Heights University Hospital

All Charges

Charge

Type

Setting

Price

SOLUTION 9NACL IRR 1000 2B7231

Facility

$154.50

Hospital Charge Code	270629461
Hospital Revenue Code	272
Min. Negotiated Rate	$20.09
Max. Negotiated Rate	$77.25
Rate for Payer: Aetna Commercial	$46.35
Rate for Payer: Aetna Medicare Advantage	$46.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.40
Rate for Payer: Cigna Commercial	$77.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.09
Rate for Payer: Oxford Commercial	$77.25
Rate for Payer: Qualcare PPO/HMO/WC	$23.18
Rate for Payer: UnitedHealthcare Commercial	$77.25

SOLUTION ANTI FOG 6CC

Facility

$6.60

Hospital Charge Code	270641500
Hospital Revenue Code	270
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$0.99
Rate for Payer: Qualcare PPO/HMO/WC	$0.99

SOLUTION ANTI FOG 6CC

Facility

$6.60

Hospital Charge Code	270641500
Hospital Revenue Code	270
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$3.30
Rate for Payer: Aetna Commercial	$1.98
Rate for Payer: Aetna Medicare Advantage	$1.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.68
Rate for Payer: Cigna Commercial	$3.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.86
Rate for Payer: Oxford Commercial	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.99
Rate for Payer: UnitedHealthcare Commercial	$3.30

SOLUTION ANTI-FOG FOG OUT

Facility

$528.25

Hospital Charge Code	270656228
Hospital Revenue Code	271
Min. Negotiated Rate	$68.67
Max. Negotiated Rate	$264.12
Rate for Payer: Aetna Commercial	$158.47
Rate for Payer: Aetna Medicare Advantage	$158.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$134.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$134.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$134.70
Rate for Payer: Cigna Commercial	$264.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.67
Rate for Payer: Oxford Commercial	$264.12
Rate for Payer: Qualcare PPO/HMO/WC	$79.24
Rate for Payer: UnitedHealthcare Commercial	$264.12

SOLUTION ANTI-FOG FOG OUT

Facility

$528.25

Hospital Charge Code	270656228
Hospital Revenue Code	271
Min. Negotiated Rate	$79.24
Max. Negotiated Rate	$79.24
Rate for Payer: Qualcare PPO/HMO/WC	$79.24

SOLUTION BSS+

Facility

$241.55

Hospital Charge Code	270600188
Hospital Revenue Code	272
Min. Negotiated Rate	$31.40
Max. Negotiated Rate	$120.78
Rate for Payer: Aetna Commercial	$72.47
Rate for Payer: Aetna Medicare Advantage	$72.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.60
Rate for Payer: Cigna Commercial	$120.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.40
Rate for Payer: Oxford Commercial	$120.78
Rate for Payer: Qualcare PPO/HMO/WC	$36.23
Rate for Payer: UnitedHealthcare Commercial	$120.78

SOLUTION BSS+

Facility

$241.55

Hospital Charge Code	270600188
Hospital Revenue Code	272
Min. Negotiated Rate	$36.23
Max. Negotiated Rate	$36.23
Rate for Payer: Qualcare PPO/HMO/WC	$36.23

SOLUTION BSS 15ml 079515

Facility

$12.45

Hospital Charge Code	270626716
Hospital Revenue Code	272
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$6.22
Rate for Payer: Aetna Commercial	$3.73
Rate for Payer: Aetna Medicare Advantage	$3.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.17
Rate for Payer: Cigna Commercial	$6.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.62
Rate for Payer: Oxford Commercial	$6.22
Rate for Payer: Qualcare PPO/HMO/WC	$1.87
Rate for Payer: UnitedHealthcare Commercial	$6.22

SOLUTION BSS 15ml 079515

Facility

$12.45

Hospital Charge Code	270626716
Hospital Revenue Code	272
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$1.87
Rate for Payer: Qualcare PPO/HMO/WC	$1.87

SOLUTION BSS 500ML

Facility

$424.00

Hospital Charge Code	270061251
Hospital Revenue Code	272
Min. Negotiated Rate	$63.60
Max. Negotiated Rate	$63.60
Rate for Payer: Qualcare PPO/HMO/WC	$63.60

SOLUTION BSS 500ML

Facility

$424.00

Hospital Charge Code	270061251
Hospital Revenue Code	272
Min. Negotiated Rate	$55.12
Max. Negotiated Rate	$212.00
Rate for Payer: Aetna Commercial	$127.20
Rate for Payer: Aetna Medicare Advantage	$127.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.12
Rate for Payer: Cigna Commercial	$212.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.12
Rate for Payer: Oxford Commercial	$212.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.60
Rate for Payer: UnitedHealthcare Commercial	$212.00

