Heights University Hospital

All Charges

Charge

Type

Setting

Price

SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS

Facility

$240,577.85

Service Code	MSDRG 019
Min. Negotiated Rate	$69,321.27
Max. Negotiated Rate	$240,577.85
Rate for Payer: Aetna Commercial	$240,577.85
Rate for Payer: Aetna Medicare Advantage	$77,856.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$220,260.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$220,260.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$72,969.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$220,260.33
Rate for Payer: Cigna Medicare Advantage	$72,969.76
Rate for Payer: Clover Medicare Advantage	$69,321.27
Rate for Payer: EmblemHealth Commercial	$218,909.28
Rate for Payer: Humana Medicare Advantage	$75,158.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$72,969.76
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$77,347.95
Rate for Payer: Wellcare Medicare Advantage	$72,969.76

SIMVASTATIN 10 MG TAB

Facility

$20.85

Hospital Charge Code	60627622
Hospital Revenue Code	250
Min. Negotiated Rate	$3.13
Max. Negotiated Rate	$3.13
Rate for Payer: Qualcare PPO/HMO/WC	$3.13

SIMVASTATIN 10 MG TAB

Facility

$20.85

Hospital Charge Code	60627622
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

SIMVASTATIN 20 MG TAB

Facility

$29.65

Hospital Charge Code	60628704
Hospital Revenue Code	250
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$14.82
Rate for Payer: Aetna Commercial	$8.89
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.56
Rate for Payer: Cigna Commercial	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.85
Rate for Payer: Oxford Commercial	$14.82
Rate for Payer: Qualcare PPO/HMO/WC	$4.45
Rate for Payer: UnitedHealthcare Commercial	$14.82

SIMVASTATIN 20 MG TAB

Facility

$29.65

Hospital Charge Code	60628704
Hospital Revenue Code	250
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$4.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.45

SIMVASTATIN 40 MG TAB

Facility

$2.45

Hospital Charge Code	60628869
Hospital Revenue Code	250
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$0.74
Rate for Payer: Aetna Medicare Advantage	$0.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.62
Rate for Payer: Cigna Commercial	$1.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.32
Rate for Payer: Oxford Commercial	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$1.23

SIMVASTATIN 40 MG TAB

Facility

$2.45

Hospital Charge Code	60628869
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

SIMVASTATIN 5 MG TAB

Facility

$16.00

Hospital Charge Code	60629047
Hospital Revenue Code	250
Min. Negotiated Rate	$2.08
Max. Negotiated Rate	$8.00
Rate for Payer: Aetna Commercial	$4.80
Rate for Payer: Aetna Medicare Advantage	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.08
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.08
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.40
Rate for Payer: UnitedHealthcare Commercial	$8.00

SIMVASTATIN 5 MG TAB

Facility

$16.00

Hospital Charge Code	60629047
Hospital Revenue Code	250
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

SINCALIDE 5 MCG INJ

Facility

$411.80

Hospital Charge Code	60627873
Hospital Revenue Code	250
Min. Negotiated Rate	$53.53
Max. Negotiated Rate	$205.90
Rate for Payer: Aetna Commercial	$123.54
Rate for Payer: Aetna Medicare Advantage	$123.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.01
Rate for Payer: Cigna Commercial	$205.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.53
Rate for Payer: Oxford Commercial	$205.90
Rate for Payer: Qualcare PPO/HMO/WC	$61.77
Rate for Payer: UnitedHealthcare Commercial	$205.90

SINCALIDE 5 MCG INJ

Facility

$411.80

Hospital Charge Code	60627873
Hospital Revenue Code	250
Min. Negotiated Rate	$61.77
Max. Negotiated Rate	$61.77
Rate for Payer: Qualcare PPO/HMO/WC	$61.77

SINCALIDE 5 MCG VIAL

Facility

$579.35

Service Code	HCPCS J2805
Hospital Charge Code	6063943241
Hospital Revenue Code	636
Min. Negotiated Rate	$86.90
Max. Negotiated Rate	$173.81
Rate for Payer: Aetna Commercial	$173.81
Rate for Payer: Aetna Medicare Advantage	$173.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.73
Rate for Payer: Cigna Commercial	$108.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.20
Rate for Payer: Qualcare PPO/HMO/WC	$86.90

SINCALIDE 5 MCG VIAL

Facility

$579.35

Service Code	HCPCS J2805
Hospital Charge Code	6063943241
Hospital Revenue Code	636
Min. Negotiated Rate	$86.90
Max. Negotiated Rate	$140.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.20
Rate for Payer: Qualcare PPO/HMO/WC	$86.90

Sincalide for Injection-Vial (

Facility

$430.04

Hospital Charge Code	4509087
Hospital Revenue Code	636
Min. Negotiated Rate	$64.51
Max. Negotiated Rate	$215.02
Rate for Payer: Aetna Commercial	$129.01
Rate for Payer: Aetna Medicare Advantage	$129.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.66
Rate for Payer: Cigna Commercial	$215.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.07
Rate for Payer: Qualcare PPO/HMO/WC	$64.51

Sincalide for Injection-Vial (

Facility

$430.04

Hospital Charge Code	4509087
Hospital Revenue Code	636
Min. Negotiated Rate	$64.51
Max. Negotiated Rate	$104.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.07
Rate for Payer: Qualcare PPO/HMO/WC	$64.51

SINEMET

Facility

$324.00

Service Code	HCPCS 80299
Hospital Charge Code	38472754
Hospital Revenue Code	301
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

SINEMET

Facility

$324.00

Service Code	HCPCS 80299
Hospital Charge Code	38472754
Hospital Revenue Code	301
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

SINEMET-10/100/TAB

Facility

$5.00

Hospital Charge Code	60633882
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

SINEMET-10/100/TAB

Facility

$5.00

Hospital Charge Code	60633882
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

SINEMET-25/100/TAB

Facility

$5.00

Hospital Charge Code	60633883
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

SINEMET-25/100/TAB

Facility

$5.00

Hospital Charge Code	60633883
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

SINEMET CR 50/200/TAB

Facility

$12.00

Hospital Charge Code	60633881
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

SINEMET CR 50/200/TAB

Facility

$12.00

Hospital Charge Code	60633881
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

SINEMET SERUM**

Facility

$322.00

Service Code	HCPCS 80299
Hospital Charge Code	3032232
Hospital Revenue Code	309
Min. Negotiated Rate	$48.30
Max. Negotiated Rate	$48.30
Rate for Payer: Qualcare PPO/HMO/WC	$48.30

SINEMET SERUM**

Facility

$322.00

Service Code	HCPCS 80299
Hospital Charge Code	3032232
Hospital Revenue Code	309
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

Know your out-of-pocket cost for care.

All Charges