Heights University Hospital

All Charges

Charge

Type

Setting

Price

MULTIPLE VITAMINS LIQ

Facility

$241.20

Service Code	NDC 54838000870
Hospital Charge Code	60628501
Hospital Revenue Code	250
Min. Negotiated Rate	$36.18
Max. Negotiated Rate	$36.18
Rate for Payer: Qualcare PPO/HMO/WC	$36.18

MULTIPLE VITAMINS LIQ

Facility

$241.20

Service Code	NDC 54838000870
Hospital Charge Code	60628501
Hospital Revenue Code	250
Min. Negotiated Rate	$31.36
Max. Negotiated Rate	$120.60
Rate for Payer: Aetna Commercial	$72.36
Rate for Payer: Aetna Medicare Advantage	$72.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.51
Rate for Payer: Cigna Commercial	$120.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.36
Rate for Payer: Oxford Commercial	$120.60
Rate for Payer: Qualcare PPO/HMO/WC	$36.18
Rate for Payer: UnitedHealthcare Commercial	$120.60

MULTIPODUS BOOT L

Facility

$530.95

Hospital Charge Code	270665976
Hospital Revenue Code	270
Min. Negotiated Rate	$79.64
Max. Negotiated Rate	$79.64
Rate for Payer: Qualcare PPO/HMO/WC	$79.64

MULTIPODUS BOOT L

Facility

$530.95

Hospital Charge Code	270665976
Hospital Revenue Code	270
Min. Negotiated Rate	$69.02
Max. Negotiated Rate	$265.48
Rate for Payer: Aetna Commercial	$159.28
Rate for Payer: Aetna Medicare Advantage	$159.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.39
Rate for Payer: Cigna Commercial	$265.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.02
Rate for Payer: Oxford Commercial	$265.48
Rate for Payer: Qualcare PPO/HMO/WC	$79.64
Rate for Payer: UnitedHealthcare Commercial	$265.48

MULTIPODUS BOOT MED.

Facility

$598.80

Hospital Charge Code	270669589
Hospital Revenue Code	274
Min. Negotiated Rate	$89.82
Max. Negotiated Rate	$144.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.91
Rate for Payer: Qualcare PPO/HMO/WC	$89.82

MULTIPODUS BOOT MED.

Facility

$598.80

Hospital Charge Code	270669589
Hospital Revenue Code	274
Min. Negotiated Rate	$89.82
Max. Negotiated Rate	$299.40
Rate for Payer: Aetna Commercial	$179.64
Rate for Payer: Aetna Medicare Advantage	$179.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$152.69
Rate for Payer: Cigna Commercial	$299.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.91
Rate for Payer: Qualcare PPO/HMO/WC	$89.82

MULTIPOLAR BIPOLAR CUP SHELL

Facility

$2,256.50

Hospital Charge Code	270657038
Hospital Revenue Code	278
Min. Negotiated Rate	$338.48
Max. Negotiated Rate	$546.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.07
Rate for Payer: Qualcare PPO/HMO/WC	$338.48

MULTIPOLAR BIPOLAR CUP SHELL

Facility

$2,256.50

Hospital Charge Code	270657038
Hospital Revenue Code	278
Min. Negotiated Rate	$338.48
Max. Negotiated Rate	$1,128.25
Rate for Payer: Aetna Commercial	$676.95
Rate for Payer: Aetna Medicare Advantage	$676.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$575.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$575.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$575.41
Rate for Payer: Cigna Commercial	$1,128.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.07
Rate for Payer: Qualcare PPO/HMO/WC	$338.48

MULTIVITAMIN10 1 VIAL

Facility

$84.00

Hospital Charge Code	60628500
Hospital Revenue Code	250
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

MULTIVITAMIN10 1 VIAL

Facility

$84.00

Hospital Charge Code	60628500
Hospital Revenue Code	250
Min. Negotiated Rate	$10.92
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$25.20
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.92
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$42.00

MULTIVITAMIN AND IRON DROPS

Facility

$4.00

Service Code	NDC 536853080
Hospital Charge Code	6063943217
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

MULTIVITAMIN AND IRON DROPS

Facility

$4.00

Service Code	NDC 536853080
Hospital Charge Code	6063943217
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MULTIVITAMINS ROWELL/CAP

Facility

$3.00

Hospital Charge Code	60633466
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

MULTIVITAMINS ROWELL/CAP

Facility

$3.00

Hospital Charge Code	60633466
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

MULTIVITAMIN WITH MINERALS TAB

Facility

$4.00

Service Code	NDC 904549261
Hospital Charge Code	60628509
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

MULTIVITAMIN WITH MINERALS TAB

Facility

$4.00

Service Code	NDC 904549261
Hospital Charge Code	60628509
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

MULTIVIT CONCENTR 5ML

Facility

$11.25

Hospital Charge Code	60628661
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

MULTIVIT CONCENTR 5ML

Facility

$11.25

Hospital Charge Code	60628661
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

MULTIVIT LIQ 5ML

Facility

$3.20

Hospital Charge Code	6023345
Hospital Revenue Code	251
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

MULTIVIT LIQ 5ML

Facility

$3.20

Hospital Charge Code	6023345
Hospital Revenue Code	251
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$1.60
Rate for Payer: Aetna Commercial	$0.96
Rate for Payer: Aetna Medicare Advantage	$0.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.82
Rate for Payer: Cigna Commercial	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.42
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.48
Rate for Payer: UnitedHealthcare Commercial	$1.60

MULTIVIT LIQ 5ML UD ADULT

Facility

$3.85

Hospital Charge Code	60628662
Hospital Revenue Code	250
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.16
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.50
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$1.93

MULTIVIT LIQ 5ML UD ADULT

Facility

$3.85

Hospital Charge Code	60628662
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

MULTIVIT W/FLOR & IRON TAB 1MG

Facility

$2.45

Hospital Charge Code	60628846
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

MULTIVIT W/FLOR & IRON TAB 1MG

Facility

$2.45

Hospital Charge Code	60628846
Hospital Revenue Code	250
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$0.74
Rate for Payer: Aetna Medicare Advantage	$0.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.62
Rate for Payer: Cigna Commercial	$1.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.32
Rate for Payer: Oxford Commercial	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$1.23

MULTIVIT W/FLUOR 0.5MG/ML

Facility

$50.45

Hospital Charge Code	60628504
Hospital Revenue Code	250
Min. Negotiated Rate	$6.56
Max. Negotiated Rate	$25.23
Rate for Payer: Aetna Commercial	$15.13
Rate for Payer: Aetna Medicare Advantage	$15.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.86
Rate for Payer: Cigna Commercial	$25.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.56
Rate for Payer: Oxford Commercial	$25.23
Rate for Payer: Qualcare PPO/HMO/WC	$7.57
Rate for Payer: UnitedHealthcare Commercial	$25.23

Know your out-of-pocket cost for care.

All Charges