Heights University Hospital

All Charges

Charge

Type

Setting

Price

NICOTINE 7 MG/24 HR ER

Facility

$42.08

Service Code	NDC 67512407
Hospital Charge Code	60628797
Hospital Revenue Code	250
Min. Negotiated Rate	$6.31
Max. Negotiated Rate	$6.31
Rate for Payer: Qualcare PPO/HMO/WC	$6.31

NICOTINE 7 MG/24 HR ER

Facility

$42.08

Service Code	NDC 67512407
Hospital Charge Code	60628797
Hospital Revenue Code	250
Min. Negotiated Rate	$5.47
Max. Negotiated Rate	$21.04
Rate for Payer: Aetna Commercial	$12.62
Rate for Payer: Aetna Medicare Advantage	$12.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.73
Rate for Payer: Cigna Commercial	$21.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.47
Rate for Payer: Oxford Commercial	$21.04
Rate for Payer: Qualcare PPO/HMO/WC	$6.31
Rate for Payer: UnitedHealthcare Commercial	$21.04

NICOTINE & COTININE, LC/MS/MS

Facility

$434.65

Service Code	HCPCS 80323
Hospital Charge Code	39990242
Hospital Revenue Code	301
Min. Negotiated Rate	$65.20
Max. Negotiated Rate	$65.20
Rate for Payer: Qualcare PPO/HMO/WC	$65.20

NICOTINE & COTININE, LC/MS/MS

Facility

$434.65

Service Code	HCPCS 80323
Hospital Charge Code	39990242
Hospital Revenue Code	301
Min. Negotiated Rate	$56.50
Max. Negotiated Rate	$217.32
Rate for Payer: Aetna Commercial	$130.40
Rate for Payer: Aetna Medicare Advantage	$130.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.84
Rate for Payer: Cigna Commercial	$217.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$65.20
Rate for Payer: UnitedHealthcare Commercial	$114.00

NICOTINE & EXPANDED METABOLITE

Facility

$390.00

Service Code	HCPCS 80323
Hospital Charge Code	3000377
Hospital Revenue Code	301
Min. Negotiated Rate	$50.70
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$117.00
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00

NICOTINE & EXPANDED METABOLITE

Facility

$390.00

Service Code	HCPCS 80323
Hospital Charge Code	3000377
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

NICOTINE GUM 2MG

Facility

$7.25

Hospital Charge Code	60627495
Hospital Revenue Code	250
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.17
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.94
Rate for Payer: Oxford Commercial	$3.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$3.62

NICOTINE GUM 2MG

Facility

$7.25

Hospital Charge Code	60627495
Hospital Revenue Code	250
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

NICOTINE METABOLITE SCREEN (UA

Facility

$116.00

Service Code	HCPCS 80307
Hospital Charge Code	401380307
Hospital Revenue Code	301
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

NICOTINE METABOLITE SCREEN (UA

Facility

$116.00

Service Code	HCPCS 80307
Hospital Charge Code	401380307
Hospital Revenue Code	301
Min. Negotiated Rate	$15.08
Max. Negotiated Rate	$227.68
Rate for Payer: Aetna Commercial	$201.33
Rate for Payer: Aetna Medicare Advantage	$62.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$62.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.68
Rate for Payer: Cigna Commercial	$62.14
Rate for Payer: Cigna Medicare Advantage	$31.07
Rate for Payer: Clover Medicare Advantage	$59.03
Rate for Payer: EmblemHealth Commercial	$186.42
Rate for Payer: Humana Medicare Advantage	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$62.14
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$65.87
Rate for Payer: Wellcare Medicare Advantage	$62.14

NICOTINE PATCH 11MG

Facility

$37.80

Hospital Charge Code	60627493
Hospital Revenue Code	250
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$5.67
Rate for Payer: Qualcare PPO/HMO/WC	$5.67

NICOTINE PATCH 11MG

Facility

$28.80

Hospital Charge Code	60727493
Hospital Revenue Code	250
Min. Negotiated Rate	$3.74
Max. Negotiated Rate	$14.40
Rate for Payer: Aetna Commercial	$8.64
Rate for Payer: Aetna Medicare Advantage	$8.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.34
Rate for Payer: Cigna Commercial	$14.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.74
Rate for Payer: Oxford Commercial	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.32
Rate for Payer: UnitedHealthcare Commercial	$14.40

NICOTINE PATCH 11MG

Facility

$37.80

Hospital Charge Code	60627493
Hospital Revenue Code	250
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$18.90
Rate for Payer: Aetna Commercial	$11.34
Rate for Payer: Aetna Medicare Advantage	$11.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.64
Rate for Payer: Cigna Commercial	$18.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.91
Rate for Payer: Oxford Commercial	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$5.67
Rate for Payer: UnitedHealthcare Commercial	$18.90

