Heights University Hospital

All Charges

Charge

Type

Setting

Price

PANITUMUMAB 20MG/ML (20ML) INJ

Facility

$18,715.00

Hospital Charge Code	60635702
Hospital Revenue Code	636
Min. Negotiated Rate	$2,807.25
Max. Negotiated Rate	$4,529.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,529.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,807.25

PANITUMUMAB 20MG/ML (20ML) INJ

Facility

$18,715.00

Hospital Charge Code	60635702
Hospital Revenue Code	636
Min. Negotiated Rate	$2,807.25
Max. Negotiated Rate	$9,357.50
Rate for Payer: Aetna Commercial	$5,614.50
Rate for Payer: Aetna Medicare Advantage	$5,614.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,772.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,772.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,772.32
Rate for Payer: Cigna Commercial	$9,357.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,529.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,807.25

PANITUMUMAB 20 MG/ML (5ML) INJ

Facility

$4,679.00

Hospital Charge Code	60635701
Hospital Revenue Code	636
Min. Negotiated Rate	$701.85
Max. Negotiated Rate	$1,132.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,132.32
Rate for Payer: Qualcare PPO/HMO/WC	$701.85

PANITUMUMAB 20 MG/ML (5ML) INJ

Facility

$4,679.00

Hospital Charge Code	60635701
Hospital Revenue Code	636
Min. Negotiated Rate	$701.85
Max. Negotiated Rate	$2,339.50
Rate for Payer: Aetna Commercial	$1,403.70
Rate for Payer: Aetna Medicare Advantage	$1,403.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,193.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,193.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,193.14
Rate for Payer: Cigna Commercial	$2,339.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,132.32
Rate for Payer: Qualcare PPO/HMO/WC	$701.85

PAN OPTIC LAMP

Facility

$96.80

Hospital Charge Code	270654005
Hospital Revenue Code	270
Min. Negotiated Rate	$14.52
Max. Negotiated Rate	$14.52
Rate for Payer: Qualcare PPO/HMO/WC	$14.52

PAN OPTIC LAMP

Facility

$96.80

Hospital Charge Code	270654005
Hospital Revenue Code	270
Min. Negotiated Rate	$12.58
Max. Negotiated Rate	$48.40
Rate for Payer: Aetna Commercial	$29.04
Rate for Payer: Aetna Medicare Advantage	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.68
Rate for Payer: Cigna Commercial	$48.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.58
Rate for Payer: Oxford Commercial	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$14.52
Rate for Payer: UnitedHealthcare Commercial	$48.40

PANSIGMOIDOSCOPY***

Facility

$190.00

Service Code	HCPCS 45330
Hospital Charge Code	2300309
Hospital Revenue Code	759
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$2,214.60
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$57.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.45
Rate for Payer: Cigna Commercial	$2,214.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.70
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

PANSIGMOIDOSCOPY***

Facility

$190.00

Service Code	HCPCS 45330
Hospital Charge Code	2300309
Hospital Revenue Code	759
Min. Negotiated Rate	$28.50
Max. Negotiated Rate	$28.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.50

PANSIGMOIDOSCOPY W/BICP CAUT**

Facility

$253.00

Service Code	HCPCS 99999
Hospital Charge Code	2300465
Hospital Revenue Code	759
Min. Negotiated Rate	$37.95
Max. Negotiated Rate	$37.95
Rate for Payer: Qualcare PPO/HMO/WC	$37.95

PANSIGMOIDOSCOPY W/BICP CAUT**

Facility

$253.00

Service Code	HCPCS 99999
Hospital Charge Code	2300465
Hospital Revenue Code	759
Min. Negotiated Rate	$32.89
Max. Negotiated Rate	$126.50
Rate for Payer: Aetna Commercial	$75.90
Rate for Payer: Aetna Medicare Advantage	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.52
Rate for Payer: Cigna Commercial	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.89
Rate for Payer: Qualcare PPO/HMO/WC	$37.95

PANSIGMOIDOSCOPY W/IRC***

Facility

$377.00

Service Code	HCPCS 99999
Hospital Charge Code	2300317
Hospital Revenue Code	759
Min. Negotiated Rate	$56.55
Max. Negotiated Rate	$56.55
Rate for Payer: Qualcare PPO/HMO/WC	$56.55

PANSIGMOIDOSCOPY W/IRC***

Facility

$377.00

Service Code	HCPCS 99999
Hospital Charge Code	2300317
Hospital Revenue Code	759
Min. Negotiated Rate	$49.01
Max. Negotiated Rate	$188.50
Rate for Payer: Aetna Commercial	$113.10
Rate for Payer: Aetna Medicare Advantage	$113.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.14
Rate for Payer: Cigna Commercial	$188.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.01
Rate for Payer: Qualcare PPO/HMO/WC	$56.55

