Heights University Hospital

All Charges

Charge

Type

Setting

Price

TAC SOL 3ML****

Facility

$164.00

Service Code	HCPCS J3490
Hospital Charge Code	6016232
Hospital Revenue Code	259
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$24.60
Rate for Payer: Qualcare PPO/HMO/WC	$24.60

TAC SOLUTION 3ML

Facility

$336.00

Hospital Charge Code	60162320
Hospital Revenue Code	250
Min. Negotiated Rate	$43.68
Max. Negotiated Rate	$168.00
Rate for Payer: Aetna Commercial	$100.80
Rate for Payer: Aetna Medicare Advantage	$100.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.68
Rate for Payer: Cigna Commercial	$168.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.68
Rate for Payer: Oxford Commercial	$168.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.40
Rate for Payer: UnitedHealthcare Commercial	$168.00

TAC SOLUTION 3ML

Facility

$336.00

Hospital Charge Code	60162320
Hospital Revenue Code	250
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$50.40
Rate for Payer: Qualcare PPO/HMO/WC	$50.40

TACTRA 11MM X 16CM-25CM

Facility

$60,925.00

Service Code	HCPCS C1813
Hospital Charge Code	270689374
Hospital Revenue Code	278
Min. Negotiated Rate	$9,138.75
Max. Negotiated Rate	$30,462.50
Rate for Payer: Aetna Commercial	$18,277.50
Rate for Payer: Aetna Medicare Advantage	$18,277.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,535.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,535.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12,185.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,535.88
Rate for Payer: Cigna Commercial	$30,462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,743.85
Rate for Payer: Qualcare PPO/HMO/WC	$9,138.75

TACTRA 11MM X 16CM-25CM

Facility

$60,925.00

Service Code	HCPCS C1813
Hospital Charge Code	270689374
Hospital Revenue Code	278
Min. Negotiated Rate	$9,138.75
Max. Negotiated Rate	$14,743.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12,185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,743.85
Rate for Payer: Qualcare PPO/HMO/WC	$9,138.75

TA EXPL PO HEMOR/THRMB/INF,NCK

Facility

$8,183.30

Service Code	HCPCS 35800
Hospital Charge Code	16000939
Hospital Revenue Code	360
Min. Negotiated Rate	$1,063.83
Max. Negotiated Rate	$13,251.23
Rate for Payer: Aetna Commercial	$2,454.99
Rate for Payer: Aetna Medicare Advantage	$2,454.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,086.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,086.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,086.74
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,063.83
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,227.49
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

TA EXPL PO HEMOR/THRMB/INF,NCK

Facility

$8,183.30

Service Code	HCPCS 35800
Hospital Charge Code	16000939
Hospital Revenue Code	360
Min. Negotiated Rate	$1,227.49
Max. Negotiated Rate	$1,227.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,227.49

TA EXPLR RTRPRTNL AREA W/WO BX

Facility

$10,376.20

Service Code	HCPCS 49010
Hospital Charge Code	1600000578
Hospital Revenue Code	360
Min. Negotiated Rate	$1,556.43
Max. Negotiated Rate	$1,556.43
Rate for Payer: Qualcare PPO/HMO/WC	$1,556.43

TA EXPLR RTRPRTNL AREA W/WO BX

Facility

$10,376.20

Service Code	HCPCS 49010
Hospital Charge Code	1600000578
Hospital Revenue Code	360
Min. Negotiated Rate	$1,348.91
Max. Negotiated Rate	$15,416.72
Rate for Payer: Aetna Commercial	$3,112.86
Rate for Payer: Aetna Medicare Advantage	$3,112.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,645.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,645.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,645.93
Rate for Payer: Cigna Commercial	$15,416.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,348.91
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,556.43
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

TAGAMET/150MG/1ML

Facility

$72.00

Hospital Charge Code	60633956
Hospital Revenue Code	250
Min. Negotiated Rate	$9.36
Max. Negotiated Rate	$36.00
Rate for Payer: Aetna Commercial	$21.60
Rate for Payer: Aetna Medicare Advantage	$21.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.36
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.36
Rate for Payer: Oxford Commercial	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$36.00

TAGAMET/150MG/1ML

Facility

$72.00

Hospital Charge Code	60633955
Hospital Revenue Code	250
Min. Negotiated Rate	$9.36
Max. Negotiated Rate	$36.00
Rate for Payer: Aetna Commercial	$21.60
Rate for Payer: Aetna Medicare Advantage	$21.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.36
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.36
Rate for Payer: Oxford Commercial	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$36.00

TAGAMET/150MG/1ML

Facility

$72.00

Hospital Charge Code	60633955
Hospital Revenue Code	250
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

TAGAMET/150MG/1ML

Facility

$72.00

Hospital Charge Code	60633956
Hospital Revenue Code	250
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

TAGAMET/150MG/1ML

Facility

$21.00

Hospital Charge Code	60633951
Hospital Revenue Code	250
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

TAGAMET/150MG/1ML

Facility

$66.00

Hospital Charge Code	60633957
Hospital Revenue Code	250
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

TAGAMET/150MG/1ML

Facility

$21.00

Hospital Charge Code	60633951
Hospital Revenue Code	250
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$10.50
Rate for Payer: Aetna Commercial	$6.30
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$10.50

TAGAMET/150MG/1ML

Facility

$66.00

Hospital Charge Code	60633957
Hospital Revenue Code	250
Min. Negotiated Rate	$8.58
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$19.80
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.58
Rate for Payer: Oxford Commercial	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$33.00

TAGAMET/200MG/TAB

Facility

$3.00

Hospital Charge Code	60634215
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

TAGAMET/200MG/TAB

Facility

$3.00

Hospital Charge Code	60634215
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

TAGAMET 300MG/50ML PM

Facility

$34.00

Hospital Charge Code	60635047
Hospital Revenue Code	250
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.10
Rate for Payer: Qualcare PPO/HMO/WC	$5.10

TAGAMET 300MG/50ML PM

Facility

$34.00

Hospital Charge Code	60635047
Hospital Revenue Code	250
Min. Negotiated Rate	$4.42
Max. Negotiated Rate	$17.00
Rate for Payer: Aetna Commercial	$10.20
Rate for Payer: Aetna Medicare Advantage	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.67
Rate for Payer: Cigna Commercial	$17.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.42
Rate for Payer: Oxford Commercial	$17.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.10
Rate for Payer: UnitedHealthcare Commercial	$17.00

TAGAMET/300MG/5ML

Facility

$3.00

Hospital Charge Code	60633962
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

TAGAMET/300MG/5ML

Facility

$3.00

Hospital Charge Code	60633962
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

TAGAMET/300MG/5ML

Facility

$485.00

Hospital Charge Code	60633954
Hospital Revenue Code	250
Min. Negotiated Rate	$63.05
Max. Negotiated Rate	$242.50
Rate for Payer: Aetna Commercial	$145.50
Rate for Payer: Aetna Medicare Advantage	$145.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.67
Rate for Payer: Cigna Commercial	$242.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.05
Rate for Payer: Oxford Commercial	$242.50
Rate for Payer: Qualcare PPO/HMO/WC	$72.75
Rate for Payer: UnitedHealthcare Commercial	$242.50

TAGAMET/300MG/5ML

Facility

$485.00

Hospital Charge Code	60633954
Hospital Revenue Code	250
Min. Negotiated Rate	$72.75
Max. Negotiated Rate	$72.75
Rate for Payer: Qualcare PPO/HMO/WC	$72.75

Know your out-of-pocket cost for care.

All Charges