Heights University Hospital

All Charges

Charge

Type

Setting

Price

BENZTROPINE INJ 1MG/ML; 2ML

Facility

$58.25

Hospital Charge Code	6000616
Hospital Revenue Code	250
Min. Negotiated Rate	$8.74
Max. Negotiated Rate	$8.74
Rate for Payer: Qualcare PPO/HMO/WC	$8.74

BENZTROPINE INJ 1MG/ML; 2ML

Facility

$58.25

Hospital Charge Code	6000616
Hospital Revenue Code	250
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$29.12
Rate for Payer: Aetna Commercial	$17.48
Rate for Payer: Aetna Medicare Advantage	$17.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.85
Rate for Payer: Cigna Commercial	$29.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.57
Rate for Payer: Oxford Commercial	$29.12
Rate for Payer: Qualcare PPO/HMO/WC	$8.74
Rate for Payer: UnitedHealthcare Commercial	$29.12

BENZTROPINE MESYLATE/0.5M

Facility

$3.00

Hospital Charge Code	60632545
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

BENZTROPINE MESYLATE/0.5M

Facility

$3.00

Hospital Charge Code	60632545
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

BENZTROPINE MESYLATE/0.5M

Facility

$3.00

Hospital Charge Code	60632542
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

BENZTROPINE MESYLATE/0.5M

Facility

$3.00

Hospital Charge Code	60632542
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

BENZTROPINE MESYLATE/1MG

Facility

$3.00

Hospital Charge Code	60632543
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

BENZTROPINE MESYLATE/1MG

Facility

$3.00

Hospital Charge Code	60632543
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

BENZTROPINE MESYLATE/2MG

Facility

$3.00

Hospital Charge Code	60632544
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

BENZTROPINE MESYLATE/2MG

Facility

$3.00

Hospital Charge Code	60632544
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

BENZYLPENICILLOYL POLYLYSI INJ

Facility

$492.85

Hospital Charge Code	60627872
Hospital Revenue Code	250
Min. Negotiated Rate	$73.93
Max. Negotiated Rate	$73.93
Rate for Payer: Qualcare PPO/HMO/WC	$73.93

BENZYLPENICILLOYL POLYLYSI INJ

Facility

$492.85

Hospital Charge Code	60627872
Hospital Revenue Code	250
Min. Negotiated Rate	$64.07
Max. Negotiated Rate	$246.43
Rate for Payer: Aetna Commercial	$147.85
Rate for Payer: Aetna Medicare Advantage	$147.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.68
Rate for Payer: Cigna Commercial	$246.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.07
Rate for Payer: Oxford Commercial	$246.43
Rate for Payer: Qualcare PPO/HMO/WC	$73.93
Rate for Payer: UnitedHealthcare Commercial	$246.43

BERING 10kX71/75mm CR-L 183540

Facility

$5,260.00

Hospital Charge Code	27063971
Hospital Revenue Code	278
Min. Negotiated Rate	$789.00
Max. Negotiated Rate	$2,630.00
Rate for Payer: Aetna Commercial	$1,578.00
Rate for Payer: Aetna Medicare Advantage	$1,578.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,341.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,341.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,052.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,341.30
Rate for Payer: Cigna Commercial	$2,630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,272.92
Rate for Payer: Qualcare PPO/HMO/WC	$789.00

BERING 10kX71/75mm CR-L 183540

Facility

$5,260.00

Hospital Charge Code	27063971
Hospital Revenue Code	278
Min. Negotiated Rate	$789.00
Max. Negotiated Rate	$1,272.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,052.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,272.92
Rate for Payer: Qualcare PPO/HMO/WC	$789.00

BETA-2 GLUCOPROTEIN ABS ****

Facility

$225.00

Service Code	HCPCS 86146
Hospital Charge Code	3007219P
Hospital Revenue Code	302
Min. Negotiated Rate	$12.72
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$82.46
Rate for Payer: Aetna Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.25
Rate for Payer: Cigna Commercial	$25.45
Rate for Payer: Cigna Medicare Advantage	$12.72
Rate for Payer: Clover Medicare Advantage	$24.18
Rate for Payer: EmblemHealth Commercial	$76.35
Rate for Payer: Humana Medicare Advantage	$26.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.25
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$26.98
Rate for Payer: Wellcare Medicare Advantage	$25.45

