Heights University Hospital

All Charges

Charge

Type

Setting

Price

PALIVIZUMAB 50 MG/0.5 ML ML

Facility

$10,511.16

Service Code	NDC 60574411401
Hospital Charge Code	6063943225
Hospital Revenue Code	250
Min. Negotiated Rate	$1,576.67
Max. Negotiated Rate	$1,576.67
Rate for Payer: Qualcare PPO/HMO/WC	$1,576.67

PALIVIZUMAB 50 MG/0.5 ML ML

Facility

$10,511.16

Service Code	NDC 60574411401
Hospital Charge Code	6063943225
Hospital Revenue Code	250
Min. Negotiated Rate	$1,366.45
Max. Negotiated Rate	$5,255.58
Rate for Payer: Aetna Commercial	$3,153.35
Rate for Payer: Aetna Medicare Advantage	$3,153.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,680.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,680.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,680.35
Rate for Payer: Cigna Commercial	$5,255.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,366.45
Rate for Payer: Oxford Commercial	$5,255.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,576.67
Rate for Payer: UnitedHealthcare Commercial	$5,255.58

PALOCOS CEMENT W/ GENTOPRYC

Facility

$2,000.00

Hospital Charge Code	270656062
Hospital Revenue Code	272
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

PALOCOS CEMENT W/ GENTOPRYC

Facility

$2,000.00

Hospital Charge Code	270656062
Hospital Revenue Code	272
Min. Negotiated Rate	$260.00
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.00
Rate for Payer: Oxford Commercial	$1,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Commercial	$1,000.00

PALOCOS CEMENT W/ GENTOPRYCIN

Facility

$2,000.05

Hospital Charge Code	27065602
Hospital Revenue Code	278
Min. Negotiated Rate	$300.01
Max. Negotiated Rate	$1,000.02
Rate for Payer: Aetna Commercial	$600.01
Rate for Payer: Aetna Medicare Advantage	$600.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.01
Rate for Payer: Cigna Commercial	$1,000.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.01
Rate for Payer: Qualcare PPO/HMO/WC	$300.01

PALOCOS CEMENT W/ GENTOPRYCIN

Facility

$2,000.05

Hospital Charge Code	27065602
Hospital Revenue Code	278
Min. Negotiated Rate	$300.01
Max. Negotiated Rate	$484.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.01
Rate for Payer: Qualcare PPO/HMO/WC	$300.01

PAMELOR 10MG/5ML

Facility

$2.00

Hospital Charge Code	60635685
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.60
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$1.00

PAMELOR 10MG/5ML

Facility

$2.00

Hospital Charge Code	60635685
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

PAMELOR/10MG/5ML

Facility

$238.00

Hospital Charge Code	60633600
Hospital Revenue Code	250
Min. Negotiated Rate	$30.94
Max. Negotiated Rate	$119.00
Rate for Payer: Aetna Commercial	$71.40
Rate for Payer: Aetna Medicare Advantage	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.69
Rate for Payer: Cigna Commercial	$119.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.94
Rate for Payer: Oxford Commercial	$119.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.70
Rate for Payer: UnitedHealthcare Commercial	$119.00

PAMELOR/10MG/5ML

Facility

$238.00

Hospital Charge Code	60633600
Hospital Revenue Code	250
Min. Negotiated Rate	$35.70
Max. Negotiated Rate	$35.70
Rate for Payer: Qualcare PPO/HMO/WC	$35.70

PAMELOR/10MG/CAP

Facility

$3.00

Hospital Charge Code	60633603
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

PAMELOR/10MG/CAP

Facility

$3.00

Hospital Charge Code	60633604
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PAMELOR/10MG/CAP

Facility

$3.00

Hospital Charge Code	60633604
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

PAMELOR/10MG/CAP

Facility

$3.00

Hospital Charge Code	60633603
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PAMELOR/25MG/CAP

Facility

$5.00

Hospital Charge Code	60633605
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

PAMELOR/25MG/CAP

Facility

$5.00

Hospital Charge Code	60633605
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

PAMELOR/50MG/CAP

Facility

$12.00

Hospital Charge Code	60633601
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

PAMELOR/50MG/CAP

Facility

$12.00

Hospital Charge Code	60633602
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

PAMELOR/50MG/CAP

Facility

$12.00

Hospital Charge Code	60633601
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

PAMELOR/50MG/CAP

Facility

$12.00

Hospital Charge Code	60633602
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

PAMELOR/75MG/CAP

Facility

$9.00

Hospital Charge Code	60633606
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

PAMELOR/75MG/CAP

Facility

$9.00

Hospital Charge Code	60633606
Hospital Revenue Code	250
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

PAMIDRONATE 30 MG/10 ML INJ

Facility

$217.08

Service Code	HCPCS J2430
Hospital Charge Code	60628541
Hospital Revenue Code	636
Min. Negotiated Rate	$32.56
Max. Negotiated Rate	$52.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.53
Rate for Payer: Qualcare PPO/HMO/WC	$32.56

PAMIDRONATE 30 MG/10 ML INJ

Facility

$217.08

Service Code	HCPCS J2430
Hospital Charge Code	60628541
Hospital Revenue Code	636
Min. Negotiated Rate	$12.42
Max. Negotiated Rate	$65.12
Rate for Payer: Aetna Commercial	$65.12
Rate for Payer: Aetna Medicare Advantage	$65.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.36
Rate for Payer: Cigna Commercial	$12.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.53
Rate for Payer: Qualcare PPO/HMO/WC	$32.56

PAMIDRONATE 90 MG/10 ML INJ

Facility

$288.23

Service Code	HCPCS J2430
Hospital Charge Code	60628543
Hospital Revenue Code	636
Min. Negotiated Rate	$43.23
Max. Negotiated Rate	$69.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.75
Rate for Payer: Qualcare PPO/HMO/WC	$43.23

Know your out-of-pocket cost for care.

All Charges