Heights University Hospital

All Charges

Charge

Type

Setting

Price

NALDECON PEDS DROPS

Facility

$163.20

Hospital Charge Code	6008254
Hospital Revenue Code	251
Min. Negotiated Rate	$21.22
Max. Negotiated Rate	$81.60
Rate for Payer: Aetna Commercial	$48.96
Rate for Payer: Aetna Medicare Advantage	$48.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.62
Rate for Payer: Cigna Commercial	$81.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.22
Rate for Payer: Oxford Commercial	$81.60
Rate for Payer: Qualcare PPO/HMO/WC	$24.48
Rate for Payer: UnitedHealthcare Commercial	$81.60

NALDECON PEDS DROPS

Facility

$163.20

Hospital Charge Code	6008254
Hospital Revenue Code	251
Min. Negotiated Rate	$24.48
Max. Negotiated Rate	$24.48
Rate for Payer: Qualcare PPO/HMO/WC	$24.48

NALDECON/TAB

Facility

$6.00

Hospital Charge Code	60633489
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

NALDECON/TAB

Facility

$6.00

Hospital Charge Code	60633489
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

NALDELATE DROPS

Facility

$44.00

Hospital Charge Code	60634620
Hospital Revenue Code	250
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$13.20
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.72
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$22.00

NALDELATE DROPS

Facility

$44.00

Hospital Charge Code	60634620
Hospital Revenue Code	250
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

NALDELATE DX ADULT

Facility

$3.00

Hospital Charge Code	60634930
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

NALDELATE DX ADULT

Facility

$3.00

Hospital Charge Code	60634930
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

NALDELATE PEDS DROPS

Facility

$12.80

Hospital Charge Code	6008262
Hospital Revenue Code	251
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$6.40
Rate for Payer: Aetna Commercial	$3.84
Rate for Payer: Aetna Medicare Advantage	$3.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.26
Rate for Payer: Cigna Commercial	$6.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.66
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.92
Rate for Payer: UnitedHealthcare Commercial	$6.40

NALDELATE PEDS DROPS

Facility

$12.80

Hospital Charge Code	6008262
Hospital Revenue Code	251
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.92

NALDELATE PED SYRP/16OZ

Facility

$30.00

Hospital Charge Code	60634616
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

NALDELATE PED SYRP/16OZ

Facility

$30.00

Hospital Charge Code	60634616
Hospital Revenue Code	250
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

NALDELATE SYRUP

Facility

$3.00

Hospital Charge Code	60634929
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

NALDELATE SYRUP

Facility

$3.00

Hospital Charge Code	60634929
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

NALDELATE SYRUP/16OZ

Facility

$43.00

Hospital Charge Code	60634619
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

NALDELATE SYRUP/16OZ

Facility

$43.00

Hospital Charge Code	60634619
Hospital Revenue Code	250
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$21.50

NALFON/600MG/TAB

Facility

$6.00

Hospital Charge Code	60634229
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

NALFON/600MG/TAB

Facility

$6.00

Hospital Charge Code	60634229
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

NAL IM RF M/DN 12x30 224001230

Facility

$5,353.00

Hospital Charge Code	270639190
Hospital Revenue Code	278
Min. Negotiated Rate	$802.95
Max. Negotiated Rate	$2,676.50
Rate for Payer: Aetna Commercial	$1,605.90
Rate for Payer: Aetna Medicare Advantage	$1,605.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,365.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,365.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,070.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,365.02
Rate for Payer: Cigna Commercial	$2,676.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,295.43
Rate for Payer: Qualcare PPO/HMO/WC	$802.95

NAL IM RF M/DN 12x30 224001230

Facility

$5,353.00

Hospital Charge Code	270639190
Hospital Revenue Code	278
Min. Negotiated Rate	$802.95
Max. Negotiated Rate	$1,295.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,070.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,295.43
Rate for Payer: Qualcare PPO/HMO/WC	$802.95

NALOXONE 0.4 MG/ML INJ

Facility

$294.80

Service Code	HCPCS 2312
Hospital Charge Code	60627734
Hospital Revenue Code	636
Min. Negotiated Rate	$44.22
Max. Negotiated Rate	$71.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.34
Rate for Payer: Qualcare PPO/HMO/WC	$44.22

NALOXONE 0.4 MG/ML INJ

Facility

$294.80

Service Code	HCPCS 2312
Hospital Charge Code	60627734
Hospital Revenue Code	636
Min. Negotiated Rate	$44.22
Max. Negotiated Rate	$147.40
Rate for Payer: Aetna Commercial	$88.44
Rate for Payer: Aetna Medicare Advantage	$88.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.17
Rate for Payer: Cigna Commercial	$147.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.34
Rate for Payer: Qualcare PPO/HMO/WC	$44.22

NALOXONE 0.4 MG/ML INJ (ADULT)

Facility

$127.30

Service Code	HCPCS J2312
Hospital Charge Code	60627733
Hospital Revenue Code	636
Min. Negotiated Rate	$19.09
Max. Negotiated Rate	$30.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.81
Rate for Payer: Qualcare PPO/HMO/WC	$19.09

NALOXONE 0.4 MG/ML INJ (ADULT)

Facility

$127.30

Service Code	HCPCS J2312
Hospital Charge Code	60627733
Hospital Revenue Code	636
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$38.19
Rate for Payer: Aetna Commercial	$38.19
Rate for Payer: Aetna Medicare Advantage	$38.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.46
Rate for Payer: Cigna Commercial	$0.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.81
Rate for Payer: Qualcare PPO/HMO/WC	$19.09

NALOXONE HCL 2MG/2ML SYRUP

Facility

$132.66

Service Code	NDC 76329336901
Hospital Charge Code	6063943143
Hospital Revenue Code	250
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$66.33
Rate for Payer: Aetna Commercial	$39.80
Rate for Payer: Aetna Medicare Advantage	$39.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.83
Rate for Payer: Cigna Commercial	$66.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.25
Rate for Payer: Oxford Commercial	$66.33
Rate for Payer: Qualcare PPO/HMO/WC	$19.90
Rate for Payer: UnitedHealthcare Commercial	$66.33

Know your out-of-pocket cost for care.

All Charges