Heights University Hospital

All Charges

Charge

Type

Setting

Price

CARDIZEM CD/240MG/UD

Facility

$7.00

Hospital Charge Code	60634637
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

CARDIZEM CD/300MG

Facility

$15.00

Hospital Charge Code	60634715
Hospital Revenue Code	250
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

CARDIZEM CD/300MG

Facility

$15.00

Hospital Charge Code	60634715
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

CARDIZEM CD/300MG/UD

Facility

$15.00

Hospital Charge Code	60634638
Hospital Revenue Code	250
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

CARDIZEM CD/300MG/UD

Facility

$15.00

Hospital Charge Code	60634638
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

CARDIZEM LA 420

Facility

$3.00

Hospital Charge Code	60635487
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

CARDIZEM LA 420

Facility

$3.00

Hospital Charge Code	60635487
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

CARDIZEM SR/120MG/CAP

Facility

$7.00

Hospital Charge Code	60632637
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

CARDIZEM SR/120MG/CAP

Facility

$7.00

Hospital Charge Code	60632637
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.10
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.91
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$3.50

CARDIZEM SR/120MG/CAP

Facility

$8.00

Hospital Charge Code	60632638
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

CARDIZEM SR/120MG/CAP

Facility

$8.00

Hospital Charge Code	60632638
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

CARDIZEM SR/60MG/CAP

Facility

$12.00

Hospital Charge Code	60632639
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

CARDIZEM SR/60MG/CAP

Facility

$21.24

Service Code	NDC 378606001
Hospital Charge Code	60632640
Hospital Revenue Code	250
Min. Negotiated Rate	$3.19
Max. Negotiated Rate	$3.19
Rate for Payer: Qualcare PPO/HMO/WC	$3.19

CARDIZEM SR/60MG/CAP

Facility

$12.00

Hospital Charge Code	60632639
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

CARDIZEM SR/60MG/CAP

Facility

$21.24

Service Code	NDC 378606001
Hospital Charge Code	60632640
Hospital Revenue Code	250
Min. Negotiated Rate	$2.76
Max. Negotiated Rate	$10.62
Rate for Payer: Aetna Commercial	$6.37
Rate for Payer: Aetna Medicare Advantage	$6.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.42
Rate for Payer: Cigna Commercial	$10.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.76
Rate for Payer: Oxford Commercial	$10.62
Rate for Payer: Qualcare PPO/HMO/WC	$3.19
Rate for Payer: UnitedHealthcare Commercial	$10.62

CARDIZEM SR/90MG/CAP

Facility

$8.00

Hospital Charge Code	60632636
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$4.00

CARDIZEM SR/90MG/CAP

Facility

$8.00

Hospital Charge Code	60632636
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

CARD TOMOGRAPHIC MULT STUDIES

Facility

$6,315.40

Service Code	HCPCS 78452
Hospital Charge Code	36540005
Hospital Revenue Code	341
Min. Negotiated Rate	$947.31
Max. Negotiated Rate	$947.31
Rate for Payer: Qualcare PPO/HMO/WC	$947.31

CARD TOMOGRAPHIC MULT STUDIES

Facility

$6,315.40

Service Code	HCPCS 78452
Hospital Charge Code	36540005
Hospital Revenue Code	341
Min. Negotiated Rate	$314.16
Max. Negotiated Rate	$3,540.00
Rate for Payer: Aetna Commercial	$1,894.62
Rate for Payer: Aetna Medicare Advantage	$1,894.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,610.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,610.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,610.43
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$821.00
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$947.31
Rate for Payer: UnitedHealthcare Commercial	$3,540.00

CARDURA TAB 8 MG

Facility

$4.00

Hospital Charge Code	60635341
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

CARDURA TAB 8 MG

Facility

$4.00

Hospital Charge Code	60635341
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

CARD US STRESS ECHO/CONTRAST

Facility

$5,900.00

Hospital Charge Code	74117073
Hospital Revenue Code	483
Min. Negotiated Rate	$885.00
Max. Negotiated Rate	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00

CARD US STRESS ECHO/CONTRAST

Facility

$5,900.00

Hospital Charge Code	74117073
Hospital Revenue Code	483
Min. Negotiated Rate	$767.00
Max. Negotiated Rate	$2,950.00
Rate for Payer: Aetna Commercial	$1,770.00
Rate for Payer: Aetna Medicare Advantage	$1,770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,504.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,504.50
Rate for Payer: Cigna Commercial	$2,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$767.00
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

CARD US STRESS ECHO/CONTRAST

Facility

$3,311.10

Hospital Charge Code	74115073
Hospital Revenue Code	483
Min. Negotiated Rate	$430.44
Max. Negotiated Rate	$1,719.00
Rate for Payer: Aetna Commercial	$993.33
Rate for Payer: Aetna Medicare Advantage	$993.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$844.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$844.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$844.33
Rate for Payer: Cigna Commercial	$1,655.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$430.44
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$496.67
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

CARD US STRESS ECHO/CONTRAST

Facility

$3,311.10

Hospital Charge Code	74116073
Hospital Revenue Code	483
Min. Negotiated Rate	$430.44
Max. Negotiated Rate	$1,719.00
Rate for Payer: Aetna Commercial	$993.33
Rate for Payer: Aetna Medicare Advantage	$993.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$844.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$844.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$844.33
Rate for Payer: Cigna Commercial	$1,655.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$430.44
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$496.67
Rate for Payer: UnitedHealthcare Commercial	$1,719.00

Know your out-of-pocket cost for care.

All Charges