Heights University Hospital

All Charges

Charge

Type

Setting

Price

TELMISARTAN 40 MG TAB

Facility

$9.55

Hospital Charge Code	60629883
Hospital Revenue Code	250
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$1.43
Rate for Payer: Qualcare PPO/HMO/WC	$1.43

TELMISARTAN 80 MG TAB

Facility

$9.25

Hospital Charge Code	60629882
Hospital Revenue Code	250
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$1.39
Rate for Payer: Qualcare PPO/HMO/WC	$1.39

TELMISARTAN 80 MG TAB

Facility

$9.25

Hospital Charge Code	60629882
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$4.62
Rate for Payer: Aetna Commercial	$2.77
Rate for Payer: Aetna Medicare Advantage	$2.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.36
Rate for Payer: Cigna Commercial	$4.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$4.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.39
Rate for Payer: UnitedHealthcare Commercial	$4.62

TEMARIL/5MG/CAP

Facility

$6.00

Hospital Charge Code	60633977
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

TEMARIL/5MG/CAP

Facility

$6.00

Hospital Charge Code	60633977
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

TEMAZEPAM 15MG

Facility

$1.95

Hospital Charge Code	6021166
Hospital Revenue Code	251
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.98
Rate for Payer: Aetna Commercial	$0.59
Rate for Payer: Aetna Medicare Advantage	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.50
Rate for Payer: Cigna Commercial	$0.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.25
Rate for Payer: Oxford Commercial	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.29
Rate for Payer: UnitedHealthcare Commercial	$0.98

TEMAZEPAM 15MG

Facility

$1.95

Hospital Charge Code	6021166
Hospital Revenue Code	251
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

TEMAZEPAM 15 MG CAP

Facility

$4.76

Service Code	NDC 51079041821
Hospital Charge Code	60627851
Hospital Revenue Code	250
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$0.71
Rate for Payer: Qualcare PPO/HMO/WC	$0.71

TEMAZEPAM 15 MG CAP

Facility

$4.76

Service Code	NDC 51079041821
Hospital Charge Code	60627851
Hospital Revenue Code	250
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$2.38
Rate for Payer: Aetna Commercial	$1.43
Rate for Payer: Aetna Medicare Advantage	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.21
Rate for Payer: Cigna Commercial	$2.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.62
Rate for Payer: Oxford Commercial	$2.38
Rate for Payer: Qualcare PPO/HMO/WC	$0.71
Rate for Payer: UnitedHealthcare Commercial	$2.38

TEMAZEPAM/15MG/CAP

Facility

$3.00

Hospital Charge Code	60633979
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

TEMAZEPAM/15MG/CAP

Facility

$3.00

Hospital Charge Code	60633979
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

TEMAZEPAM/30MG/CAP

Facility

$3.00

Hospital Charge Code	60633980
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

TEMAZEPAM/30MG/CAP

Facility

$3.00

Hospital Charge Code	60633980
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

TEMAZEPAM/30MG/CAP

Facility

$5.56

Service Code	NDC 51079041920
Hospital Charge Code	60633978
Hospital Revenue Code	250
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$2.78
Rate for Payer: Aetna Commercial	$1.67
Rate for Payer: Aetna Medicare Advantage	$1.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.42
Rate for Payer: Cigna Commercial	$2.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.72
Rate for Payer: Oxford Commercial	$2.78
Rate for Payer: Qualcare PPO/HMO/WC	$0.83
Rate for Payer: UnitedHealthcare Commercial	$2.78

TEMAZEPAM/30MG/CAP

Facility

$5.56

Service Code	NDC 51079041920
Hospital Charge Code	60633978
Hospital Revenue Code	250
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$0.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.83

TEMAZEPAM 7.5 MG CAP

Facility

$49.70

Hospital Charge Code	60629846
Hospital Revenue Code	250
Min. Negotiated Rate	$7.46
Max. Negotiated Rate	$7.46
Rate for Payer: Qualcare PPO/HMO/WC	$7.46

