Heights University Hospital

All Charges

Charge

Type

Setting

Price

MUMPS SKIN TEST

Facility

$227.00

Hospital Charge Code	60634533
Hospital Revenue Code	250
Min. Negotiated Rate	$34.05
Max. Negotiated Rate	$34.05
Rate for Payer: Qualcare PPO/HMO/WC	$34.05

MUMPS SKIN TEST

Facility

$227.00

Hospital Charge Code	60634533
Hospital Revenue Code	250
Min. Negotiated Rate	$29.51
Max. Negotiated Rate	$113.50
Rate for Payer: Aetna Commercial	$68.10
Rate for Payer: Aetna Medicare Advantage	$68.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.88
Rate for Payer: Cigna Commercial	$113.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.51
Rate for Payer: Oxford Commercial	$113.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.05
Rate for Payer: UnitedHealthcare Commercial	$113.50

MUMPS SKIN TEST

Facility

$381.00

Hospital Charge Code	60635238
Hospital Revenue Code	250
Min. Negotiated Rate	$49.53
Max. Negotiated Rate	$190.50
Rate for Payer: Aetna Commercial	$114.30
Rate for Payer: Aetna Medicare Advantage	$114.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.16
Rate for Payer: Cigna Commercial	$190.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.53
Rate for Payer: Oxford Commercial	$190.50
Rate for Payer: Qualcare PPO/HMO/WC	$57.15
Rate for Payer: UnitedHealthcare Commercial	$190.50

MUMPS SKIN TEST

Facility

$381.00

Hospital Charge Code	60635238
Hospital Revenue Code	250
Min. Negotiated Rate	$57.15
Max. Negotiated Rate	$57.15
Rate for Payer: Qualcare PPO/HMO/WC	$57.15

MUMPS VIRUS AB

Facility

$602.00

Service Code	HCPCS 86375
Hospital Charge Code	38476029
Hospital Revenue Code	302
Min. Negotiated Rate	$90.30
Max. Negotiated Rate	$90.30
Rate for Payer: Qualcare PPO/HMO/WC	$90.30

MUMPS VIRUS AB

Facility

$602.00

Service Code	HCPCS 86375
Hospital Charge Code	38476029
Hospital Revenue Code	302
Min. Negotiated Rate	$78.26
Max. Negotiated Rate	$301.00
Rate for Payer: Aetna Commercial	$180.60
Rate for Payer: Aetna Medicare Advantage	$180.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.51
Rate for Payer: Cigna Commercial	$301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.26
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.30
Rate for Payer: UnitedHealthcare Commercial	$114.00

MUMPS VIRUS ANTIBODY, IGG

Facility

$164.00

Service Code	HCPCS 86735
Hospital Charge Code	3009412
Hospital Revenue Code	302
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.28
Rate for Payer: Aetna Medicare Advantage	$13.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.82
Rate for Payer: Cigna Commercial	$13.05
Rate for Payer: Cigna Medicare Advantage	$6.53
Rate for Payer: Clover Medicare Advantage	$12.40
Rate for Payer: EmblemHealth Commercial	$39.15
Rate for Payer: Humana Medicare Advantage	$13.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.83
Rate for Payer: Wellcare Medicare Advantage	$13.05

MUMPS VIRUS ANTIBODY, IGG

Facility

$164.00

Service Code	HCPCS 86735
Hospital Charge Code	3009412
Hospital Revenue Code	302
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$24.60
Rate for Payer: Qualcare PPO/HMO/WC	$24.60

MUMPS VIRUS RNA,QL,RT-PCR (V-C

Facility

$342.64

Service Code	HCPCS 87790
Hospital Charge Code	397080015
Hospital Revenue Code	306
Min. Negotiated Rate	$44.54
Max. Negotiated Rate	$171.32
Rate for Payer: Aetna Commercial	$102.79
Rate for Payer: Aetna Medicare Advantage	$102.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.37
Rate for Payer: Cigna Commercial	$171.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.40
Rate for Payer: UnitedHealthcare Commercial	$114.00

MUMPS VIRUS RNA,QL,RT-PCR (V-C

Facility

$342.64

Service Code	HCPCS 87790
Hospital Charge Code	397080015
Hospital Revenue Code	306
Min. Negotiated Rate	$51.40
Max. Negotiated Rate	$51.40
Rate for Payer: Qualcare PPO/HMO/WC	$51.40

MUPIROCIN 2 % CREAM

Facility

$380.76

Service Code	NDC 29152725
Hospital Charge Code	60628763
Hospital Revenue Code	250
Min. Negotiated Rate	$49.50
Max. Negotiated Rate	$190.38
Rate for Payer: Aetna Commercial	$114.23
Rate for Payer: Aetna Medicare Advantage	$114.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.09
Rate for Payer: Cigna Commercial	$190.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.50
Rate for Payer: Oxford Commercial	$190.38
Rate for Payer: Qualcare PPO/HMO/WC	$57.11
Rate for Payer: UnitedHealthcare Commercial	$190.38

MUPIROCIN 2 % CREAM

Facility

$380.76

Service Code	NDC 29152725
Hospital Charge Code	60628763
Hospital Revenue Code	250
Min. Negotiated Rate	$57.11
Max. Negotiated Rate	$57.11
Rate for Payer: Qualcare PPO/HMO/WC	$57.11

