Heights University Hospital

All Charges

Charge

Type

Setting

Price

ROBITUSSIN PE/16OZ

Facility

$66.00

Hospital Charge Code	60634595
Hospital Revenue Code	250
Min. Negotiated Rate	$8.58
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$19.80
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.58
Rate for Payer: Oxford Commercial	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$33.00

ROBITUSSIN-PE/480ML

Facility

$3.00

Hospital Charge Code	60633836
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ROBITUSSIN-PE/480ML

Facility

$3.00

Hospital Charge Code	60633836
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

ROBOTIC SURG TECH CODE

Facility

$0.01

Hospital Charge Code	73004010
Hospital Revenue Code	360
Max. Negotiated Rate	$1,864.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

ROBOTIC SURG TECH CODE

Facility

$0.01

Hospital Charge Code	73004010
Hospital Revenue Code	360
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

ROBOTIC SURG TIME 1ST HOUR

Facility

$50,000.00

Hospital Charge Code	73004001
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$25,000.00
Rate for Payer: Aetna Commercial	$15,000.00
Rate for Payer: Aetna Medicare Advantage	$15,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,750.00
Rate for Payer: Cigna Commercial	$25,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,500.00

ROBOTIC SURG TIME 1ST HOUR

Facility

$50,000.00

Hospital Charge Code	73004001
Hospital Revenue Code	360
Min. Negotiated Rate	$7,500.00
Max. Negotiated Rate	$7,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,500.00

ROBOTIC SURG TIME EACH ADDL HR

Facility

$45,000.00

Hospital Charge Code	73004005
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$22,500.00
Rate for Payer: Aetna Commercial	$13,500.00
Rate for Payer: Aetna Medicare Advantage	$13,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,475.00
Rate for Payer: Cigna Commercial	$22,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,850.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,750.00

ROBOTIC SURG TIME EACH ADDL HR

Facility

$45,000.00

Hospital Charge Code	73004005
Hospital Revenue Code	360
Min. Negotiated Rate	$6,750.00
Max. Negotiated Rate	$6,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,750.00

ROCALTROL/0.25MCG/CAP

Facility

$9.00

Hospital Charge Code	60633838
Hospital Revenue Code	250
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

ROCALTROL/0.25MCG/CAP

Facility

$13.00

Hospital Charge Code	60633837
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$3.90
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Oxford Commercial	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$6.50

ROCALTROL/0.25MCG/CAP

Facility

$9.00

Hospital Charge Code	60633838
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

ROCALTROL/0.25MCG/CAP

Facility

$13.00

Hospital Charge Code	60633837
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

ROCALTROL/0.5MCG/CAP

Facility

$18.02

Service Code	NDC 30698014401
Hospital Charge Code	60633839
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

ROCALTROL/0.5MCG/CAP

Facility

$18.02

Service Code	NDC 30698014401
Hospital Charge Code	60633839
Hospital Revenue Code	250
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$9.01
Rate for Payer: Aetna Commercial	$5.41
Rate for Payer: Aetna Medicare Advantage	$5.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.60
Rate for Payer: Cigna Commercial	$9.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Oxford Commercial	$9.01
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$9.01

ROCEPHIN/10GM

Facility

$344.00

Hospital Charge Code	60633842
Hospital Revenue Code	636
Min. Negotiated Rate	$51.60
Max. Negotiated Rate	$83.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.25
Rate for Payer: Qualcare PPO/HMO/WC	$51.60

ROCEPHIN/10GM

Facility

$344.00

Hospital Charge Code	60633842
Hospital Revenue Code	636
Min. Negotiated Rate	$51.60
Max. Negotiated Rate	$172.00
Rate for Payer: Aetna Commercial	$103.20
Rate for Payer: Aetna Medicare Advantage	$103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.72
Rate for Payer: Cigna Commercial	$172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.25
Rate for Payer: Qualcare PPO/HMO/WC	$51.60

ROCEPHIN/1GM

Facility

$196.00

Hospital Charge Code	60633841
Hospital Revenue Code	636
Min. Negotiated Rate	$29.40
Max. Negotiated Rate	$47.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.43
Rate for Payer: Qualcare PPO/HMO/WC	$29.40

ROCEPHIN/1GM

Facility

$196.00

Hospital Charge Code	60633841
Hospital Revenue Code	636
Min. Negotiated Rate	$29.40
Max. Negotiated Rate	$98.00
Rate for Payer: Aetna Commercial	$58.80
Rate for Payer: Aetna Medicare Advantage	$58.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.98
Rate for Payer: Cigna Commercial	$98.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.43
Rate for Payer: Qualcare PPO/HMO/WC	$29.40

ROCEPHIN 1GM/50ML

Facility

$200.00

Hospital Charge Code	60635028
Hospital Revenue Code	636
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$60.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

ROCEPHIN 1GM/50ML

Facility

$200.00

Hospital Charge Code	60635028
Hospital Revenue Code	636
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$48.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

ROCEPHIN 1GM ADD/D5W

Facility

$348.00

Hospital Charge Code	60635004
Hospital Revenue Code	636
Min. Negotiated Rate	$52.20
Max. Negotiated Rate	$84.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.22
Rate for Payer: Qualcare PPO/HMO/WC	$52.20

ROCEPHIN 1GM ADD/D5W

Facility

$348.00

Hospital Charge Code	60635004
Hospital Revenue Code	636
Min. Negotiated Rate	$52.20
Max. Negotiated Rate	$174.00
Rate for Payer: Aetna Commercial	$104.40
Rate for Payer: Aetna Medicare Advantage	$104.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.74
Rate for Payer: Cigna Commercial	$174.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.22
Rate for Payer: Qualcare PPO/HMO/WC	$52.20

ROCEPHIN 1 GM ADD/NS

Facility

$379.00

Hospital Charge Code	60635007
Hospital Revenue Code	636
Min. Negotiated Rate	$56.85
Max. Negotiated Rate	$189.50
Rate for Payer: Aetna Commercial	$113.70
Rate for Payer: Aetna Medicare Advantage	$113.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.64
Rate for Payer: Cigna Commercial	$189.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.72
Rate for Payer: Qualcare PPO/HMO/WC	$56.85

ROCEPHIN 1 GM ADD/NS

Facility

$379.00

Hospital Charge Code	60635007
Hospital Revenue Code	636
Min. Negotiated Rate	$56.85
Max. Negotiated Rate	$91.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.72
Rate for Payer: Qualcare PPO/HMO/WC	$56.85

Know your out-of-pocket cost for care.

All Charges