Heights University Hospital

All Charges

Charge

Type

Setting

Price

VANTIN 100MG/5ML SUSP50ML

Facility

$74.00

Hospital Charge Code	60635220
Hospital Revenue Code	250
Min. Negotiated Rate	$9.62
Max. Negotiated Rate	$37.00
Rate for Payer: Aetna Commercial	$22.20
Rate for Payer: Aetna Medicare Advantage	$22.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.87
Rate for Payer: Cigna Commercial	$37.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.62
Rate for Payer: Oxford Commercial	$37.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.10
Rate for Payer: UnitedHealthcare Commercial	$37.00

VANTIN 100MG/5ML SUSP50ML

Facility

$74.00

Hospital Charge Code	60635220
Hospital Revenue Code	250
Min. Negotiated Rate	$11.10
Max. Negotiated Rate	$11.10
Rate for Payer: Qualcare PPO/HMO/WC	$11.10

VANTIN 100MG/5ML SUSP75ML

Facility

$144.00

Hospital Charge Code	60635221
Hospital Revenue Code	250
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.60

VANTIN 100MG/5ML SUSP75ML

Facility

$144.00

Hospital Charge Code	60635221
Hospital Revenue Code	250
Min. Negotiated Rate	$18.72
Max. Negotiated Rate	$72.00
Rate for Payer: Aetna Commercial	$43.20
Rate for Payer: Aetna Medicare Advantage	$43.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.72
Rate for Payer: Cigna Commercial	$72.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.72
Rate for Payer: Oxford Commercial	$72.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.60
Rate for Payer: UnitedHealthcare Commercial	$72.00

VANTIN 100MGU/D TAB

Facility

$45.16

Service Code	NDC 781543820
Hospital Charge Code	60635215
Hospital Revenue Code	250
Min. Negotiated Rate	$6.77
Max. Negotiated Rate	$6.77
Rate for Payer: Qualcare PPO/HMO/WC	$6.77

VANTIN 100MGU/D TAB

Facility

$45.16

Service Code	NDC 781543820
Hospital Charge Code	60635215
Hospital Revenue Code	250
Min. Negotiated Rate	$5.87
Max. Negotiated Rate	$22.58
Rate for Payer: Aetna Commercial	$13.55
Rate for Payer: Aetna Medicare Advantage	$13.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.52
Rate for Payer: Cigna Commercial	$22.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.87
Rate for Payer: Oxford Commercial	$22.58
Rate for Payer: Qualcare PPO/HMO/WC	$6.77
Rate for Payer: UnitedHealthcare Commercial	$22.58

VANTIN 200MG U/D TAB

Facility

$21.00

Hospital Charge Code	60635216
Hospital Revenue Code	250
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

VANTIN 200MG U/D TAB

Facility

$21.00

Hospital Charge Code	60635216
Hospital Revenue Code	250
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$10.50
Rate for Payer: Aetna Commercial	$6.30
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$10.50

VANTIN 50MG/5ML SUSP100ML

Facility

$101.00

Hospital Charge Code	60635219
Hospital Revenue Code	250
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$15.15
Rate for Payer: Qualcare PPO/HMO/WC	$15.15

VANTIN 50MG/5ML SUSP100ML

Facility

$101.00

Hospital Charge Code	60635219
Hospital Revenue Code	250
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$50.50
Rate for Payer: Aetna Commercial	$30.30
Rate for Payer: Aetna Medicare Advantage	$30.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.75
Rate for Payer: Cigna Commercial	$50.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.13
Rate for Payer: Oxford Commercial	$50.50
Rate for Payer: Qualcare PPO/HMO/WC	$15.15
Rate for Payer: UnitedHealthcare Commercial	$50.50

VANTIN 50MG/5ML SUSP 50ML

Facility

$46.00

Hospital Charge Code	60635217
Hospital Revenue Code	250
Min. Negotiated Rate	$5.98
Max. Negotiated Rate	$23.00
Rate for Payer: Aetna Commercial	$13.80
Rate for Payer: Aetna Medicare Advantage	$13.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.73
Rate for Payer: Cigna Commercial	$23.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.98
Rate for Payer: Oxford Commercial	$23.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.90
Rate for Payer: UnitedHealthcare Commercial	$23.00

