Heights University Hospital

All Charges

Charge

Type

Setting

Price

VANCOCIN/10GM

Facility

$92.00

Hospital Charge Code	60634117
Hospital Revenue Code	250
Min. Negotiated Rate	$11.96
Max. Negotiated Rate	$46.00
Rate for Payer: Aetna Commercial	$27.60
Rate for Payer: Aetna Medicare Advantage	$27.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.46
Rate for Payer: Cigna Commercial	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.96
Rate for Payer: Oxford Commercial	$46.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.80
Rate for Payer: UnitedHealthcare Commercial	$46.00

VANCOCIN/10GM

Facility

$92.00

Hospital Charge Code	60634117
Hospital Revenue Code	250
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.80

VANCOCIN/125MG/CAP

Facility

$28.00

Hospital Charge Code	60634118
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

VANCOCIN/125MG/CAP

Facility

$28.00

Hospital Charge Code	60634118
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

VANCOCIN/1GM

Facility

$65.00

Hospital Charge Code	60634119
Hospital Revenue Code	250
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

VANCOCIN/1GM

Facility

$65.00

Hospital Charge Code	60634119
Hospital Revenue Code	250
Min. Negotiated Rate	$8.45
Max. Negotiated Rate	$32.50
Rate for Payer: Aetna Commercial	$19.50
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.45
Rate for Payer: Oxford Commercial	$32.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$32.50

VANCOCIN/250MG/5ML

Facility

$181.00

Hospital Charge Code	60634123
Hospital Revenue Code	250
Min. Negotiated Rate	$23.53
Max. Negotiated Rate	$90.50
Rate for Payer: Aetna Commercial	$54.30
Rate for Payer: Aetna Medicare Advantage	$54.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.16
Rate for Payer: Cigna Commercial	$90.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.53
Rate for Payer: Oxford Commercial	$90.50
Rate for Payer: Qualcare PPO/HMO/WC	$27.15
Rate for Payer: UnitedHealthcare Commercial	$90.50

VANCOCIN/250MG/5ML

Facility

$181.00

Hospital Charge Code	60634123
Hospital Revenue Code	250
Min. Negotiated Rate	$27.15
Max. Negotiated Rate	$27.15
Rate for Payer: Qualcare PPO/HMO/WC	$27.15

VANCOCIN/250MG/CAP

Facility

$89.00

Hospital Charge Code	60634120
Hospital Revenue Code	250
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$13.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.35

VANCOCIN/250MG/CAP

Facility

$89.00

Hospital Charge Code	60634120
Hospital Revenue Code	250
Min. Negotiated Rate	$11.57
Max. Negotiated Rate	$44.50
Rate for Payer: Aetna Commercial	$26.70
Rate for Payer: Aetna Medicare Advantage	$26.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.70
Rate for Payer: Cigna Commercial	$44.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.57
Rate for Payer: Oxford Commercial	$44.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.35
Rate for Payer: UnitedHealthcare Commercial	$44.50

VANCOCIN/500MG

Facility

$49.00

Hospital Charge Code	60634122
Hospital Revenue Code	250
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$7.35
Rate for Payer: Qualcare PPO/HMO/WC	$7.35

VANCOCIN/500MG

Facility

$49.00

Hospital Charge Code	60634122
Hospital Revenue Code	250
Min. Negotiated Rate	$6.37
Max. Negotiated Rate	$24.50
Rate for Payer: Aetna Commercial	$14.70
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.49
Rate for Payer: Cigna Commercial	$24.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.37
Rate for Payer: Oxford Commercial	$24.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.35
Rate for Payer: UnitedHealthcare Commercial	$24.50

VANCOCIN/500MG

Facility

$49.00

Hospital Charge Code	60634121
Hospital Revenue Code	250
Min. Negotiated Rate	$6.37
Max. Negotiated Rate	$24.50
Rate for Payer: Aetna Commercial	$14.70
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.49
Rate for Payer: Cigna Commercial	$24.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.37
Rate for Payer: Oxford Commercial	$24.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.35
Rate for Payer: UnitedHealthcare Commercial	$24.50

