Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLASMA FROZEN WITHIN 24 H (ADD

Facility

$289.45

Hospital Charge Code	3101535
Hospital Revenue Code	390
Min. Negotiated Rate	$43.42
Max. Negotiated Rate	$43.42
Rate for Payer: Qualcare PPO/HMO/WC	$43.42

PLASMA FROZEN WITHIN 24 H (ADD

Facility

$289.45

Hospital Charge Code	3101535
Hospital Revenue Code	390
Min. Negotiated Rate	$37.63
Max. Negotiated Rate	$756.00
Rate for Payer: Aetna Commercial	$86.83
Rate for Payer: Aetna Medicare Advantage	$86.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.81
Rate for Payer: Cigna Commercial	$144.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.63
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.42
Rate for Payer: UnitedHealthcare Commercial	$756.00

PLASMA HEMOGLOBIN

Facility

$51.75

Service Code	HCPCS 83051
Hospital Charge Code	38478084
Hospital Revenue Code	301
Min. Negotiated Rate	$7.76
Max. Negotiated Rate	$7.76
Rate for Payer: Qualcare PPO/HMO/WC	$7.76

PLASMA HEMOGLOBIN

Facility

$51.75

Service Code	HCPCS 83051
Hospital Charge Code	38478084
Hospital Revenue Code	301
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$114.00
Rate for Payer: Humana Medicare Advantage	$7.53
Rate for Payer: Aetna Commercial	$23.68
Rate for Payer: Aetna Medicare Advantage	$7.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.78
Rate for Payer: Cigna Commercial	$7.31
Rate for Payer: Cigna Medicare Advantage	$3.65
Rate for Payer: Clover Medicare Advantage	$6.94
Rate for Payer: EmblemHealth Commercial	$21.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.73
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.76
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.31
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.75
Rate for Payer: Wellcare Medicare Advantage	$7.31

PLASMA HOOK FOR COBLATOR II

Facility

$714.25

Hospital Charge Code	270630933
Hospital Revenue Code	278
Min. Negotiated Rate	$107.14
Max. Negotiated Rate	$172.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.85
Rate for Payer: Qualcare PPO/HMO/WC	$107.14

PLASMA HOOK FOR COBLATOR II

Facility

$714.25

Hospital Charge Code	270630933
Hospital Revenue Code	278
Min. Negotiated Rate	$107.14
Max. Negotiated Rate	$357.12
Rate for Payer: Aetna Commercial	$214.28
Rate for Payer: Aetna Medicare Advantage	$214.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.13
Rate for Payer: Cigna Commercial	$357.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.85
Rate for Payer: Qualcare PPO/HMO/WC	$107.14

PLASMA LYTE 148 NORM R 1000cc

Facility

$7.25

Hospital Charge Code	270650171
Hospital Revenue Code	270
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

PLASMA LYTE 148 NORM R 1000cc

Facility

$7.25

Hospital Charge Code	270650171
Hospital Revenue Code	270
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.17
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.94
Rate for Payer: Oxford Commercial	$3.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$3.62

PLASMA LYTE 56 (NORM.M)

Facility

$11.00

Hospital Charge Code	270651077
Hospital Revenue Code	270
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

PLASMA LYTE 56 (NORM.M)

Facility

$11.00

Hospital Charge Code	270651077
Hospital Revenue Code	270
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$5.50
Rate for Payer: Aetna Commercial	$3.30
Rate for Payer: Aetna Medicare Advantage	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.81
Rate for Payer: Cigna Commercial	$5.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.43
Rate for Payer: Oxford Commercial	$5.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.65
Rate for Payer: UnitedHealthcare Commercial	$5.50

PLASMANATE *******

Facility

$425.00

Hospital Charge Code	7000482
Hospital Revenue Code	279
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

PLASMANATE *******

Facility

$425.00

Hospital Charge Code	7000482
Hospital Revenue Code	279
Min. Negotiated Rate	$55.25
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$127.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Oxford Commercial	$212.50
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$212.50

PLASMAPHERESIS

Facility

$1,057.00

Service Code	HCPCS 36520
Hospital Charge Code	3400033
Hospital Revenue Code	761
Min. Negotiated Rate	$158.55
Max. Negotiated Rate	$158.55
Rate for Payer: Qualcare PPO/HMO/WC	$158.55

PLASMAPHERESIS

Facility

$1,057.00

Service Code	HCPCS 36520
Hospital Charge Code	3400033
Hospital Revenue Code	761
Min. Negotiated Rate	$137.41
Max. Negotiated Rate	$528.50
Rate for Payer: Aetna Commercial	$317.10
Rate for Payer: Aetna Medicare Advantage	$317.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.54
Rate for Payer: Cigna Commercial	$528.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.41
Rate for Payer: Oxford Commercial	$528.50
Rate for Payer: Qualcare PPO/HMO/WC	$158.55
Rate for Payer: UnitedHealthcare Commercial	$528.50

