Heights University Hospital

All Charges

Charge

Type

Setting

Price

BETAMETHASONE DIPROP LOT 60ML

Facility

$299.55

Hospital Charge Code	6000673
Hospital Revenue Code	251
Min. Negotiated Rate	$44.93
Max. Negotiated Rate	$44.93
Rate for Payer: Qualcare PPO/HMO/WC	$44.93

BETAMETHASONE DIPROP LOT 60ML

Facility

$299.55

Hospital Charge Code	6000673
Hospital Revenue Code	251
Min. Negotiated Rate	$38.94
Max. Negotiated Rate	$149.78
Rate for Payer: Aetna Commercial	$89.86
Rate for Payer: Aetna Medicare Advantage	$89.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.39
Rate for Payer: Cigna Commercial	$149.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.94
Rate for Payer: Oxford Commercial	$149.78
Rate for Payer: Qualcare PPO/HMO/WC	$44.93
Rate for Payer: UnitedHealthcare Commercial	$149.78

BETAMETHASONE INJ 3MG/ML

Facility

$283.81

Service Code	HCPCS J0702
Hospital Charge Code	6000624
Hospital Revenue Code	636
Min. Negotiated Rate	$42.57
Max. Negotiated Rate	$68.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.68
Rate for Payer: Qualcare PPO/HMO/WC	$42.57

BETAMETHASONE INJ 3MG/ML

Facility

$283.81

Service Code	HCPCS J0702
Hospital Charge Code	6000624
Hospital Revenue Code	636
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$85.14
Rate for Payer: Aetna Commercial	$85.14
Rate for Payer: Aetna Medicare Advantage	$85.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.37
Rate for Payer: Cigna Commercial	$6.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.68
Rate for Payer: Qualcare PPO/HMO/WC	$42.57

BETAMETHASONE INJ 4MG/1ML 5ML

Facility

$98.60

Hospital Charge Code	60628182
Hospital Revenue Code	250
Min. Negotiated Rate	$14.79
Max. Negotiated Rate	$14.79
Rate for Payer: Qualcare PPO/HMO/WC	$14.79

BETAMETHASONE INJ 4MG/1ML 5ML

Facility

$98.60

Hospital Charge Code	60628182
Hospital Revenue Code	250
Min. Negotiated Rate	$12.82
Max. Negotiated Rate	$49.30
Rate for Payer: Aetna Commercial	$29.58
Rate for Payer: Aetna Medicare Advantage	$29.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.14
Rate for Payer: Cigna Commercial	$49.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.82
Rate for Payer: Oxford Commercial	$49.30
Rate for Payer: Qualcare PPO/HMO/WC	$14.79
Rate for Payer: UnitedHealthcare Commercial	$49.30

BETAMETHASONE LOT VAL 60ML

Facility

$53.80

Hospital Charge Code	6000657
Hospital Revenue Code	251
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

BETAMETHASONE LOT VAL 60ML

Facility

$53.80

Hospital Charge Code	6000657
Hospital Revenue Code	251
Min. Negotiated Rate	$6.99
Max. Negotiated Rate	$26.90
Rate for Payer: Aetna Commercial	$16.14
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.99
Rate for Payer: Oxford Commercial	$26.90
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$26.90

BETAMETHASONE OINT 45GM VAL

Facility

$680.59

Service Code	NDC 472038145
Hospital Charge Code	6000640
Hospital Revenue Code	251
Min. Negotiated Rate	$102.09
Max. Negotiated Rate	$102.09
Rate for Payer: Qualcare PPO/HMO/WC	$102.09

BETAMETHASONE OINT 45GM VAL

Facility

$680.59

Service Code	NDC 472038145
Hospital Charge Code	6000640
Hospital Revenue Code	251
Min. Negotiated Rate	$88.48
Max. Negotiated Rate	$340.30
Rate for Payer: Aetna Commercial	$204.18
Rate for Payer: Aetna Medicare Advantage	$204.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.55
Rate for Payer: Cigna Commercial	$340.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.48
Rate for Payer: Oxford Commercial	$340.30
Rate for Payer: Qualcare PPO/HMO/WC	$102.09
Rate for Payer: UnitedHealthcare Commercial	$340.30

BETAMETHASONE VALERATE 0.

