Heights University Hospital

All Charges

Charge

Type

Setting

Price

ROCEPHIN 2GM/50ML

Facility

$379.00

Hospital Charge Code	60635029
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 2GM/50ML

Facility

$379.00

Hospital Charge Code	60635029
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

ROCEPHIN 2GM ADD/D5W

Facility

$348.00

Hospital Charge Code	60635005
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 2GM ADD/D5W

Facility

$348.00

Hospital Charge Code	60635005
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/500MG

Facility

$110.00

Hospital Charge Code	60633840
Hospital Revenue Code	636
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$33.00
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

ROCEPHIN/500MG

Facility

$110.00

Hospital Charge Code	60633840
Hospital Revenue Code	636
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$26.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

ROCKY MOUNTAIN SPOT IGG,IGM

Facility

$184.00

Service Code	HCPCS 86757
Hospital Charge Code	3000367
Hospital Revenue Code	300
Min. Negotiated Rate	$9.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$62.69
Rate for Payer: Aetna Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.90
Rate for Payer: Cigna Commercial	$19.35
Rate for Payer: Cigna Medicare Advantage	$9.68
Rate for Payer: Clover Medicare Advantage	$18.38
Rate for Payer: EmblemHealth Commercial	$58.05
Rate for Payer: Humana Medicare Advantage	$19.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.51
Rate for Payer: Wellcare Medicare Advantage	$19.35

ROCKY MOUNTAIN SPOT IGG,IGM

Facility

$184.00

Service Code	HCPCS 86757
Hospital Charge Code	3000367
Hospital Revenue Code	300
Min. Negotiated Rate	$27.60
Max. Negotiated Rate	$27.60
Rate for Payer: Qualcare PPO/HMO/WC	$27.60

ROCKY MOUNTAIN SPOTTED FEVER

Facility

$128.00

Service Code	HCPCS 86000
Hospital Charge Code	3006889
Hospital Revenue Code	305
Min. Negotiated Rate	$19.20
Max. Negotiated Rate	$19.20
Rate for Payer: Qualcare PPO/HMO/WC	$19.20

ROCKY MOUNTAIN SPOTTED FEVER

Facility

$128.00

Service Code	HCPCS 86000
Hospital Charge Code	3006889
Hospital Revenue Code	305
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$22.62
Rate for Payer: Aetna Medicare Advantage	$6.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.57
Rate for Payer: Cigna Commercial	$6.98
Rate for Payer: Cigna Medicare Advantage	$3.49
Rate for Payer: Clover Medicare Advantage	$6.63
Rate for Payer: EmblemHealth Commercial	$20.94
Rate for Payer: Humana Medicare Advantage	$7.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.40
Rate for Payer: Wellcare Medicare Advantage	$6.98

ROCKY MTN SPOTTED FEV IGG RN

Facility

$100.00

Service Code	HCPCS 86757
Hospital Charge Code	3006895
Hospital Revenue Code	302
Min. Negotiated Rate	$9.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$62.69
Rate for Payer: Aetna Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.90
Rate for Payer: Cigna Commercial	$19.35
Rate for Payer: Cigna Medicare Advantage	$9.68
Rate for Payer: Clover Medicare Advantage	$18.38
Rate for Payer: EmblemHealth Commercial	$58.05
Rate for Payer: Humana Medicare Advantage	$19.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.51
Rate for Payer: Wellcare Medicare Advantage	$19.35

ROCKY MTN SPOTTED FEV IGG RN

Facility

$100.00

Service Code	HCPCS 86757
Hospital Charge Code	3006895
Hospital Revenue Code	302
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

ROCKY MTN SPOTTED FEV IGM

Facility

$100.00

Service Code	HCPCS 86757
Hospital Charge Code	3006890
Hospital Revenue Code	302
Min. Negotiated Rate	$9.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$62.69
Rate for Payer: Aetna Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.90
Rate for Payer: Cigna Commercial	$19.35
Rate for Payer: Cigna Medicare Advantage	$9.68
Rate for Payer: Clover Medicare Advantage	$18.38
Rate for Payer: EmblemHealth Commercial	$58.05
Rate for Payer: Humana Medicare Advantage	$19.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.35
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.51
Rate for Payer: Wellcare Medicare Advantage	$19.35

