Heights University Hospital

All Charges

Charge

Type

Setting

Price

SENSORCAINE 0.25%/30ML

Facility

$27.47

Service Code	NDC 409155930
Hospital Charge Code	60633863
Hospital Revenue Code	250
Min. Negotiated Rate	$4.12
Max. Negotiated Rate	$4.12
Rate for Payer: Qualcare PPO/HMO/WC	$4.12

SENSORCAINE 0.25% 50ML

Facility

$80.87

Service Code	NDC 63323046557
Hospital Charge Code	6063943296
Hospital Revenue Code	250
Min. Negotiated Rate	$12.13
Max. Negotiated Rate	$12.13
Rate for Payer: Qualcare PPO/HMO/WC	$12.13

SENSORCAINE 0.25% 50ML

Facility

$80.87

Service Code	NDC 63323046557
Hospital Charge Code	6063943296
Hospital Revenue Code	250
Min. Negotiated Rate	$10.51
Max. Negotiated Rate	$40.44
Rate for Payer: Aetna Commercial	$24.26
Rate for Payer: Aetna Medicare Advantage	$24.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.62
Rate for Payer: Cigna Commercial	$40.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.51
Rate for Payer: Oxford Commercial	$40.44
Rate for Payer: Qualcare PPO/HMO/WC	$12.13
Rate for Payer: UnitedHealthcare Commercial	$40.44

SENSORCAINE 0.25% W/EPI/3

Facility

$28.54

Service Code	NDC 409904217
Hospital Charge Code	60633865
Hospital Revenue Code	250
Min. Negotiated Rate	$4.28
Max. Negotiated Rate	$4.28
Rate for Payer: Qualcare PPO/HMO/WC	$4.28

SENSORCAINE 0.25% W/EPI/3

Facility

$28.54

Service Code	NDC 409904217
Hospital Charge Code	60633865
Hospital Revenue Code	250
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$14.27
Rate for Payer: Aetna Commercial	$8.56
Rate for Payer: Aetna Medicare Advantage	$8.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.28
Rate for Payer: Cigna Commercial	$14.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.71
Rate for Payer: Oxford Commercial	$14.27
Rate for Payer: Qualcare PPO/HMO/WC	$4.28
Rate for Payer: UnitedHealthcare Commercial	$14.27

SENSORCAINE 0.5%

Facility

$82.60

Hospital Charge Code	6008197
Hospital Revenue Code	250
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$12.39
Rate for Payer: Qualcare PPO/HMO/WC	$12.39

SENSORCAINE 0.5%

Facility

$82.60

Hospital Charge Code	6008197
Hospital Revenue Code	250
Min. Negotiated Rate	$10.74
Max. Negotiated Rate	$41.30
Rate for Payer: Aetna Commercial	$24.78
Rate for Payer: Aetna Medicare Advantage	$24.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.06
Rate for Payer: Cigna Commercial	$41.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.74
Rate for Payer: Oxford Commercial	$41.30
Rate for Payer: Qualcare PPO/HMO/WC	$12.39
Rate for Payer: UnitedHealthcare Commercial	$41.30

SENSORCAINE 0.5%/30ML

Facility

$27.00

Service Code	NDC 409153025
Hospital Charge Code	60633866
Hospital Revenue Code	250
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

SENSORCAINE 0.5%/30ML

Facility

$27.00

Service Code	NDC 409153025
Hospital Charge Code	60633866
Hospital Revenue Code	250
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$8.10
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.51
Rate for Payer: Oxford Commercial	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$13.50

SENSORCAINE 0.5%/30ML

Facility

$28.00

Hospital Charge Code	60633867
Hospital Revenue Code	250
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$14.00

SENSORCAINE 0.5%/30ML

Facility

$28.00

Hospital Charge Code	60633867
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

SENSORCAINE 0.5% W/EPI/30

Facility

$32.00

Hospital Charge Code	60633868
Hospital Revenue Code	250
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

SENSORCAINE 0.5% W/EPI/30

Facility

$32.00

Hospital Charge Code	60633868
Hospital Revenue Code	250
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$9.60
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$16.00

SENSORCAINE 0.75%/30ML

Facility

$23.00

Hospital Charge Code	60633869
Hospital Revenue Code	250
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$6.90
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Oxford Commercial	$11.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$11.50

SENSORCAINE 0.75%/30ML

Facility

$23.00

Hospital Charge Code	60633869
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

SENSORCAINE 0.75% W/EPI/1

Facility

$28.00

Hospital Charge Code	60633870
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

SENSORCAINE 0.75% W/EPI/1

Facility

$28.00

Hospital Charge Code	60633870
Hospital Revenue Code	250
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$14.00

SENSORCAINE MPF 0.75%10ML

Facility

$24.00

Hospital Charge Code	60635356
Hospital Revenue Code	250
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

SENSORCAINE MPF 0.75%10ML

Facility

$24.00

Hospital Charge Code	60635356
Hospital Revenue Code	250
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$7.20
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.12
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$12.00

SENSOR FINGER ADULT SPOT 20IN

Facility

$993.90

Hospital Charge Code	270666966
Hospital Revenue Code	270
Min. Negotiated Rate	$129.21
Max. Negotiated Rate	$496.95
Rate for Payer: Aetna Commercial	$298.17
Rate for Payer: Aetna Medicare Advantage	$298.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.44
Rate for Payer: Cigna Commercial	$496.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.21
Rate for Payer: Oxford Commercial	$496.95
Rate for Payer: Qualcare PPO/HMO/WC	$149.09
Rate for Payer: UnitedHealthcare Commercial	$496.95

SENSOR FINGER ADULT SPOT 20IN

Facility

$993.90

Hospital Charge Code	270666966
Hospital Revenue Code	270
Min. Negotiated Rate	$149.09
Max. Negotiated Rate	$149.09
Rate for Payer: Qualcare PPO/HMO/WC	$149.09

SENSOR FLO-TRAC 1-60 152CM

Facility

$2,036.85

Hospital Charge Code	270663136
Hospital Revenue Code	278
Min. Negotiated Rate	$305.53
Max. Negotiated Rate	$492.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$407.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$492.92
Rate for Payer: Qualcare PPO/HMO/WC	$305.53

SENSOR FLO-TRAC 1-60 152CM

Facility

$2,036.85

Hospital Charge Code	270663136
Hospital Revenue Code	278
Min. Negotiated Rate	$305.53
Max. Negotiated Rate	$1,018.42
Rate for Payer: Aetna Commercial	$611.05
Rate for Payer: Aetna Medicare Advantage	$611.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$519.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$519.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$407.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$519.40
Rate for Payer: Cigna Commercial	$1,018.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$492.92
Rate for Payer: Qualcare PPO/HMO/WC	$305.53

SENSOR FLOTRAC 84 MHD85

Facility

$325.00

Hospital Charge Code	270666465
Hospital Revenue Code	271
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$48.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

SENSOR FLOTRAC 84 MHD85

Facility

$325.00

Hospital Charge Code	270666465
Hospital Revenue Code	271
Min. Negotiated Rate	$42.25
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$97.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.25
Rate for Payer: Oxford Commercial	$162.50
Rate for Payer: Qualcare PPO/HMO/WC	$48.75
Rate for Payer: UnitedHealthcare Commercial	$162.50

Know your out-of-pocket cost for care.

All Charges