Heights University Hospital

All Charges

Charge

Type

Setting

Price

NEO-SYNEPHRINE 0.5% NASAL

Facility

$12.00

Hospital Charge Code	60633519
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

NEO-SYNEPHRINE 0.5% NASAL

Facility

$12.00

Hospital Charge Code	60633519
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

NEO-SYNEPHRINE 10% OPHTH

Facility

$71.00

Hospital Charge Code	60633521
Hospital Revenue Code	250
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

NEO-SYNEPHRINE 10% OPHTH

Facility

$71.00

Hospital Charge Code	60633521
Hospital Revenue Code	250
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$35.50
Rate for Payer: Aetna Commercial	$21.30
Rate for Payer: Aetna Medicare Advantage	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.11
Rate for Payer: Cigna Commercial	$35.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.23
Rate for Payer: Oxford Commercial	$35.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$35.50

NEO-SYNEPHRINE 1% NASAL

Facility

$12.00

Hospital Charge Code	60633520
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

NEO-SYNEPHRINE 1% NASAL

Facility

$12.00

Hospital Charge Code	60633520
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

NEOSYNEPHRINE SPRAY 1/2%

Facility

$6.00

Hospital Charge Code	60634649
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

NEOSYNEPHRINE SPRAY 1/2%

Facility

$6.00

Hospital Charge Code	60634649
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

NEO-VAC SUCTION CATHETER 3.5

Facility

$75.00

Hospital Charge Code	270332273
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

NEO-VAC SUCTION CATHETER 3.5

Facility

$75.00

Hospital Charge Code	270332273
Hospital Revenue Code	272
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$22.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.75
Rate for Payer: Oxford Commercial	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$37.50

NEPHELOMETRY, EACH, ANALYTE 1

Facility

$450.27

Service Code	HCPCS 83883
Hospital Charge Code	3000401A
Hospital Revenue Code	301
Min. Negotiated Rate	$67.54
Max. Negotiated Rate	$67.54
Rate for Payer: Qualcare PPO/HMO/WC	$67.54

NEPHELOMETRY, EACH, ANALYTE 1

Facility

$450.27

Service Code	HCPCS 83883
Hospital Charge Code	3000401A
Hospital Revenue Code	301
Min. Negotiated Rate	$6.80
Max. Negotiated Rate	$165.64
Rate for Payer: Aetna Commercial	$44.06
Rate for Payer: Aetna Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.83
Rate for Payer: Cigna Commercial	$13.60
Rate for Payer: Cigna Medicare Advantage	$6.80
Rate for Payer: Clover Medicare Advantage	$12.92
Rate for Payer: EmblemHealth Commercial	$40.80
Rate for Payer: Humana Medicare Advantage	$14.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.54
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.42
Rate for Payer: Wellcare Medicare Advantage	$13.60

NEPHELOMETRY, EACH, ANALYTE 2

Facility

$150.00

Service Code	HCPCS 83883
Hospital Charge Code	3000402
Hospital Revenue Code	301
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

NEPHELOMETRY, EACH, ANALYTE 2

Facility

$150.00

Service Code	HCPCS 83883
Hospital Charge Code	3000402
Hospital Revenue Code	301
Min. Negotiated Rate	$6.80
Max. Negotiated Rate	$165.64
Rate for Payer: Aetna Commercial	$44.06
Rate for Payer: Aetna Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.83
Rate for Payer: Cigna Commercial	$13.60
Rate for Payer: Cigna Medicare Advantage	$6.80
Rate for Payer: Clover Medicare Advantage	$12.92
Rate for Payer: EmblemHealth Commercial	$40.80
Rate for Payer: Humana Medicare Advantage	$14.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.42
Rate for Payer: Wellcare Medicare Advantage	$13.60

