Heights University Hospital

All Charges

Charge

Type

Setting

Price

TI-MESH 6 X 8- HERNIA

Facility

$552.00

Hospital Charge Code	270338795
Hospital Revenue Code	278
Min. Negotiated Rate	$82.80
Max. Negotiated Rate	$276.00
Rate for Payer: Aetna Commercial	$165.60
Rate for Payer: Aetna Medicare Advantage	$165.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.76
Rate for Payer: Cigna Commercial	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.58
Rate for Payer: Qualcare PPO/HMO/WC	$82.80

TI-MESH 6 X 8- HERNIA

Facility

$552.00

Hospital Charge Code	270338795
Hospital Revenue Code	278
Min. Negotiated Rate	$82.80
Max. Negotiated Rate	$133.58
Rate for Payer: Qualcare PPO/HMO/WC	$82.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.58

TIMOLOL 10 MG TAB

Facility

$4.85

Hospital Charge Code	60627611
Hospital Revenue Code	250
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$2.42
Rate for Payer: Aetna Commercial	$1.46
Rate for Payer: Aetna Medicare Advantage	$1.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.24
Rate for Payer: Cigna Commercial	$2.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.63
Rate for Payer: Oxford Commercial	$2.42
Rate for Payer: Qualcare PPO/HMO/WC	$0.73
Rate for Payer: UnitedHealthcare Commercial	$2.42

TIMOLOL 10 MG TAB

Facility

$4.85

Hospital Charge Code	60627611
Hospital Revenue Code	250
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$0.73
Rate for Payer: Qualcare PPO/HMO/WC	$0.73

TIMOLOL DORZOLAMIDE OPH 5ML

Facility

$254.45

Hospital Charge Code	60628941
Hospital Revenue Code	250
Min. Negotiated Rate	$33.08
Max. Negotiated Rate	$127.22
Rate for Payer: Aetna Commercial	$76.33
Rate for Payer: Aetna Medicare Advantage	$76.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.88
Rate for Payer: Cigna Commercial	$127.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.08
Rate for Payer: Oxford Commercial	$127.22
Rate for Payer: Qualcare PPO/HMO/WC	$38.17
Rate for Payer: UnitedHealthcare Commercial	$127.22

TIMOLOL DORZOLAMIDE OPH 5ML

Facility

$254.45

Hospital Charge Code	60628941
Hospital Revenue Code	250
Min. Negotiated Rate	$38.17
Max. Negotiated Rate	$38.17
Rate for Payer: Qualcare PPO/HMO/WC	$38.17

TIMOLOL HCTZ TAB 10-25MG

Facility

$5.65

Hospital Charge Code	60628722
Hospital Revenue Code	250
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$1.70
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.73
Rate for Payer: Oxford Commercial	$2.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$2.83

TIMOLOL HCTZ TAB 10-25MG

Facility

$5.65

Hospital Charge Code	60628722
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

TIMOLOL MALEATE 0.5% 0.3ML OPT

Facility

$27.00

Service Code	HCPCS C1713
Hospital Charge Code	606390577
Hospital Revenue Code	250
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

TIMOLOL MALEATE 0.5% 0.3ML OPT

Facility

$27.00

Service Code	HCPCS C1713
Hospital Charge Code	606390577
Hospital Revenue Code	250
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$8.10
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.51
Rate for Payer: Oxford Commercial	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$13.50

TIMOLOL MALEATE 2.5 ML

Facility

$74.90

Hospital Charge Code	6006597
Hospital Revenue Code	251
Min. Negotiated Rate	$9.74
Max. Negotiated Rate	$37.45
Rate for Payer: Aetna Commercial	$22.47
Rate for Payer: Aetna Medicare Advantage	$22.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.10
Rate for Payer: Cigna Commercial	$37.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.74
Rate for Payer: Oxford Commercial	$37.45
Rate for Payer: Qualcare PPO/HMO/WC	$11.23
Rate for Payer: UnitedHealthcare Commercial	$37.45

TIMOLOL MALEATE 2.5 ML

Facility

$74.90

Hospital Charge Code	6006597
Hospital Revenue Code	251
Min. Negotiated Rate	$11.23
Max. Negotiated Rate	$11.23
Rate for Payer: Qualcare PPO/HMO/WC	$11.23

TIMOLOL OPH .25% 2.5ML

Facility

$64.00

Hospital Charge Code	6006118
Hospital Revenue Code	251
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

