Heights University Hospital

All Charges

Charge

Type

Setting

Price

TACK BNX PATELLA 3.5 20 523520

Facility

$1,250.00

Hospital Charge Code	270620668
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$375.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

TACK BNX PATELLA 3.5 20 523520

Facility

$1,250.00

Hospital Charge Code	270620668
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

TACK PLATE

Facility

$770.00

Service Code	HCPCS C1713
Hospital Charge Code	270676418
Hospital Revenue Code	278
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$385.00
Rate for Payer: Aetna Commercial	$231.00
Rate for Payer: Aetna Medicare Advantage	$231.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.35
Rate for Payer: Cigna Commercial	$385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.34
Rate for Payer: Qualcare PPO/HMO/WC	$115.50

TACK PLATE

Facility

$770.00

Service Code	HCPCS C1713
Hospital Charge Code	270676418
Hospital Revenue Code	278
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$186.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.34
Rate for Payer: Qualcare PPO/HMO/WC	$115.50

TACRINE CAP 20MG

Facility

$10.90

Hospital Charge Code	6008809
Hospital Revenue Code	252
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$5.45
Rate for Payer: Aetna Commercial	$3.27
Rate for Payer: Aetna Medicare Advantage	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.78
Rate for Payer: Cigna Commercial	$5.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.42
Rate for Payer: Oxford Commercial	$5.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Commercial	$5.45

TACRINE CAP 20MG

Facility

$10.90

Hospital Charge Code	6008809
Hospital Revenue Code	252
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

TACRINE CAP 30MG

Facility

$10.90

Hospital Charge Code	6008817
Hospital Revenue Code	252
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

TACRINE CAP 30MG

Facility

$10.90

Hospital Charge Code	6008817
Hospital Revenue Code	252
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$5.45
Rate for Payer: Aetna Commercial	$3.27
Rate for Payer: Aetna Medicare Advantage	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.78
Rate for Payer: Cigna Commercial	$5.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.42
Rate for Payer: Oxford Commercial	$5.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Commercial	$5.45

TACRINE CAP 40MG

Facility

$10.90

Hospital Charge Code	6008825
Hospital Revenue Code	252
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

TACRINE CAP 40MG

Facility

$10.90

Hospital Charge Code	6008825
Hospital Revenue Code	252
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$5.45
Rate for Payer: Aetna Commercial	$3.27
Rate for Payer: Aetna Medicare Advantage	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.78
Rate for Payer: Cigna Commercial	$5.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.42
Rate for Payer: Oxford Commercial	$5.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Commercial	$5.45

TACROLIMUS

Facility

$408.85

Service Code	HCPCS 80197
Hospital Charge Code	3006747
Hospital Revenue Code	301
Min. Negotiated Rate	$6.87
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$44.49
Rate for Payer: Aetna Medicare Advantage	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.31
Rate for Payer: Cigna Commercial	$13.73
Rate for Payer: Cigna Medicare Advantage	$6.87
Rate for Payer: Clover Medicare Advantage	$13.04
Rate for Payer: EmblemHealth Commercial	$41.19
Rate for Payer: Humana Medicare Advantage	$14.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.15
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.33
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.73
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.55
Rate for Payer: Wellcare Medicare Advantage	$13.73

TACROLIMUS

Facility

$303.00

Service Code	HCPCS 80197
Hospital Charge Code	38472920
Hospital Revenue Code	301
Min. Negotiated Rate	$6.87
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$44.49
Rate for Payer: Aetna Medicare Advantage	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.31
Rate for Payer: Cigna Commercial	$13.73
Rate for Payer: Cigna Medicare Advantage	$6.87
Rate for Payer: Clover Medicare Advantage	$13.04
Rate for Payer: EmblemHealth Commercial	$41.19
Rate for Payer: Humana Medicare Advantage	$14.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.39
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.73
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.55
Rate for Payer: Wellcare Medicare Advantage	$13.73

TACROLIMUS

Facility

$303.00

Service Code	HCPCS 80197
Hospital Charge Code	38472920
Hospital Revenue Code	301
Min. Negotiated Rate	$45.45
Max. Negotiated Rate	$45.45
Rate for Payer: Qualcare PPO/HMO/WC	$45.45

TACROLIMUS

Facility

$408.85

Service Code	HCPCS 80197
Hospital Charge Code	3006747
Hospital Revenue Code	301
Min. Negotiated Rate	$61.33
Max. Negotiated Rate	$61.33
Rate for Payer: Qualcare PPO/HMO/WC	$61.33

