Heights University Hospital

All Charges

Charge

Type

Setting

Price

QUELICIN/20MG/1ML

Facility

$76.18

Service Code	NDC 61553036465
Hospital Charge Code	60633794
Hospital Revenue Code	250
Min. Negotiated Rate	$11.43
Max. Negotiated Rate	$11.43
Rate for Payer: Qualcare PPO/HMO/WC	$11.43

QUELICIN/20MG/1ML

Facility

$76.18

Service Code	NDC 61553036465
Hospital Charge Code	60633794
Hospital Revenue Code	250
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$38.09
Rate for Payer: Aetna Commercial	$22.85
Rate for Payer: Aetna Medicare Advantage	$22.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.43
Rate for Payer: Cigna Commercial	$38.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.90
Rate for Payer: Oxford Commercial	$38.09
Rate for Payer: Qualcare PPO/HMO/WC	$11.43
Rate for Payer: UnitedHealthcare Commercial	$38.09

QUESTRAN/EACH

Facility

$7.00

Hospital Charge Code	60633795
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.10
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.91
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$3.50

QUESTRAN/EACH

Facility

$7.00

Hospital Charge Code	60633795
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

QUESTRAN LIGHT

Facility

$5.00

Hospital Charge Code	60635017
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

QUESTRAN LIGHT

Facility

$5.00

Hospital Charge Code	60635017
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

QUEST SPECIMEN PROCESSING FEE

Facility

$6.85

Hospital Charge Code	3000974
Hospital Revenue Code	300
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$1.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.03

QUEST SPECIMEN PROCESSING FEE

Facility

$6.85

Hospital Charge Code	3000974
Hospital Revenue Code	300
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$2.06
Rate for Payer: Aetna Medicare Advantage	$2.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.75
Rate for Payer: Cigna Commercial	$3.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.89
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.03
Rate for Payer: UnitedHealthcare Commercial	$114.00

QUEST TEST # 93882 VGKC

Facility

$2,002.18

Service Code	HCPCS 83519
Hospital Charge Code	3035450A
Hospital Revenue Code	301
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$300.33
Rate for Payer: Aetna Commercial	$59.62
Rate for Payer: Aetna Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.42
Rate for Payer: Cigna Commercial	$18.40
Rate for Payer: Cigna Medicare Advantage	$9.20
Rate for Payer: Clover Medicare Advantage	$17.48
Rate for Payer: EmblemHealth Commercial	$55.20
Rate for Payer: Humana Medicare Advantage	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.33
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.40
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.50
Rate for Payer: Wellcare Medicare Advantage	$18.40

QUEST TEST # 93882 VGKC

Facility

$2,002.18

Service Code	HCPCS 83519
Hospital Charge Code	3035450A
Hospital Revenue Code	301
Min. Negotiated Rate	$300.33
Max. Negotiated Rate	$300.33
Rate for Payer: Qualcare PPO/HMO/WC	$300.33

QUEST TEST # 93883 VGKC

Facility

$2,002.17

Service Code	HCPCS 83519XU
Hospital Charge Code	3035450B
Hospital Revenue Code	301
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$1,001.09
Rate for Payer: Aetna Commercial	$600.65
Rate for Payer: Aetna Medicare Advantage	$600.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.55
Rate for Payer: Cigna Commercial	$1,001.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.33
Rate for Payer: UnitedHealthcare Commercial	$114.00

QUEST TEST # 93883 VGKC

Facility

$2,002.17

Service Code	HCPCS 83519XU
Hospital Charge Code	3035450B
Hospital Revenue Code	301
Min. Negotiated Rate	$300.33
Max. Negotiated Rate	$300.33
Rate for Payer: Qualcare PPO/HMO/WC	$300.33

QUETIAPINE 100 MG TAB

Facility

$45.96

Service Code	NDC 54022125
Hospital Charge Code	60628749
Hospital Revenue Code	250
Min. Negotiated Rate	$6.89
Max. Negotiated Rate	$6.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.89

QUETIAPINE 100 MG TAB

Facility

$45.96

Service Code	NDC 54022125
Hospital Charge Code	60628749
Hospital Revenue Code	250
Min. Negotiated Rate	$5.97
Max. Negotiated Rate	$22.98
Rate for Payer: Aetna Commercial	$13.79
Rate for Payer: Aetna Medicare Advantage	$13.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.72
Rate for Payer: Cigna Commercial	$22.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.97
Rate for Payer: Oxford Commercial	$22.98
Rate for Payer: Qualcare PPO/HMO/WC	$6.89
Rate for Payer: UnitedHealthcare Commercial	$22.98