SOLUTION BSS 500 ML PLUS

Facility

$266.15

Hospital Charge Code	270684102
Hospital Revenue Code	272
Min. Negotiated Rate	$39.92
Max. Negotiated Rate	$39.92
Rate for Payer: Qualcare PPO/HMO/WC	$39.92

SOLUTION BSS 500 ML PLUS

Facility

$266.15

Hospital Charge Code	270684102
Hospital Revenue Code	272
Min. Negotiated Rate	$34.60
Max. Negotiated Rate	$133.07
Rate for Payer: Aetna Commercial	$79.84
Rate for Payer: Aetna Medicare Advantage	$79.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.87
Rate for Payer: Cigna Commercial	$133.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.60
Rate for Payer: Oxford Commercial	$133.07
Rate for Payer: Qualcare PPO/HMO/WC	$39.92
Rate for Payer: UnitedHealthcare Commercial	$133.07

SOLUTION BSS SM 15ML BO

Facility

$16.85

Hospital Charge Code	270061250
Hospital Revenue Code	272
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$5.05
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.19
Rate for Payer: Oxford Commercial	$8.43
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$8.43

SOLUTION BSS SM 15ML BO

Facility

$16.85

Hospital Charge Code	270061250
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

SOLUTION DEX 10% INJ 500ml

Facility

$22.50

Hospital Charge Code	270649137
Hospital Revenue Code	258
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

SOLUTION DEX 10% INJ 500ml

Facility

$22.50

Hospital Charge Code	270649137
Hospital Revenue Code	258
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$6.75
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$11.25

SOLUTION DEX 5% INJ 500ml

Facility

$22.50

Hospital Charge Code	270649139
Hospital Revenue Code	258
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$11.25
Rate for Payer: Aetna Commercial	$6.75
Rate for Payer: Aetna Medicare Advantage	$6.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.74
Rate for Payer: Cigna Commercial	$11.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$3.38
Rate for Payer: UnitedHealthcare Commercial	$11.25

SOLUTION DEX 5% INJ 500ml

Facility

$22.50

Hospital Charge Code	270649139
Hospital Revenue Code	258
Min. Negotiated Rate	$3.38
Max. Negotiated Rate	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$3.38

SOLUTION DIANEAL PDIL 1.5% DEX

Facility

$154.58

Hospital Charge Code	270650533
Hospital Revenue Code	272
Min. Negotiated Rate	$23.19
Max. Negotiated Rate	$23.19
Rate for Payer: Qualcare PPO/HMO/WC	$23.19

SOLUTION DIANEAL PDIL 1.5% DEX

Facility

$154.58

Hospital Charge Code	270650533
Hospital Revenue Code	272
Min. Negotiated Rate	$20.10
Max. Negotiated Rate	$77.29
Rate for Payer: Aetna Commercial	$46.37
Rate for Payer: Aetna Medicare Advantage	$46.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.42
Rate for Payer: Cigna Commercial	$77.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.10
Rate for Payer: Oxford Commercial	$77.29
Rate for Payer: Qualcare PPO/HMO/WC	$23.19
Rate for Payer: UnitedHealthcare Commercial	$77.29

SOLUTION DIANEAL PDIL 2.5% DEX

Facility

$177.65

Hospital Charge Code	270650534
Hospital Revenue Code	272
Min. Negotiated Rate	$26.65
Max. Negotiated Rate	$26.65
Rate for Payer: Qualcare PPO/HMO/WC	$26.65

SOLUTION DIANEAL PDIL 2.5% DEX

Facility

$177.65

Hospital Charge Code	270650534
Hospital Revenue Code	272
Min. Negotiated Rate	$23.09
Max. Negotiated Rate	$88.83
Rate for Payer: Aetna Commercial	$53.30
Rate for Payer: Aetna Medicare Advantage	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.30
Rate for Payer: Cigna Commercial	$88.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.09
Rate for Payer: Oxford Commercial	$88.83
Rate for Payer: Qualcare PPO/HMO/WC	$26.65
Rate for Payer: UnitedHealthcare Commercial	$88.83

SOLUTION EKG EXG-SOL 4 OZ

Facility

$55.00

Hospital Charge Code	270331297
Hospital Revenue Code	272
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

SOLUTION EKG EXG-SOL 4 OZ

Facility

$55.00

Hospital Charge Code	270331297
Hospital Revenue Code	272
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$16.50
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.15
Rate for Payer: Oxford Commercial	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$27.50

Know your out-of-pocket cost for care.

All Charges