Heights University Hospital

All Charges

Charge

Type

Setting

Price

PERM PACEMAKER ATRIA

Facility

$57,852.45

Service Code	HCPCS 33206
Hospital Charge Code	366833206
Hospital Revenue Code	480
Min. Negotiated Rate	$8,677.87
Max. Negotiated Rate	$8,677.87
Rate for Payer: Qualcare PPO/HMO/WC	$8,677.87

PERM PACEMAKER ATRIA

Facility

$57,852.45

Service Code	HCPCS 33206
Hospital Charge Code	7411009
Hospital Revenue Code	480
Min. Negotiated Rate	$8,677.87
Max. Negotiated Rate	$8,677.87
Rate for Payer: Qualcare PPO/HMO/WC	$8,677.87

PERM PACEMAKER DUAL

Facility

$39,837.00

Service Code	HCPCS 33208
Hospital Charge Code	366833208
Hospital Revenue Code	480
Min. Negotiated Rate	$336.16
Max. Negotiated Rate	$24,890.32
Rate for Payer: Aetna Better Health Medicaid	$16,790.24
Rate for Payer: Aetna Commercial	$11,951.10
Rate for Payer: Aetna Medicare Advantage	$11,951.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,158.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,158.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$336.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,158.43
Rate for Payer: Cigna Commercial	$24,890.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,178.81
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,975.55
Rate for Payer: UnitedHealthcare Commercial	$1,793.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,126.04

PERM PACEMAKER DUAL

Facility

$39,837.00

Service Code	HCPCS 33208
Hospital Charge Code	7411013
Hospital Revenue Code	481
Min. Negotiated Rate	$5,975.55
Max. Negotiated Rate	$5,975.55
Rate for Payer: Qualcare PPO/HMO/WC	$5,975.55

PERM PACEMAKER DUAL

Facility

$39,837.00

Service Code	HCPCS 33208
Hospital Charge Code	366833208
Hospital Revenue Code	480
Min. Negotiated Rate	$5,975.55
Max. Negotiated Rate	$5,975.55
Rate for Payer: Qualcare PPO/HMO/WC	$5,975.55

PERM PACEMAKER DUAL

Facility

$39,837.00

Service Code	HCPCS 33208
Hospital Charge Code	7411013
Hospital Revenue Code	481
Min. Negotiated Rate	$4,350.00
Max. Negotiated Rate	$24,890.32
Rate for Payer: Aetna Better Health Medicaid	$16,790.24
Rate for Payer: Aetna Commercial	$11,951.10
Rate for Payer: Aetna Medicare Advantage	$11,951.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,158.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,158.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,158.43
Rate for Payer: Cigna Commercial	$24,890.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,178.81
Rate for Payer: Oxford Commercial	$10,092.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,975.55
Rate for Payer: UnitedHealthcare Commercial	$11,456.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,126.04

PERM PACEMAKER VENT

Facility

$32,811.00

Service Code	HCPCS 33207
Hospital Charge Code	366833207
Hospital Revenue Code	480
Min. Negotiated Rate	$4,921.65
Max. Negotiated Rate	$4,921.65
Rate for Payer: Qualcare PPO/HMO/WC	$4,921.65

PERM PACEMAKER VENT

Facility

$32,811.00

Service Code	HCPCS 33207
Hospital Charge Code	7411011
Hospital Revenue Code	480
Min. Negotiated Rate	$471.50
Max. Negotiated Rate	$24,890.32
Rate for Payer: Aetna Better Health Medicaid	$16,790.24
Rate for Payer: Aetna Commercial	$9,843.30
Rate for Payer: Aetna Medicare Advantage	$9,843.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,366.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,366.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$471.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,366.81
Rate for Payer: Cigna Commercial	$24,890.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,265.43
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,921.65
Rate for Payer: UnitedHealthcare Commercial	$1,793.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,126.04

PERM PACEMAKER VENT

Facility

$32,811.00

Service Code	HCPCS 33207
Hospital Charge Code	366833207
Hospital Revenue Code	480
Min. Negotiated Rate	$471.50
Max. Negotiated Rate	$24,890.32
Rate for Payer: Aetna Better Health Medicaid	$16,790.24
Rate for Payer: Aetna Commercial	$9,843.30
Rate for Payer: Aetna Medicare Advantage	$9,843.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,366.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,366.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$471.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,366.81
Rate for Payer: Cigna Commercial	$24,890.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,265.43
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,921.65
Rate for Payer: UnitedHealthcare Commercial	$1,793.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,126.04

