Heights University Hospital

All Charges

Charge

Type

Setting

Price

PANCREAT EXOCRINE CELL AB

Facility

$60.25

Service Code	HCPCS 86255
Hospital Charge Code	38476000
Hospital Revenue Code	302
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$9.04
Rate for Payer: Qualcare PPO/HMO/WC	$9.04

PANCREAT EXOCRINE CELL AB

Facility

$60.25

Service Code	HCPCS 86255
Hospital Charge Code	38476000
Hospital Revenue Code	302
Min. Negotiated Rate	$6.03
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.04
Rate for Payer: Aetna Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.15
Rate for Payer: Cigna Commercial	$12.05
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.04
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.77
Rate for Payer: Wellcare Medicare Advantage	$12.05

PANCREATIC ELASTASE, FECAL

Facility

$75.65

Service Code	HCPCS 82656
Hospital Charge Code	3038144
Hospital Revenue Code	301
Min. Negotiated Rate	$11.35
Max. Negotiated Rate	$11.35
Rate for Payer: Qualcare PPO/HMO/WC	$11.35

PANCREATIC ELASTASE, FECAL

Facility

$75.65

Service Code	HCPCS 82656
Hospital Charge Code	3038144
Hospital Revenue Code	301
Min. Negotiated Rate	$5.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.36
Rate for Payer: Aetna Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.25
Rate for Payer: Cigna Commercial	$11.53
Rate for Payer: Cigna Medicare Advantage	$5.76
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.83
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.22
Rate for Payer: Wellcare Medicare Advantage	$11.53

PANCREATIC POLYPEPTIDE

Facility

$390.00

Service Code	HCPCS 83519
Hospital Charge Code	39900446
Hospital Revenue Code	301
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$59.62
Rate for Payer: Aetna Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.42
Rate for Payer: Cigna Commercial	$18.40
Rate for Payer: Cigna Medicare Advantage	$9.20
Rate for Payer: Clover Medicare Advantage	$17.48
Rate for Payer: EmblemHealth Commercial	$55.20
Rate for Payer: Humana Medicare Advantage	$18.95
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	$18.40
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.50
Rate for Payer: Wellcare Medicare Advantage	$18.40

PANCREATIC POLYPEPTIDE

Facility

$390.00

Service Code	HCPCS 83519
Hospital Charge Code	39900446
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PANCREATOGRAM-ENDO RETRO

Facility

$840.00

Hospital Charge Code	2009375
Hospital Revenue Code	320
Min. Negotiated Rate	$109.20
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$252.00
Rate for Payer: Aetna Medicare Advantage	$252.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.20
Rate for Payer: Cigna Commercial	$420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.20
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

PANCREATOGRAM-ENDO RETRO

Facility

$840.00

Hospital Charge Code	2009375
Hospital Revenue Code	320
Min. Negotiated Rate	$126.00
Max. Negotiated Rate	$126.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.00

PANCREAZE 21000U

Facility

$48.24

Service Code	NDC 62541040510
Hospital Charge Code	606390159
Hospital Revenue Code	250
Min. Negotiated Rate	$7.24
Max. Negotiated Rate	$7.24
Rate for Payer: Qualcare PPO/HMO/WC	$7.24

PANCREAZE 21000U

Facility

$48.24

Service Code	NDC 62541040510
Hospital Charge Code	606390159
Hospital Revenue Code	250
Min. Negotiated Rate	$6.27
Max. Negotiated Rate	$24.12
Rate for Payer: Aetna Commercial	$14.47
Rate for Payer: Aetna Medicare Advantage	$14.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.30
Rate for Payer: Cigna Commercial	$24.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.27
Rate for Payer: Oxford Commercial	$24.12
Rate for Payer: Qualcare PPO/HMO/WC	$7.24
Rate for Payer: UnitedHealthcare Commercial	$24.12

PANCRELIPASE 4200 U

Facility

$8.11

Hospital Charge Code	606390040
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$4.05
Rate for Payer: Aetna Commercial	$2.43
Rate for Payer: Aetna Medicare Advantage	$2.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.07
Rate for Payer: Cigna Commercial	$4.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.05
Rate for Payer: Oxford Commercial	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.22
Rate for Payer: UnitedHealthcare Commercial	$4.05

PANCRELIPASE 4200 U

Facility

$8.11

Hospital Charge Code	606390040
Hospital Revenue Code	250
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$1.22
Rate for Payer: Qualcare PPO/HMO/WC	$1.22

