Heights University Hospital

All Charges

Charge

Type

Setting

Price

ROPIVACAINE 0.5% PF 20ML

Facility

$45.02

Service Code	HCPCS J2795
Hospital Charge Code	60639601
Hospital Revenue Code	636
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$10.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

ROPIVACAINE 0.5% PF 20ML

Facility

$45.02

Service Code	HCPCS J2795
Hospital Charge Code	60639601
Hospital Revenue Code	636
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$13.51
Rate for Payer: Aetna Commercial	$13.51
Rate for Payer: Aetna Medicare Advantage	$13.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.48
Rate for Payer: Cigna Commercial	$0.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

ROPIVACAINE 2 MG/ML INJ

Facility

$141.65

Hospital Charge Code	60628981
Hospital Revenue Code	636
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$70.83
Rate for Payer: Aetna Commercial	$42.49
Rate for Payer: Aetna Medicare Advantage	$42.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.12
Rate for Payer: Cigna Commercial	$70.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.28
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

ROPIVACAINE 2 MG/ML INJ

Facility

$141.65

Hospital Charge Code	60628981
Hospital Revenue Code	636
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$34.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.28
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

ROPIVACAINE 5% 30ML

Facility

$5.83

Service Code	NDC 63323028631
Hospital Charge Code	6063943240
Hospital Revenue Code	250
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$2.92
Rate for Payer: Aetna Commercial	$1.75
Rate for Payer: Aetna Medicare Advantage	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.49
Rate for Payer: Cigna Commercial	$2.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.76
Rate for Payer: Oxford Commercial	$2.92
Rate for Payer: Qualcare PPO/HMO/WC	$0.87
Rate for Payer: UnitedHealthcare Commercial	$2.92

ROPIVACAINE 5% 30ML

Facility

$5.83

Service Code	NDC 63323028631
Hospital Charge Code	6063943240
Hospital Revenue Code	250
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$0.87
Rate for Payer: Qualcare PPO/HMO/WC	$0.87

ROSETTE

Facility

$167.25

Service Code	HCPCS 85461
Hospital Charge Code	3100138A
Hospital Revenue Code	300
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$25.09
Rate for Payer: Qualcare PPO/HMO/WC	$25.09

ROSETTE

Facility

$167.25

Service Code	HCPCS 85461
Hospital Charge Code	3100138A
Hospital Revenue Code	300
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$30.33
Rate for Payer: Aetna Medicare Advantage	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.30
Rate for Payer: Cigna Commercial	$9.36
Rate for Payer: Cigna Medicare Advantage	$4.68
Rate for Payer: Clover Medicare Advantage	$8.89
Rate for Payer: EmblemHealth Commercial	$28.08
Rate for Payer: Humana Medicare Advantage	$9.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.09
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.36
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.92
Rate for Payer: Wellcare Medicare Advantage	$9.36

ROSIDIAL SSB

Facility

$39.70

Hospital Charge Code	270636426
Hospital Revenue Code	271
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$5.96
Rate for Payer: Qualcare PPO/HMO/WC	$5.96

ROSIDIAL SSB

Facility

$39.70

Hospital Charge Code	270636426
Hospital Revenue Code	271
Min. Negotiated Rate	$5.16
Max. Negotiated Rate	$19.85
Rate for Payer: Aetna Commercial	$11.91
Rate for Payer: Aetna Medicare Advantage	$11.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.12
Rate for Payer: Cigna Commercial	$19.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.16
Rate for Payer: Oxford Commercial	$19.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.96
Rate for Payer: UnitedHealthcare Commercial	$19.85

ROSIDIAL SSB 10X

Facility

$75.25

Hospital Charge Code	270636427
Hospital Revenue Code	271
Min. Negotiated Rate	$11.29
Max. Negotiated Rate	$11.29
Rate for Payer: Qualcare PPO/HMO/WC	$11.29

ROSIDIAL SSB 10X

Facility

$75.25

Hospital Charge Code	270636427
Hospital Revenue Code	271
Min. Negotiated Rate	$9.78
Max. Negotiated Rate	$37.62
Rate for Payer: Aetna Commercial	$22.57
Rate for Payer: Aetna Medicare Advantage	$22.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.19
Rate for Payer: Cigna Commercial	$37.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.78
Rate for Payer: Oxford Commercial	$37.62
Rate for Payer: Qualcare PPO/HMO/WC	$11.29
Rate for Payer: UnitedHealthcare Commercial	$37.62

ROSIDIAL SSB 12X

Facility

$48.70

Hospital Charge Code	270636428
Hospital Revenue Code	271
Min. Negotiated Rate	$6.33
Max. Negotiated Rate	$24.35
Rate for Payer: Aetna Commercial	$14.61
Rate for Payer: Aetna Medicare Advantage	$14.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.42
Rate for Payer: Cigna Commercial	$24.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.33
Rate for Payer: Oxford Commercial	$24.35
Rate for Payer: Qualcare PPO/HMO/WC	$7.30
Rate for Payer: UnitedHealthcare Commercial	$24.35