PERM PACEMAKER VENT

Facility

$32,811.00

Service Code	HCPCS 33207
Hospital Charge Code	7411011
Hospital Revenue Code	480
Min. Negotiated Rate	$4,921.65
Max. Negotiated Rate	$4,921.65
Rate for Payer: Qualcare PPO/HMO/WC	$4,921.65

PEROXIDASE STAIN

Facility

$363.25

Service Code	HCPCS 88319
Hospital Charge Code	3030038
Hospital Revenue Code	310
Min. Negotiated Rate	$47.22
Max. Negotiated Rate	$1,918.64
Rate for Payer: Aetna Commercial	$108.97
Rate for Payer: Aetna Medicare Advantage	$108.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$92.63
Rate for Payer: Cigna Commercial	$1,918.64
Rate for Payer: Cigna Medicare Advantage	$75.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.22
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.49
Rate for Payer: UnitedHealthcare Commercial	$114.00

PEROXIDASE STAIN

Facility

$363.25

Service Code	HCPCS 88319
Hospital Charge Code	3030038
Hospital Revenue Code	310
Min. Negotiated Rate	$54.49
Max. Negotiated Rate	$54.49
Rate for Payer: Qualcare PPO/HMO/WC	$54.49

PERPHENAZIN-AMITRIPTYLIN

Facility

$3.00

Hospital Charge Code	60633639
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

PERPHENAZIN-AMITRIPTYLIN

Facility

$3.00

Hospital Charge Code	60633638
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

PERPHENAZIN-AMITRIPTYLIN

Facility

$3.00

Hospital Charge Code	60633639
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PERPHENAZIN-AMITRIPTYLIN

Facility

$3.00

Hospital Charge Code	60633638
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PERPHENAZINE 2 MG TAB

Facility

$13.13

Service Code	HCPCS Q0175
Hospital Charge Code	60627814
Hospital Revenue Code	636
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$6.57
Rate for Payer: Aetna Commercial	$3.94
Rate for Payer: Aetna Medicare Advantage	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.35
Rate for Payer: Cigna Commercial	$6.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.97

PERPHENAZINE 2 MG TAB

Facility

$13.13

Service Code	HCPCS Q0175
Hospital Charge Code	60627814
Hospital Revenue Code	636
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$3.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.97

PERPHENAZINE 4 MG TAB

Facility

$18.02

Service Code	HCPCS Q0175
Hospital Charge Code	60627815
Hospital Revenue Code	636
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$9.01
Rate for Payer: Aetna Commercial	$5.41
Rate for Payer: Aetna Medicare Advantage	$5.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.60
Rate for Payer: Cigna Commercial	$9.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.36
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

PERPHENAZINE 4 MG TAB

Facility

$18.02

Service Code	HCPCS Q0175
Hospital Charge Code	60627815
Hospital Revenue Code	636
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$4.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.36
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

PERPHENAZINE 4 MG U/D

Facility

$3.00

Hospital Charge Code	60634406
Hospital Revenue Code	636
Min. Negotiated Rate	$0.45
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	$0.73
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PERPHENAZINE 4 MG U/D

Facility

$3.00

Hospital Charge Code	60634406
Hospital Revenue Code	636
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.73
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PERPHENAZINE 5 MG/ML INJ

Facility

$43.25

Hospital Charge Code	6009948
Hospital Revenue Code	250
Min. Negotiated Rate	$5.62
Max. Negotiated Rate	$21.62
Rate for Payer: Aetna Commercial	$12.97
Rate for Payer: Aetna Medicare Advantage	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.62
Rate for Payer: Oxford Commercial	$21.62
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$21.62

PERPHENAZINE 5 MG/ML INJ

Facility

$43.25

Hospital Charge Code	6009948
Hospital Revenue Code	250
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

PERPHENAZINE 8 MG TAB

Facility

$21.84

Service Code	HCPCS Q0175
Hospital Charge Code	60627816
Hospital Revenue Code	636
Min. Negotiated Rate	$3.28
Max. Negotiated Rate	$5.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.29
Rate for Payer: Qualcare PPO/HMO/WC	$3.28

Know your out-of-pocket cost for care.

All Charges