Heights University Hospital

All Charges

Charge

Type

Setting

Price

RABAXISAL/TAB

Facility

$3.00

Hospital Charge Code	60634394
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

RABAXISAL/TAB

Facility

$3.00

Hospital Charge Code	60634394
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

RABEPRAZOLE 20 MG ER TAB

Facility

$7.15

Hospital Charge Code	60629121
Hospital Revenue Code	250
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$1.07
Rate for Payer: Qualcare PPO/HMO/WC	$1.07

RABEPRAZOLE 20 MG ER TAB

Facility

$7.15

Hospital Charge Code	60629121
Hospital Revenue Code	250
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$3.58
Rate for Payer: Aetna Commercial	$2.15
Rate for Payer: Aetna Medicare Advantage	$2.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.82
Rate for Payer: Cigna Commercial	$3.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.93
Rate for Payer: Oxford Commercial	$3.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.07
Rate for Payer: UnitedHealthcare Commercial	$3.58

RABIES ANTIBODY

Facility

$343.25

Service Code	HCPCS 86382
Hospital Charge Code	3006875
Hospital Revenue Code	302
Min. Negotiated Rate	$8.46
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.79
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.91
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	$61.96
Rate for Payer: Cigna Commercial	$16.91
Rate for Payer: Cigna Medicare Advantage	$8.46
Rate for Payer: Clover Medicare Advantage	$16.06
Rate for Payer: EmblemHealth Commercial	$50.73
Rate for Payer: Humana Medicare Advantage	$17.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.49
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.91
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.92
Rate for Payer: Wellcare Medicare Advantage	$16.91

RABIES ANTIBODY

Facility

$343.25

Service Code	HCPCS 86382
Hospital Charge Code	3006875
Hospital Revenue Code	302
Min. Negotiated Rate	$51.49
Max. Negotiated Rate	$51.49
Rate for Payer: Qualcare PPO/HMO/WC	$51.49

RABIES IG 300 IU/ML (1ML)

Facility

$3,510.20

Service Code	HCPCS 90375
Hospital Charge Code	606390187
Hospital Revenue Code	636
Min. Negotiated Rate	$526.53
Max. Negotiated Rate	$1,053.06
Rate for Payer: Aetna Commercial	$1,053.06
Rate for Payer: Aetna Medicare Advantage	$1,053.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$895.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$895.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$895.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$849.47
Rate for Payer: Qualcare PPO/HMO/WC	$526.53

RABIES IG 300 IU/ML (1ML)

Facility

$3,510.20

Service Code	HCPCS 90375
Hospital Charge Code	606390187
Hospital Revenue Code	636
Min. Negotiated Rate	$526.53
Max. Negotiated Rate	$849.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$849.47
Rate for Payer: Qualcare PPO/HMO/WC	$526.53

RABIES IG 300 IU/ML (5ML)

Facility

$17,268.25

Service Code	HCPCS 90375
Hospital Charge Code	606390186
Hospital Revenue Code	636
Min. Negotiated Rate	$2,590.24
Max. Negotiated Rate	$5,180.48
Rate for Payer: Aetna Commercial	$5,180.48
Rate for Payer: Aetna Medicare Advantage	$5,180.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,403.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,403.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,403.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,178.92
Rate for Payer: Qualcare PPO/HMO/WC	$2,590.24

RABIES IG 300 IU/ML (5ML)

Facility

$17,268.25

Service Code	HCPCS 90375
Hospital Charge Code	606390186
Hospital Revenue Code	636
Min. Negotiated Rate	$2,590.24
Max. Negotiated Rate	$4,178.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,178.92
Rate for Payer: Qualcare PPO/HMO/WC	$2,590.24

RABIES IMMUNE GLOBULIN

Facility

$194.00

Service Code	HCPCS 90376
Hospital Charge Code	60635489
Hospital Revenue Code	636
Min. Negotiated Rate	$29.10
Max. Negotiated Rate	$46.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.95
Rate for Payer: Qualcare PPO/HMO/WC	$29.10

RABIES IMMUNE GLOBULIN

Facility

$194.00

Service Code	HCPCS 90376
Hospital Charge Code	60635489
Hospital Revenue Code	636
Min. Negotiated Rate	$29.10
Max. Negotiated Rate	$58.20
Rate for Payer: Aetna Commercial	$58.20
Rate for Payer: Aetna Medicare Advantage	$58.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.95
Rate for Payer: Qualcare PPO/HMO/WC	$29.10

RABIES IMMUNE GLOBULIN 2 ML

Facility

$4,825.54

Service Code	HCPCS 90375
Hospital Charge Code	606350973
Hospital Revenue Code	636
Min. Negotiated Rate	$723.83
Max. Negotiated Rate	$1,447.66
Rate for Payer: Aetna Commercial	$1,447.66
Rate for Payer: Aetna Medicare Advantage	$1,447.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,230.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,230.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,230.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,167.78
Rate for Payer: Qualcare PPO/HMO/WC	$723.83

