Heights University Hospital

All Charges

Charge

Type

Setting

Price

OXYHOOD LARGE DISP

Facility

$682.45

Hospital Charge Code	270614394
Hospital Revenue Code	272
Min. Negotiated Rate	$88.72
Max. Negotiated Rate	$341.23
Rate for Payer: Aetna Commercial	$204.74
Rate for Payer: Aetna Medicare Advantage	$204.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.02
Rate for Payer: Cigna Commercial	$341.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.72
Rate for Payer: Oxford Commercial	$341.23
Rate for Payer: Qualcare PPO/HMO/WC	$102.37
Rate for Payer: UnitedHealthcare Commercial	$341.23

OXYIR 5 MG

Facility

$3.00

Hospital Charge Code	60635323
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

OXYIR 5 MG

Facility

$3.00

Hospital Charge Code	60635323
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

OXYMETAZOLINE NASAL

Facility

$9.00

Hospital Charge Code	6013098
Hospital Revenue Code	251
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

OXYMETAZOLINE NASAL

Facility

$9.00

Hospital Charge Code	6013098
Hospital Revenue Code	251
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

OXYMETAZOLINE NSL SPR 0.05%

Facility

$26.73

Service Code	NDC 45802041059
Hospital Charge Code	60628076
Hospital Revenue Code	250
Min. Negotiated Rate	$3.47
Max. Negotiated Rate	$13.37
Rate for Payer: Aetna Commercial	$8.02
Rate for Payer: Aetna Medicare Advantage	$8.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.82
Rate for Payer: Cigna Commercial	$13.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.47
Rate for Payer: Oxford Commercial	$13.37
Rate for Payer: Qualcare PPO/HMO/WC	$4.01
Rate for Payer: UnitedHealthcare Commercial	$13.37

OXYMETAZOLINE NSL SPR 0.05%

Facility

$26.73

Service Code	NDC 45802041059
Hospital Charge Code	60628076
Hospital Revenue Code	250
Min. Negotiated Rate	$4.01
Max. Negotiated Rate	$4.01
Rate for Payer: Qualcare PPO/HMO/WC	$4.01

OXYTOCIN 10 UNITS/ML INJ

Facility

$7.24

Service Code	HCPCS J2590
Hospital Charge Code	60628284
Hospital Revenue Code	636
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.75
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

OXYTOCIN 10 UNITS/ML INJ

Facility

$7.24

Service Code	HCPCS J2590
Hospital Charge Code	60628284
Hospital Revenue Code	636
Min. Negotiated Rate	$1.09
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	$1.75
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

OXYTOCIN 30 U 0.9 SOD CHL NS

Facility

$72.29

Service Code	HCPCS J2590
Hospital Charge Code	606350996
Hospital Revenue Code	636
Min. Negotiated Rate	$10.84
Max. Negotiated Rate	$36.15
Rate for Payer: Aetna Commercial	$21.69
Rate for Payer: Aetna Medicare Advantage	$21.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.43
Rate for Payer: Cigna Commercial	$36.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.49
Rate for Payer: Qualcare PPO/HMO/WC	$10.84

OXYTOCIN 30 U 0.9 SOD CHL NS

Facility

$72.29

Service Code	HCPCS J2590
Hospital Charge Code	606350996
Hospital Revenue Code	636
Min. Negotiated Rate	$10.84
Max. Negotiated Rate	$17.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.49
Rate for Payer: Qualcare PPO/HMO/WC	$10.84

OXYTOCIN 30U IN 500ML OF LR

Facility

$115.51

Service Code	HCPCS J2590
Hospital Charge Code	606361022
Hospital Revenue Code	636
Min. Negotiated Rate	$17.33
Max. Negotiated Rate	$57.76
Rate for Payer: Aetna Commercial	$34.65
Rate for Payer: Aetna Medicare Advantage	$34.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.46
Rate for Payer: Cigna Commercial	$57.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.95
Rate for Payer: Qualcare PPO/HMO/WC	$17.33

OXYTOCIN 30U IN 500ML OF LR

Facility

$115.51

Service Code	HCPCS J2590
Hospital Charge Code	606361022
Hospital Revenue Code	636
Min. Negotiated Rate	$17.33
Max. Negotiated Rate	$27.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.95
Rate for Payer: Qualcare PPO/HMO/WC	$17.33

OXYTOCIN 30UNIT .9% 500ML

Facility

$31.20

Hospital Charge Code	60635760
Hospital Revenue Code	636
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$7.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.55
Rate for Payer: Qualcare PPO/HMO/WC	$4.68

OXYTOCIN 30UNIT .9% 500ML

Facility

$31.20

Hospital Charge Code	60635760
Hospital Revenue Code	636
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$15.60
Rate for Payer: Aetna Commercial	$9.36
Rate for Payer: Aetna Medicare Advantage	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.96
Rate for Payer: Cigna Commercial	$15.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.55
Rate for Payer: Qualcare PPO/HMO/WC	$4.68

OXYTOCIN 30UNITS.9% 500ML

Facility

$31.20

Hospital Charge Code	60635769
Hospital Revenue Code	636
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$15.60
Rate for Payer: Aetna Commercial	$9.36
Rate for Payer: Aetna Medicare Advantage	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.96
Rate for Payer: Cigna Commercial	$15.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.55
Rate for Payer: Qualcare PPO/HMO/WC	$4.68

OXYTOCIN 30UNITS.9% 500ML

Facility

$31.20

Hospital Charge Code	60635769
Hospital Revenue Code	636
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$7.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.55
Rate for Payer: Qualcare PPO/HMO/WC	$4.68

OXYTOCIN CHALLENGE TEST

Facility

$669.00

Service Code	HCPCS 59020
Hospital Charge Code	83653010
Hospital Revenue Code	720
Min. Negotiated Rate	$100.35
Max. Negotiated Rate	$100.35
Rate for Payer: Qualcare PPO/HMO/WC	$100.35

OXYTOCIN CHALLENGE TEST

Facility

$669.00

Service Code	HCPCS 59020
Hospital Charge Code	83653010
Hospital Revenue Code	720
Min. Negotiated Rate	$45.64
Max. Negotiated Rate	$2,979.00
Rate for Payer: Aetna Commercial	$200.70
Rate for Payer: Aetna Medicare Advantage	$200.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.59
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.97
Rate for Payer: Oxford Commercial	$2,624.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.35
Rate for Payer: UnitedHealthcare Commercial	$2,979.00

OYSTER IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	401186003I
Hospital Revenue Code	302
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.91
Rate for Payer: Aetna Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.13
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: Cigna Medicare Advantage	$2.61
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
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
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.53
Rate for Payer: Wellcare Medicare Advantage	$5.22

OYSTER IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	401186003I
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

OYSTER SHELL CALCIUM/1.25

Facility

$3.00

Hospital Charge Code	60633597
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

OYSTER SHELL CALCIUM/1.25

Facility

$3.00

Hospital Charge Code	60633597
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

OYSTER SHELL CALCIUM/1.25

Facility

$3.00

Hospital Charge Code	60633599
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

OYSTER SHELL CALCIUM/1.25

Facility

$3.00

Hospital Charge Code	60633599
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

Know your out-of-pocket cost for care.

All Charges