PANSIGMOIDOSCOPY W/POLYPECT***

Facility

$552.00

Service Code	HCPCS 45333
Hospital Charge Code	2300325
Hospital Revenue Code	759
Min. Negotiated Rate	$82.80
Max. Negotiated Rate	$82.80
Rate for Payer: Qualcare PPO/HMO/WC	$82.80

PANSIGMOIDOSCOPY W/POLYPECT***

Facility

$552.00

Service Code	HCPCS 45333
Hospital Charge Code	2300325
Hospital Revenue Code	759
Min. Negotiated Rate	$71.76
Max. Negotiated Rate	$2,214.60
Rate for Payer: Aetna Commercial	$165.60
Rate for Payer: Aetna Medicare Advantage	$165.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.76
Rate for Payer: Cigna Commercial	$2,214.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.76
Rate for Payer: Qualcare PPO/HMO/WC	$82.80

PANSIGMOIDOSCOPY W/REMOVAL FB

Facility

$460.00

Service Code	HCPCS 45332
Hospital Charge Code	2300333
Hospital Revenue Code	759
Min. Negotiated Rate	$59.80
Max. Negotiated Rate	$2,849.67
Rate for Payer: Aetna Commercial	$138.00
Rate for Payer: Aetna Medicare Advantage	$138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.30
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.80
Rate for Payer: Qualcare PPO/HMO/WC	$69.00

PANSIGMOIDOSCOPY W/REMOVAL FB

Facility

$460.00

Service Code	HCPCS 45332
Hospital Charge Code	2300333
Hospital Revenue Code	759
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$69.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.00

PANTALAR ARTHRODESIS

Facility

$57,834.50

Service Code	HCPCS 28705
Hospital Charge Code	1600000886
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$41,754.94
Rate for Payer: Aetna Commercial	$17,350.35
Rate for Payer: Aetna Medicare Advantage	$17,350.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,747.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,747.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,747.80
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,518.48
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,675.17
Rate for Payer: UnitedHealthcare Commercial	$9,851.00

PANTALAR ARTHRODESIS

Facility

$57,834.50

Service Code	HCPCS 28705
Hospital Charge Code	1600000886
Hospital Revenue Code	360
Min. Negotiated Rate	$8,675.17
Max. Negotiated Rate	$8,675.17
Rate for Payer: Qualcare PPO/HMO/WC	$8,675.17

PANTOPRAZOLE 20 MG ECT

Facility

$4.00

Service Code	NDC 8060601
Hospital Charge Code	60630100
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PANTOPRAZOLE 20 MG ECT

Facility

$4.00

Service Code	NDC 8060601
Hospital Charge Code	60630100
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

PANTOPRAZOLE 40MG/100ML NACL

Facility

$192.96

Service Code	HCPCS J2470
Hospital Charge Code	60629227
Hospital Revenue Code	636
Min. Negotiated Rate	$28.94
Max. Negotiated Rate	$46.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.70
Rate for Payer: Qualcare PPO/HMO/WC	$28.94

PANTOPRAZOLE 40MG/100ML NACL

Facility

$192.96

Service Code	HCPCS J2470
Hospital Charge Code	60629227
Hospital Revenue Code	636
Min. Negotiated Rate	$28.94
Max. Negotiated Rate	$96.48
Rate for Payer: Aetna Commercial	$57.89
Rate for Payer: Aetna Medicare Advantage	$57.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.20
Rate for Payer: Cigna Commercial	$96.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.70
Rate for Payer: Qualcare PPO/HMO/WC	$28.94

PANTOPRAZOLE INJ 400MG/1000DSW

Facility

$101.15

Hospital Charge Code	60629209
Hospital Revenue Code	250
Min. Negotiated Rate	$15.17
Max. Negotiated Rate	$15.17
Rate for Payer: Qualcare PPO/HMO/WC	$15.17

PANTOPRAZOLE INJ 400MG/1000DSW

Facility

$101.15

Hospital Charge Code	60629209
Hospital Revenue Code	250
Min. Negotiated Rate	$13.15
Max. Negotiated Rate	$50.58
Rate for Payer: Aetna Commercial	$30.34
Rate for Payer: Aetna Medicare Advantage	$30.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.79
Rate for Payer: Cigna Commercial	$50.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.15
Rate for Payer: Oxford Commercial	$50.58
Rate for Payer: Qualcare PPO/HMO/WC	$15.17
Rate for Payer: UnitedHealthcare Commercial	$50.58

PANTOPTAZOLE 40MG TABLET EC

Facility

$67.13

Service Code	NDC 8060701
Hospital Charge Code	60629236
Hospital Revenue Code	250
Min. Negotiated Rate	$10.07
Max. Negotiated Rate	$10.07
Rate for Payer: Qualcare PPO/HMO/WC	$10.07

Know your out-of-pocket cost for care.

All Charges