Heights University Hospital

All Charges

Charge

Type

Setting

Price

VANCOMYCIN INJ 500MG

Facility

$61.45

Hospital Charge Code	600559
Hospital Revenue Code	250
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$9.22
Rate for Payer: Qualcare PPO/HMO/WC	$9.22

VANCOMYCIN IVPB 500MG/NS 100ML

Facility

$54.85

Hospital Charge Code	60627330
Hospital Revenue Code	250
Min. Negotiated Rate	$8.23
Max. Negotiated Rate	$8.23
Rate for Payer: Qualcare PPO/HMO/WC	$8.23

VANCOMYCIN IVPB 500MG/NS 100ML

Facility

$54.85

Hospital Charge Code	60627330
Hospital Revenue Code	250
Min. Negotiated Rate	$7.13
Max. Negotiated Rate	$27.43
Rate for Payer: Aetna Commercial	$16.45
Rate for Payer: Aetna Medicare Advantage	$16.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.99
Rate for Payer: Cigna Commercial	$27.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.13
Rate for Payer: Oxford Commercial	$27.43
Rate for Payer: Qualcare PPO/HMO/WC	$8.23
Rate for Payer: UnitedHealthcare Commercial	$27.43

VANCOMYCIN IVPB 750MG/D5W 250M

Facility

$97.15

Service Code	NDC 409653101
Hospital Charge Code	60627333
Hospital Revenue Code	250
Min. Negotiated Rate	$12.63
Max. Negotiated Rate	$48.58
Rate for Payer: Aetna Commercial	$29.14
Rate for Payer: Aetna Medicare Advantage	$29.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.77
Rate for Payer: Cigna Commercial	$48.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.63
Rate for Payer: Oxford Commercial	$48.58
Rate for Payer: Qualcare PPO/HMO/WC	$14.57
Rate for Payer: UnitedHealthcare Commercial	$48.58

VANCOMYCIN IVPB 750MG/D5W 250M

Facility

$97.15

Service Code	NDC 409653101
Hospital Charge Code	60627333
Hospital Revenue Code	250
Min. Negotiated Rate	$14.57
Max. Negotiated Rate	$14.57
Rate for Payer: Qualcare PPO/HMO/WC	$14.57

VANCOMYCIN IVPB 750MG/NS 250ML

Facility

$96.00

Hospital Charge Code	60627332
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 IVPB 750MG/NS 250ML

Facility

$96.00

Hospital Charge Code	60627332
Hospital Revenue Code	250
Min. Negotiated Rate	$14.40
Max. Negotiated Rate	$14.40
Rate for Payer: Qualcare PPO/HMO/WC	$14.40

VANCOMYCIN LQ 1GM

Facility

$317.45

Hospital Charge Code	6005607
Hospital Revenue Code	252
Min. Negotiated Rate	$41.27
Max. Negotiated Rate	$158.72
Rate for Payer: Aetna Commercial	$95.23
Rate for Payer: Aetna Medicare Advantage	$95.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.95
Rate for Payer: Cigna Commercial	$158.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.27
Rate for Payer: Oxford Commercial	$158.72
Rate for Payer: Qualcare PPO/HMO/WC	$47.62
Rate for Payer: UnitedHealthcare Commercial	$158.72

VANCOMYCIN LQ 1GM

Facility

$317.45

Hospital Charge Code	6005607
Hospital Revenue Code	252
Min. Negotiated Rate	$47.62
Max. Negotiated Rate	$47.62
Rate for Payer: Qualcare PPO/HMO/WC	$47.62

VANCOMYCIN PEAK

Facility

$174.00

Service Code	HCPCS 80202
Hospital Charge Code	38479045
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	$22.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
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 PEAK

Facility

$174.00

Service Code	HCPCS 80202
Hospital Charge Code	38479045
Hospital Revenue Code	301
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

VANCOMYCIN, PEAK

Facility

$390.00

Service Code	HCPCS 80202
Hospital Charge Code	3008406
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VANCOMYCIN, PEAK

Facility

$390.00

Service Code	HCPCS 80202
Hospital Charge Code	3008406
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, TROUGH

Facility

$667.59

Service Code	HCPCS 80202
Hospital Charge Code	3008398
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	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
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, TROUGH

Facility

$667.59

Service Code	HCPCS 80202
Hospital Charge Code	3008398
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

VANCOMYCIN,TROUGH

Facility

$174.00

Service Code	HCPCS 80202
Hospital Charge Code	38479047
Hospital Revenue Code	301
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

VANCOMYCIN,TROUGH

Facility

$174.00

Service Code	HCPCS 80202
Hospital Charge Code	38479047
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	$22.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
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 (VANCOCIN)

Facility

$174.00

Service Code	HCPCS 80202
Hospital Charge Code	38472702
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	$22.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
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 (VANCOCIN)

Facility

$174.00

Service Code	HCPCS 80202
Hospital Charge Code	38472702
Hospital Revenue Code	301
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

VANCOMYOCIN 2MG 100ML VPB

Facility

$225.12

Service Code	NDC 70594004402
Hospital Charge Code	60649032
Hospital Revenue Code	636
Min. Negotiated Rate	$33.77
Max. Negotiated Rate	$54.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.48
Rate for Payer: Qualcare PPO/HMO/WC	$33.77

VANCOMYOCIN 2MG 100ML VPB

Facility

$225.12

Service Code	NDC 70594004402
Hospital Charge Code	60649032
Hospital Revenue Code	636
Min. Negotiated Rate	$33.77
Max. Negotiated Rate	$112.56
Rate for Payer: Aetna Commercial	$67.54
Rate for Payer: Aetna Medicare Advantage	$67.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.41
Rate for Payer: Cigna Commercial	$112.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.48
Rate for Payer: Qualcare PPO/HMO/WC	$33.77

VANILLYLMANDELIC ACID (VMA)

Facility

$321.00

Service Code	HCPCS 84585
Hospital Charge Code	38472665
Hospital Revenue Code	301
Min. Negotiated Rate	$48.15
Max. Negotiated Rate	$48.15
Rate for Payer: Qualcare PPO/HMO/WC	$48.15

VANILLYLMANDELIC ACID (VMA)

Facility

$321.00

Service Code	HCPCS 84585
Hospital Charge Code	38472665
Hospital Revenue Code	301
Min. Negotiated Rate	$7.75
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$50.22
Rate for Payer: Aetna Medicare Advantage	$15.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.50
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	$56.79
Rate for Payer: Cigna Commercial	$15.50
Rate for Payer: Cigna Medicare Advantage	$7.75
Rate for Payer: Clover Medicare Advantage	$14.72
Rate for Payer: EmblemHealth Commercial	$46.50
Rate for Payer: Humana Medicare Advantage	$15.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.15
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.50
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.43
Rate for Payer: Wellcare Medicare Advantage	$15.50

VANTIN 100MG/5ML SUSP100M

Facility

$170.00

Hospital Charge Code	60635222
Hospital Revenue Code	250
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

VANTIN 100MG/5ML SUSP100M

Facility

$170.00

Hospital Charge Code	60635222
Hospital Revenue Code	250
Min. Negotiated Rate	$22.10
Max. Negotiated Rate	$85.00
Rate for Payer: Aetna Commercial	$51.00
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.10
Rate for Payer: Oxford Commercial	$85.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$85.00

Know your out-of-pocket cost for care.

All Charges