Heights University Hospital

All Charges

Charge

Type

Setting

Price

PAMIDRONATE 90 MG/10 ML INJ

Facility

$288.23

Service Code	HCPCS J2430
Hospital Charge Code	60628543
Hospital Revenue Code	636
Min. Negotiated Rate	$12.42
Max. Negotiated Rate	$86.47
Rate for Payer: Aetna Commercial	$86.47
Rate for Payer: Aetna Medicare Advantage	$86.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.50
Rate for Payer: Cigna Commercial	$12.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.75
Rate for Payer: Qualcare PPO/HMO/WC	$43.23

PAMIDRONATE DISODIUM VL 30MG

Facility

$1,763.85

Hospital Charge Code	6007637
Hospital Revenue Code	636
Min. Negotiated Rate	$264.58
Max. Negotiated Rate	$881.92
Rate for Payer: Aetna Commercial	$529.15
Rate for Payer: Aetna Medicare Advantage	$529.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$449.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$449.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$449.78
Rate for Payer: Cigna Commercial	$881.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$426.85
Rate for Payer: Qualcare PPO/HMO/WC	$264.58

PAMIDRONATE DISODIUM VL 30MG

Facility

$1,763.85

Hospital Charge Code	6007637
Hospital Revenue Code	636
Min. Negotiated Rate	$264.58
Max. Negotiated Rate	$426.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$426.85
Rate for Payer: Qualcare PPO/HMO/WC	$264.58

PAMIDRONATE INJ 30MG

Facility

$1,175.70

Hospital Charge Code	60628674
Hospital Revenue Code	636
Min. Negotiated Rate	$176.35
Max. Negotiated Rate	$587.85
Rate for Payer: Aetna Commercial	$352.71
Rate for Payer: Aetna Medicare Advantage	$352.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.80
Rate for Payer: Cigna Commercial	$587.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.52
Rate for Payer: Qualcare PPO/HMO/WC	$176.35

PAMIDRONATE INJ 30MG

Facility

$1,175.70

Hospital Charge Code	60628674
Hospital Revenue Code	636
Min. Negotiated Rate	$176.35
Max. Negotiated Rate	$284.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.52
Rate for Payer: Qualcare PPO/HMO/WC	$176.35

PAMIDRONATE IV 90MG/IL NS

Facility

$3,525.15

Hospital Charge Code	60628676
Hospital Revenue Code	636
Min. Negotiated Rate	$528.77
Max. Negotiated Rate	$1,762.58
Rate for Payer: Aetna Commercial	$1,057.55
Rate for Payer: Aetna Medicare Advantage	$1,057.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$898.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$898.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$898.91
Rate for Payer: Cigna Commercial	$1,762.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$853.09
Rate for Payer: Qualcare PPO/HMO/WC	$528.77

PAMIDRONATE IV 90MG/IL NS

Facility

$3,525.15

Hospital Charge Code	60628676
Hospital Revenue Code	636
Min. Negotiated Rate	$528.77
Max. Negotiated Rate	$853.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$853.09
Rate for Payer: Qualcare PPO/HMO/WC	$528.77

PAMPERS DIAPERS 16-28LBS SZ 3

Facility

$4.00

Hospital Charge Code	270624537
Hospital Revenue Code	270
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PAMPERS DIAPERS 16-28LBS SZ 3

Facility

$4.00

Hospital Charge Code	270624537
Hospital Revenue Code	270
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

PAMPERS DIAPERS 21-37LBS SZ 4

Facility

$4.00

Hospital Charge Code	270601000
Hospital Revenue Code	270
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

PAMPERS DIAPERS 21-37LBS SZ 4

Facility

$4.00

Hospital Charge Code	270601000
Hospital Revenue Code	270
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PAMPERS DIAPERS 8-14LBS SZ 1

Facility

$4.00

Hospital Charge Code	270623178
Hospital Revenue Code	270
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PAMPERS DIAPERS 8-14LBS SZ 1

Facility

$4.00

Hospital Charge Code	270623178
Hospital Revenue Code	270
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

PANAFIL 1OZ

Facility

$389.00

Hospital Charge Code	60635547
Hospital Revenue Code	250
Min. Negotiated Rate	$58.35
Max. Negotiated Rate	$58.35
Rate for Payer: Qualcare PPO/HMO/WC	$58.35

PANAFIL 1OZ

Facility

$389.00

Hospital Charge Code	60635547
Hospital Revenue Code	250
Min. Negotiated Rate	$50.57
Max. Negotiated Rate	$194.50
Rate for Payer: Aetna Commercial	$116.70
Rate for Payer: Aetna Medicare Advantage	$116.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.19
Rate for Payer: Cigna Commercial	$194.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.57
Rate for Payer: Oxford Commercial	$194.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.35
Rate for Payer: UnitedHealthcare Commercial	$194.50

PANA SPRAY AIR MOTOR LUBRICANT

Facility

$265.00

Hospital Charge Code	270664999
Hospital Revenue Code	270
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$39.75
Rate for Payer: Qualcare PPO/HMO/WC	$39.75

PANA SPRAY AIR MOTOR LUBRICANT

Facility

$265.00

Hospital Charge Code	270664999
Hospital Revenue Code	270
Min. Negotiated Rate	$34.45
Max. Negotiated Rate	$132.50
Rate for Payer: Aetna Commercial	$79.50
Rate for Payer: Aetna Medicare Advantage	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.58
Rate for Payer: Cigna Commercial	$132.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.45
Rate for Payer: Oxford Commercial	$132.50
Rate for Payer: Qualcare PPO/HMO/WC	$39.75
Rate for Payer: UnitedHealthcare Commercial	$132.50

PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC

Facility

$97,794.39

Service Code	MSDRG 406
Min. Negotiated Rate	$30,400.85
Max. Negotiated Rate	$97,794.39
Rate for Payer: Aetna Commercial	$97,794.39
Rate for Payer: Aetna Medicare Advantage	$31,648.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79,668.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79,668.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$32,000.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79,668.63
Rate for Payer: Cigna Commercial	$62,415.20
Rate for Payer: Cigna Medicare Advantage	$32,000.89
Rate for Payer: Clover Medicare Advantage	$30,400.85
Rate for Payer: EmblemHealth Commercial	$96,002.67
Rate for Payer: Humana Medicare Advantage	$32,960.92
Rate for Payer: Oxford Commercial	$39,007.69
Rate for Payer: UnitedHealthcare Commercial	$44,277.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$32,000.89
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$33,920.94
Rate for Payer: Wellcare Medicare Advantage	$32,000.89

PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC

Facility

$184,464.60

Service Code	MSDRG 405
Min. Negotiated Rate	$54,025.72
Max. Negotiated Rate	$184,464.60
Rate for Payer: Aetna Commercial	$184,464.60
Rate for Payer: Aetna Medicare Advantage	$59,697.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151,894.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151,894.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$56,869.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151,894.17
Rate for Payer: Cigna Commercial	$117,730.63
Rate for Payer: Cigna Medicare Advantage	$56,869.18
Rate for Payer: Clover Medicare Advantage	$54,025.72
Rate for Payer: EmblemHealth Commercial	$170,607.54
Rate for Payer: Humana Medicare Advantage	$58,575.26
Rate for Payer: Oxford Commercial	$73,578.23
Rate for Payer: UnitedHealthcare Commercial	$83,518.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$56,869.18
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$60,281.33
Rate for Payer: Wellcare Medicare Advantage	$56,869.18

PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC

Facility

$76,247.76

Service Code	MSDRG 407
Min. Negotiated Rate	$24,145.12
Max. Negotiated Rate	$76,247.76
Rate for Payer: Aetna Commercial	$74,844.65
Rate for Payer: Aetna Medicare Advantage	$24,221.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59,269.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59,269.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25,415.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59,269.05
Rate for Payer: Cigna Commercial	$47,768.01
Rate for Payer: Cigna Medicare Advantage	$25,415.92
Rate for Payer: Clover Medicare Advantage	$24,145.12
Rate for Payer: EmblemHealth Commercial	$76,247.76
Rate for Payer: Humana Medicare Advantage	$26,178.40
Rate for Payer: Oxford Commercial	$29,853.62
Rate for Payer: UnitedHealthcare Commercial	$33,886.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$25,415.92
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$26,940.88
Rate for Payer: Wellcare Medicare Advantage	$25,415.92

PANCREAS TRANSPLANT

Facility

$105,660.04

Service Code	APR-DRG 0062
Min. Negotiated Rate	$79,705.89
Max. Negotiated Rate	$105,660.04
Rate for Payer: Aetna Better Health Medicaid	$103,588.27
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$105,660.04
Rate for Payer: Wellpoint Medicaid Managed Care	$79,705.89

PANCREAS TRANSPLANT

Facility

$87,772.45

Service Code	APR-DRG 0061
Min. Negotiated Rate	$56,688.87
Max. Negotiated Rate	$87,772.45
Rate for Payer: Aetna Better Health Medicaid	$86,051.42
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$87,772.45
Rate for Payer: Wellpoint Medicaid Managed Care	$56,688.87

PANCREAS TRANSPLANT

Facility

$241,963.75

Service Code	MSDRG 010
Min. Negotiated Rate	$69,699.04
Max. Negotiated Rate	$241,963.75
Rate for Payer: Aetna Commercial	$241,963.75
Rate for Payer: Aetna Medicare Advantage	$78,305.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132,597.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132,597.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$73,367.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132,597.27
Rate for Payer: Cigna Medicare Advantage	$73,367.41
Rate for Payer: Clover Medicare Advantage	$69,699.04
Rate for Payer: EmblemHealth Commercial	$220,102.23
Rate for Payer: Humana Medicare Advantage	$75,568.43
Rate for Payer: UnitedHealthcare Medicare Advantage	$73,367.41
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$77,769.45
Rate for Payer: Wellcare Medicare Advantage	$73,367.41

PANCREAS TRANSPLANT

Facility

$162,475.67

Service Code	APR-DRG 0064
Min. Negotiated Rate	$141,015.31
Max. Negotiated Rate	$162,475.67
Rate for Payer: Aetna Better Health Medicaid	$159,289.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$162,475.67
Rate for Payer: Wellpoint Medicaid Managed Care	$141,015.31

PANCREAS TRANSPLANT

Facility

$128,630.10

Service Code	APR-DRG 0063
Min. Negotiated Rate	$89,119.72
Max. Negotiated Rate	$128,630.10
Rate for Payer: Aetna Better Health Medicaid	$126,107.94
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$128,630.10
Rate for Payer: Wellpoint Medicaid Managed Care	$89,119.72

Know your out-of-pocket cost for care.

All Charges