NEPHELOMETRY, EACH, ANALYTE 2

Facility

$450.27

Service Code	HCPCS 83883
Hospital Charge Code	3000401B
Hospital Revenue Code	301
Min. Negotiated Rate	$67.54
Max. Negotiated Rate	$67.54
Rate for Payer: Qualcare PPO/HMO/WC	$67.54

NEPHELOMETRY, EACH, ANALYTE 2

Facility

$450.27

Service Code	HCPCS 83883
Hospital Charge Code	3000401B
Hospital Revenue Code	301
Min. Negotiated Rate	$6.80
Max. Negotiated Rate	$165.64
Rate for Payer: Aetna Commercial	$44.06
Rate for Payer: Aetna Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.83
Rate for Payer: Cigna Commercial	$13.60
Rate for Payer: Cigna Medicare Advantage	$6.80
Rate for Payer: Clover Medicare Advantage	$12.92
Rate for Payer: EmblemHealth Commercial	$40.80
Rate for Payer: Humana Medicare Advantage	$14.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.54
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.60
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.42
Rate for Payer: Wellcare Medicare Advantage	$13.60

NEPHRITIS AND NEPHROSIS

Facility

$5,887.16

Service Code	APR-DRG 4621
Min. Negotiated Rate	$4,403.00
Max. Negotiated Rate	$5,887.16
Rate for Payer: Aetna Better Health Medicaid	$5,771.73
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,887.16
Rate for Payer: Wellpoint Medicaid Managed Care	$4,403.00

NEPHRITIS AND NEPHROSIS

Facility

$8,558.27

Service Code	APR-DRG 4622
Min. Negotiated Rate	$6,211.96
Max. Negotiated Rate	$8,558.27
Rate for Payer: Aetna Better Health Medicaid	$8,390.46
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,558.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6,211.96

NEPHRITIS AND NEPHROSIS

Facility

$30,170.31

Service Code	APR-DRG 4624
Min. Negotiated Rate	$23,195.98
Max. Negotiated Rate	$30,170.31
Rate for Payer: Aetna Better Health Medicaid	$29,578.74
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$30,170.31
Rate for Payer: Wellpoint Medicaid Managed Care	$23,195.98

NEPHRITIS AND NEPHROSIS

Facility

$15,641.98

Service Code	APR-DRG 4623
Min. Negotiated Rate	$11,477.05
Max. Negotiated Rate	$15,641.98
Rate for Payer: Aetna Better Health Medicaid	$15,335.27
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,641.98
Rate for Payer: Wellpoint Medicaid Managed Care	$11,477.05

NEPHRO 1MG CAP

Facility

$2.00

Hospital Charge Code	60635660
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

NEPHRO 1MG CAP

Facility

$2.00

Hospital Charge Code	60635660
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.60
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$1.00

NEPHRO BALLOON ULTRAXXCATH 6CM

Facility

$1,370.25

Service Code	HCPCS C1729
Hospital Charge Code	270693483
Hospital Revenue Code	278
Min. Negotiated Rate	$205.54
Max. Negotiated Rate	$685.12
Rate for Payer: Aetna Commercial	$411.07
Rate for Payer: Aetna Medicare Advantage	$411.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.41
Rate for Payer: Cigna Commercial	$685.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.60
Rate for Payer: Qualcare PPO/HMO/WC	$205.54

NEPHRO BALLOON ULTRAXXCATH 6CM

Facility

$1,370.25

Service Code	HCPCS C1729
Hospital Charge Code	270693483
Hospital Revenue Code	278
Min. Negotiated Rate	$205.54
Max. Negotiated Rate	$331.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.60
Rate for Payer: Qualcare PPO/HMO/WC	$205.54

NEPHROGENOUS CYCLIC AMP

Facility

$391.00

Service Code	HCPCS 82030
Hospital Charge Code	38476219
Hospital Revenue Code	307
Min. Negotiated Rate	$58.65
Max. Negotiated Rate	$58.65
Rate for Payer: Qualcare PPO/HMO/WC	$58.65

Know your out-of-pocket cost for care.

All Charges