Heights University Hospital

All Charges

Charge

Type

Setting

Price

MYSOLINE/50MG/TAB

Facility

$3.00

Hospital Charge Code	60633480
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

MYXREDLIN INSULIN HUMAN 100UM/

Facility

$210.00

Hospital Charge Code	606390575
Hospital Revenue Code	250
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$63.00
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$105.00

MYXREDLIN INSULIN HUMAN 100UM/

Facility

$210.00

Hospital Charge Code	606390575
Hospital Revenue Code	250
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

Facility

$409.25

Hospital Charge Code	270622422
Hospital Revenue Code	272
Min. Negotiated Rate	$61.39
Max. Negotiated Rate	$61.39
Rate for Payer: Qualcare PPO/HMO/WC	$61.39

Facility

$409.25

Hospital Charge Code	270622422
Hospital Revenue Code	272
Min. Negotiated Rate	$53.20
Max. Negotiated Rate	$204.62
Rate for Payer: Aetna Commercial	$122.78
Rate for Payer: Aetna Medicare Advantage	$122.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.36
Rate for Payer: Cigna Commercial	$204.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.20
Rate for Payer: Oxford Commercial	$204.62
Rate for Payer: Qualcare PPO/HMO/WC	$61.39
Rate for Payer: UnitedHealthcare Commercial	$204.62

N300 LEAD ANCHOR KIT

Facility

$125.00

Hospital Charge Code	270703935
Hospital Revenue Code	279
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

N300 LEAD ANCHOR KIT

Facility

$125.00

Hospital Charge Code	270703935
Hospital Revenue Code	279
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

NABFERON ANTIBODY TEST

Facility

$343.25

Service Code	HCPCS 86382
Hospital Charge Code	3008903
Hospital Revenue Code	302
Min. Negotiated Rate	$51.49
Max. Negotiated Rate	$51.49
Rate for Payer: Qualcare PPO/HMO/WC	$51.49

NABFERON ANTIBODY TEST

Facility

$343.25

Service Code	HCPCS 86382
Hospital Charge Code	3008903
Hospital Revenue Code	302
Min. Negotiated Rate	$8.46
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.79
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.96
Rate for Payer: Cigna Commercial	$16.91
Rate for Payer: Cigna Medicare Advantage	$8.46
Rate for Payer: Clover Medicare Advantage	$16.06
Rate for Payer: EmblemHealth Commercial	$50.73
Rate for Payer: Humana Medicare Advantage	$17.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.49
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.91
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.92
Rate for Payer: Wellcare Medicare Advantage	$16.91

NABUMETONE 500 MG TAB

Facility

$12.85

Hospital Charge Code	60627690
Hospital Revenue Code	250
Min. Negotiated Rate	$1.67
Max. Negotiated Rate	$6.42
Rate for Payer: Aetna Commercial	$3.85
Rate for Payer: Aetna Medicare Advantage	$3.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.28
Rate for Payer: Cigna Commercial	$6.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.67
Rate for Payer: Oxford Commercial	$6.42
Rate for Payer: Qualcare PPO/HMO/WC	$1.93
Rate for Payer: UnitedHealthcare Commercial	$6.42

NABUMETONE 500 MG TAB

Facility

$12.85

Hospital Charge Code	60627690
Hospital Revenue Code	250
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.93

NABUMETONE 500MG TAB

Facility

$8.71

Service Code	NDC 115165701
Hospital Charge Code	6063943141
Hospital Revenue Code	250
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$4.36
Rate for Payer: Aetna Commercial	$2.61
Rate for Payer: Aetna Medicare Advantage	$2.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.22
Rate for Payer: Cigna Commercial	$4.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.13
Rate for Payer: Oxford Commercial	$4.36
Rate for Payer: Qualcare PPO/HMO/WC	$1.31
Rate for Payer: UnitedHealthcare Commercial	$4.36

NABUMETONE 500MG TAB

Facility

$8.71

Service Code	NDC 115165701
Hospital Charge Code	6063943141
Hospital Revenue Code	250
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$1.31

NABUMETONE 750MG TAB

Facility

$10.25

Service Code	NDC 115165801
Hospital Charge Code	6063943142
Hospital Revenue Code	250
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$5.12
Rate for Payer: Aetna Commercial	$3.08
Rate for Payer: Aetna Medicare Advantage	$3.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.61
Rate for Payer: Cigna Commercial	$5.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.33
Rate for Payer: Oxford Commercial	$5.12
Rate for Payer: Qualcare PPO/HMO/WC	$1.54
Rate for Payer: UnitedHealthcare Commercial	$5.12

NABUMETONE 750MG TAB

Facility

$10.25

Service Code	NDC 115165801
Hospital Charge Code	6063943142
Hospital Revenue Code	250
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.54

N-ACETYL PROCAINAMIDE (NAPA)

Facility

$161.65

Service Code	HCPCS 80192
Hospital Charge Code	3008901
Hospital Revenue Code	301
Min. Negotiated Rate	$24.25
Max. Negotiated Rate	$24.25
Rate for Payer: Qualcare PPO/HMO/WC	$24.25

N-ACETYL PROCAINAMIDE (NAPA)

Facility

$161.65

Service Code	HCPCS 80192
Hospital Charge Code	3008901
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.27
Rate for Payer: Aetna Medicare Advantage	$16.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.75
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	$61.37
Rate for Payer: Cigna Commercial	$16.75
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.91
Rate for Payer: EmblemHealth Commercial	$50.25
Rate for Payer: Humana Medicare Advantage	$17.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.01
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.75
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.75
Rate for Payer: Wellcare Medicare Advantage	$16.75

NACL 0.45% 1000ML

Facility

$9.65

Hospital Charge Code	270040210
Hospital Revenue Code	258
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$2.90
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.25
Rate for Payer: Oxford Commercial	$4.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$4.83

NACL 0.45% 1000ML

Facility

$9.65

Hospital Charge Code	270040210
Hospital Revenue Code	258
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

NACL 0.45% 1000ML*****

Facility

$5.00

Hospital Charge Code	7000201
Hospital Revenue Code	258
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

NACL 0.45% 1000ML*****

Facility

$5.00

Hospital Charge Code	7000201
Hospital Revenue Code	258
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

NACL 0.45% INJ 1000ML 7985-09

Facility

$4.99

Hospital Charge Code	270649311
Hospital Revenue Code	258
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

NACL 0.45% INJ 1000ML 7985-09

Facility

$4.99

Hospital Charge Code	270649311
Hospital Revenue Code	258
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

NACL 0.45% INJ 500ML 7985-03

Facility

$4.70

Hospital Charge Code	270649312
Hospital Revenue Code	258
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$2.35
Rate for Payer: Aetna Commercial	$1.41
Rate for Payer: Aetna Medicare Advantage	$1.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.20
Rate for Payer: Cigna Commercial	$2.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.61
Rate for Payer: Oxford Commercial	$2.35
Rate for Payer: Qualcare PPO/HMO/WC	$0.71
Rate for Payer: UnitedHealthcare Commercial	$2.35

NACL 0.45% INJ 500ML 7985-03

Facility

$4.70

Hospital Charge Code	270649312
Hospital Revenue Code	258
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$0.71
Rate for Payer: Qualcare PPO/HMO/WC	$0.71

Know your out-of-pocket cost for care.

All Charges