Heights University Hospital

All Charges

Charge

Type

Setting

Price

NITROUS OXIDE ANALGESIA SUPPLY

Facility

$15.29

Hospital Charge Code	270999015
Hospital Revenue Code	270
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$7.64
Rate for Payer: Aetna Commercial	$4.59
Rate for Payer: Aetna Medicare Advantage	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.90
Rate for Payer: Cigna Commercial	$7.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.99
Rate for Payer: Oxford Commercial	$7.64
Rate for Payer: Qualcare PPO/HMO/WC	$2.29
Rate for Payer: UnitedHealthcare Commercial	$7.64

NITROUS OXIDE ANALGESIA SUPPLY

Facility

$15.29

Hospital Charge Code	270999015
Hospital Revenue Code	270
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$2.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.29

NIVEA LOTION

Facility

$28.80

Hospital Charge Code	60628868
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

NIVEA LOTION

Facility

$28.80

Hospital Charge Code	60628868
Hospital Revenue Code	250
Min. Negotiated Rate	$4.32
Max. Negotiated Rate	$4.32
Rate for Payer: Qualcare PPO/HMO/WC	$4.32

NIVEA SKIN CREAM

Facility

$17.95

Hospital Charge Code	60628427
Hospital Revenue Code	250
Min. Negotiated Rate	$2.33
Max. Negotiated Rate	$8.97
Rate for Payer: Aetna Commercial	$5.38
Rate for Payer: Aetna Medicare Advantage	$5.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.58
Rate for Payer: Cigna Commercial	$8.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.33
Rate for Payer: Oxford Commercial	$8.97
Rate for Payer: Qualcare PPO/HMO/WC	$2.69
Rate for Payer: UnitedHealthcare Commercial	$8.97

NIVEA SKIN CREAM

Facility

$17.95

Hospital Charge Code	60628427
Hospital Revenue Code	250
Min. Negotiated Rate	$2.69
Max. Negotiated Rate	$2.69
Rate for Payer: Qualcare PPO/HMO/WC	$2.69

NIVESTYM 480MCG/.8ML PER MCG

Facility

$1,599.22

Service Code	HCPCS Q5110
Hospital Charge Code	606390440
Hospital Revenue Code	636
Min. Negotiated Rate	$239.88
Max. Negotiated Rate	$479.77
Rate for Payer: Aetna Commercial	$479.77
Rate for Payer: Aetna Medicare Advantage	$479.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$407.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$407.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$407.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.01
Rate for Payer: Qualcare PPO/HMO/WC	$239.88

NIVESTYM 480MCG/.8ML PER MCG

Facility

$1,599.22

Service Code	HCPCS Q5110
Hospital Charge Code	606390440
Hospital Revenue Code	636
Min. Negotiated Rate	$239.88
Max. Negotiated Rate	$387.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.01
Rate for Payer: Qualcare PPO/HMO/WC	$239.88

NIZATIDINE 150 MG

Facility

$1.95

Hospital Charge Code	6022818
Hospital Revenue Code	251
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

NIZATIDINE 150 MG

Facility

$1.95

Hospital Charge Code	6022818
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

NIZATIDINE 150 MG CAP

Facility

$13.65

Hospital Charge Code	60628170
Hospital Revenue Code	250
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$4.09
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.77
Rate for Payer: Oxford Commercial	$6.83
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$6.83

NIZATIDINE 150 MG CAP

Facility

$13.65

Hospital Charge Code	60628170
Hospital Revenue Code	250
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

NIZORAL/200MG/TAB

Facility

$9.00

Hospital Charge Code	60634702
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

NIZORAL/200MG/TAB

Facility

$9.00

Hospital Charge Code	60634702
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

NIZORAL 2%/15GM

Facility

$44.00

Hospital Charge Code	60633539
Hospital Revenue Code	250
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

NIZORAL 2%/15GM

Facility

$44.00

Hospital Charge Code	60633539
Hospital Revenue Code	250
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$13.20
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.72
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$22.00

NIZORAL SHAMPOO 4 OZ

Facility

$35.00

Hospital Charge Code	60635484
Hospital Revenue Code	250
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$5.25

NIZORAL SHAMPOO 4 OZ

Facility

$35.00

Hospital Charge Code	60635484
Hospital Revenue Code	250
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$17.50
Rate for Payer: Aetna Commercial	$10.50
Rate for Payer: Aetna Medicare Advantage	$10.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.93
Rate for Payer: Cigna Commercial	$17.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.55
Rate for Payer: Oxford Commercial	$17.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.25
Rate for Payer: UnitedHealthcare Commercial	$17.50

NJX AA&/STRD GNCLR NRV BRNCH

Facility

$3,865.20

Service Code	HCPCS 64454
Hospital Charge Code	321564454
Hospital Revenue Code	361
Min. Negotiated Rate	$579.78
Max. Negotiated Rate	$579.78
Rate for Payer: Qualcare PPO/HMO/WC	$579.78

NJX AA&/STRD GNCLR NRV BRNCH

Facility

$3,865.20

Service Code	HCPCS 64454
Hospital Charge Code	411064454
Hospital Revenue Code	361
Min. Negotiated Rate	$502.48
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,159.56
Rate for Payer: Aetna Medicare Advantage	$1,159.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$985.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$985.63
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	$985.63
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$502.48
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$579.78
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

NJX AA&/STRD GNCLR NRV BRNCH

Facility

$3,865.20

Service Code	HCPCS 64454
Hospital Charge Code	411064454
Hospital Revenue Code	361
Min. Negotiated Rate	$579.78
Max. Negotiated Rate	$579.78
Rate for Payer: Qualcare PPO/HMO/WC	$579.78

NJX AA&/STRD GNCLR NRV BRNCH

Facility

$3,865.20

Service Code	HCPCS 64454
Hospital Charge Code	321564454
Hospital Revenue Code	361
Min. Negotiated Rate	$502.48
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,159.56
Rate for Payer: Aetna Medicare Advantage	$1,159.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$985.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$985.63
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	$985.63
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$502.48
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$579.78
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

NJX AA&/STRD GNCLR NRV BRNCH

Facility

$2,930.12

Service Code	HCPCS 64454
Hospital Charge Code	1600000661
Hospital Revenue Code	360
Min. Negotiated Rate	$439.52
Max. Negotiated Rate	$439.52
Rate for Payer: Qualcare PPO/HMO/WC	$439.52

NJX AA&/STRD GNCLR NRV BRNCH

Facility

$2,930.12

Service Code	HCPCS 64454
Hospital Charge Code	1600000661
Hospital Revenue Code	360
Min. Negotiated Rate	$380.92
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$879.04
Rate for Payer: Aetna Medicare Advantage	$879.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$747.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$747.18
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	$747.18
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.92
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$439.52
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

NJX AA&/STRD GR OCPL NRV

Facility

$1,630.99

Service Code	HCPCS 64405
Hospital Charge Code	321564405
Hospital Revenue Code	361
Min. Negotiated Rate	$212.03
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$489.30
Rate for Payer: Aetna Medicare Advantage	$489.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$415.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$415.90
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	$415.90
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$212.03
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$244.65
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

Know your out-of-pocket cost for care.

All Charges