Heights University Hospital

All Charges

Charge

Type

Setting

Price

Papaverine 30mg/1ml 2ml vial

Facility

$10.72

Hospital Charge Code	6000429
Hospital Revenue Code	636
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$2.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.59
Rate for Payer: Qualcare PPO/HMO/WC	$1.61

Papaverine 30mg/1ml 2ml vial

Facility

$10.72

Hospital Charge Code	6000429
Hospital Revenue Code	636
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$5.36
Rate for Payer: Aetna Commercial	$3.22
Rate for Payer: Aetna Medicare Advantage	$3.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.73
Rate for Payer: Cigna Commercial	$5.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.59
Rate for Payer: Qualcare PPO/HMO/WC	$1.61

PAPAVERINE 30MG/ML VIAL

Facility

$287.63

Service Code	HCPCS J2440
Hospital Charge Code	60631898
Hospital Revenue Code	636
Min. Negotiated Rate	$43.14
Max. Negotiated Rate	$69.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.61
Rate for Payer: Qualcare PPO/HMO/WC	$43.14

PAPAVERINE 30MG/ML VIAL

Facility

$287.63

Service Code	HCPCS J2440
Hospital Charge Code	60631898
Hospital Revenue Code	636
Min. Negotiated Rate	$43.14
Max. Negotiated Rate	$143.81
Rate for Payer: Aetna Commercial	$86.29
Rate for Payer: Aetna Medicare Advantage	$86.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.35
Rate for Payer: Cigna Commercial	$143.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.61
Rate for Payer: Qualcare PPO/HMO/WC	$43.14

PAPAVERINE 39MG/ML 10ML

Facility

$34.60

Hospital Charge Code	6006464
Hospital Revenue Code	250
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$17.30
Rate for Payer: Aetna Commercial	$10.38
Rate for Payer: Aetna Medicare Advantage	$10.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.82
Rate for Payer: Cigna Commercial	$17.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$17.30
Rate for Payer: Qualcare PPO/HMO/WC	$5.19
Rate for Payer: UnitedHealthcare Commercial	$17.30

PAPAVERINE 39MG/ML 10ML

Facility

$34.60

Hospital Charge Code	6006464
Hospital Revenue Code	250
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$5.19
Rate for Payer: Qualcare PPO/HMO/WC	$5.19

PAPER COPY WHITE8-1/2 X 11

Facility

$15.45

Hospital Charge Code	270650856
Hospital Revenue Code	272
Min. Negotiated Rate	$2.01
Max. Negotiated Rate	$7.72
Rate for Payer: Aetna Commercial	$4.63
Rate for Payer: Aetna Medicare Advantage	$4.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.94
Rate for Payer: Cigna Commercial	$7.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.01
Rate for Payer: Oxford Commercial	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$2.32
Rate for Payer: UnitedHealthcare Commercial	$7.72

PAPER COPY WHITE8-1/2 X 11

Facility

$15.45

Hospital Charge Code	270650856
Hospital Revenue Code	272
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$2.32
Rate for Payer: Qualcare PPO/HMO/WC	$2.32

PAPERED ROUTER 1.7MMx16MM

Facility

$577.55

Hospital Charge Code	270673034
Hospital Revenue Code	272
Min. Negotiated Rate	$86.63
Max. Negotiated Rate	$86.63
Rate for Payer: Qualcare PPO/HMO/WC	$86.63

PAPERED ROUTER 1.7MMx16MM

Facility

$577.55

Hospital Charge Code	270673034
Hospital Revenue Code	272
Min. Negotiated Rate	$75.08
Max. Negotiated Rate	$288.77
Rate for Payer: Aetna Commercial	$173.26
Rate for Payer: Aetna Medicare Advantage	$173.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.28
Rate for Payer: Cigna Commercial	$288.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.08
Rate for Payer: Oxford Commercial	$288.77
Rate for Payer: Qualcare PPO/HMO/WC	$86.63
Rate for Payer: UnitedHealthcare Commercial	$288.77

PAPERED ROUTER 1.7x25MM

Facility

$603.75

Hospital Charge Code	270673204
Hospital Revenue Code	272
Min. Negotiated Rate	$78.49
Max. Negotiated Rate	$301.88
Rate for Payer: Aetna Commercial	$181.12
Rate for Payer: Aetna Medicare Advantage	$181.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.96
Rate for Payer: Cigna Commercial	$301.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.49
Rate for Payer: Oxford Commercial	$301.88
Rate for Payer: Qualcare PPO/HMO/WC	$90.56
Rate for Payer: UnitedHealthcare Commercial	$301.88

