Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

PHOSLO GEL CAPS

Facility

OP

$1.00

Hospital Charge Code	60635476
Hospital Revenue Code	250
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.50
Rate for Payer: Aetna Commercial	$0.30
Rate for Payer: Aetna Medicare Advantage	$0.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.26
Rate for Payer: Cigna Commercial	$0.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.13
Rate for Payer: Oxford Commercial	$0.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.15
Rate for Payer: UnitedHealthcare Commercial	$0.50

PHOS-LO/TAB

Facility

OP

$3.00

Hospital Charge Code	60634446
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

PHOS-LO/TAB

Facility

IP

$3.00

Hospital Charge Code	60634446
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PHOSPH ANTIB (IGG,IGA,IGM) PLA

Facility

IP

$80.35

Service Code	HCPCS 86148
Hospital Charge Code	401186148C
Hospital Revenue Code	306
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$12.05
Rate for Payer: Qualcare PPO/HMO/WC	$12.05

PHOSPH ANTIB (IGG,IGA,IGM) PLA

Facility

OP

$80.35

Service Code	HCPCS 86148
Hospital Charge Code	401186148D
Hospital Revenue Code	306
Min. Negotiated Rate	$8.04
Max. Negotiated Rate	$114.00
Rate for Payer: Cigna Commercial	$16.07
Rate for Payer: Aetna Commercial	$52.07
Rate for Payer: Aetna Medicare Advantage	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.88
Rate for Payer: Cigna Medicare Advantage	$8.04
Rate for Payer: Clover Medicare Advantage	$15.27
Rate for Payer: EmblemHealth Commercial	$48.21
Rate for Payer: Humana Medicare Advantage	$16.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.07
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.03
Rate for Payer: Wellcare Medicare Advantage	$16.07

PHOSPH ANTIB (IGG,IGA,IGM) PLA

Facility

IP

$80.35

Service Code	HCPCS 86148
Hospital Charge Code	401186148D
Hospital Revenue Code	306
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$12.05
Rate for Payer: Qualcare PPO/HMO/WC	$12.05

PHOSPH ANTIB (IGG,IGA,IGM) PLA

Facility

OP

$80.35

Service Code	HCPCS 86148
Hospital Charge Code	401186148B
Hospital Revenue Code	306
Min. Negotiated Rate	$8.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.07
Rate for Payer: Aetna Medicare Advantage	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.88
Rate for Payer: Cigna Commercial	$16.07
Rate for Payer: Cigna Medicare Advantage	$8.04
Rate for Payer: Clover Medicare Advantage	$15.27
Rate for Payer: EmblemHealth Commercial	$48.21
Rate for Payer: Humana Medicare Advantage	$16.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.07
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.03
Rate for Payer: Wellcare Medicare Advantage	$16.07

PHOSPH ANTIB (IGG,IGA,IGM) PLA

Facility

IP

$80.35

Service Code	HCPCS 86148
Hospital Charge Code	401186148B
Hospital Revenue Code	306
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$12.05
Rate for Payer: Qualcare PPO/HMO/WC	$12.05

PHOSPH ANTIB (IGG,IGA,IGM) PLA

Facility

OP

$80.35

Service Code	HCPCS 86148
Hospital Charge Code	401186148C
Hospital Revenue Code	306
Min. Negotiated Rate	$8.04
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$52.07
Rate for Payer: Aetna Medicare Advantage	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.88
Rate for Payer: Cigna Commercial	$16.07
Rate for Payer: Cigna Medicare Advantage	$8.04
Rate for Payer: Clover Medicare Advantage	$15.27
Rate for Payer: EmblemHealth Commercial	$48.21
Rate for Payer: Humana Medicare Advantage	$16.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.07
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.03
Rate for Payer: Wellcare Medicare Advantage	$16.07

PHOSPH ANTIBOD (IGG,IGA,IGM)

Facility

IP

$148.86

Service Code	HCPCS 83520
Hospital Charge Code	401383520D
Hospital Revenue Code	301
Min. Negotiated Rate	$22.33
Max. Negotiated Rate	$22.33
Rate for Payer: Qualcare PPO/HMO/WC	$22.33

PHOSPH ANTIBOD (IGG,IGA,IGM)

Facility

OP

$148.86

Service Code	HCPCS 83520
Hospital Charge Code	401383520F
Hospital Revenue Code	301
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.95
Rate for Payer: Aetna Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.28
Rate for Payer: Cigna Commercial	$17.27
Rate for Payer: Cigna Medicare Advantage	$8.63
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.33
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.31
Rate for Payer: Wellcare Medicare Advantage	$17.27

PHOSPH ANTIBOD (IGG,IGA,IGM)

Facility

IP

$148.86

Service Code	HCPCS 83520
Hospital Charge Code	401383520F
Hospital Revenue Code	301
Min. Negotiated Rate	$22.33
Max. Negotiated Rate	$22.33
Rate for Payer: Qualcare PPO/HMO/WC	$22.33

