Heights University Hospital

All Charges

Charge

Type

Setting

Price

TRIAMCINOLONE ACETONIDE 0.25%

Facility

$29.82

Service Code	NDC 45802006335
Hospital Charge Code	6063943306
Hospital Revenue Code	250
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$14.91
Rate for Payer: Aetna Commercial	$8.95
Rate for Payer: Aetna Medicare Advantage	$8.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.60
Rate for Payer: Cigna Commercial	$14.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.88
Rate for Payer: Oxford Commercial	$14.91
Rate for Payer: Qualcare PPO/HMO/WC	$4.47
Rate for Payer: UnitedHealthcare Commercial	$14.91

TRIAMCINOLONE ACETONIDE 0.25%

Facility

$29.82

Service Code	NDC 45802006335
Hospital Charge Code	6063943306
Hospital Revenue Code	250
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$4.47
Rate for Payer: Qualcare PPO/HMO/WC	$4.47

TRIAMCINOLONE AEROSOL 63G

Facility

$252.00

Hospital Charge Code	60628887
Hospital Revenue Code	250
Min. Negotiated Rate	$32.76
Max. Negotiated Rate	$126.00
Rate for Payer: Aetna Commercial	$75.60
Rate for Payer: Aetna Medicare Advantage	$75.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.26
Rate for Payer: Cigna Commercial	$126.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.76
Rate for Payer: Oxford Commercial	$126.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.80
Rate for Payer: UnitedHealthcare Commercial	$126.00

TRIAMCINOLONE AEROSOL 63G

Facility

$252.00

Hospital Charge Code	60628887
Hospital Revenue Code	250
Min. Negotiated Rate	$37.80
Max. Negotiated Rate	$37.80
Rate for Payer: Qualcare PPO/HMO/WC	$37.80

TRIAMCINOLONE CRM 0.025% 15GM

Facility

$11.25

Hospital Charge Code	60628403
Hospital Revenue Code	250
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

TRIAMCINOLONE CRM 0.025% 15GM

Facility

$11.25

Hospital Charge Code	60628403
Hospital Revenue Code	250
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$3.38
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$5.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$5.62

TRIAMCINOLONE CRM .025%

Facility

$48.00

Hospital Charge Code	6005433
Hospital Revenue Code	251
Min. Negotiated Rate	$6.24
Max. Negotiated Rate	$24.00
Rate for Payer: Aetna Commercial	$14.40
Rate for Payer: Aetna Medicare Advantage	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.24
Rate for Payer: Cigna Commercial	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.24
Rate for Payer: Oxford Commercial	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.20
Rate for Payer: UnitedHealthcare Commercial	$24.00

TRIAMCINOLONE CRM .025%

Facility

$34.60

Hospital Charge Code	6005458
Hospital Revenue Code	251
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$17.30
Rate for Payer: Aetna Commercial	$10.38
Rate for Payer: Aetna Medicare Advantage	$10.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.82
Rate for Payer: Cigna Commercial	$17.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$17.30
Rate for Payer: Qualcare PPO/HMO/WC	$5.19
Rate for Payer: UnitedHealthcare Commercial	$17.30

TRIAMCINOLONE CRM .025%

Facility

$48.00

Hospital Charge Code	6005433
Hospital Revenue Code	251
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$7.20

TRIAMCINOLONE CRM .025%

Facility

$34.60

Hospital Charge Code	6005458
Hospital Revenue Code	251
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$5.19
Rate for Payer: Qualcare PPO/HMO/WC	$5.19

TRIAMCINOLONE CRM .5%

Facility

$181.15

Hospital Charge Code	6005466
Hospital Revenue Code	251
Min. Negotiated Rate	$23.55
Max. Negotiated Rate	$90.58
Rate for Payer: Aetna Commercial	$54.34
Rate for Payer: Aetna Medicare Advantage	$54.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.19
Rate for Payer: Cigna Commercial	$90.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.55
Rate for Payer: Oxford Commercial	$90.58
Rate for Payer: Qualcare PPO/HMO/WC	$27.17
Rate for Payer: UnitedHealthcare Commercial	$90.58

TRIAMCINOLONE CRM .5%

Facility

$181.15

Hospital Charge Code	6005466
Hospital Revenue Code	251
Min. Negotiated Rate	$27.17
Max. Negotiated Rate	$27.17
Rate for Payer: Qualcare PPO/HMO/WC	$27.17

TRIAMCINOLONE DENTALPASTE 0.1%

Facility

$108.00

Service Code	NDC 64980032005
Hospital Charge Code	60628408
Hospital Revenue Code	250
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$16.20