TEMAZEPAM 7.5 MG CAP

Facility

$49.70

Hospital Charge Code	60629846
Hospital Revenue Code	250
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$24.85
Rate for Payer: Aetna Commercial	$14.91
Rate for Payer: Aetna Medicare Advantage	$14.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.67
Rate for Payer: Cigna Commercial	$24.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.46
Rate for Payer: Oxford Commercial	$24.85
Rate for Payer: Qualcare PPO/HMO/WC	$7.46
Rate for Payer: UnitedHealthcare Commercial	$24.85

TEMAZEPAM (RESTORIL)

Facility

$324.00

Service Code	HCPCS 80346
Hospital Charge Code	38472751
Hospital Revenue Code	301
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

TEMAZEPAM (RESTORIL)

Facility

$324.00

Service Code	HCPCS 80346
Hospital Charge Code	38472751
Hospital Revenue Code	301
Min. Negotiated Rate	$42.12
Max. Negotiated Rate	$162.00
Rate for Payer: Aetna Commercial	$97.20
Rate for Payer: Aetna Medicare Advantage	$97.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.62
Rate for Payer: Cigna Commercial	$162.00
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

TEMNO COAXIAL BIO NDLE22GX15CM

Facility

$241.13

Hospital Charge Code	270657364R
Hospital Revenue Code	272
Min. Negotiated Rate	$36.17
Max. Negotiated Rate	$36.17
Rate for Payer: Qualcare PPO/HMO/WC	$36.17

TEMNO COAXIAL BIO NDLE22GX15CM

Facility

$48.23

Hospital Charge Code	270657364
Hospital Revenue Code	272
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$7.23
Rate for Payer: Qualcare PPO/HMO/WC	$7.23

TEMNO COAXIAL BIO NDLE22GX15CM

Facility

$48.23

Hospital Charge Code	270657364
Hospital Revenue Code	272
Min. Negotiated Rate	$6.27
Max. Negotiated Rate	$24.11
Rate for Payer: Aetna Commercial	$14.47
Rate for Payer: Aetna Medicare Advantage	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.30
Rate for Payer: Cigna Commercial	$24.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.27
Rate for Payer: Oxford Commercial	$24.11
Rate for Payer: Qualcare PPO/HMO/WC	$7.23
Rate for Payer: UnitedHealthcare Commercial	$24.11

TEMNO COAXIAL BIO NDLE22GX15CM

Facility

$241.13

Hospital Charge Code	270657364R
Hospital Revenue Code	272
Min. Negotiated Rate	$31.35
Max. Negotiated Rate	$120.56
Rate for Payer: Aetna Commercial	$72.34
Rate for Payer: Aetna Medicare Advantage	$72.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.49
Rate for Payer: Cigna Commercial	$120.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.35
Rate for Payer: Oxford Commercial	$120.56
Rate for Payer: Qualcare PPO/HMO/WC	$36.17
Rate for Payer: UnitedHealthcare Commercial	$120.56

TEMNO COXIAL BIO NDLE 22GX11CM

Facility

$46.44

Hospital Charge Code	270655044
Hospital Revenue Code	272
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$6.97
Rate for Payer: Qualcare PPO/HMO/WC	$6.97

TEMNO COXIAL BIO NDLE 22GX11CM

Facility

$46.44

Hospital Charge Code	270655044
Hospital Revenue Code	272
Min. Negotiated Rate	$6.04
Max. Negotiated Rate	$23.22
Rate for Payer: Aetna Commercial	$13.93
Rate for Payer: Aetna Medicare Advantage	$13.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.84
Rate for Payer: Cigna Commercial	$23.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.04
Rate for Payer: Oxford Commercial	$23.22
Rate for Payer: Qualcare PPO/HMO/WC	$6.97
Rate for Payer: UnitedHealthcare Commercial	$23.22

Know your out-of-pocket cost for care.

All Charges