Heights University Hospital

All Charges

Charge

Type

Setting

Price

SOLUTION EYE IRRIGATING 15 ML

Facility

$9.00

Hospital Charge Code	6024228
Hospital Revenue Code	251
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

SOLUTION EYE IRRIGATING 15 ML

Facility

$9.00

Hospital Charge Code	6024228
Hospital Revenue Code	251
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

SOLUTION GLYCINE 1.5% 3000ML

Facility

$60.45

Hospital Charge Code	270061490
Hospital Revenue Code	270
Min. Negotiated Rate	$9.07
Max. Negotiated Rate	$9.07
Rate for Payer: Qualcare PPO/HMO/WC	$9.07

SOLUTION GLYCINE 1.5% 3000ML

Facility

$60.45

Hospital Charge Code	270061490
Hospital Revenue Code	270
Min. Negotiated Rate	$7.86
Max. Negotiated Rate	$30.23
Rate for Payer: Aetna Commercial	$18.14
Rate for Payer: Aetna Medicare Advantage	$18.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.41
Rate for Payer: Cigna Commercial	$30.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.86
Rate for Payer: Oxford Commercial	$30.23
Rate for Payer: Qualcare PPO/HMO/WC	$9.07
Rate for Payer: UnitedHealthcare Commercial	$30.23

SOLUTION HUMIDIFIER 500ml

Facility

$6.76

Hospital Charge Code	270649321
Hospital Revenue Code	270
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$1.01
Rate for Payer: Qualcare PPO/HMO/WC	$1.01

SOLUTION HUMIDIFIER 500ml

Facility

$6.76

Hospital Charge Code	270649321
Hospital Revenue Code	270
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$3.38
Rate for Payer: Aetna Commercial	$2.03
Rate for Payer: Aetna Medicare Advantage	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.72
Rate for Payer: Cigna Commercial	$3.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.88
Rate for Payer: Oxford Commercial	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$1.01
Rate for Payer: UnitedHealthcare Commercial	$3.38

SOLUTION HYDROGEN PEROXIDE 3%

Facility

$55.45

Hospital Charge Code	270649477
Hospital Revenue Code	270
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$8.32
Rate for Payer: Qualcare PPO/HMO/WC	$8.32

SOLUTION HYDROGEN PEROXIDE 3%

Facility

$55.45

Hospital Charge Code	270649477
Hospital Revenue Code	270
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$27.73
Rate for Payer: Aetna Commercial	$16.64
Rate for Payer: Aetna Medicare Advantage	$16.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.14
Rate for Payer: Cigna Commercial	$27.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.21
Rate for Payer: Oxford Commercial	$27.73
Rate for Payer: Qualcare PPO/HMO/WC	$8.32
Rate for Payer: UnitedHealthcare Commercial	$27.73

SOLUTION IRRIG 0.9% NACL 100ML

Facility

$2.48

Hospital Charge Code	270649322
Hospital Revenue Code	270
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

SOLUTION IRRIG 0.9% NACL 100ML

Facility

$2.48

Hospital Charge Code	270649322
Hospital Revenue Code	270
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$1.24
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	$0.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.63
Rate for Payer: Cigna Commercial	$1.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.32
Rate for Payer: Oxford Commercial	$1.24
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$1.24

SOLUTION POTASSIUM CHLORIDE

Facility

$83.00

Hospital Charge Code	270331404
Hospital Revenue Code	272
Min. Negotiated Rate	$10.79
Max. Negotiated Rate	$41.50
Rate for Payer: Aetna Commercial	$24.90
Rate for Payer: Aetna Medicare Advantage	$24.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.16
Rate for Payer: Cigna Commercial	$41.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.79
Rate for Payer: Oxford Commercial	$41.50
Rate for Payer: Qualcare PPO/HMO/WC	$12.45
Rate for Payer: UnitedHealthcare Commercial	$41.50

SOLUTION POTASSIUM CHLORIDE

Facility

$83.00

Hospital Charge Code	270331404
Hospital Revenue Code	272
Min. Negotiated Rate	$12.45
Max. Negotiated Rate	$12.45
Rate for Payer: Qualcare PPO/HMO/WC	$12.45