Facility

$482.40

Service Code	NDC 168004160
Hospital Charge Code	60632555
Hospital Revenue Code	250
Min. Negotiated Rate	$62.71
Max. Negotiated Rate	$241.20
Rate for Payer: Aetna Commercial	$144.72
Rate for Payer: Aetna Medicare Advantage	$144.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.01
Rate for Payer: Cigna Commercial	$241.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.71
Rate for Payer: Oxford Commercial	$241.20
Rate for Payer: Qualcare PPO/HMO/WC	$72.36
Rate for Payer: UnitedHealthcare Commercial	$241.20

BETAMETHASONE VALERATE 0.

Facility

$9.00

Hospital Charge Code	60632552
Hospital Revenue Code	250
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

BETAMETHASONE VALERATE 0.

Facility

$9.00

Hospital Charge Code	60632552
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

BETAMETHASONE VALERATE 0.

Facility

$28.00

Hospital Charge Code	60632554
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

BETAMETHASONE VALERATE 0.

Facility

$9.00

Hospital Charge Code	60632553
Hospital Revenue Code	250
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

BETAMETHASONE VALERATE 0.

Facility

$482.40

Service Code	NDC 168004160
Hospital Charge Code	60632555
Hospital Revenue Code	250
Min. Negotiated Rate	$72.36
Max. Negotiated Rate	$72.36
Rate for Payer: Qualcare PPO/HMO/WC	$72.36

BETAMETHASONE VALERATE 0.

Facility

$28.00

Hospital Charge Code	60632554
Hospital Revenue Code	250
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$14.00

BETAMETHASONE VALERATE 0.

Facility

$9.00

Hospital Charge Code	60632553
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

betamethasone valerate cr 0.1%

Facility

$129.13

Hospital Charge Code	6063943320
Hospital Revenue Code	250
Min. Negotiated Rate	$19.37
Max. Negotiated Rate	$19.37
Rate for Payer: Qualcare PPO/HMO/WC	$19.37

betamethasone valerate cr 0.1%

Facility

$129.13

Hospital Charge Code	6063943320
Hospital Revenue Code	250
Min. Negotiated Rate	$16.79
Max. Negotiated Rate	$64.56
Rate for Payer: Aetna Commercial	$38.74
Rate for Payer: Aetna Medicare Advantage	$38.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.93
Rate for Payer: Cigna Commercial	$64.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.79
Rate for Payer: Oxford Commercial	$64.56
Rate for Payer: Qualcare PPO/HMO/WC	$19.37
Rate for Payer: UnitedHealthcare Commercial	$64.56

BETAMETHOSONE CRM 0.05% AF 50G

Facility

$367.40

Hospital Charge Code	60628575
Hospital Revenue Code	250
Min. Negotiated Rate	$55.11
Max. Negotiated Rate	$55.11
Rate for Payer: Qualcare PPO/HMO/WC	$55.11

BETAMETHOSONE CRM 0.05% AF 50G

Facility

$367.40

Hospital Charge Code	60628575
Hospital Revenue Code	250
Min. Negotiated Rate	$47.76
Max. Negotiated Rate	$183.70
Rate for Payer: Aetna Commercial	$110.22
Rate for Payer: Aetna Medicare Advantage	$110.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.69
Rate for Payer: Cigna Commercial	$183.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.76
Rate for Payer: Oxford Commercial	$183.70
Rate for Payer: Qualcare PPO/HMO/WC	$55.11
Rate for Payer: UnitedHealthcare Commercial	$183.70

BETAPACE/160MG/CAP

Facility

$113.90

Service Code	NDC 70515010610
Hospital Charge Code	60634905
Hospital Revenue Code	250
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

BETAPACE/160MG/CAP

Facility

$113.90

Service Code	NDC 70515010610
Hospital Charge Code	60634905
Hospital Revenue Code	250
Min. Negotiated Rate	$17.09
Max. Negotiated Rate	$17.09
Rate for Payer: Qualcare PPO/HMO/WC	$17.09

BETAPACE/240MG/CAP

Facility

$47.24

Service Code	NDC 50419010710
Hospital Charge Code	60634906
Hospital Revenue Code	250
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Qualcare PPO/HMO/WC	$7.09

Know your out-of-pocket cost for care.

All Charges