QUETIAPINE 25 MG TAB

Facility

$26.80

Service Code	NDC 54022025
Hospital Charge Code	60628748
Hospital Revenue Code	250
Min. Negotiated Rate	$3.48
Max. Negotiated Rate	$13.40
Rate for Payer: Aetna Commercial	$8.04
Rate for Payer: Aetna Medicare Advantage	$8.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.83
Rate for Payer: Cigna Commercial	$13.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.48
Rate for Payer: Oxford Commercial	$13.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.02
Rate for Payer: UnitedHealthcare Commercial	$13.40

QUETIAPINE 25 MG TAB

Facility

$26.80

Service Code	NDC 54022025
Hospital Charge Code	60628748
Hospital Revenue Code	250
Min. Negotiated Rate	$4.02
Max. Negotiated Rate	$4.02
Rate for Payer: Qualcare PPO/HMO/WC	$4.02

QUETIAPINE 300MG TAB

Facility

$107.33

Service Code	NDC 68084053401
Hospital Charge Code	6063943168
Hospital Revenue Code	250
Min. Negotiated Rate	$13.95
Max. Negotiated Rate	$53.66
Rate for Payer: Aetna Commercial	$32.20
Rate for Payer: Aetna Medicare Advantage	$32.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.37
Rate for Payer: Cigna Commercial	$53.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.95
Rate for Payer: Oxford Commercial	$53.66
Rate for Payer: Qualcare PPO/HMO/WC	$16.10
Rate for Payer: UnitedHealthcare Commercial	$53.66

QUETIAPINE 300MG TAB

Facility

$107.33

Service Code	NDC 68084053401
Hospital Charge Code	6063943168
Hospital Revenue Code	250
Min. Negotiated Rate	$16.10
Max. Negotiated Rate	$16.10
Rate for Payer: Qualcare PPO/HMO/WC	$16.10

QUETIAPINE XR 150 MG TAB

Facility

$109.75

Service Code	NDC 310028160
Hospital Charge Code	60630019
Hospital Revenue Code	250
Min. Negotiated Rate	$14.27
Max. Negotiated Rate	$54.88
Rate for Payer: Aetna Commercial	$32.92
Rate for Payer: Aetna Medicare Advantage	$32.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.99
Rate for Payer: Cigna Commercial	$54.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.27
Rate for Payer: Oxford Commercial	$54.88
Rate for Payer: Qualcare PPO/HMO/WC	$16.46
Rate for Payer: UnitedHealthcare Commercial	$54.88

QUETIAPINE XR 150 MG TAB

Facility

$109.75

Service Code	NDC 310028160
Hospital Charge Code	60630019
Hospital Revenue Code	250
Min. Negotiated Rate	$16.46
Max. Negotiated Rate	$16.46
Rate for Payer: Qualcare PPO/HMO/WC	$16.46

QUETIAPINE XR 150MG TAB

Facility

$31.48

Hospital Charge Code	60635782
Hospital Revenue Code	250
Min. Negotiated Rate	$4.09
Max. Negotiated Rate	$15.74
Rate for Payer: Aetna Commercial	$9.44
Rate for Payer: Aetna Medicare Advantage	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.03
Rate for Payer: Cigna Commercial	$15.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.09
Rate for Payer: Oxford Commercial	$15.74
Rate for Payer: Qualcare PPO/HMO/WC	$4.72
Rate for Payer: UnitedHealthcare Commercial	$15.74

QUETIAPINE XR 150MG TAB

Facility

$31.48

Hospital Charge Code	60635782
Hospital Revenue Code	250
Min. Negotiated Rate	$4.72
Max. Negotiated Rate	$4.72
Rate for Payer: Qualcare PPO/HMO/WC	$4.72

QUETIAPINE XR 200 MG TAB

Facility

$120.80

Service Code	NDC 310028239
Hospital Charge Code	60630020
Hospital Revenue Code	250
Min. Negotiated Rate	$18.12
Max. Negotiated Rate	$18.12
Rate for Payer: Qualcare PPO/HMO/WC	$18.12

QUETIAPINE XR 200 MG TAB

Facility

$120.80

Service Code	NDC 310028239
Hospital Charge Code	60630020
Hospital Revenue Code	250
Min. Negotiated Rate	$15.70
Max. Negotiated Rate	$60.40
Rate for Payer: Aetna Commercial	$36.24
Rate for Payer: Aetna Medicare Advantage	$36.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.80
Rate for Payer: Cigna Commercial	$60.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.70
Rate for Payer: Oxford Commercial	$60.40
Rate for Payer: Qualcare PPO/HMO/WC	$18.12
Rate for Payer: UnitedHealthcare Commercial	$60.40

QUETIAPINE XR 50 MG TAB

Facility

$61.10

Service Code	NDC 310028060
Hospital Charge Code	60630018
Hospital Revenue Code	250
Min. Negotiated Rate	$9.16
Max. Negotiated Rate	$9.16
Rate for Payer: Qualcare PPO/HMO/WC	$9.16

Know your out-of-pocket cost for care.

All Charges