Heights University Hospital

All Charges

Charge

Type

Setting

Price

NITROGLYCERIN PATCH 0.1MG/HR

Facility

$12.46

Service Code	NDC 378910293
Hospital Charge Code	60627660
Hospital Revenue Code	250
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$6.23
Rate for Payer: Aetna Commercial	$3.74
Rate for Payer: Aetna Medicare Advantage	$3.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.18
Rate for Payer: Cigna Commercial	$6.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.62
Rate for Payer: Oxford Commercial	$6.23
Rate for Payer: Qualcare PPO/HMO/WC	$1.87
Rate for Payer: UnitedHealthcare Commercial	$6.23

NITROGLYCERIN PATCH 0.3MG/HR

Facility

$36.58

Service Code	NDC 85331530
Hospital Charge Code	60627654
Hospital Revenue Code	250
Min. Negotiated Rate	$4.76
Max. Negotiated Rate	$18.29
Rate for Payer: Aetna Commercial	$10.97
Rate for Payer: Aetna Medicare Advantage	$10.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.33
Rate for Payer: Cigna Commercial	$18.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.76
Rate for Payer: Oxford Commercial	$18.29
Rate for Payer: Qualcare PPO/HMO/WC	$5.49
Rate for Payer: UnitedHealthcare Commercial	$18.29

NITROGLYCERIN PATCH 0.3MG/HR

Facility

$36.58

Service Code	NDC 85331530
Hospital Charge Code	60627654
Hospital Revenue Code	250
Min. Negotiated Rate	$5.49
Max. Negotiated Rate	$5.49
Rate for Payer: Qualcare PPO/HMO/WC	$5.49

NITROGLYCERIN PATCH 0.4MG/HR

Facility

$12.46

Service Code	NDC 85332030
Hospital Charge Code	60627655
Hospital Revenue Code	250
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$6.23
Rate for Payer: Aetna Commercial	$3.74
Rate for Payer: Aetna Medicare Advantage	$3.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.18
Rate for Payer: Cigna Commercial	$6.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.62
Rate for Payer: Oxford Commercial	$6.23
Rate for Payer: Qualcare PPO/HMO/WC	$1.87
Rate for Payer: UnitedHealthcare Commercial	$6.23

NITROGLYCERIN PATCH 0.4MG/HR

Facility

$12.46

Service Code	NDC 85332030
Hospital Charge Code	60627655
Hospital Revenue Code	250
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$1.87
Rate for Payer: Qualcare PPO/HMO/WC	$1.87

NITROGLYCERIN PATCH 0.6MG/HR

Facility

$16.08

Service Code	NDC 378911693
Hospital Charge Code	60627656
Hospital Revenue Code	250
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$2.41
Rate for Payer: Qualcare PPO/HMO/WC	$2.41

NITROGLYCERIN PATCH 0.6MG/HR

Facility

$16.08

Service Code	NDC 378911693
Hospital Charge Code	60627656
Hospital Revenue Code	250
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$8.04
Rate for Payer: Aetna Commercial	$4.82
Rate for Payer: Aetna Medicare Advantage	$4.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.10
Rate for Payer: Cigna Commercial	$8.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.09
Rate for Payer: Oxford Commercial	$8.04
Rate for Payer: Qualcare PPO/HMO/WC	$2.41
Rate for Payer: UnitedHealthcare Commercial	$8.04

NITROGLYCERIN TAB SL 0.6MG

Facility

$41.60

Hospital Charge Code	6013056
Hospital Revenue Code	251
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$6.24
Rate for Payer: Qualcare PPO/HMO/WC	$6.24

NITROGLYCERIN TAB SL 0.6MG

Facility

$41.60

Hospital Charge Code	6013056
Hospital Revenue Code	251
Min. Negotiated Rate	$5.41
Max. Negotiated Rate	$20.80
Rate for Payer: Aetna Commercial	$12.48
Rate for Payer: Aetna Medicare Advantage	$12.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.61
Rate for Payer: Cigna Commercial	$20.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.41
Rate for Payer: Oxford Commercial	$20.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.24
Rate for Payer: UnitedHealthcare Commercial	$20.80

NITROGLYCERIN TOP PATCH 0.4MG

Facility

$1.95

Hospital Charge Code	6023105
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

NITROGLYCERIN TOP PATCH 0.4MG

Facility

$1.95

Hospital Charge Code	6023105
Hospital Revenue Code	251
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

NITROPRUSSIDE 50MG/2ML VIAL

Facility

$1,727.26

Service Code	NDC 187430202
Hospital Charge Code	60630163
Hospital Revenue Code	250
Min. Negotiated Rate	$259.09
Max. Negotiated Rate	$259.09
Rate for Payer: Qualcare PPO/HMO/WC	$259.09

NITROPRUSSIDE 50MG/2ML VIAL

Facility

$1,727.26

Service Code	NDC 187430202
Hospital Charge Code	60630163
Hospital Revenue Code	250
Min. Negotiated Rate	$224.54
Max. Negotiated Rate	$863.63
Rate for Payer: Aetna Commercial	$518.18
Rate for Payer: Aetna Medicare Advantage	$518.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$440.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$440.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$440.45
Rate for Payer: Cigna Commercial	$863.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.54
Rate for Payer: Oxford Commercial	$863.63
Rate for Payer: Qualcare PPO/HMO/WC	$259.09
Rate for Payer: UnitedHealthcare Commercial	$863.63

NITROPRUSSIDE SOD INJ 50MG

Facility

$174.75

Hospital Charge Code	6003982
Hospital Revenue Code	250
Min. Negotiated Rate	$22.72
Max. Negotiated Rate	$87.38
Rate for Payer: Aetna Commercial	$52.42
Rate for Payer: Aetna Medicare Advantage	$52.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.56
Rate for Payer: Cigna Commercial	$87.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.72
Rate for Payer: Oxford Commercial	$87.38
Rate for Payer: Qualcare PPO/HMO/WC	$26.21
Rate for Payer: UnitedHealthcare Commercial	$87.38

NITROPRUSSIDE SOD INJ 50MG

Facility

$174.75

Hospital Charge Code	6003982
Hospital Revenue Code	250
Min. Negotiated Rate	$26.21
Max. Negotiated Rate	$26.21
Rate for Payer: Qualcare PPO/HMO/WC	$26.21

NITROSTAT 0.03MG/SL/TAB

Facility

$4.00

Hospital Charge Code	60634330
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NITROSTAT 0.03MG/SL/TAB

Facility

$4.00

Hospital Charge Code	60634330
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

NITROSTAT/0.15MG/TAB

Facility

$3.00

Hospital Charge Code	60633538
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

NITROSTAT/0.15MG/TAB

Facility

$3.00

Hospital Charge Code	60633538
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

NITROSTAT/0.4MG/TAB

Facility

$4.00

Hospital Charge Code	60633537
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NITROSTAT/0.4MG/TAB

Facility

$4.00

Hospital Charge Code	60633537
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

NITROSTAT 0.6MG/SL/TAB

Facility

$3.00

Hospital Charge Code	60634331
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

NITROSTAT 0.6MG/SL/TAB

Facility

$3.00

Hospital Charge Code	60634331
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

NITROUS OXIDE 56LBS

Facility

$495.00

Hospital Charge Code	270653914
Hospital Revenue Code	272
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$74.25
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

NITROUS OXIDE 56LBS

Facility

$495.00

Hospital Charge Code	270653914
Hospital Revenue Code	272
Min. Negotiated Rate	$64.35
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$148.50
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.35
Rate for Payer: Oxford Commercial	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Commercial	$247.50

Know your out-of-pocket cost for care.

All Charges