SOLUTIONS BETADINE 2OZ

Facility

$3.14

Hospital Charge Code	270650264
Hospital Revenue Code	270
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$1.57
Rate for Payer: Aetna Commercial	$0.94
Rate for Payer: Aetna Medicare Advantage	$0.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.80
Rate for Payer: Cigna Commercial	$1.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.41
Rate for Payer: Oxford Commercial	$1.57
Rate for Payer: Qualcare PPO/HMO/WC	$0.47
Rate for Payer: UnitedHealthcare Commercial	$1.57

SOLUTIONS BETADINE 2OZ

Facility

$3.14

Hospital Charge Code	270650264
Hospital Revenue Code	270
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$0.47
Rate for Payer: Qualcare PPO/HMO/WC	$0.47

SOLUTION STERILE 2000ML

Facility

$27.66

Hospital Charge Code	270690942
Hospital Revenue Code	270
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$13.83
Rate for Payer: Aetna Commercial	$8.30
Rate for Payer: Aetna Medicare Advantage	$8.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.05
Rate for Payer: Cigna Commercial	$13.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$13.83
Rate for Payer: Qualcare PPO/HMO/WC	$4.15
Rate for Payer: UnitedHealthcare Commercial	$13.83

SOLUTION STERILE 2000ML

Facility

$27.66

Hospital Charge Code	270690942
Hospital Revenue Code	270
Min. Negotiated Rate	$4.15
Max. Negotiated Rate	$4.15
Rate for Payer: Qualcare PPO/HMO/WC	$4.15

SOLUTION STERILE WATER 2000ML

Facility

$39.62

Hospital Charge Code	270690943
Hospital Revenue Code	270
Min. Negotiated Rate	$5.15
Max. Negotiated Rate	$19.81
Rate for Payer: Aetna Commercial	$11.89
Rate for Payer: Aetna Medicare Advantage	$11.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.10
Rate for Payer: Cigna Commercial	$19.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.15
Rate for Payer: Oxford Commercial	$19.81
Rate for Payer: Qualcare PPO/HMO/WC	$5.94
Rate for Payer: UnitedHealthcare Commercial	$19.81

SOLUTION STERILE WATER 2000ML

Facility

$39.62

Hospital Charge Code	270690943
Hospital Revenue Code	270
Min. Negotiated Rate	$5.94
Max. Negotiated Rate	$5.94
Rate for Payer: Qualcare PPO/HMO/WC	$5.94

SOLUTION WATER STERILE 2000ML

Facility

$28.50

Hospital Charge Code	270690933
Hospital Revenue Code	270
Min. Negotiated Rate	$4.28
Max. Negotiated Rate	$4.28
Rate for Payer: Qualcare PPO/HMO/WC	$4.28

SOLUTION WATER STERILE 2000ML

Facility

$28.50

Hospital Charge Code	270690933
Hospital Revenue Code	270
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$14.25
Rate for Payer: Aetna Commercial	$8.55
Rate for Payer: Aetna Medicare Advantage	$8.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.27
Rate for Payer: Cigna Commercial	$14.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.71
Rate for Payer: Oxford Commercial	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$4.28
Rate for Payer: UnitedHealthcare Commercial	$14.25

SOL W/4.25%DIANEAL PDII 2000ML

Facility

$174.05

Hospital Charge Code	270650535
Hospital Revenue Code	272
Min. Negotiated Rate	$22.63
Max. Negotiated Rate	$87.03
Rate for Payer: Aetna Commercial	$52.22
Rate for Payer: Aetna Medicare Advantage	$52.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.38
Rate for Payer: Cigna Commercial	$87.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.63
Rate for Payer: Oxford Commercial	$87.03
Rate for Payer: Qualcare PPO/HMO/WC	$26.11
Rate for Payer: UnitedHealthcare Commercial	$87.03

SOL W/4.25%DIANEAL PDII 2000ML

Facility

$174.05

Hospital Charge Code	270650535
Hospital Revenue Code	272
Min. Negotiated Rate	$26.11
Max. Negotiated Rate	$26.11
Rate for Payer: Qualcare PPO/HMO/WC	$26.11

SOMA COMPOUND 200-325/TAB

Facility

$8.00

Hospital Charge Code	60633912
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

SOMA COMPOUND 200-325/TAB

Facility

$8.00

Hospital Charge Code	60633912
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

SOMA (PLAIN)

Facility

$6.00

Hospital Charge Code	60634439
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

Know your out-of-pocket cost for care.

All Charges