TRIAMCINOLONE DENTALPASTE 0.1%

Facility

$108.00

Service Code	NDC 64980032005
Hospital Charge Code	60628408
Hospital Revenue Code	250
Min. Negotiated Rate	$14.04
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna Commercial	$32.40
Rate for Payer: Aetna Medicare Advantage	$32.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.54
Rate for Payer: Cigna Commercial	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.04
Rate for Payer: Oxford Commercial	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.20
Rate for Payer: UnitedHealthcare Commercial	$54.00

TRIAMCINOLONE INJ 50MG/5ML

Facility

$88.78

Service Code	HCPCS J3301
Hospital Charge Code	60628211
Hospital Revenue Code	636
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$26.63
Rate for Payer: Aetna Commercial	$26.63
Rate for Payer: Aetna Medicare Advantage	$26.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.64
Rate for Payer: Cigna Commercial	$0.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.48
Rate for Payer: Qualcare PPO/HMO/WC	$13.32

TRIAMCINOLONE INJ 50MG/5ML

Facility

$88.78

Service Code	HCPCS J3301
Hospital Charge Code	60628211
Hospital Revenue Code	636
Min. Negotiated Rate	$13.32
Max. Negotiated Rate	$21.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.48
Rate for Payer: Qualcare PPO/HMO/WC	$13.32

TRIAMCINOLONE OINT 0.025%

Facility

$41.00

Service Code	NDC 45802005435
Hospital Charge Code	60628405
Hospital Revenue Code	250
Min. Negotiated Rate	$5.33
Max. Negotiated Rate	$20.50
Rate for Payer: Aetna Commercial	$12.30
Rate for Payer: Aetna Medicare Advantage	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.46
Rate for Payer: Cigna Commercial	$20.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.33
Rate for Payer: Oxford Commercial	$20.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.15
Rate for Payer: UnitedHealthcare Commercial	$20.50

TRIAMCINOLONE OINT 0.025%

Facility

$41.00

Service Code	NDC 45802005435
Hospital Charge Code	60628405
Hospital Revenue Code	250
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$6.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.15

TRIAMCINOLONE OINT 0.1% 15GM

Facility

$37.39

Service Code	NDC 168000615
Hospital Charge Code	60628406
Hospital Revenue Code	250
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$18.70
Rate for Payer: Aetna Commercial	$11.22
Rate for Payer: Aetna Medicare Advantage	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.53
Rate for Payer: Cigna Commercial	$18.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.86
Rate for Payer: Oxford Commercial	$18.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.61
Rate for Payer: UnitedHealthcare Commercial	$18.70

TRIAMCINOLONE OINT 0.1% 15GM

Facility

$37.39

Service Code	NDC 168000615
Hospital Charge Code	60628406
Hospital Revenue Code	250
Min. Negotiated Rate	$5.61
Max. Negotiated Rate	$5.61
Rate for Payer: Qualcare PPO/HMO/WC	$5.61

TRIAMCINOLONE OINT .1%

Facility

$21.15

Hospital Charge Code	6005474
Hospital Revenue Code	251
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

TRIAMCINOLONE OINT .1%

Facility

$21.15

Hospital Charge Code	6005474
Hospital Revenue Code	251
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$10.57
Rate for Payer: Aetna Commercial	$6.34
Rate for Payer: Aetna Medicare Advantage	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.39
Rate for Payer: Cigna Commercial	$10.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.75
Rate for Payer: Oxford Commercial	$10.57
Rate for Payer: Qualcare PPO/HMO/WC	$3.17
Rate for Payer: UnitedHealthcare Commercial	$10.57

TRIAMCINOLONE ORAL INH

Facility

$24.85

Hospital Charge Code	60628042
Hospital Revenue Code	250
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$7.46
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.23
Rate for Payer: Oxford Commercial	$12.43
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$12.43

TRIAMCINOLONE ORAL INH

Facility

$24.85

Hospital Charge Code	60628042
Hospital Revenue Code	250
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

TRIAMCNOLNE ACET INH 100MG/PFF

Facility

$109.45

Hospital Charge Code	6005425
Hospital Revenue Code	250
Min. Negotiated Rate	$14.23
Max. Negotiated Rate	$54.73
Rate for Payer: Aetna Commercial	$32.84
Rate for Payer: Aetna Medicare Advantage	$32.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.91
Rate for Payer: Cigna Commercial	$54.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.23
Rate for Payer: Oxford Commercial	$54.73
Rate for Payer: Qualcare PPO/HMO/WC	$16.42
Rate for Payer: UnitedHealthcare Commercial	$54.73

Know your out-of-pocket cost for care.

All Charges