercial	$61.80

ATROMID-S/500MG/CAP

Facility

$6.00

Hospital Charge Code	60632503
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

ATROMID-S/500MG/CAP

Facility

$6.00

Hospital Charge Code	60632503
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

ATROP/HYOS/SCOP/PHENOB ELIXIR

Facility

$72.29

Service Code	NDC 66213042304
Hospital Charge Code	60637426
Hospital Revenue Code	250
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$36.15
Rate for Payer: Aetna Commercial	$21.69
Rate for Payer: Aetna Medicare Advantage	$21.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.43
Rate for Payer: Cigna Commercial	$36.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.40
Rate for Payer: Oxford Commercial	$36.15
Rate for Payer: Qualcare PPO/HMO/WC	$10.84
Rate for Payer: UnitedHealthcare Commercial	$36.15

ATROP/HYOS/SCOP/PHENOB ELIXIR

Facility

$72.29

Service Code	NDC 66213042304
Hospital Charge Code	60637426
Hospital Revenue Code	250
Min. Negotiated Rate	$10.84
Max. Negotiated Rate	$10.84
Rate for Payer: Qualcare PPO/HMO/WC	$10.84

ATROPINE

Facility

$47.35

Hospital Charge Code	270656753
Hospital Revenue Code	270
Min. Negotiated Rate	$6.16
Max. Negotiated Rate	$23.68
Rate for Payer: Aetna Commercial	$14.21
Rate for Payer: Aetna Medicare Advantage	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.07
Rate for Payer: Cigna Commercial	$23.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.16
Rate for Payer: Oxford Commercial	$23.68
Rate for Payer: Qualcare PPO/HMO/WC	$7.10
Rate for Payer: UnitedHealthcare Commercial	$23.68

ATROPINE

Facility

$47.35

Hospital Charge Code	270656753
Hospital Revenue Code	270
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$7.10
Rate for Payer: Qualcare PPO/HMO/WC	$7.10

ATROPINE 0.4 MG/ML INJ (1 ML)

Facility

$28.01

Service Code	HCPCS J0461
Hospital Charge Code	60627424
Hospital Revenue Code	636
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$6.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.78
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

ATROPINE 0.4 MG/ML INJ (1 ML)

Facility

$28.01

Service Code	HCPCS J0461
Hospital Charge Code	60627424
Hospital Revenue Code	636
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$8.40
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$0.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.78
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

ATROPINE 0.4 MG/ML INJ (1ML)

Facility

$58.63

Service Code	HCPCS J0461
Hospital Charge Code	60627423
Hospital Revenue Code	636
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$17.59
Rate for Payer: Aetna Commercial	$17.59
Rate for Payer: Aetna Medicare Advantage	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.95
Rate for Payer: Cigna Commercial	$0.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.19
Rate for Payer: Qualcare PPO/HMO/WC	$8.79

ATROPINE 0.4 MG/ML INJ (1ML)

Facility

$58.63

Service Code	HCPCS J0461
Hospital Charge Code	60627423
Hospital Revenue Code	636
Min. Negotiated Rate	$8.79
Max. Negotiated Rate	$14.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.19
Rate for Payer: Qualcare PPO/HMO/WC	$8.79

ATROPINE 0.4 MG TAB

Facility

$4.00

Hospital Charge Code	60628568
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ATROPINE 0.4 MG TAB

Facility

$4.00

Hospital Charge Code	60628568
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

ATROPINE 0.8MG/2ML

Facility

$4.00

Service Code	HCPCS J0461
Hospital Charge Code	6063943061
Hospital Revenue Code	636
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ATROPINE 0.8MG/2ML

Facility

$4.00

Service Code	HCPCS J0461
Hospital Charge Code	6063943061
Hospital Revenue Code	636
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$1.20
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$0.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ATROPINE 1% OPHTHALMIN SOLN 2M

Facility

$320.66

Service Code	NDC 17478021502
Hospital Charge Code	6063943291
Hospital Revenue Code	250
Min. Negotiated Rate	$48.10
Max. Negotiated Rate	$48.10
Rate for Payer: Qualcare PPO/HMO/WC	$48.10

ATROPINE 1% OPHTHALMIN SOLN 2M

Facility

$320.66

Service Code	NDC 17478021502
Hospital Charge Code	6063943291
Hospital Revenue Code	250
Min. Negotiated Rate	$41.69
Max. Negotiated Rate	$160.33
Rate for Payer: Aetna Commercial	$96.20
Rate for Payer: Aetna Medicare Advantage	$96.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.77
Rate for Payer: Cigna Commercial	$160.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.69
Rate for Payer: Oxford Commercial	$160.33
Rate for Payer: Qualcare PPO/HMO/WC	$48.10
Rate for Payer: UnitedHealthcare Commercial	$160.33

ATROPINE 1% OPHTH SOLN UD

Facility

$2,404.97

Service Code	NDC 17478021505
Hospital Charge Code	60628064
Hospital Revenue Code	250
Min. Negotiated Rate	$360.75
Max. Negotiated Rate	$360.75
Rate for Payer: Qualcare PPO/HMO/WC	$360.75

Know your out-of-pocket cost for care.

All Charges