PANCRELIPASE CAP EC

Facility

$3.20

Hospital Charge Code	6027205
Hospital Revenue Code	251
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$1.60
Rate for Payer: Aetna Commercial	$0.96
Rate for Payer: Aetna Medicare Advantage	$0.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.82
Rate for Payer: Cigna Commercial	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.42
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.48
Rate for Payer: UnitedHealthcare Commercial	$1.60

PANCRELIPASE CAP EC

Facility

$3.20

Hospital Charge Code	6027205
Hospital Revenue Code	251
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

PANCRELIPASE POWD 120GM

Facility

$519.70

Hospital Charge Code	6010375
Hospital Revenue Code	251
Min. Negotiated Rate	$67.56
Max. Negotiated Rate	$259.85
Rate for Payer: Aetna Commercial	$155.91
Rate for Payer: Aetna Medicare Advantage	$155.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.52
Rate for Payer: Cigna Commercial	$259.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.56
Rate for Payer: Oxford Commercial	$259.85
Rate for Payer: Qualcare PPO/HMO/WC	$77.95
Rate for Payer: UnitedHealthcare Commercial	$259.85

PANCRELIPASE POWD 120GM

Facility

$519.70

Hospital Charge Code	6010375
Hospital Revenue Code	251
Min. Negotiated Rate	$77.95
Max. Negotiated Rate	$77.95
Rate for Payer: Qualcare PPO/HMO/WC	$77.95

PANCRNIUM BROM INJ 1MG/ML 10ML

Facility

$21.15

Hospital Charge Code	6004063
Hospital Revenue Code	250
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$3.17
Rate for Payer: Qualcare PPO/HMO/WC	$3.17

PANCRNIUM BROM INJ 1MG/ML 10ML

Facility

$21.15

Hospital Charge Code	6004063
Hospital Revenue Code	250
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$10.57
Rate for Payer: Aetna Commercial	$6.34
Rate for Payer: Aetna Medicare Advantage	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.39
Rate for Payer: Cigna Commercial	$10.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.75
Rate for Payer: Oxford Commercial	$10.57
Rate for Payer: Qualcare PPO/HMO/WC	$3.17
Rate for Payer: UnitedHealthcare Commercial	$10.57

PANCURON BRONO AMP 20MG 1ML

Facility

$195.85

Hospital Charge Code	6006787
Hospital Revenue Code	250
Min. Negotiated Rate	$29.38
Max. Negotiated Rate	$29.38
Rate for Payer: Qualcare PPO/HMO/WC	$29.38

PANCURON BRONO AMP 20MG 1ML

Facility

$195.85

Hospital Charge Code	6006787
Hospital Revenue Code	250
Min. Negotiated Rate	$25.46
Max. Negotiated Rate	$97.92
Rate for Payer: Aetna Commercial	$58.76
Rate for Payer: Aetna Medicare Advantage	$58.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.94
Rate for Payer: Cigna Commercial	$97.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.46
Rate for Payer: Oxford Commercial	$97.92
Rate for Payer: Qualcare PPO/HMO/WC	$29.38
Rate for Payer: UnitedHealthcare Commercial	$97.92

PANCURONIUM BROMIDE/1MG/1

Facility

$9.38

Service Code	NDC 409464601
Hospital Charge Code	60633607
Hospital Revenue Code	250
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$1.41
Rate for Payer: Qualcare PPO/HMO/WC	$1.41

PANCURONIUM BROMIDE/1MG/1

Facility

$9.38

Service Code	NDC 409464601
Hospital Charge Code	60633607
Hospital Revenue Code	250
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$4.69
Rate for Payer: Aetna Commercial	$2.81
Rate for Payer: Aetna Medicare Advantage	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.39
Rate for Payer: Cigna Commercial	$4.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.22
Rate for Payer: Oxford Commercial	$4.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.41
Rate for Payer: UnitedHealthcare Commercial	$4.69

PANCURONIUM BROMIDE VL 2ML

Facility

$9.00

Hospital Charge Code	6023360
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

PANCURONIUM BROMIDE VL 2ML

Facility

$9.00

Hospital Charge Code	6023360
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

PANEL 1

Facility

$667.59

Service Code	HCPCS 86146
Hospital Charge Code	39708028A
Hospital Revenue Code	302
Min. Negotiated Rate	$12.72
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$82.46
Rate for Payer: Aetna Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.25
Rate for Payer: Cigna Commercial	$25.45
Rate for Payer: Cigna Medicare Advantage	$12.72
Rate for Payer: Clover Medicare Advantage	$24.18
Rate for Payer: EmblemHealth Commercial	$76.35
Rate for Payer: Humana Medicare Advantage	$26.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$25.45
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$26.98
Rate for Payer: Wellcare Medicare Advantage	$25.45

Know your out-of-pocket cost for care.

All Charges