Heights University Hospital

All Charges

Charge

Type

Setting

Price

NALBUPHINE 20 MG/ML AMP

Facility

$32.32

Hospital Charge Code	606380008
Hospital Revenue Code	636
Min. Negotiated Rate	$4.85
Max. Negotiated Rate	$7.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.82
Rate for Payer: Qualcare PPO/HMO/WC	$4.85

NALBUPHINE 20MG/ML AMPUL

Facility

$37.11

Hospital Charge Code	60631806
Hospital Revenue Code	636
Min. Negotiated Rate	$5.57
Max. Negotiated Rate	$18.55
Rate for Payer: Aetna Commercial	$11.13
Rate for Payer: Aetna Medicare Advantage	$11.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.46
Rate for Payer: Cigna Commercial	$18.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.98
Rate for Payer: Qualcare PPO/HMO/WC	$5.57

NALBUPHINE 20MG/ML AMPUL

Facility

$37.11

Hospital Charge Code	60631806
Hospital Revenue Code	636
Min. Negotiated Rate	$5.57
Max. Negotiated Rate	$8.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.98
Rate for Payer: Qualcare PPO/HMO/WC	$5.57

NALBUPHINE 20 MG/ML INJ (10 ML

Facility

$301.59

Hospital Charge Code	6063943218
Hospital Revenue Code	636
Min. Negotiated Rate	$45.24
Max. Negotiated Rate	$150.79
Rate for Payer: Aetna Commercial	$90.48
Rate for Payer: Aetna Medicare Advantage	$90.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.91
Rate for Payer: Cigna Commercial	$150.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.98
Rate for Payer: Qualcare PPO/HMO/WC	$45.24

NALBUPHINE 20 MG/ML INJ (10 ML

Facility

$301.59

Hospital Charge Code	6063943218
Hospital Revenue Code	636
Min. Negotiated Rate	$45.24
Max. Negotiated Rate	$72.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.98
Rate for Payer: Qualcare PPO/HMO/WC	$45.24

NALBUPHINE 20 MG/ML INJ (1 ML)

Facility

$41.81

Service Code	NDC 409146501
Hospital Charge Code	606380003
Hospital Revenue Code	250
Min. Negotiated Rate	$5.44
Max. Negotiated Rate	$20.91
Rate for Payer: Aetna Commercial	$12.54
Rate for Payer: Aetna Medicare Advantage	$12.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.66
Rate for Payer: Cigna Commercial	$20.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.44
Rate for Payer: Oxford Commercial	$20.91
Rate for Payer: Qualcare PPO/HMO/WC	$6.27
Rate for Payer: UnitedHealthcare Commercial	$20.91

NALBUPHINE 20 MG/ML INJ (1 ML)

Facility

$41.81

Service Code	NDC 409146501
Hospital Charge Code	606380003
Hospital Revenue Code	250
Min. Negotiated Rate	$6.27
Max. Negotiated Rate	$6.27
Rate for Payer: Qualcare PPO/HMO/WC	$6.27

NALBUPHINE INJ AMP 10MG/ML

Facility

$10.90

Hospital Charge Code	6009617
Hospital Revenue Code	250
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

NALBUPHINE INJ AMP 10MG/ML

Facility

$10.90

Hospital Charge Code	6009617
Hospital Revenue Code	250
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$5.45
Rate for Payer: Aetna Commercial	$3.27
Rate for Payer: Aetna Medicare Advantage	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.78
Rate for Payer: Cigna Commercial	$5.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.42
Rate for Payer: Oxford Commercial	$5.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Commercial	$5.45

NALBUPHINE VIAL 10MG

Facility

$3.20

Hospital Charge Code	6022693
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

NALBUPHINE VIAL 10MG

Facility

$3.20

Hospital Charge Code	6022693
Hospital Revenue Code	250
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

NALDECON DX/30ML

Facility

$30.00

Hospital Charge Code	60633490
Hospital Revenue Code	250
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$15.00
Rate for Payer: Aetna Commercial	$9.00
Rate for Payer: Aetna Medicare Advantage	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.65
Rate for Payer: Cigna Commercial	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$15.00

