Heights University Hospital

All Charges

Charge

Type

Setting

Price

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

NIGHT DRAINAGE SYSTEM *******

Facility

$115.00

Hospital Charge Code	8003857
Hospital Revenue Code	272
Min. Negotiated Rate	$14.95
Max. Negotiated Rate	$57.50
Rate for Payer: Aetna Commercial	$34.50
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.95
Rate for Payer: Oxford Commercial	$57.50
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Commercial	$57.50

NIGHT DRAINAGE SYSTEM *******

Facility

$115.00

Hospital Charge Code	8003857
Hospital Revenue Code	272
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

NIMBEX 2MG/ML

Facility

$80.00

Hospital Charge Code	60635112
Hospital Revenue Code	250
Min. Negotiated Rate	$10.40
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$24.00
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.40
Rate for Payer: Oxford Commercial	$40.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Commercial	$40.00

NIMBEX 2MG/ML

Facility

$80.00

Hospital Charge Code	60635112
Hospital Revenue Code	250
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

NIMODIPINE 30 MG CAP

Facility

$128.84

Service Code	NDC 23155051230
Hospital Charge Code	60628536
Hospital Revenue Code	250
Min. Negotiated Rate	$16.75
Max. Negotiated Rate	$64.42
Rate for Payer: Aetna Commercial	$38.65
Rate for Payer: Aetna Medicare Advantage	$38.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.85
Rate for Payer: Cigna Commercial	$64.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.75
Rate for Payer: Oxford Commercial	$64.42
Rate for Payer: Qualcare PPO/HMO/WC	$19.33
Rate for Payer: UnitedHealthcare Commercial	$64.42

NIMODIPINE 30 MG CAP

Facility

$128.84

Service Code	NDC 23155051230
Hospital Charge Code	60628536
Hospital Revenue Code	250
Min. Negotiated Rate	$19.33
Max. Negotiated Rate	$19.33
Rate for Payer: Qualcare PPO/HMO/WC	$19.33

NIMODIPINE CAP 30MG

Facility

$35.20

Hospital Charge Code	60628666
Hospital Revenue Code	250
Min. Negotiated Rate	$5.28
Max. Negotiated Rate	$5.28
Rate for Payer: Qualcare PPO/HMO/WC	$5.28

NIMODIPINE CAP 30MG

Facility

$35.20

Hospital Charge Code	60628666
Hospital Revenue Code	250
Min. Negotiated Rate	$4.58
Max. Negotiated Rate	$17.60
Rate for Payer: Aetna Commercial	$10.56
Rate for Payer: Aetna Medicare Advantage	$10.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.98
Rate for Payer: Cigna Commercial	$17.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.58
Rate for Payer: Oxford Commercial	$17.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.28
Rate for Payer: UnitedHealthcare Commercial	$17.60

NIMODIPINE ORAL SUSP 60MG/10ML

Facility

$683.40

Service Code	NDC 24338026010
Hospital Charge Code	606390450
Hospital Revenue Code	250
Min. Negotiated Rate	$88.84
Max. Negotiated Rate	$341.70
Rate for Payer: Aetna Commercial	$205.02
Rate for Payer: Aetna Medicare Advantage	$205.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.27
Rate for Payer: Cigna Commercial	$341.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.84
Rate for Payer: Oxford Commercial	$341.70
Rate for Payer: Qualcare PPO/HMO/WC	$102.51
Rate for Payer: UnitedHealthcare Commercial	$341.70

NIMODIPINE ORAL SUSP 60MG/10ML

Facility

$683.40

Service Code	NDC 24338026010
Hospital Charge Code	606390450
Hospital Revenue Code	250
Min. Negotiated Rate	$102.51
Max. Negotiated Rate	$102.51
Rate for Payer: Qualcare PPO/HMO/WC	$102.51

NIPPLE/AREOLA RECONSTRUCTION

Facility

$35,786.50

Service Code	HCPCS 19350
Hospital Charge Code	16000666
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$10,735.95
Rate for Payer: Aetna Commercial	$10,735.95
Rate for Payer: Aetna Medicare Advantage	$10,735.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,125.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,125.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,125.56
Rate for Payer: Cigna Commercial	$9,324.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,652.24
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,367.98
Rate for Payer: UnitedHealthcare Commercial	$5,529.00

NIPPLE/AREOLA RECONSTRUCTION

Facility

$35,786.50

Service Code	HCPCS 19350
Hospital Charge Code	16000666
Hospital Revenue Code	360
Min. Negotiated Rate	$5,367.98
Max. Negotiated Rate	$5,367.98
Rate for Payer: Qualcare PPO/HMO/WC	$5,367.98

