Heights University Hospital

All Charges

Charge

Type

Setting

Price

BENADRYL ELIX 12.5MG/5CC

Facility

$1.00

Hospital Charge Code	60634767
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.15

BENADRYL ELIXER/5ML

Facility

$93.00

Hospital Charge Code	60634970
Hospital Revenue Code	250
Min. Negotiated Rate	$12.09
Max. Negotiated Rate	$46.50
Rate for Payer: Aetna Commercial	$27.90
Rate for Payer: Aetna Medicare Advantage	$27.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.71
Rate for Payer: Cigna Commercial	$46.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.09
Rate for Payer: Oxford Commercial	$46.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.95
Rate for Payer: UnitedHealthcare Commercial	$46.50

BENADRYL ELIXER/5ML

Facility

$93.00

Hospital Charge Code	60634970
Hospital Revenue Code	250
Min. Negotiated Rate	$13.95
Max. Negotiated Rate	$13.95
Rate for Payer: Qualcare PPO/HMO/WC	$13.95

BENADRYL/KAO/TETRACYCLINE

Facility

$43.00

Hospital Charge Code	60634866
Hospital Revenue Code	250
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$21.50

BENADRYL/KAO/TETRACYCLINE

Facility

$43.00

Hospital Charge Code	60634866
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

BENAZEPRIL 10 MG TAB

Facility

$7.25

Hospital Charge Code	60628570
Hospital Revenue Code	250
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.17
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.94
Rate for Payer: Oxford Commercial	$3.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$3.62

BENAZEPRIL 10 MG TAB

Facility

$7.25

Hospital Charge Code	60628570
Hospital Revenue Code	250
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

BENAZEPRIL 20 MG TAB

Facility

$7.25

Hospital Charge Code	60628571
Hospital Revenue Code	250
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

BENAZEPRIL 20 MG TAB

Facility

$7.25

Hospital Charge Code	60628571
Hospital Revenue Code	250
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.17
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.94
Rate for Payer: Oxford Commercial	$3.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$3.62

BENAZEPRIL HYDROCHLORIDE 5 MG

Facility

$6.06

Hospital Charge Code	6063943184
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.91

BENAZEPRIL HYDROCHLORIDE 5 MG

Facility

$6.06

Hospital Charge Code	6063943184
Hospital Revenue Code	250
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$3.03
Rate for Payer: Aetna Commercial	$1.82
Rate for Payer: Aetna Medicare Advantage	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.55
Rate for Payer: Cigna Commercial	$3.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.79
Rate for Payer: Oxford Commercial	$3.03
Rate for Payer: Qualcare PPO/HMO/WC	$0.91
Rate for Payer: UnitedHealthcare Commercial	$3.03

BENCE-JONES PROTEIN***

Facility

$69.00

Hospital Charge Code	3010402
Hospital Revenue Code	301
Min. Negotiated Rate	$10.35
Max. Negotiated Rate	$10.35
Rate for Payer: Qualcare PPO/HMO/WC	$10.35

BENCE-JONES PROTEIN***

Facility

$69.00

Hospital Charge Code	3010402
Hospital Revenue Code	301
Min. Negotiated Rate	$8.97
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$20.70
Rate for Payer: Aetna Medicare Advantage	$20.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.59
Rate for Payer: Cigna Commercial	$34.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.35
Rate for Payer: UnitedHealthcare Commercial	$114.00

BENCE JONES,SCREEN

Facility

$399.00

Service Code	HCPCS 86320
Hospital Charge Code	38477029
Hospital Revenue Code	302
Min. Negotiated Rate	$59.85
Max. Negotiated Rate	$59.85
Rate for Payer: Qualcare PPO/HMO/WC	$59.85

BENCE JONES,SCREEN

Facility

$399.00

Service Code	HCPCS 86320
Hospital Charge Code	38477029
Hospital Revenue Code	302
Min. Negotiated Rate	$14.96
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$96.94
Rate for Payer: Aetna Medicare Advantage	$29.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.63
Rate for Payer: Cigna Commercial	$29.92
Rate for Payer: Cigna Medicare Advantage	$14.96
Rate for Payer: Clover Medicare Advantage	$28.42
Rate for Payer: EmblemHealth Commercial	$89.76
Rate for Payer: Humana Medicare Advantage	$30.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.87
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.92
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$31.72
Rate for Payer: Wellcare Medicare Advantage	$29.92

Benchmark Ber Str 105

Facility

$4,975.00

Hospital Charge Code	270685065N
Hospital Revenue Code	272
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$746.25
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

Benchmark Ber Str 105

Facility

$4,975.00

Hospital Charge Code	270685065S
Hospital Revenue Code	272
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$746.25
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

Benchmark Ber Str 105

Facility

$4,975.00

Hospital Charge Code	270685065N
Hospital Revenue Code	272
Min. Negotiated Rate	$646.75
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,492.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$646.75
Rate for Payer: Oxford Commercial	$2,487.50
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Commercial	$2,487.50

Benchmark Ber Str 105

Facility

$4,975.00

Hospital Charge Code	270685065S
Hospital Revenue Code	272
Min. Negotiated Rate	$646.75
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,492.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$646.75
Rate for Payer: Oxford Commercial	$2,487.50
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Commercial	$2,487.50

Benchmark Ber Str 95

Facility

$4,975.00

Hospital Charge Code	270685064N
Hospital Revenue Code	272
Min. Negotiated Rate	$646.75
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,492.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$646.75
Rate for Payer: Oxford Commercial	$2,487.50
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Commercial	$2,487.50

Benchmark Ber Str 95

Facility

$4,975.00

Hospital Charge Code	270685064S
Hospital Revenue Code	272
Min. Negotiated Rate	$646.75
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,492.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$646.75
Rate for Payer: Oxford Commercial	$2,487.50
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Commercial	$2,487.50

Benchmark Ber Str 95

Facility

$4,975.00

Hospital Charge Code	270685064N
Hospital Revenue Code	272
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$746.25
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

Benchmark Ber Str 95

Facility

$4,975.00

Hospital Charge Code	270685064S
Hospital Revenue Code	272
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$746.25
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

BENDING IRON F/1.5 & 2mm PLATE

Facility

$795.70

Service Code	HCPCS C1713
Hospital Charge Code	270651502
Hospital Revenue Code	278
Min. Negotiated Rate	$119.36
Max. Negotiated Rate	$192.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.56
Rate for Payer: Qualcare PPO/HMO/WC	$119.36

BENDING IRON F/1.5 & 2mm PLATE

Facility

$795.70

Service Code	HCPCS C1713
Hospital Charge Code	270651502
Hospital Revenue Code	278
Min. Negotiated Rate	$119.36
Max. Negotiated Rate	$397.85
Rate for Payer: Aetna Commercial	$238.71
Rate for Payer: Aetna Medicare Advantage	$238.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$202.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$202.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$202.90
Rate for Payer: Cigna Commercial	$397.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$192.56
Rate for Payer: Qualcare PPO/HMO/WC	$119.36

Know your out-of-pocket cost for care.

All Charges