Heights University Hospital

All Charges

Charge

Type

Setting

Price

PHOSPHOHEXOSE ISOMERASE

Facility

$73.00

Service Code	HCPCS 84087
Hospital Charge Code	38477067
Hospital Revenue Code	301
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$34.77
Rate for Payer: Aetna Medicare Advantage	$10.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.31
Rate for Payer: Cigna Commercial	$10.73
Rate for Payer: Cigna Medicare Advantage	$5.37
Rate for Payer: Clover Medicare Advantage	$10.19
Rate for Payer: EmblemHealth Commercial	$32.19
Rate for Payer: Humana Medicare Advantage	$11.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.73
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11.37
Rate for Payer: Wellcare Medicare Advantage	$10.73

PHOSPHOHEXOSE ISOMERASE

Facility

$73.00

Service Code	HCPCS 84087
Hospital Charge Code	38477067
Hospital Revenue Code	301
Min. Negotiated Rate	$10.95
Max. Negotiated Rate	$10.95
Rate for Payer: Qualcare PPO/HMO/WC	$10.95

PHOSPHOLINE IODIDE 0.25%

Facility

$129.00

Hospital Charge Code	60633661
Hospital Revenue Code	250
Min. Negotiated Rate	$19.35
Max. Negotiated Rate	$19.35
Rate for Payer: Qualcare PPO/HMO/WC	$19.35

PHOSPHOLINE IODIDE 0.25%

Facility

$129.00

Hospital Charge Code	60633661
Hospital Revenue Code	250
Min. Negotiated Rate	$16.77
Max. Negotiated Rate	$64.50
Rate for Payer: Aetna Commercial	$38.70
Rate for Payer: Aetna Medicare Advantage	$38.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.90
Rate for Payer: Cigna Commercial	$64.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.77
Rate for Payer: Oxford Commercial	$64.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.35
Rate for Payer: UnitedHealthcare Commercial	$64.50

PHOSPHOLINE IODINE .03%

Facility

$74.00

Hospital Charge Code	60634554
Hospital Revenue Code	250
Min. Negotiated Rate	$11.10
Max. Negotiated Rate	$11.10
Rate for Payer: Qualcare PPO/HMO/WC	$11.10

PHOSPHOLINE IODINE .03%

Facility

$74.00

Hospital Charge Code	60634554
Hospital Revenue Code	250
Min. Negotiated Rate	$9.62
Max. Negotiated Rate	$37.00
Rate for Payer: Aetna Commercial	$22.20
Rate for Payer: Aetna Medicare Advantage	$22.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.87
Rate for Payer: Cigna Commercial	$37.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.62
Rate for Payer: Oxford Commercial	$37.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.10
Rate for Payer: UnitedHealthcare Commercial	$37.00

PHOSPHOLINE IODINE .06%

Facility

$107.00

Hospital Charge Code	60634555
Hospital Revenue Code	250
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

PHOSPHOLINE IODINE .06%

Facility

$107.00

Hospital Charge Code	60634555
Hospital Revenue Code	250
Min. Negotiated Rate	$13.91
Max. Negotiated Rate	$53.50
Rate for Payer: Aetna Commercial	$32.10
Rate for Payer: Aetna Medicare Advantage	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.29
Rate for Payer: Cigna Commercial	$53.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.91
Rate for Payer: Oxford Commercial	$53.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Commercial	$53.50

PHOSPHOLINE IODINE .125%

Facility

$122.00

Hospital Charge Code	60634556
Hospital Revenue Code	250
Min. Negotiated Rate	$15.86
Max. Negotiated Rate	$61.00
Rate for Payer: Aetna Commercial	$36.60
Rate for Payer: Aetna Medicare Advantage	$36.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.11
Rate for Payer: Cigna Commercial	$61.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.86
Rate for Payer: Oxford Commercial	$61.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.30
Rate for Payer: UnitedHealthcare Commercial	$61.00

PHOSPHOLINE IODINE .125%

Facility

$122.00

Hospital Charge Code	60634556
Hospital Revenue Code	250
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$18.30
Rate for Payer: Qualcare PPO/HMO/WC	$18.30

PHOSPHOLIPASE A2 RECEP AB IFA

Facility

$198.10

Service Code	HCPCS 86255
Hospital Charge Code	401186255A
Hospital Revenue Code	302
Min. Negotiated Rate	$29.71
Max. Negotiated Rate	$29.71
Rate for Payer: Qualcare PPO/HMO/WC	$29.71