NICOTINE PATCH 11MG

Facility

$28.80

Hospital Charge Code	60727493
Hospital Revenue Code	250
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$4.32
Rate for Payer: Qualcare PPO/HMO/WC	$4.32

NICOTINE PATCH 22MG/DAY

Facility

$30.75

Hospital Charge Code	6016307
Hospital Revenue Code	251
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$15.38
Rate for Payer: Aetna Commercial	$9.22
Rate for Payer: Aetna Medicare Advantage	$9.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.84
Rate for Payer: Cigna Commercial	$15.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.00
Rate for Payer: Oxford Commercial	$15.38
Rate for Payer: Qualcare PPO/HMO/WC	$4.61
Rate for Payer: UnitedHealthcare Commercial	$15.38

NICOTINE PATCH 22MG/DAY

Facility

$30.75

Hospital Charge Code	6016307
Hospital Revenue Code	251
Min. Negotiated Rate	$4.61
Max. Negotiated Rate	$4.61
Rate for Payer: Qualcare PPO/HMO/WC	$4.61

NIFEDIPINE 10 MG CAP

Facility

$7.17

Service Code	NDC 228249710
Hospital Charge Code	60627589
Hospital Revenue Code	250
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$3.58
Rate for Payer: Aetna Commercial	$2.15
Rate for Payer: Aetna Medicare Advantage	$2.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.83
Rate for Payer: Cigna Commercial	$3.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.93
Rate for Payer: Oxford Commercial	$3.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.08
Rate for Payer: UnitedHealthcare Commercial	$3.58

NIFEDIPINE 10 MG CAP

Facility

$7.17

Service Code	NDC 228249710
Hospital Charge Code	60627589
Hospital Revenue Code	250
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$1.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.08

NIFEDIPINE 30 MG ER TAB

Facility

$8.84

Service Code	NDC 51079040020
Hospital Charge Code	6009815
Hospital Revenue Code	250
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$1.33
Rate for Payer: Qualcare PPO/HMO/WC	$1.33

NIFEDIPINE 30 MG ER TAB

Facility

$8.84

Service Code	NDC 51079040020
Hospital Charge Code	6009815
Hospital Revenue Code	250
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$4.42
Rate for Payer: Aetna Commercial	$2.65
Rate for Payer: Aetna Medicare Advantage	$2.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.25
Rate for Payer: Cigna Commercial	$4.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.15
Rate for Payer: Oxford Commercial	$4.42
Rate for Payer: Qualcare PPO/HMO/WC	$1.33
Rate for Payer: UnitedHealthcare Commercial	$4.42

NIFEDIPINE 60 MG ER TAB

Facility

$15.34

Service Code	NDC 51079089620
Hospital Charge Code	6009823
Hospital Revenue Code	250
Min. Negotiated Rate	$2.30
Max. Negotiated Rate	$2.30
Rate for Payer: Qualcare PPO/HMO/WC	$2.30

NIFEDIPINE 60 MG ER TAB

Facility

$15.34

Service Code	NDC 51079089620
Hospital Charge Code	6009823
Hospital Revenue Code	250
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$7.67
Rate for Payer: Aetna Commercial	$4.60
Rate for Payer: Aetna Medicare Advantage	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.91
Rate for Payer: Cigna Commercial	$7.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.99
Rate for Payer: Oxford Commercial	$7.67
Rate for Payer: Qualcare PPO/HMO/WC	$2.30
Rate for Payer: UnitedHealthcare Commercial	$7.67

NIFEDIPINE CAP 10MG

Facility

$1.95

Hospital Charge Code	6022701
Hospital Revenue Code	251
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

NIFEDIPINE CAP 10MG

Facility

$1.95

Hospital Charge Code	6022701
Hospital Revenue Code	251
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.98
Rate for Payer: Aetna Commercial	$0.59
Rate for Payer: Aetna Medicare Advantage	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.50
Rate for Payer: Cigna Commercial	$0.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.25
Rate for Payer: Oxford Commercial	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.29
Rate for Payer: UnitedHealthcare Commercial	$0.98

NIFEDIPINE CC (ADALAT)90MG TAB

Facility

$19.50

Service Code	NDC 378039001
Hospital Charge Code	60630140
Hospital Revenue Code	250
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$9.75
Rate for Payer: Aetna Commercial	$5.85
Rate for Payer: Aetna Medicare Advantage	$5.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.97
Rate for Payer: Cigna Commercial	$9.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.54
Rate for Payer: Oxford Commercial	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$2.92
Rate for Payer: UnitedHealthcare Commercial	$9.75

Know your out-of-pocket cost for care.

All Charges