ROCKY MTN SPOTTED FEV IGM

Facility

$100.00

Service Code	HCPCS 86757
Hospital Charge Code	3006890
Hospital Revenue Code	302
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

ROCURONIUM 50 MG/5ML INJ

Facility

$170.25

Service Code	NDC 52045015
Hospital Charge Code	60627490
Hospital Revenue Code	250
Min. Negotiated Rate	$25.54
Max. Negotiated Rate	$25.54
Rate for Payer: Qualcare PPO/HMO/WC	$25.54

ROCURONIUM 50 MG/5ML INJ

Facility

$170.25

Service Code	NDC 52045015
Hospital Charge Code	60627490
Hospital Revenue Code	250
Min. Negotiated Rate	$22.13
Max. Negotiated Rate	$85.12
Rate for Payer: Aetna Commercial	$51.08
Rate for Payer: Aetna Medicare Advantage	$51.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.41
Rate for Payer: Cigna Commercial	$85.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.13
Rate for Payer: Oxford Commercial	$85.12
Rate for Payer: Qualcare PPO/HMO/WC	$25.54
Rate for Payer: UnitedHealthcare Commercial	$85.12

ROCURONIUM BROMIDE10MG/ML 10ML

Facility

$252.99

Service Code	NDC 781322070
Hospital Charge Code	606390129
Hospital Revenue Code	250
Min. Negotiated Rate	$32.89
Max. Negotiated Rate	$126.50
Rate for Payer: Aetna Commercial	$75.90
Rate for Payer: Aetna Medicare Advantage	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.51
Rate for Payer: Cigna Commercial	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.89
Rate for Payer: Oxford Commercial	$126.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.95
Rate for Payer: UnitedHealthcare Commercial	$126.50

ROCURONIUM BROMIDE10MG/ML 10ML

Facility

$252.99

Service Code	NDC 781322070
Hospital Charge Code	606390129
Hospital Revenue Code	250
Min. Negotiated Rate	$37.95
Max. Negotiated Rate	$37.95
Rate for Payer: Qualcare PPO/HMO/WC	$37.95

ROCURONIUM BROMIDE VL 10MG

Facility

$117.80

Hospital Charge Code	6013197
Hospital Revenue Code	250
Min. Negotiated Rate	$15.31
Max. Negotiated Rate	$58.90
Rate for Payer: Aetna Commercial	$35.34
Rate for Payer: Aetna Medicare Advantage	$35.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.04
Rate for Payer: Cigna Commercial	$58.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.31
Rate for Payer: Oxford Commercial	$58.90
Rate for Payer: Qualcare PPO/HMO/WC	$17.67
Rate for Payer: UnitedHealthcare Commercial	$58.90

ROCURONIUM BROMIDE VL 10MG

Facility

$117.80

Hospital Charge Code	6013197
Hospital Revenue Code	250
Min. Negotiated Rate	$17.67
Max. Negotiated Rate	$17.67
Rate for Payer: Qualcare PPO/HMO/WC	$17.67

ROD

Facility

$1,325.00

Hospital Charge Code	270703489
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$320.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

ROD

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270681172
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$937.50
Rate for Payer: Aetna Commercial	$562.50
Rate for Payer: Aetna Medicare Advantage	$562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$478.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$478.12
Rate for Payer: Cigna Commercial	$937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

ROD

Facility

$1,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270681172
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$453.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$453.75
Rate for Payer: Qualcare PPO/HMO/WC	$281.25

ROD

Facility

$1,325.00

Hospital Charge Code	270703489
Hospital Revenue Code	278
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$397.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.65
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

ROD 100MM

Facility

$1,150.00

Service Code	HCPCS C1713
Hospital Charge Code	270704447
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$345.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.30
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

Know your out-of-pocket cost for care.

All Charges