ROSIDIAL SSB 12X

Facility

$48.70

Hospital Charge Code	270636428
Hospital Revenue Code	271
Min. Negotiated Rate	$7.30
Max. Negotiated Rate	$7.30
Rate for Payer: Qualcare PPO/HMO/WC	$7.30

ROSIDIAL SSB 12X1

Facility

$89.95

Hospital Charge Code	270636429
Hospital Revenue Code	271
Min. Negotiated Rate	$11.69
Max. Negotiated Rate	$44.98
Rate for Payer: Aetna Commercial	$26.98
Rate for Payer: Aetna Medicare Advantage	$26.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.94
Rate for Payer: Cigna Commercial	$44.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.69
Rate for Payer: Oxford Commercial	$44.98
Rate for Payer: Qualcare PPO/HMO/WC	$13.49
Rate for Payer: UnitedHealthcare Commercial	$44.98

ROSIDIAL SSB 12X1

Facility

$89.95

Hospital Charge Code	270636429
Hospital Revenue Code	271
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$13.49
Rate for Payer: Qualcare PPO/HMO/WC	$13.49

ROSIDIAL SSB 6X

Facility

$26.85

Hospital Charge Code	270636424
Hospital Revenue Code	271
Min. Negotiated Rate	$4.03
Max. Negotiated Rate	$4.03
Rate for Payer: Qualcare PPO/HMO/WC	$4.03

ROSIDIAL SSB 6X

Facility

$33.95

Hospital Charge Code	270636425
Hospital Revenue Code	271
Min. Negotiated Rate	$4.41
Max. Negotiated Rate	$16.98
Rate for Payer: Aetna Commercial	$10.19
Rate for Payer: Aetna Medicare Advantage	$10.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.66
Rate for Payer: Cigna Commercial	$16.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.41
Rate for Payer: Oxford Commercial	$16.98
Rate for Payer: Qualcare PPO/HMO/WC	$5.09
Rate for Payer: UnitedHealthcare Commercial	$16.98

ROSIDIAL SSB 6X

Facility

$26.85

Hospital Charge Code	270636424
Hospital Revenue Code	271
Min. Negotiated Rate	$3.49
Max. Negotiated Rate	$13.43
Rate for Payer: Aetna Commercial	$8.05
Rate for Payer: Aetna Medicare Advantage	$8.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.85
Rate for Payer: Cigna Commercial	$13.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.49
Rate for Payer: Oxford Commercial	$13.43
Rate for Payer: Qualcare PPO/HMO/WC	$4.03
Rate for Payer: UnitedHealthcare Commercial	$13.43

ROSIDIAL SSB 6X

Facility

$33.95

Hospital Charge Code	270636425
Hospital Revenue Code	271
Min. Negotiated Rate	$5.09
Max. Negotiated Rate	$5.09
Rate for Payer: Qualcare PPO/HMO/WC	$5.09

ROSIGLITAZONE 2 MG TAB

Facility

$9.65

Hospital Charge Code	60629180
Hospital Revenue Code	250
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$2.90
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.25
Rate for Payer: Oxford Commercial	$4.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$4.83

ROSIGLITAZONE 2 MG TAB

Facility

$9.65

Hospital Charge Code	60629180
Hospital Revenue Code	250
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

ROSIGLITAZONE 4 MG TAB

Facility

$20.85

Hospital Charge Code	60629053
Hospital Revenue Code	250
Min. Negotiated Rate	$2.71
Max. Negotiated Rate	$10.43
Rate for Payer: Aetna Commercial	$6.25
Rate for Payer: Aetna Medicare Advantage	$6.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.32
Rate for Payer: Cigna Commercial	$10.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.71
Rate for Payer: Oxford Commercial	$10.43
Rate for Payer: Qualcare PPO/HMO/WC	$3.13
Rate for Payer: UnitedHealthcare Commercial	$10.43

ROSIGLITAZONE 4 MG TAB

Facility

$20.85

Hospital Charge Code	60629053
Hospital Revenue Code	250
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$3.13
Rate for Payer: Qualcare PPO/HMO/WC	$3.13

ROSIGLITAZONE 8 MG TAB

Facility

$37.65

Hospital Charge Code	60629056
Hospital Revenue Code	250
Min. Negotiated Rate	$4.89
Max. Negotiated Rate	$18.82
Rate for Payer: Aetna Commercial	$11.29
Rate for Payer: Aetna Medicare Advantage	$11.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.60
Rate for Payer: Cigna Commercial	$18.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.89
Rate for Payer: Oxford Commercial	$18.82
Rate for Payer: Qualcare PPO/HMO/WC	$5.65
Rate for Payer: UnitedHealthcare Commercial	$18.82

Know your out-of-pocket cost for care.

All Charges