Heights University Hospital

All Charges

Charge

Type

Setting

Price

POTASSIUM CHL CAP SR 8MEQ

Facility

$4.00

Hospital Charge Code	60627929
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

POTASSIUM CHL CAP SR 8MEQ

Facility

$4.00

Hospital Charge Code	60627929
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

POTASSIUM CHL INJ 20MEQ/10ML

Facility

$8.04

Service Code	HCPCS J3480
Hospital Charge Code	60627923
Hospital Revenue Code	636
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$1.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.21

POTASSIUM CHL INJ 20MEQ/10ML

Facility

$8.04

Service Code	HCPCS J3480
Hospital Charge Code	60627923
Hospital Revenue Code	636
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.41
Rate for Payer: Aetna Commercial	$2.41
Rate for Payer: Aetna Medicare Advantage	$2.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.05
Rate for Payer: Cigna Commercial	$0.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.21

POTASSIUM CHL INJ 40MEQ/20ML

Facility

$10.65

Service Code	HCPCS J3480
Hospital Charge Code	60627926
Hospital Revenue Code	636
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$2.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.60

POTASSIUM CHL INJ 40MEQ/20ML

Facility

$10.65

Service Code	HCPCS J3480
Hospital Charge Code	60627926
Hospital Revenue Code	636
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$3.19
Rate for Payer: Aetna Commercial	$3.19
Rate for Payer: Aetna Medicare Advantage	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.72
Rate for Payer: Cigna Commercial	$0.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.60

POTASSIUM CHL IVPB 10MEQ/100ML

Facility

$18.63

Service Code	HCPCS J3480
Hospital Charge Code	60628788
Hospital Revenue Code	636
Min. Negotiated Rate	$2.79
Max. Negotiated Rate	$4.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.51
Rate for Payer: Qualcare PPO/HMO/WC	$2.79

POTASSIUM CHL IVPB 10MEQ/100ML

Facility

$18.63

Service Code	HCPCS J3480
Hospital Charge Code	60628788
Hospital Revenue Code	636
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$5.59
Rate for Payer: Aetna Commercial	$5.59
Rate for Payer: Aetna Medicare Advantage	$5.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.75
Rate for Payer: Cigna Commercial	$0.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.51
Rate for Payer: Qualcare PPO/HMO/WC	$2.79

POTASSIUM CHL IVPB 20MEQ/ 10ML

Facility

$7.70

Hospital Charge Code	60627924
Hospital Revenue Code	250
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$3.85
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.96
Rate for Payer: Cigna Commercial	$3.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.00
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$3.85

POTASSIUM CHL IVPB 20MEQ/ 10ML

Facility

$7.70

Hospital Charge Code	60627924
Hospital Revenue Code	250
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

POTASSIUM CHL IVPB 40MEQ/100ML

Facility

$10.90

Hospital Charge Code	60628792
Hospital Revenue Code	250
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$5.45
Rate for Payer: Aetna Commercial	$3.27
Rate for Payer: Aetna Medicare Advantage	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.78
Rate for Payer: Cigna Commercial	$5.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.42
Rate for Payer: Oxford Commercial	$5.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Commercial	$5.45

POTASSIUM CHL IVPB 40MEQ/100ML

Facility

$10.90

Hospital Charge Code	60628792
Hospital Revenue Code	250
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

POTASSIUM CHL LQ 20ME

Facility

$1.95

Hospital Charge Code	6022768
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

POTASSIUM CHL LQ 20ME

Facility

$1.95

Hospital Charge Code	6022768
Hospital Revenue Code	251
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

POTASSIUM CHL LQ 40MEQ/30ML C

Facility

$3.20

Hospital Charge Code	6027171
Hospital Revenue Code	251
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$1.60
Rate for Payer: Aetna Commercial	$0.96
Rate for Payer: Aetna Medicare Advantage	$0.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.82
Rate for Payer: Cigna Commercial	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.42
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.48
Rate for Payer: UnitedHealthcare Commercial	$1.60

POTASSIUM CHL LQ 40MEQ/30ML C

Facility

$3.20

Hospital Charge Code	6027171
Hospital Revenue Code	251
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

POTASSIUM CHLOR 10MEQ/50ML BAG

Facility

$62.75

Hospital Charge Code	60629034
Hospital Revenue Code	250
Min. Negotiated Rate	$9.41
Max. Negotiated Rate	$9.41
Rate for Payer: Qualcare PPO/HMO/WC	$9.41

POTASSIUM CHLOR 10MEQ/50ML BAG

Facility

$62.75

Hospital Charge Code	60629034
Hospital Revenue Code	250
Min. Negotiated Rate	$8.16
Max. Negotiated Rate	$31.38
Rate for Payer: Aetna Commercial	$18.82
Rate for Payer: Aetna Medicare Advantage	$18.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.00
Rate for Payer: Cigna Commercial	$31.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.16
Rate for Payer: Oxford Commercial	$31.38
Rate for Payer: Qualcare PPO/HMO/WC	$9.41
Rate for Payer: UnitedHealthcare Commercial	$31.38

POTASSIUM CHLORIDE

Facility

$30.35

Service Code	NDC 338067304
Hospital Charge Code	60628918
Hospital Revenue Code	250
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$4.55
Rate for Payer: Qualcare PPO/HMO/WC	$4.55

POTASSIUM CHLORIDE

Facility

$30.35

Service Code	NDC 338067304
Hospital Charge Code	60628918
Hospital Revenue Code	250
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$15.18
Rate for Payer: Aetna Commercial	$9.11
Rate for Payer: Aetna Medicare Advantage	$9.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.74
Rate for Payer: Cigna Commercial	$15.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.95
Rate for Payer: Oxford Commercial	$15.18
Rate for Payer: Qualcare PPO/HMO/WC	$4.55
Rate for Payer: UnitedHealthcare Commercial	$15.18

POTASSIUM CHLORIDE

Facility

$4.00

Service Code	NDC 63323096520
Hospital Charge Code	60627927
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

POTASSIUM CHLORIDE

Facility

$31.22

Service Code	NDC 338067504
Hospital Charge Code	60627902
Hospital Revenue Code	250
Min. Negotiated Rate	$4.06
Max. Negotiated Rate	$15.61
Rate for Payer: Aetna Commercial	$9.37
Rate for Payer: Aetna Medicare Advantage	$9.37
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	$15.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.06
Rate for Payer: Oxford Commercial	$15.61
Rate for Payer: Qualcare PPO/HMO/WC	$4.68
Rate for Payer: UnitedHealthcare Commercial	$15.61

POTASSIUM CHLORIDE

Facility

$18.89

Service Code	NDC 338067104
Hospital Charge Code	60628525
Hospital Revenue Code	250
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$9.45
Rate for Payer: Aetna Commercial	$5.67
Rate for Payer: Aetna Medicare Advantage	$5.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.82
Rate for Payer: Cigna Commercial	$9.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.46
Rate for Payer: Oxford Commercial	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$2.83
Rate for Payer: UnitedHealthcare Commercial	$9.45

POTASSIUM CHLORIDE

Facility

$18.89

Service Code	NDC 338067104
Hospital Charge Code	60628525
Hospital Revenue Code	250
Min. Negotiated Rate	$2.83
Max. Negotiated Rate	$2.83
Rate for Payer: Qualcare PPO/HMO/WC	$2.83

POTASSIUM CHLORIDE

Facility

$31.22

Service Code	NDC 338067504
Hospital Charge Code	60627902
Hospital Revenue Code	250
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$4.68
Rate for Payer: Qualcare PPO/HMO/WC	$4.68

Know your out-of-pocket cost for care.

All Charges