VANCOCIN/500MG

Facility

$49.00

Hospital Charge Code	60634121
Hospital Revenue Code	250
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$7.35
Rate for Payer: Qualcare PPO/HMO/WC	$7.35

VANCOCIN/500MG ADD

Facility

$51.00

Hospital Charge Code	60634816
Hospital Revenue Code	250
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

VANCOCIN/500MG ADD

Facility

$51.00

Hospital Charge Code	60634816
Hospital Revenue Code	250
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$25.50
Rate for Payer: Aetna Commercial	$15.30
Rate for Payer: Aetna Medicare Advantage	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.01
Rate for Payer: Cigna Commercial	$25.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.63
Rate for Payer: Oxford Commercial	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$25.50

VANCOMYCIM VL 1GM

Facility

$96.00

Hospital Charge Code	6007066
Hospital Revenue Code	250
Min. Negotiated Rate	$14.40
Max. Negotiated Rate	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$14.40

VANCOMYCIM VL 1GM

Facility

$96.00

Hospital Charge Code	6007066
Hospital Revenue Code	250
Min. Negotiated Rate	$12.48
Max. Negotiated Rate	$48.00
Rate for Payer: Aetna Commercial	$28.80
Rate for Payer: Aetna Medicare Advantage	$28.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.48
Rate for Payer: Cigna Commercial	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.48
Rate for Payer: Oxford Commercial	$48.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.40
Rate for Payer: UnitedHealthcare Commercial	$48.00

VANCOMYCIN

Facility

$60.37

Service Code	NDC 409653331
Hospital Charge Code	60627328
Hospital Revenue Code	250
Min. Negotiated Rate	$7.85
Max. Negotiated Rate	$30.18
Rate for Payer: Aetna Commercial	$18.11
Rate for Payer: Aetna Medicare Advantage	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.39
Rate for Payer: Cigna Commercial	$30.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.85
Rate for Payer: Oxford Commercial	$30.18
Rate for Payer: Qualcare PPO/HMO/WC	$9.06
Rate for Payer: UnitedHealthcare Commercial	$30.18

VANCOMYCIN

Facility

$390.00

Service Code	HCPCS 80202
Hospital Charge Code	3008414
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VANCOMYCIN

Facility

$40.20

Service Code	HCPCS J3373
Hospital Charge Code	60627331
Hospital Revenue Code	636
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$12.06
Rate for Payer: Aetna Commercial	$12.06
Rate for Payer: Aetna Medicare Advantage	$12.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.25
Rate for Payer: Cigna Commercial	$0.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.73
Rate for Payer: Qualcare PPO/HMO/WC	$6.03

VANCOMYCIN

Facility

$40.20

Service Code	HCPCS J3373
Hospital Charge Code	60627331
Hospital Revenue Code	636
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$9.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.73
Rate for Payer: Qualcare PPO/HMO/WC	$6.03

VANCOMYCIN

Facility

$60.37

Service Code	NDC 409653331
Hospital Charge Code	60627328
Hospital Revenue Code	250
Min. Negotiated Rate	$9.06
Max. Negotiated Rate	$9.06
Rate for Payer: Qualcare PPO/HMO/WC	$9.06

VANCOMYCIN

Facility

$390.00

Service Code	HCPCS 80202
Hospital Charge Code	3008414
Hospital Revenue Code	301
Min. Negotiated Rate	$6.77
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$43.87
Rate for Payer: Aetna Medicare Advantage	$13.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.61
Rate for Payer: Cigna Commercial	$13.54
Rate for Payer: Cigna Medicare Advantage	$6.77
Rate for Payer: Clover Medicare Advantage	$12.86
Rate for Payer: EmblemHealth Commercial	$40.62
Rate for Payer: Humana Medicare Advantage	$13.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.54
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.35
Rate for Payer: Wellcare Medicare Advantage	$13.54

VANCOMYCIN 1.25GM/250ML

Facility

$1,809.00

Service Code	HCPCS J3373
Hospital Charge Code	606390398
Hospital Revenue Code	636
Min. Negotiated Rate	$271.35
Max. Negotiated Rate	$437.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.78
Rate for Payer: Qualcare PPO/HMO/WC	$271.35

Know your out-of-pocket cost for care.

All Charges