Heights University Hospital

All Charges

Charge

Type

Setting

Price

CARBOXYMETHYLCELLULOSE 1% OPHT

Facility

$4.00

Service Code	NDC 23455430
Hospital Charge Code	60628095
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

CARBOXYMETHYLCELLULOSE 1% OPHT

Facility

$4.00

Service Code	NDC 23455430
Hospital Charge Code	60628095
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

CARCINOEMBRYONIC ANTIGEN - CEA

Facility

$624.00

Service Code	HCPCS 82378
Hospital Charge Code	38472167
Hospital Revenue Code	301
Min. Negotiated Rate	$93.60
Max. Negotiated Rate	$93.60
Rate for Payer: Qualcare PPO/HMO/WC	$93.60

CARCINOEMBRYONIC ANTIGEN - CEA

Facility

$624.00

Service Code	HCPCS 82378
Hospital Charge Code	38472167
Hospital Revenue Code	301
Min. Negotiated Rate	$9.48
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$61.43
Rate for Payer: Aetna Medicare Advantage	$18.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.47
Rate for Payer: Cigna Commercial	$18.96
Rate for Payer: Cigna Medicare Advantage	$9.48
Rate for Payer: Clover Medicare Advantage	$18.01
Rate for Payer: EmblemHealth Commercial	$56.88
Rate for Payer: Humana Medicare Advantage	$19.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.96
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.10
Rate for Payer: Wellcare Medicare Advantage	$18.96

CARDEC-DM/120ML

Facility

$5.00

Hospital Charge Code	60632622
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

CARDEC-DM/120ML

Facility

$5.00

Hospital Charge Code	60632622
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

CARDEC-DM/480ML

Facility

$43.00

Hospital Charge Code	60632623
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

CARDEC-DM/480ML

Facility

$43.00

Hospital Charge Code	60632623
Hospital Revenue Code	250
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$12.90
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$21.50
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$21.50

CARDEC DM DROPS (1ML)

Facility

$4.00

Service Code	NDC 52083005501
Hospital Charge Code	60635796
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

CARDEC DM DROPS (1ML)

Facility

$4.00

Service Code	NDC 52083005501
Hospital Charge Code	60635796
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

CARDEC DM DROPS 30 ML

Facility

$32.00

Hospital Charge Code	60629157
Hospital Revenue Code	250
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

CARDEC DM DROPS 30 ML

Facility

$32.00

Hospital Charge Code	60629157
Hospital Revenue Code	250
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$9.60
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$16.00

CARDEC-DM DROPS/30ML

Facility

$24.00

Hospital Charge Code	60632621
Hospital Revenue Code	250
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$7.20
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.12
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$12.00

CARDEC-DM DROPS/30ML

Facility

$24.00

Hospital Charge Code	60632621
Hospital Revenue Code	250
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

CARDENE 20MG/200ML PREMIX

Facility

$817.27

Service Code	NDC 10122031410
Hospital Charge Code	60635698
Hospital Revenue Code	250
Min. Negotiated Rate	$106.25
Max. Negotiated Rate	$408.63
Rate for Payer: Aetna Commercial	$245.18
Rate for Payer: Aetna Medicare Advantage	$245.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.40
Rate for Payer: Cigna Commercial	$408.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.25
Rate for Payer: Oxford Commercial	$408.63
Rate for Payer: Qualcare PPO/HMO/WC	$122.59
Rate for Payer: UnitedHealthcare Commercial	$408.63

CARDENE 20MG/200ML PREMIX

Facility

$817.27

Service Code	NDC 10122031410
Hospital Charge Code	60635698
Hospital Revenue Code	250
Min. Negotiated Rate	$122.59
Max. Negotiated Rate	$122.59
Rate for Payer: Qualcare PPO/HMO/WC	$122.59

CARDENE/20MG/CAP

Facility

$6.00

Hospital Charge Code	60632625
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

CARDENE/20MG/CAP

Facility

$6.00

Hospital Charge Code	60632625
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

CARDENE/20MG/CAP

Facility

$6.00

Hospital Charge Code	60632624
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

CARDENE/20MG/CAP

Facility

$6.00

Hospital Charge Code	60632624
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

CARDENE/30MG/CAP

Facility

$6.00

Hospital Charge Code	60632627
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

CARDENE/30MG/CAP

Facility

$6.00

Hospital Charge Code	60632626
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

CARDENE/30MG/CAP

Facility

$6.00

Hospital Charge Code	60632627
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

CARDENE/30MG/CAP

Facility

$6.00

Hospital Charge Code	60632626
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

CARDENE IV 25MG

Facility

$147.00

Hospital Charge Code	60635173
Hospital Revenue Code	250
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$22.05
Rate for Payer: Qualcare PPO/HMO/WC	$22.05

Know your out-of-pocket cost for care.

All Charges