PHOSPH ANTIBOD (IGG,IGA,IGM)

Facility

IP

$148.86

Service Code	HCPCS 83520
Hospital Charge Code	401383520E
Hospital Revenue Code	301
Min. Negotiated Rate	$22.33
Max. Negotiated Rate	$22.33
Rate for Payer: Qualcare PPO/HMO/WC	$22.33

PHOSPH ANTIBOD (IGG,IGA,IGM)

Facility

OP

$148.86

Service Code	HCPCS 83520
Hospital Charge Code	401383520D
Hospital Revenue Code	301
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.95
Rate for Payer: Aetna Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.28
Rate for Payer: Cigna Commercial	$17.27
Rate for Payer: Cigna Medicare Advantage	$8.63
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.33
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.31
Rate for Payer: Wellcare Medicare Advantage	$17.27

PHOSPH ANTIBOD (IGG,IGA,IGM)

Facility

OP

$148.86

Service Code	HCPCS 83520
Hospital Charge Code	401383520E
Hospital Revenue Code	301
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.95
Rate for Payer: Aetna Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.28
Rate for Payer: Cigna Commercial	$17.27
Rate for Payer: Cigna Medicare Advantage	$8.63
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.33
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.31
Rate for Payer: Wellcare Medicare Advantage	$17.27

PHOSPHATE24HR URINE WO CREATIN

Facility

IP

$65.24

Service Code	HCPCS 84105
Hospital Charge Code	401184105
Hospital Revenue Code	301
Min. Negotiated Rate	$9.79
Max. Negotiated Rate	$9.79
Rate for Payer: Qualcare PPO/HMO/WC	$9.79

PHOSPHATE24HR URINE WO CREATIN

Facility

OP

$65.24

Service Code	HCPCS 84105
Hospital Charge Code	401184105
Hospital Revenue Code	301
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$18.73
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.18
Rate for Payer: Cigna Commercial	$5.78
Rate for Payer: Cigna Medicare Advantage	$2.89
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.79
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.13
Rate for Payer: Wellcare Medicare Advantage	$5.78

PHOSPHATIDY GLYCEROL

Facility

OP

$131.38

Service Code	HCPCS 84999
Hospital Charge Code	38478103
Hospital Revenue Code	301
Min. Negotiated Rate	$17.08
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.41
Rate for Payer: Aetna Medicare Advantage	$39.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.50
Rate for Payer: Cigna Commercial	$65.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.71
Rate for Payer: UnitedHealthcare Commercial	$114.00

PHOSPHATIDY GLYCEROL

Facility

IP

$131.38

Service Code	HCPCS 84999
Hospital Charge Code	38478103
Hospital Revenue Code	301
Min. Negotiated Rate	$19.71
Max. Negotiated Rate	$19.71
Rate for Payer: Qualcare PPO/HMO/WC	$19.71

PHOSPHATIDYLGLYCEROL,AMNIOTIC

Facility

OP

$348.00

Service Code	HCPCS 84081
Hospital Charge Code	38473118
Hospital Revenue Code	301
Min. Negotiated Rate	$8.26
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$53.52
Rate for Payer: Aetna Medicare Advantage	$16.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.53
Rate for Payer: Cigna Commercial	$16.52
Rate for Payer: Cigna Medicare Advantage	$8.26
Rate for Payer: Clover Medicare Advantage	$15.69
Rate for Payer: EmblemHealth Commercial	$49.56
Rate for Payer: Humana Medicare Advantage	$17.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.24
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.52
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.51
Rate for Payer: Wellcare Medicare Advantage	$16.52

PHOSPHATIDYLGLYCEROL,AMNIOTIC

Facility

IP

$348.00

Service Code	HCPCS 84081
Hospital Charge Code	38473118
Hospital Revenue Code	301
Min. Negotiated Rate	$52.20
Max. Negotiated Rate	$52.20
Rate for Payer: Qualcare PPO/HMO/WC	$52.20

PHOSPH BUFFERED SAL 50ML

Facility

OP

$3.00

Hospital Charge Code	60635085
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

PHOSPH BUFFERED SAL 50ML

Facility

IP

$3.00

Hospital Charge Code	60635085
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PHOSPHEROUS

Facility

IP

$141.80

Service Code	HCPCS 84100CE
Hospital Charge Code	8200323RS
Hospital Revenue Code	301
Min. Negotiated Rate	$21.27
Max. Negotiated Rate	$21.27
Rate for Payer: Qualcare PPO/HMO/WC	$21.27

PHOSPHEROUS

Facility

OP

$141.80

Service Code	HCPCS 84100CE
Hospital Charge Code	8200323RS
Hospital Revenue Code	301
Min. Negotiated Rate	$18.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.54
Rate for Payer: Aetna Medicare Advantage	$42.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.16
Rate for Payer: Cigna Commercial	$70.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.27
Rate for Payer: UnitedHealthcare Commercial	$114.00