VANTIN 50MG/5ML SUSP 50ML

Facility

$46.00

Hospital Charge Code	60635217
Hospital Revenue Code	250
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$6.90
Rate for Payer: Qualcare PPO/HMO/WC	$6.90

VANTIN 50MG/5ML SUSP 75ML

Facility

$84.00

Hospital Charge Code	60635218
Hospital Revenue Code	250
Min. Negotiated Rate	$10.92
Max. Negotiated Rate	$42.00
Rate for Payer: Aetna Commercial	$25.20
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.92
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$42.00

VANTIN 50MG/5ML SUSP 75ML

Facility

$84.00

Hospital Charge Code	60635218
Hospital Revenue Code	250
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

VAP CHOLESTEROL I

Facility

$390.00

Service Code	HCPCS 83701
Hospital Charge Code	39990143A
Hospital Revenue Code	301
Min. Negotiated Rate	$16.93
Max. Negotiated Rate	$124.06
Rate for Payer: Aetna Commercial	$109.71
Rate for Payer: Aetna Medicare Advantage	$33.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$33.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.06
Rate for Payer: Cigna Commercial	$33.86
Rate for Payer: Cigna Medicare Advantage	$16.93
Rate for Payer: Clover Medicare Advantage	$32.17
Rate for Payer: EmblemHealth Commercial	$101.58
Rate for Payer: Humana Medicare Advantage	$34.88
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	$33.86
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$35.89
Rate for Payer: Wellcare Medicare Advantage	$33.86

VAP CHOLESTEROL I

Facility

$390.00

Service Code	HCPCS 83701
Hospital Charge Code	39990143A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VAP CHOLESTEROL II

Facility

$390.00

Service Code	HCPCS 84478
Hospital Charge Code	39990143B
Hospital Revenue Code	301
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.60
Rate for Payer: Aetna Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.03
Rate for Payer: Cigna Commercial	$5.74
Rate for Payer: Cigna Medicare Advantage	$2.87
Rate for Payer: Clover Medicare Advantage	$5.45
Rate for Payer: EmblemHealth Commercial	$17.22
Rate for Payer: Humana Medicare Advantage	$5.91
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	$5.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.08
Rate for Payer: Wellcare Medicare Advantage	$5.74

VAP CHOLESTEROL II

Facility

$390.00

Service Code	HCPCS 84478
Hospital Charge Code	39990143B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

VAPONEPHRINE/15ML

Facility

$66.00

Hospital Charge Code	60634605
Hospital Revenue Code	250
Min. Negotiated Rate	$8.58
Max. Negotiated Rate	$33.00
Rate for Payer: Aetna Commercial	$19.80
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.58
Rate for Payer: Oxford Commercial	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$33.00

VAPONEPHRINE/15ML

Facility

$66.00

Hospital Charge Code	60634605
Hospital Revenue Code	250
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

VAPORTRODE

Facility

$733.00

Hospital Charge Code	270335243
Hospital Revenue Code	272
Min. Negotiated Rate	$95.29
Max. Negotiated Rate	$366.50
Rate for Payer: Aetna Commercial	$219.90
Rate for Payer: Aetna Medicare Advantage	$219.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.91
Rate for Payer: Cigna Commercial	$366.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.29
Rate for Payer: Oxford Commercial	$366.50
Rate for Payer: Qualcare PPO/HMO/WC	$109.95
Rate for Payer: UnitedHealthcare Commercial	$366.50

VAPORTRODE

Facility

$733.00

Hospital Charge Code	270335243
Hospital Revenue Code	272
Min. Negotiated Rate	$109.95
Max. Negotiated Rate	$109.95
Rate for Payer: Qualcare PPO/HMO/WC	$109.95

VAPR 2.3 MM THERM END

Facility

$1,300.00

Hospital Charge Code	270658649
Hospital Revenue Code	270
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

VAPR 2.3 MM THERM END

Facility

$1,300.00

Hospital Charge Code	270658637
Hospital Revenue Code	270
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

VAPR 2.3 MM THERM END

Facility

$1,300.00

Hospital Charge Code	270658649
Hospital Revenue Code	270
Min. Negotiated Rate	$169.00
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$390.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.00
Rate for Payer: Oxford Commercial	$650.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00
Rate for Payer: UnitedHealthcare Commercial	$650.00

Know your out-of-pocket cost for care.

All Charges