RABIES IMMUNE GLOBULIN 2 ML

Facility

$4,825.54

Service Code	HCPCS 90375
Hospital Charge Code	606350973
Hospital Revenue Code	636
Min. Negotiated Rate	$723.83
Max. Negotiated Rate	$1,167.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,167.78
Rate for Payer: Qualcare PPO/HMO/WC	$723.83

RABIES VACCINE 2.5 IU PDR

Facility

$1,019.15

Service Code	HCPCS 90675
Hospital Charge Code	60630111
Hospital Revenue Code	636
Min. Negotiated Rate	$152.87
Max. Negotiated Rate	$246.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.63
Rate for Payer: Qualcare PPO/HMO/WC	$152.87

RABIES VACCINE 2.5 IU PDR

Facility

$1,019.15

Service Code	HCPCS 90675
Hospital Charge Code	60630111
Hospital Revenue Code	636
Min. Negotiated Rate	$152.87
Max. Negotiated Rate	$305.75
Rate for Payer: Aetna Commercial	$305.75
Rate for Payer: Aetna Medicare Advantage	$305.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$259.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$259.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$259.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.63
Rate for Payer: Qualcare PPO/HMO/WC	$152.87

RABIES VACCINE (IMOVAX)

Facility

$722.00

Service Code	HCPCS 90675
Hospital Charge Code	60634532
Hospital Revenue Code	636
Min. Negotiated Rate	$108.30
Max. Negotiated Rate	$216.60
Rate for Payer: Aetna Commercial	$216.60
Rate for Payer: Aetna Medicare Advantage	$216.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.72
Rate for Payer: Qualcare PPO/HMO/WC	$108.30

RABIES VACCINE (IMOVAX)

Facility

$722.00

Service Code	HCPCS 90675
Hospital Charge Code	60634532
Hospital Revenue Code	636
Min. Negotiated Rate	$108.30
Max. Negotiated Rate	$174.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.72
Rate for Payer: Qualcare PPO/HMO/WC	$108.30

RABIES VACCINE - INJ

Facility

$1,437.65

Service Code	HCPCS 90675
Hospital Charge Code	60628309
Hospital Revenue Code	636
Min. Negotiated Rate	$215.65
Max. Negotiated Rate	$347.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.91
Rate for Payer: Qualcare PPO/HMO/WC	$215.65

RABIES VACCINE - INJ

Facility

$1,437.65

Service Code	HCPCS 90675
Hospital Charge Code	60628309
Hospital Revenue Code	636
Min. Negotiated Rate	$215.65
Max. Negotiated Rate	$431.30
Rate for Payer: Aetna Commercial	$431.30
Rate for Payer: Aetna Medicare Advantage	$431.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$366.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$366.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$366.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.91
Rate for Payer: Qualcare PPO/HMO/WC	$215.65

RABIES VACCINE INJ 2.5IU/VIAL

Facility

$738.60

Hospital Charge Code	6004774
Hospital Revenue Code	250
Min. Negotiated Rate	$96.02
Max. Negotiated Rate	$369.30
Rate for Payer: Aetna Commercial	$221.58
Rate for Payer: Aetna Medicare Advantage	$221.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$188.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$188.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$188.34
Rate for Payer: Cigna Commercial	$369.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.02
Rate for Payer: Oxford Commercial	$369.30
Rate for Payer: Qualcare PPO/HMO/WC	$110.79
Rate for Payer: UnitedHealthcare Commercial	$369.30

RABIES VACCINE INJ 2.5IU/VIAL

Facility

$738.60

Hospital Charge Code	6004774
Hospital Revenue Code	250
Min. Negotiated Rate	$110.79
Max. Negotiated Rate	$110.79
Rate for Payer: Qualcare PPO/HMO/WC	$110.79

RABIES VACCINE (RABAVERT)

Facility

$1,260.27

Service Code	HCPCS 90675
Hospital Charge Code	60639517
Hospital Revenue Code	636
Min. Negotiated Rate	$189.04
Max. Negotiated Rate	$378.08
Rate for Payer: Aetna Commercial	$378.08
Rate for Payer: Aetna Medicare Advantage	$378.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$321.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$321.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$321.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.99
Rate for Payer: Qualcare PPO/HMO/WC	$189.04

RABIES VACCINE (RABAVERT)

Facility

$1,260.27

Service Code	HCPCS 90675
Hospital Charge Code	60639517
Hospital Revenue Code	636
Min. Negotiated Rate	$189.04
Max. Negotiated Rate	$304.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.99
Rate for Payer: Qualcare PPO/HMO/WC	$189.04

RABIES VACCINE (RABAVERT) EX

Facility

$2,048.26

Service Code	NDC 63851050101
Hospital Charge Code	60639517EX
Hospital Revenue Code	259
Min. Negotiated Rate	$307.24
Max. Negotiated Rate	$307.24
Rate for Payer: Qualcare PPO/HMO/WC	$307.24

Know your out-of-pocket cost for care.

All Charges