NALDECON DX/30ML

Facility

$30.00

Hospital Charge Code	60633490
Hospital Revenue Code	250
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

NALDECON DX PED SYRUP

Facility

$18.00

Hospital Charge Code	60634888
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

NALDECON DX PED SYRUP

Facility

$18.00

Hospital Charge Code	60634888
Hospital Revenue Code	250
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$5.40
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Oxford Commercial	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$9.00

NALDECON EX DROPS

Facility

$26.00

Hospital Charge Code	60634957
Hospital Revenue Code	250
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$13.00
Rate for Payer: Aetna Commercial	$7.80
Rate for Payer: Aetna Medicare Advantage	$7.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.63
Rate for Payer: Cigna Commercial	$13.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$13.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.90
Rate for Payer: UnitedHealthcare Commercial	$13.00

NALDECON EX DROPS

Facility

$26.00

Hospital Charge Code	60634957
Hospital Revenue Code	250
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.90

NALDECON EX SYRP/16OZ

Facility

$81.00

Hospital Charge Code	60634617
Hospital Revenue Code	250
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$12.15
Rate for Payer: Qualcare PPO/HMO/WC	$12.15

NALDECON EX SYRP/16OZ

Facility

$81.00

Hospital Charge Code	60634617
Hospital Revenue Code	250
Min. Negotiated Rate	$10.53
Max. Negotiated Rate	$40.50
Rate for Payer: Aetna Commercial	$24.30
Rate for Payer: Aetna Medicare Advantage	$24.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.66
Rate for Payer: Cigna Commercial	$40.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.53
Rate for Payer: Oxford Commercial	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$12.15
Rate for Payer: UnitedHealthcare Commercial	$40.50

NALDECON PED DROPS/30ML

Facility

$38.00

Hospital Charge Code	60634618
Hospital Revenue Code	250
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

NALDECON PED DROPS/30ML

Facility

$38.00

Hospital Charge Code	60634618
Hospital Revenue Code	250
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$19.00
Rate for Payer: Aetna Commercial	$11.40
Rate for Payer: Aetna Medicare Advantage	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.69
Rate for Payer: Cigna Commercial	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.94
Rate for Payer: Oxford Commercial	$19.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$19.00

NALDECON PEDIATRIC/30ML

Facility

$69.00

Hospital Charge Code	60633492
Hospital Revenue Code	250
Min. Negotiated Rate	$10.35
Max. Negotiated Rate	$10.35
Rate for Payer: Qualcare PPO/HMO/WC	$10.35

NALDECON PEDIATRIC/30ML

Facility

$69.00

Hospital Charge Code	60633492
Hospital Revenue Code	250
Min. Negotiated Rate	$8.97
Max. Negotiated Rate	$34.50
Rate for Payer: Aetna Commercial	$20.70
Rate for Payer: Aetna Medicare Advantage	$20.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.59
Rate for Payer: Cigna Commercial	$34.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.97
Rate for Payer: Oxford Commercial	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.35
Rate for Payer: UnitedHealthcare Commercial	$34.50

NALDECON PEDIATRIC/480ML

Facility

$258.00

Hospital Charge Code	60633491
Hospital Revenue Code	250
Min. Negotiated Rate	$38.70
Max. Negotiated Rate	$38.70
Rate for Payer: Qualcare PPO/HMO/WC	$38.70

NALDECON PEDIATRIC/480ML

Facility

$258.00

Hospital Charge Code	60633491
Hospital Revenue Code	250
Min. Negotiated Rate	$33.54
Max. Negotiated Rate	$129.00
Rate for Payer: Aetna Commercial	$77.40
Rate for Payer: Aetna Medicare Advantage	$77.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.79
Rate for Payer: Cigna Commercial	$129.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.54
Rate for Payer: Oxford Commercial	$129.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.70
Rate for Payer: UnitedHealthcare Commercial	$129.00

Know your out-of-pocket cost for care.

All Charges