Heights University Hospital

All Charges

Charge

Type

Setting

Price

NALOXONE HCL 2MG/2ML SYRUP

Facility

$132.66

Service Code	NDC 76329336901
Hospital Charge Code	6063943143
Hospital Revenue Code	250
Min. Negotiated Rate	$19.90
Max. Negotiated Rate	$19.90
Rate for Payer: Qualcare PPO/HMO/WC	$19.90

NALOXONE INJ 1.0MG/ML 2ML

Facility

$19.85

Hospital Charge Code	6003859
Hospital Revenue Code	250
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$9.93
Rate for Payer: Aetna Commercial	$5.96
Rate for Payer: Aetna Medicare Advantage	$5.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.06
Rate for Payer: Cigna Commercial	$9.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.58
Rate for Payer: Oxford Commercial	$9.93
Rate for Payer: Qualcare PPO/HMO/WC	$2.98
Rate for Payer: UnitedHealthcare Commercial	$9.93

NALOXONE INJ 1.0MG/ML 2ML

Facility

$19.85

Hospital Charge Code	6003859
Hospital Revenue Code	250
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$2.98
Rate for Payer: Qualcare PPO/HMO/WC	$2.98

NALOXONE VIAL 0.4MG

Facility

$3.85

Hospital Charge Code	6012900
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

NALOXONE VIAL 0.4MG

Facility

$3.85

Hospital Charge Code	6012900
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

NALOXONE VIAL 4 MG

Facility

$9.00

Hospital Charge Code	6013007
Hospital Revenue Code	250
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

NALOXONE VIAL 4 MG

Facility

$9.00

Hospital Charge Code	6013007
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

NALTREXONE 50 MG TAB

Facility

$28.61

Service Code	NDC 16729008101
Hospital Charge Code	60628852
Hospital Revenue Code	250
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$4.29
Rate for Payer: Qualcare PPO/HMO/WC	$4.29

NALTREXONE 50 MG TAB

Facility

$28.61

Service Code	NDC 16729008101
Hospital Charge Code	60628852
Hospital Revenue Code	250
Min. Negotiated Rate	$3.72
Max. Negotiated Rate	$14.30
Rate for Payer: Aetna Commercial	$8.58
Rate for Payer: Aetna Medicare Advantage	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.30
Rate for Payer: Cigna Commercial	$14.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.72
Rate for Payer: Oxford Commercial	$14.30
Rate for Payer: Qualcare PPO/HMO/WC	$4.29
Rate for Payer: UnitedHealthcare Commercial	$14.30

NANDROL DEC INJ 50MG/ML 1 ML

Facility

$48.00

Hospital Charge Code	6003867
Hospital Revenue Code	250
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

NANDROL DEC INJ 50MG/ML 1 ML

Facility

$48.00

Hospital Charge Code	6003867
Hospital Revenue Code	250
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna Commercial	$14.40
Rate for Payer: Aetna Medicare Advantage	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.24
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.24
Rate for Payer: Oxford Commercial	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$24.00

NANDROL DE VL 1CMG/ML 2ML VIAL

Facility

$64.00

Hospital Charge Code	60629361
Hospital Revenue Code	250
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$19.20
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.32
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$32.00

NANDROL DE VL 1CMG/ML 2ML VIAL

Facility

$64.00

Hospital Charge Code	60629361
Hospital Revenue Code	250
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

NanoCross .014 Long 150mm -210

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270686204
Hospital Revenue Code	278
Min. Negotiated Rate	$277.83
Max. Negotiated Rate	$926.10
Rate for Payer: Aetna Commercial	$555.66
Rate for Payer: Aetna Medicare Advantage	$555.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$472.31
Rate for Payer: Cigna Commercial	$926.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83

NanoCross .014 Long 150mm -210

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270686204
Hospital Revenue Code	278
Min. Negotiated Rate	$277.83
Max. Negotiated Rate	$448.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83

NANONEEDLE SCOPE 180MM

Facility

$1,750.00

Hospital Charge Code	270704957
Hospital Revenue Code	279
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

NANONEEDLE SCOPE 180MM

Facility

$1,750.00

Hospital Charge Code	270704957
Hospital Revenue Code	279
Min. Negotiated Rate	$227.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$875.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$875.00

NANONEEDLE SCOPE HFLO KIT 180

Facility

$425.00

Hospital Charge Code	270704958
Hospital Revenue Code	279
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

NANONEEDLE SCOPE HFLO KIT 180

Facility

$425.00

Hospital Charge Code	270704958
Hospital Revenue Code	279
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Oxford Commercial	$212.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$212.50

NANO STEMLESS SHOULDER

Facility

$44,378.25

Service Code	HCPCS C1789
Hospital Charge Code	270706046
Hospital Revenue Code	278
Min. Negotiated Rate	$6,656.74
Max. Negotiated Rate	$10,739.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,875.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,739.54
Rate for Payer: Qualcare PPO/HMO/WC	$6,656.74

NANO STEMLESS SHOULDER

Facility

$44,378.25

Service Code	HCPCS C1789
Hospital Charge Code	270706046
Hospital Revenue Code	278
Min. Negotiated Rate	$6,656.74
Max. Negotiated Rate	$22,189.12
Rate for Payer: Aetna Commercial	$13,313.48
Rate for Payer: Aetna Medicare Advantage	$13,313.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,316.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,316.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,875.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,316.45
Rate for Payer: Cigna Commercial	$22,189.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,739.54
Rate for Payer: Qualcare PPO/HMO/WC	$6,656.74

NANO STEMLESS SHOULDER 38MM

Facility

$44,378.25

Service Code	HCPCS C1716
Hospital Charge Code	270705539
Hospital Revenue Code	278
Min. Negotiated Rate	$6,656.74
Max. Negotiated Rate	$10,739.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,875.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,739.54
Rate for Payer: Qualcare PPO/HMO/WC	$6,656.74

NANO STEMLESS SHOULDER 38MM

Facility

$44,378.25

Service Code	HCPCS C1716
Hospital Charge Code	270705539
Hospital Revenue Code	278
Min. Negotiated Rate	$1,197.08
Max. Negotiated Rate	$13,313.48
Rate for Payer: Aetna Commercial	$13,313.48
Rate for Payer: Aetna Medicare Advantage	$13,313.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,316.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,316.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,875.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,316.45
Rate for Payer: Cigna Commercial	$1,197.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,739.54
Rate for Payer: Qualcare PPO/HMO/WC	$6,656.74

NAPHAZOL ANTAZ OPH SOL 15ML

Facility

$109.45

Hospital Charge Code	6003891
Hospital Revenue Code	252
Min. Negotiated Rate	$14.23
Max. Negotiated Rate	$54.73
Rate for Payer: Aetna Commercial	$32.84
Rate for Payer: Aetna Medicare Advantage	$32.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.91
Rate for Payer: Cigna Commercial	$54.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.23
Rate for Payer: Oxford Commercial	$54.73
Rate for Payer: Qualcare PPO/HMO/WC	$16.42
Rate for Payer: UnitedHealthcare Commercial	$54.73

NAPHAZOL ANTAZ OPH SOL 15ML

Facility

$109.45

Hospital Charge Code	6003891
Hospital Revenue Code	252
Min. Negotiated Rate	$16.42
Max. Negotiated Rate	$16.42
Rate for Payer: Qualcare PPO/HMO/WC	$16.42

Know your out-of-pocket cost for care.

All Charges