PHOSPHOLIPASE A2 RECEP AB IFA

Facility

$198.10

Service Code	HCPCS 86255
Hospital Charge Code	401186255A
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	$25.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.71
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

PHOSPHOLIPIDS

Facility

$383.25

Service Code	HCPCS 84311
Hospital Charge Code	3007579
Hospital Revenue Code	301
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.24
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.68
Rate for Payer: Cigna Commercial	$8.10
Rate for Payer: Cigna Medicare Advantage	$4.05
Rate for Payer: Clover Medicare Advantage	$7.70
Rate for Payer: EmblemHealth Commercial	$24.30
Rate for Payer: Humana Medicare Advantage	$8.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$57.49
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.10
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.59
Rate for Payer: Wellcare Medicare Advantage	$8.10

PHOSPHOLIPIDS

Facility

$390.00

Service Code	HCPCS 84311
Hospital Charge Code	39900135
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PHOSPHOLIPIDS

Facility

$383.25

Service Code	HCPCS 84311
Hospital Charge Code	3007579
Hospital Revenue Code	301
Min. Negotiated Rate	$57.49
Max. Negotiated Rate	$57.49
Rate for Payer: Qualcare PPO/HMO/WC	$57.49

PHOSPHOLIPIDS

Facility

$390.00

Service Code	HCPCS 84311
Hospital Charge Code	39900135
Hospital Revenue Code	301
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$26.24
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.68
Rate for Payer: Cigna Commercial	$8.10
Rate for Payer: Cigna Medicare Advantage	$4.05
Rate for Payer: Clover Medicare Advantage	$7.70
Rate for Payer: EmblemHealth Commercial	$24.30
Rate for Payer: Humana Medicare Advantage	$8.34
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	$8.10
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$8.59
Rate for Payer: Wellcare Medicare Advantage	$8.10

PHOSPHOROUS URINE

Facility

$390.00

Service Code	HCPCS 84105
Hospital Charge Code	39990241H
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	$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	$5.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.13
Rate for Payer: Wellcare Medicare Advantage	$5.78

PHOSPHOROUS URINE

Facility

$390.00

Service Code	HCPCS 84105
Hospital Charge Code	39990241H
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PHOSPHORUS

Facility

$141.80

Service Code	HCPCS 84100
Hospital Charge Code	8200322RS
Hospital Revenue Code	301
Min. Negotiated Rate	$21.27
Max. Negotiated Rate	$21.27
Rate for Payer: Qualcare PPO/HMO/WC	$21.27

PHOSPHORUS

Facility

$141.80

Service Code	HCPCS 84100
Hospital Charge Code	8200322RS
Hospital Revenue Code	301
Min. Negotiated Rate	$2.37
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.36
Rate for Payer: Aetna Medicare Advantage	$4.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.74
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	$17.37
Rate for Payer: Cigna Commercial	$4.74
Rate for Payer: Cigna Medicare Advantage	$2.37
Rate for Payer: Clover Medicare Advantage	$4.50
Rate for Payer: EmblemHealth Commercial	$14.22
Rate for Payer: Humana Medicare Advantage	$4.88
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
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.74
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.02
Rate for Payer: Wellcare Medicare Advantage	$4.74

PHOSPHORUS***

Facility

$18.00

Hospital Charge Code	3012093
Hospital Revenue Code	309
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

PHOSPHORUS***

Facility

$18.00

Hospital Charge Code	3012093
Hospital Revenue Code	309
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$5.40
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$114.00

PHOSPHORUS RANDOM UR

Facility

$163.00

Service Code	HCPCS 84105
Hospital Charge Code	38479041
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	$21.19
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.45
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

PHOSPHORUS RANDOM UR

Facility

$163.00

Service Code	HCPCS 84105
Hospital Charge Code	38479041
Hospital Revenue Code	301
Min. Negotiated Rate	$24.45
Max. Negotiated Rate	$24.45
Rate for Payer: Qualcare PPO/HMO/WC	$24.45

PHOSPHORUS, SERUM

Facility

$656.14

Service Code	HCPCS 84100
Hospital Charge Code	3002094
Hospital Revenue Code	301
Min. Negotiated Rate	$98.42
Max. Negotiated Rate	$98.42
Rate for Payer: Qualcare PPO/HMO/WC	$98.42

Know your out-of-pocket cost for care.

All Charges