PAPERED ROUTER 1.7x25MM

Facility

$603.75

Hospital Charge Code	270673204
Hospital Revenue Code	272
Min. Negotiated Rate	$90.56
Max. Negotiated Rate	$90.56
Rate for Payer: Qualcare PPO/HMO/WC	$90.56

PAPER RECORDER RED

Facility

$10.59

Hospital Charge Code	270649472
Hospital Revenue Code	270
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$1.59
Rate for Payer: Qualcare PPO/HMO/WC	$1.59

PAPER RECORDER RED

Facility

$10.59

Hospital Charge Code	270649472
Hospital Revenue Code	270
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$5.29
Rate for Payer: Aetna Commercial	$3.18
Rate for Payer: Aetna Medicare Advantage	$3.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.70
Rate for Payer: Cigna Commercial	$5.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.38
Rate for Payer: Oxford Commercial	$5.29
Rate for Payer: Qualcare PPO/HMO/WC	$1.59
Rate for Payer: UnitedHealthcare Commercial	$5.29

PAPER STRYKER ENDOSCOPY

Facility

$3.00

Hospital Charge Code	270657633
Hospital Revenue Code	270
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PAPER STRYKER ENDOSCOPY

Facility

$3.00

Hospital Charge Code	270657633
Hospital Revenue Code	270
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

PAPER WASP IGE

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3035141
Hospital Revenue Code	305
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

PAPER WASP IGE

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3035141
Hospital Revenue Code	305
Min. Negotiated Rate	$2.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.91
Rate for Payer: Aetna Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.13
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: Cigna Medicare Advantage	$2.61
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.53
Rate for Payer: Wellcare Medicare Advantage	$5.22

PAP IG, CT-NG, HPV-HR I

Facility

$223.00

Service Code	HCPCS 87491
Hospital Charge Code	3038521A
Hospital Revenue Code	300
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$128.57
Rate for Payer: Aetna Commercial	$113.69
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.57
Rate for Payer: Cigna Commercial	$35.09
Rate for Payer: Cigna Medicare Advantage	$17.55
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.99
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

PAP IG, CT-NG, HPV-HR I

Facility

$223.00

Service Code	HCPCS 87491
Hospital Charge Code	3038521A
Hospital Revenue Code	300
Min. Negotiated Rate	$33.45
Max. Negotiated Rate	$33.45
Rate for Payer: Qualcare PPO/HMO/WC	$33.45

PAP IG, CT-NG, HPV-HR II

Facility

$210.00

Service Code	HCPCS 87591
Hospital Charge Code	3038521B
Hospital Revenue Code	300
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$128.57
Rate for Payer: Aetna Commercial	$113.69
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.57
Rate for Payer: Cigna Commercial	$35.09
Rate for Payer: Cigna Medicare Advantage	$17.55
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

PAP IG, CT-NG, HPV-HR II

Facility

$210.00

Service Code	HCPCS 87591
Hospital Charge Code	3038521B
Hospital Revenue Code	300
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

PAP IG, CT-NG, HPV-HR III

Facility

$248.55

Service Code	HCPCS 87624
Hospital Charge Code	3038521C
Hospital Revenue Code	300
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$128.57
Rate for Payer: Aetna Commercial	$113.69
Rate for Payer: Aetna Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.57
Rate for Payer: Cigna Commercial	$35.09
Rate for Payer: Cigna Medicare Advantage	$17.55
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.31
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.28
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$37.20
Rate for Payer: Wellcare Medicare Advantage	$35.09

PAP IG, CT-NG, HPV-HR III

Facility

$248.55

Service Code	HCPCS 87624
Hospital Charge Code	3038521C
Hospital Revenue Code	300
Min. Negotiated Rate	$37.28
Max. Negotiated Rate	$37.28
Rate for Payer: Qualcare PPO/HMO/WC	$37.28

PAP IG, CT-NG, HPV-HR IV

Facility

$672.00

Service Code	HCPCS 88175
Hospital Charge Code	3038521D
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

Know your out-of-pocket cost for care.

All Charges