MUPIROCIN 2 % OINTMENT

Facility

$80.40

Service Code	NDC 29152544
Hospital Charge Code	60628327
Hospital Revenue Code	250
Min. Negotiated Rate	$10.45
Max. Negotiated Rate	$40.20
Rate for Payer: Aetna Commercial	$24.12
Rate for Payer: Aetna Medicare Advantage	$24.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.50
Rate for Payer: Cigna Commercial	$40.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.45
Rate for Payer: Oxford Commercial	$40.20
Rate for Payer: Qualcare PPO/HMO/WC	$12.06
Rate for Payer: UnitedHealthcare Commercial	$40.20

MUPIROCIN 2 % OINTMENT

Facility

$80.40

Service Code	NDC 29152544
Hospital Charge Code	60628327
Hospital Revenue Code	250
Min. Negotiated Rate	$12.06
Max. Negotiated Rate	$12.06
Rate for Payer: Qualcare PPO/HMO/WC	$12.06

MUPIROCIN 2% TOPICAL OIN UDOSE

Facility

$2.50

Hospital Charge Code	60629878
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

MUPIROCIN 2% TOPICAL OIN UDOSE

Facility

$2.50

Hospital Charge Code	60629878
Hospital Revenue Code	250
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$0.38
Rate for Payer: Qualcare PPO/HMO/WC	$0.38

MUPIROCIN OINT 2% 15GM

Facility

$122.90

Hospital Charge Code	6007595
Hospital Revenue Code	252
Min. Negotiated Rate	$15.98
Max. Negotiated Rate	$61.45
Rate for Payer: Aetna Commercial	$36.87
Rate for Payer: Aetna Medicare Advantage	$36.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.34
Rate for Payer: Cigna Commercial	$61.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.98
Rate for Payer: Oxford Commercial	$61.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.43
Rate for Payer: UnitedHealthcare Commercial	$61.45

MUPIROCIN OINT 2% 15GM

Facility

$122.90

Hospital Charge Code	6007595
Hospital Revenue Code	252
Min. Negotiated Rate	$18.43
Max. Negotiated Rate	$18.43
Rate for Payer: Qualcare PPO/HMO/WC	$18.43

MUPIROCIN OINT 2% 1GM EA

Facility

$34.37

Service Code	NDC 50268057260
Hospital Charge Code	606390194
Hospital Revenue Code	250
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$17.18
Rate for Payer: Aetna Commercial	$10.31
Rate for Payer: Aetna Medicare Advantage	$10.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.76
Rate for Payer: Cigna Commercial	$17.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.47
Rate for Payer: Oxford Commercial	$17.18
Rate for Payer: Qualcare PPO/HMO/WC	$5.16
Rate for Payer: UnitedHealthcare Commercial	$17.18

MUPIROCIN OINT 2% 1GM EA

Facility

$34.37

Service Code	NDC 50268057260
Hospital Charge Code	606390194
Hospital Revenue Code	250
Min. Negotiated Rate	$5.16
Max. Negotiated Rate	$5.16
Rate for Payer: Qualcare PPO/HMO/WC	$5.16

MUPIROCIN OINT 2% 22GM

Facility

$227.85

Hospital Charge Code	60628994
Hospital Revenue Code	250
Min. Negotiated Rate	$29.62
Max. Negotiated Rate	$113.92
Rate for Payer: Aetna Commercial	$68.36
Rate for Payer: Aetna Medicare Advantage	$68.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.10
Rate for Payer: Cigna Commercial	$113.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.62
Rate for Payer: Oxford Commercial	$113.92
Rate for Payer: Qualcare PPO/HMO/WC	$34.18
Rate for Payer: UnitedHealthcare Commercial	$113.92

MUPIROCIN OINT 2% 22GM

Facility

$227.85

Hospital Charge Code	60628994
Hospital Revenue Code	250
Min. Negotiated Rate	$34.18
Max. Negotiated Rate	$34.18
Rate for Payer: Qualcare PPO/HMO/WC	$34.18

MURO 128 2% OPTH DROP15ML

Facility

$115.58

Service Code	NDC 24208027615
Hospital Charge Code	60635474
Hospital Revenue Code	250
Min. Negotiated Rate	$15.03
Max. Negotiated Rate	$57.79
Rate for Payer: Aetna Commercial	$34.67
Rate for Payer: Aetna Medicare Advantage	$34.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.47
Rate for Payer: Cigna Commercial	$57.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.03
Rate for Payer: Oxford Commercial	$57.79
Rate for Payer: Qualcare PPO/HMO/WC	$17.34
Rate for Payer: UnitedHealthcare Commercial	$57.79

MURO 128 2% OPTH DROP15ML

Facility

$115.58

Service Code	NDC 24208027615
Hospital Charge Code	60635474
Hospital Revenue Code	250
Min. Negotiated Rate	$17.34
Max. Negotiated Rate	$17.34
Rate for Payer: Qualcare PPO/HMO/WC	$17.34

MURO 128 5% OPHTH/15ML

Facility

$121.67

Service Code	NDC 24208027715
Hospital Charge Code	60633467
Hospital Revenue Code	250
Min. Negotiated Rate	$18.25
Max. Negotiated Rate	$18.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.25

Know your out-of-pocket cost for care.

All Charges