Heights University Hospital

All Charges

Charge

Type

Setting

Price

NOVAFED A/CAP

Facility

$3.00

Hospital Charge Code	60633554
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

NOVASURE ADVANCE

Facility

$5,690.00

Hospital Charge Code	270679291
Hospital Revenue Code	272
Min. Negotiated Rate	$739.70
Max. Negotiated Rate	$2,845.00
Rate for Payer: Aetna Commercial	$1,707.00
Rate for Payer: Aetna Medicare Advantage	$1,707.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,450.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,450.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,450.95
Rate for Payer: Cigna Commercial	$2,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$739.70
Rate for Payer: Oxford Commercial	$2,845.00
Rate for Payer: Qualcare PPO/HMO/WC	$853.50
Rate for Payer: UnitedHealthcare Commercial	$2,845.00

NOVASURE ADVANCE

Facility

$5,690.00

Hospital Charge Code	270679291
Hospital Revenue Code	272
Min. Negotiated Rate	$853.50
Max. Negotiated Rate	$853.50
Rate for Payer: Qualcare PPO/HMO/WC	$853.50

NOVASURE W/SURESOUND DEVICE

Facility

$5,750.00

Hospital Charge Code	270641829
Hospital Revenue Code	272
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$862.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

NOVASURE W/SURESOUND DEVICE

Facility

$5,750.00

Hospital Charge Code	270641829
Hospital Revenue Code	272
Min. Negotiated Rate	$747.50
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$1,725.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$747.50
Rate for Payer: Oxford Commercial	$2,875.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Commercial	$2,875.00

NOVOCAIN 1%/30ML

Facility

$63.00

Hospital Charge Code	60633556
Hospital Revenue Code	250
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna Commercial	$18.90
Rate for Payer: Aetna Medicare Advantage	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.07
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.19
Rate for Payer: Oxford Commercial	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$31.50

NOVOCAIN 1%/30ML

Facility

$63.00

Hospital Charge Code	60633556
Hospital Revenue Code	250
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

NOVOCAIN 2%/30ML

Facility

$42.00

Hospital Charge Code	60633557
Hospital Revenue Code	250
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

NOVOCAIN 2%/30ML

Facility

$42.00

Hospital Charge Code	60633557
Hospital Revenue Code	250
Min. Negotiated Rate	$5.46
Max. Negotiated Rate	$21.00
Rate for Payer: Aetna Commercial	$12.60
Rate for Payer: Aetna Medicare Advantage	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.71
Rate for Payer: Cigna Commercial	$21.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.46
Rate for Payer: Oxford Commercial	$21.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Commercial	$21.00

NOVOFINE NEEDLE

Facility

$18.75

Hospital Charge Code	6063943151
Hospital Revenue Code	270
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$9.38
Rate for Payer: Aetna Commercial	$5.62
Rate for Payer: Aetna Medicare Advantage	$5.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.78
Rate for Payer: Cigna Commercial	$9.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.44
Rate for Payer: Oxford Commercial	$9.38
Rate for Payer: Qualcare PPO/HMO/WC	$2.81
Rate for Payer: UnitedHealthcare Commercial	$9.38

NOVOFINE NEEDLE

Facility

$18.75

Hospital Charge Code	6063943151
Hospital Revenue Code	270
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$2.81
Rate for Payer: Qualcare PPO/HMO/WC	$2.81

NOVOLIN L

Facility

$37.00

Hospital Charge Code	60635486
Hospital Revenue Code	250
Min. Negotiated Rate	$5.55
Max. Negotiated Rate	$5.55
Rate for Payer: Qualcare PPO/HMO/WC	$5.55

NOVOLIN L

Facility

$37.00

Hospital Charge Code	60635486
Hospital Revenue Code	250
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$18.50
Rate for Payer: Aetna Commercial	$11.10
Rate for Payer: Aetna Medicare Advantage	$11.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.44
Rate for Payer: Cigna Commercial	$18.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.81
Rate for Payer: Oxford Commercial	$18.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.55
Rate for Payer: UnitedHealthcare Commercial	$18.50

NOVOLIN MIX 70/30

Facility

$4.00

Service Code	NDC 169183711
Hospital Charge Code	60635485
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NOVOLIN MIX 70/30

Facility

$4.00

Service Code	NDC 169183711
Hospital Charge Code	60635485
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

NOVOLIN N 100UNITS/ML

Facility

$4.00

Service Code	NDC 169183411
Hospital Charge Code	60633558
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NOVOLIN N 100UNITS/ML

Facility

$4.00

Service Code	NDC 169183411
Hospital Charge Code	60633558
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

NOVOLIN R 100 UN/ML VIAL

Facility

$47.00

Hospital Charge Code	83652583
Hospital Revenue Code	250
Min. Negotiated Rate	$6.11
Max. Negotiated Rate	$23.50
Rate for Payer: Aetna Commercial	$14.10
Rate for Payer: Aetna Medicare Advantage	$14.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.98
Rate for Payer: Cigna Commercial	$23.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.11
Rate for Payer: Oxford Commercial	$23.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.05
Rate for Payer: UnitedHealthcare Commercial	$23.50

NOVOLIN R 100 UN/ML VIAL

Facility

$47.00

Hospital Charge Code	83652583
Hospital Revenue Code	250
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$7.05
Rate for Payer: Qualcare PPO/HMO/WC	$7.05

NOVOLIN R 10ML VIAL (100U/ML)

Facility

$289.20

Hospital Charge Code	606390569
Hospital Revenue Code	250
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$43.38
Rate for Payer: Qualcare PPO/HMO/WC	$43.38

NOVOLIN R 10ML VIAL (100U/ML)

Facility

$289.20

Hospital Charge Code	606390569
Hospital Revenue Code	250
Min. Negotiated Rate	$37.60
Max. Negotiated Rate	$144.60
Rate for Payer: Aetna Commercial	$86.76
Rate for Payer: Aetna Medicare Advantage	$86.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.75
Rate for Payer: Cigna Commercial	$144.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.60
Rate for Payer: Oxford Commercial	$144.60
Rate for Payer: Qualcare PPO/HMO/WC	$43.38
Rate for Payer: UnitedHealthcare Commercial	$144.60

NOVOLIN R PER 5 UNITS

Facility

$4.00

Service Code	NDC 169183311
Hospital Charge Code	60632252
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NOVOLIN R PER 5 UNITS

Facility

$4.00

Service Code	NDC 169183311
Hospital Charge Code	60632252
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

NOVOLOG 100UNITS/ML

Facility

$4.00

Service Code	NDC 169330312
Hospital Charge Code	60635373
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

NOVOLOG 100UNITS/ML

Facility

$4.00

Service Code	NDC 169330312
Hospital Charge Code	60635373
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

Know your out-of-pocket cost for care.

All Charges