NITINOL PILOT WIRE

Facility

$625.00

Service Code	HCPCS C1769
Hospital Charge Code	270700461
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

NITINOL PILOT WIRE

Facility

$625.00

Service Code	HCPCS C1769
Hospital Charge Code	270700461
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$187.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

NITINOL STAPLE KIT 12X12MM

Facility

$5,515.00

Hospital Charge Code	270699042
Hospital Revenue Code	278
Min. Negotiated Rate	$827.25
Max. Negotiated Rate	$1,334.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,103.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,334.63
Rate for Payer: Qualcare PPO/HMO/WC	$827.25

NITINOL STAPLE KIT 12X12MM

Facility

$5,515.00

Hospital Charge Code	270699042
Hospital Revenue Code	278
Min. Negotiated Rate	$827.25
Max. Negotiated Rate	$2,757.50
Rate for Payer: Aetna Commercial	$1,654.50
Rate for Payer: Aetna Medicare Advantage	$1,654.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,406.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,406.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,103.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,406.33
Rate for Payer: Cigna Commercial	$2,757.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,334.63
Rate for Payer: Qualcare PPO/HMO/WC	$827.25

NITINOL WIRES

Facility

$1,404.00

Hospital Charge Code	270704178
Hospital Revenue Code	279
Min. Negotiated Rate	$182.52
Max. Negotiated Rate	$702.00
Rate for Payer: Aetna Commercial	$421.20
Rate for Payer: Aetna Medicare Advantage	$421.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.02
Rate for Payer: Cigna Commercial	$702.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.52
Rate for Payer: Oxford Commercial	$702.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.60
Rate for Payer: UnitedHealthcare Commercial	$702.00

NITINOL WIRES

Facility

$1,404.00

Hospital Charge Code	270704178
Hospital Revenue Code	279
Min. Negotiated Rate	$210.60
Max. Negotiated Rate	$210.60
Rate for Payer: Qualcare PPO/HMO/WC	$210.60

NITRATE, URINE***

Facility

$22.00

Service Code	HCPCS 84311
Hospital Charge Code	3031325
Hospital Revenue Code	301
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

NITRATE, URINE***

Facility

$22.00

Service Code	HCPCS 84311
Hospital Charge Code	3031325
Hospital Revenue Code	301
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.24
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.68
Rate for Payer: Cigna Commercial	$8.10
Rate for Payer: Cigna Medicare Advantage	$4.05
Rate for Payer: Clover Medicare Advantage	$7.70
Rate for Payer: EmblemHealth Commercial	$24.30
Rate for Payer: Humana Medicare Advantage	$8.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.10
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.59
Rate for Payer: Wellcare Medicare Advantage	$8.10

NITRAZINE PAPER W/DISPENS

Facility

$266.53

Service Code	NDC 3052620
Hospital Charge Code	60633527
Hospital Revenue Code	250
Min. Negotiated Rate	$39.98
Max. Negotiated Rate	$39.98
Rate for Payer: Qualcare PPO/HMO/WC	$39.98

NITRAZINE PAPER W/DISPENS

Facility

$266.53

Service Code	NDC 3052620
Hospital Charge Code	60633527
Hospital Revenue Code	250
Min. Negotiated Rate	$34.65
Max. Negotiated Rate	$133.26
Rate for Payer: Aetna Commercial	$79.96
Rate for Payer: Aetna Medicare Advantage	$79.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.97
Rate for Payer: Cigna Commercial	$133.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.65
Rate for Payer: Oxford Commercial	$133.26
Rate for Payer: Qualcare PPO/HMO/WC	$39.98
Rate for Payer: UnitedHealthcare Commercial	$133.26

NITRIC OXIDE PER HOUR

Facility

$1,288.05

Hospital Charge Code	31701001
Hospital Revenue Code	270
Min. Negotiated Rate	$193.21
Max. Negotiated Rate	$193.21
Rate for Payer: Qualcare PPO/HMO/WC	$193.21

NITRIC OXIDE PER HOUR

Facility

$1,288.05

Hospital Charge Code	31701001
Hospital Revenue Code	270
Min. Negotiated Rate	$167.45
Max. Negotiated Rate	$644.02
Rate for Payer: Aetna Commercial	$386.42
Rate for Payer: Aetna Medicare Advantage	$386.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$328.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$328.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$328.45
Rate for Payer: Cigna Commercial	$644.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.45
Rate for Payer: Oxford Commercial	$644.02
Rate for Payer: Qualcare PPO/HMO/WC	$193.21
Rate for Payer: UnitedHealthcare Commercial	$644.02

Know your out-of-pocket cost for care.

All Charges