BETA-2 GLUCOPROTEIN ABS ****

Facility

$225.00

Service Code	HCPCS 86146
Hospital Charge Code	3007219P
Hospital Revenue Code	302
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

BETA-2 GLYCOPROTEIN IGA

Facility

$302.45

Service Code	HCPCS 86146
Hospital Charge Code	3007219B
Hospital Revenue Code	302
Min. Negotiated Rate	$12.72
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$82.46
Rate for Payer: Aetna Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.25
Rate for Payer: Cigna Commercial	$25.45
Rate for Payer: Cigna Medicare Advantage	$12.72
Rate for Payer: Clover Medicare Advantage	$24.18
Rate for Payer: EmblemHealth Commercial	$76.35
Rate for Payer: Humana Medicare Advantage	$26.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.37
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$26.98
Rate for Payer: Wellcare Medicare Advantage	$25.45

BETA-2 GLYCOPROTEIN IGA

Facility

$302.45

Service Code	HCPCS 86146
Hospital Charge Code	3007219B
Hospital Revenue Code	302
Min. Negotiated Rate	$45.37
Max. Negotiated Rate	$45.37
Rate for Payer: Qualcare PPO/HMO/WC	$45.37

BETA-2 GLYCOPROTEIN IGG

Facility

$302.45

Service Code	HCPCS 86146
Hospital Charge Code	3007219A
Hospital Revenue Code	302
Min. Negotiated Rate	$12.72
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$82.46
Rate for Payer: Aetna Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.25
Rate for Payer: Cigna Commercial	$25.45
Rate for Payer: Cigna Medicare Advantage	$12.72
Rate for Payer: Clover Medicare Advantage	$24.18
Rate for Payer: EmblemHealth Commercial	$76.35
Rate for Payer: Humana Medicare Advantage	$26.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.37
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$26.98
Rate for Payer: Wellcare Medicare Advantage	$25.45

BETA-2 GLYCOPROTEIN IGG

Facility

$302.45

Service Code	HCPCS 86146
Hospital Charge Code	3007219A
Hospital Revenue Code	302
Min. Negotiated Rate	$45.37
Max. Negotiated Rate	$45.37
Rate for Payer: Qualcare PPO/HMO/WC	$45.37

BETA-2 GLYCOPROTEIN IGM

Facility

$302.45

Service Code	HCPCS 86146
Hospital Charge Code	3007219C
Hospital Revenue Code	302
Min. Negotiated Rate	$45.37
Max. Negotiated Rate	$45.37
Rate for Payer: Qualcare PPO/HMO/WC	$45.37

BETA-2 GLYCOPROTEIN IGM

Facility

$302.45

Service Code	HCPCS 86146
Hospital Charge Code	3007219C
Hospital Revenue Code	302
Min. Negotiated Rate	$12.72
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$82.46
Rate for Payer: Aetna Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.25
Rate for Payer: Cigna Commercial	$25.45
Rate for Payer: Cigna Medicare Advantage	$12.72
Rate for Payer: Clover Medicare Advantage	$24.18
Rate for Payer: EmblemHealth Commercial	$76.35
Rate for Payer: Humana Medicare Advantage	$26.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.37
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$26.98
Rate for Payer: Wellcare Medicare Advantage	$25.45

BETA-2 MICROGLOBIN, CSF

Facility

$167.25

Service Code	HCPCS 82232
Hospital Charge Code	3007217
Hospital Revenue Code	301
Min. Negotiated Rate	$8.09
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.42
Rate for Payer: Aetna Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$45.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.28
Rate for Payer: Cigna Commercial	$16.18
Rate for Payer: Cigna Medicare Advantage	$8.09
Rate for Payer: Clover Medicare Advantage	$15.37
Rate for Payer: EmblemHealth Commercial	$48.54
Rate for Payer: Humana Medicare Advantage	$16.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.09
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.15
Rate for Payer: Wellcare Medicare Advantage	$16.18

BETA-2 MICROGLOBIN, CSF

Facility

$167.25

Service Code	HCPCS 82232
Hospital Charge Code	3007217
Hospital Revenue Code	301
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$25.09
Rate for Payer: Qualcare PPO/HMO/WC	$25.09

BETA-2 MICROGLOBIN, URINE

Facility

$167.25

Service Code	HCPCS 82232
Hospital Charge Code	3007216
Hospital Revenue Code	301
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$25.09
Rate for Payer: Qualcare PPO/HMO/WC	$25.09

Know your out-of-pocket cost for care.

All Charges