PLASMA PLATELET RICH PRP

Facility

$2,500.00

Hospital Charge Code	270646448
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

PLASMA PLATELET RICH PRP

Facility

$2,500.00

Hospital Charge Code	270646448
Hospital Revenue Code	272
Min. Negotiated Rate	$325.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$1,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$1,250.00

PLASMA PROTEIN 5% INJ 250ML

Facility

$90.90

Hospital Charge Code	6004451
Hospital Revenue Code	250
Min. Negotiated Rate	$13.63
Max. Negotiated Rate	$13.63
Rate for Payer: Qualcare PPO/HMO/WC	$13.63

PLASMA PROTEIN 5% INJ 250ML

Facility

$90.90

Hospital Charge Code	6004451
Hospital Revenue Code	250
Min. Negotiated Rate	$11.82
Max. Negotiated Rate	$45.45
Rate for Payer: Aetna Commercial	$27.27
Rate for Payer: Aetna Medicare Advantage	$27.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.18
Rate for Payer: Cigna Commercial	$45.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.82
Rate for Payer: Oxford Commercial	$45.45
Rate for Payer: Qualcare PPO/HMO/WC	$13.63
Rate for Payer: UnitedHealthcare Commercial	$45.45

PLASMA PROTEIN INJ 500ML

Facility

$826.25

Hospital Charge Code	6006761
Hospital Revenue Code	250
Min. Negotiated Rate	$107.41
Max. Negotiated Rate	$413.12
Rate for Payer: Aetna Commercial	$247.88
Rate for Payer: Aetna Medicare Advantage	$247.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.69
Rate for Payer: Cigna Commercial	$413.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.41
Rate for Payer: Oxford Commercial	$413.12
Rate for Payer: Qualcare PPO/HMO/WC	$123.94
Rate for Payer: UnitedHealthcare Commercial	$413.12

PLASMA PROTEIN INJ 500ML

Facility

$826.25

Hospital Charge Code	6006761
Hospital Revenue Code	250
Min. Negotiated Rate	$123.94
Max. Negotiated Rate	$123.94
Rate for Payer: Qualcare PPO/HMO/WC	$123.94

PLASMA RENIN ACTIVITY

Facility

$667.59

Service Code	HCPCS 84244
Hospital Charge Code	39900128
Hospital Revenue Code	301
Min. Negotiated Rate	$10.99
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$71.25
Rate for Payer: Aetna Medicare Advantage	$21.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.99
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	$80.57
Rate for Payer: Cigna Commercial	$21.99
Rate for Payer: Cigna Medicare Advantage	$10.99
Rate for Payer: Clover Medicare Advantage	$20.89
Rate for Payer: EmblemHealth Commercial	$65.97
Rate for Payer: Humana Medicare Advantage	$22.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.79
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.99
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$23.31
Rate for Payer: Wellcare Medicare Advantage	$21.99

PLASMA RENIN ACTIVITY

Facility

$667.59

Service Code	HCPCS 84244
Hospital Charge Code	39900128
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

PLASMA STEM STRAIGHT 13x167MM

Facility

$28,420.00

Service Code	HCPCS C1776
Hospital Charge Code	270676119
Hospital Revenue Code	278
Min. Negotiated Rate	$4,263.00
Max. Negotiated Rate	$6,877.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,684.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,877.64
Rate for Payer: Qualcare PPO/HMO/WC	$4,263.00

PLASMA STEM STRAIGHT 13x167MM

Facility

$28,420.00

Service Code	HCPCS C1776
Hospital Charge Code	270676119
Hospital Revenue Code	278
Min. Negotiated Rate	$4,263.00
Max. Negotiated Rate	$14,210.00
Rate for Payer: Aetna Commercial	$8,526.00
Rate for Payer: Aetna Medicare Advantage	$8,526.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,247.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,247.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,684.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,247.10
Rate for Payer: Cigna Commercial	$14,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,877.64
Rate for Payer: Qualcare PPO/HMO/WC	$4,263.00

PLASMAX 800-0515

Facility

$4,005.00

Hospital Charge Code	270637573
Hospital Revenue Code	272
Min. Negotiated Rate	$600.75
Max. Negotiated Rate	$600.75
Rate for Payer: Qualcare PPO/HMO/WC	$600.75

Know your out-of-pocket cost for care.

All Charges