TIMOLOL OPH .25% 2.5ML

Facility

$64.00

Hospital Charge Code	6006118
Hospital Revenue Code	251
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$19.20
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.32
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$32.00

TIMOLOL OPH .5% 2.5ML

Facility

$74.90

Hospital Charge Code	6006126
Hospital Revenue Code	251
Min. Negotiated Rate	$11.23
Max. Negotiated Rate	$11.23
Rate for Payer: Qualcare PPO/HMO/WC	$11.23

TIMOLOL OPH .5% 2.5ML

Facility

$74.90

Hospital Charge Code	6006126
Hospital Revenue Code	251
Min. Negotiated Rate	$9.74
Max. Negotiated Rate	$37.45
Rate for Payer: Aetna Commercial	$22.47
Rate for Payer: Aetna Medicare Advantage	$22.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.10
Rate for Payer: Cigna Commercial	$37.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.74
Rate for Payer: Oxford Commercial	$37.45
Rate for Payer: Qualcare PPO/HMO/WC	$11.23
Rate for Payer: UnitedHealthcare Commercial	$37.45

TIMOLOL OPHTHALMIC 0.25% SOL

Facility

$100.50

Service Code	NDC 61314022605
Hospital Charge Code	60629863
Hospital Revenue Code	251
Min. Negotiated Rate	$13.06
Max. Negotiated Rate	$50.25
Rate for Payer: Aetna Commercial	$30.15
Rate for Payer: Aetna Medicare Advantage	$30.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.63
Rate for Payer: Cigna Commercial	$50.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.06
Rate for Payer: Oxford Commercial	$50.25
Rate for Payer: Qualcare PPO/HMO/WC	$15.07
Rate for Payer: UnitedHealthcare Commercial	$50.25

TIMOLOL OPHTHALMIC 0.25% SOL

Facility

$100.50

Service Code	NDC 61314022605
Hospital Charge Code	60629863
Hospital Revenue Code	251
Min. Negotiated Rate	$15.07
Max. Negotiated Rate	$15.07
Rate for Payer: Qualcare PPO/HMO/WC	$15.07

TIMOLOL OPHTHALMIC 0.5% SOLN

Facility

$113.90

Service Code	NDC 61314022705
Hospital Charge Code	6006142
Hospital Revenue Code	251
Min. Negotiated Rate	$14.81
Max. Negotiated Rate	$56.95
Rate for Payer: Aetna Commercial	$34.17
Rate for Payer: Aetna Medicare Advantage	$34.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.04
Rate for Payer: Cigna Commercial	$56.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.81
Rate for Payer: Oxford Commercial	$56.95
Rate for Payer: Qualcare PPO/HMO/WC	$17.09
Rate for Payer: UnitedHealthcare Commercial	$56.95

TIMOLOL OPHTHALMIC 0.5% SOLN

Facility

$113.90

Service Code	NDC 61314022705
Hospital Charge Code	6006142
Hospital Revenue Code	251
Min. Negotiated Rate	$17.09
Max. Negotiated Rate	$17.09
Rate for Payer: Qualcare PPO/HMO/WC	$17.09

TIMOLOL OPHTHALMIC .25% GEL

Facility

$147.20

Hospital Charge Code	60629955
Hospital Revenue Code	250
Min. Negotiated Rate	$19.14
Max. Negotiated Rate	$73.60
Rate for Payer: Aetna Commercial	$44.16
Rate for Payer: Aetna Medicare Advantage	$44.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.54
Rate for Payer: Cigna Commercial	$73.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.14
Rate for Payer: Oxford Commercial	$73.60
Rate for Payer: Qualcare PPO/HMO/WC	$22.08
Rate for Payer: UnitedHealthcare Commercial	$73.60

TIMOLOL OPHTHALMIC .25% GEL

Facility

$147.20

Hospital Charge Code	60629955
Hospital Revenue Code	250
Min. Negotiated Rate	$22.08
Max. Negotiated Rate	$22.08
Rate for Payer: Qualcare PPO/HMO/WC	$22.08

TIMOPTIC 0.25%/10ML

Facility

$150.00

Hospital Charge Code	60634033
Hospital Revenue Code	250
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$45.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$75.00

TIMOPTIC 0.25%/10ML

Facility

$150.00

Hospital Charge Code	60634033
Hospital Revenue Code	250
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

TIMOPTIC 0.25%/5ML

Facility

$56.00

Hospital Charge Code	60634032
Hospital Revenue Code	250
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

Know your out-of-pocket cost for care.

All Charges