TACROLIMUS 0.5MG CAP

Facility

$15.75

Hospital Charge Code	606350915
Hospital Revenue Code	636
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$3.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.81
Rate for Payer: Qualcare PPO/HMO/WC	$2.36

TACROLIMUS 0.5MG CAP

Facility

$15.75

Hospital Charge Code	606350915
Hospital Revenue Code	636
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$7.88
Rate for Payer: Aetna Commercial	$4.72
Rate for Payer: Aetna Medicare Advantage	$4.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.02
Rate for Payer: Cigna Commercial	$7.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.81
Rate for Payer: Qualcare PPO/HMO/WC	$2.36

TACROLIMUS 1 MG CAP UD

Facility

$35.04

Service Code	HCPCS J7507
Hospital Charge Code	60629951
Hospital Revenue Code	636
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$10.51
Rate for Payer: Aetna Commercial	$10.51
Rate for Payer: Aetna Medicare Advantage	$10.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.94
Rate for Payer: Cigna Commercial	$0.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.48
Rate for Payer: Qualcare PPO/HMO/WC	$5.26

TACROLIMUS 1 MG CAP UD

Facility

$35.04

Service Code	HCPCS J7507
Hospital Charge Code	60629951
Hospital Revenue Code	636
Min. Negotiated Rate	$5.26
Max. Negotiated Rate	$8.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.48
Rate for Payer: Qualcare PPO/HMO/WC	$5.26

TACROLIMUS LC/MS/MS

Facility

$390.00

Service Code	HCPCS 80197
Hospital Charge Code	39900011
Hospital Revenue Code	301
Min. Negotiated Rate	$6.87
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$44.49
Rate for Payer: Aetna Medicare Advantage	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.31
Rate for Payer: Cigna Commercial	$13.73
Rate for Payer: Cigna Medicare Advantage	$6.87
Rate for Payer: Clover Medicare Advantage	$13.04
Rate for Payer: EmblemHealth Commercial	$41.19
Rate for Payer: Humana Medicare Advantage	$14.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.73
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.55
Rate for Payer: Wellcare Medicare Advantage	$13.73

TACROLIMUS LC/MS/MS

Facility

$390.00

Service Code	HCPCS 80197
Hospital Charge Code	39900011
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

TACROLIUMUS 5MG ORAL

Facility

$149.41

Service Code	HCPCS J7507
Hospital Charge Code	6063943354
Hospital Revenue Code	636
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$44.82
Rate for Payer: Aetna Commercial	$44.82
Rate for Payer: Aetna Medicare Advantage	$44.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.10
Rate for Payer: Cigna Commercial	$0.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.16
Rate for Payer: Qualcare PPO/HMO/WC	$22.41

TACROLIUMUS 5MG ORAL

Facility

$149.41

Service Code	HCPCS J7507
Hospital Charge Code	6063943354
Hospital Revenue Code	636
Min. Negotiated Rate	$22.41
Max. Negotiated Rate	$36.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.16
Rate for Payer: Qualcare PPO/HMO/WC	$22.41

TACSHIELD 10CMx15CM 31628

Facility

$2,303.75

Hospital Charge Code	270660106
Hospital Revenue Code	278
Min. Negotiated Rate	$345.56
Max. Negotiated Rate	$1,151.88
Rate for Payer: Aetna Commercial	$691.12
Rate for Payer: Aetna Medicare Advantage	$691.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$587.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$587.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$587.46
Rate for Payer: Cigna Commercial	$1,151.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$557.51
Rate for Payer: Qualcare PPO/HMO/WC	$345.56

TACSHIELD 10CMx15CM 31628

Facility

$2,303.75

Hospital Charge Code	270660106
Hospital Revenue Code	278
Min. Negotiated Rate	$345.56
Max. Negotiated Rate	$557.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$460.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$557.51
Rate for Payer: Qualcare PPO/HMO/WC	$345.56

TAC SOL 3ML****

Facility

$164.00

Service Code	HCPCS J3490
Hospital Charge Code	6016232
Hospital Revenue Code	259
Min. Negotiated Rate	$21.32
Max. Negotiated Rate	$82.00
Rate for Payer: Aetna Commercial	$49.20
Rate for Payer: Aetna Medicare Advantage	$49.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.82
Rate for Payer: Cigna Commercial	$82.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.32
Rate for Payer: Oxford Commercial	$82.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.60
Rate for Payer: UnitedHealthcare Commercial	$82.00

Know your out-of-pocket cost for care.

All Charges