Heights University Hospital

All Charges

Charge

Type

Setting

Price

PLETAL 100MG TAB

Facility

$7.00

Hospital Charge Code	60635518
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

PLETAL 100MG TAB

Facility

$7.00

Hospital Charge Code	60635518
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.10
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.91
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$3.50

PLEURAL BIOPSY/ABRAHAMS

Facility

$803.25

Hospital Charge Code	2708001497
Hospital Revenue Code	270
Min. Negotiated Rate	$104.42
Max. Negotiated Rate	$401.62
Rate for Payer: Aetna Commercial	$240.97
Rate for Payer: Aetna Medicare Advantage	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.83
Rate for Payer: Cigna Commercial	$401.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.42
Rate for Payer: Oxford Commercial	$401.62
Rate for Payer: Qualcare PPO/HMO/WC	$120.49
Rate for Payer: UnitedHealthcare Commercial	$401.62

PLEURAL BIOPSY/ABRAHAMS

Facility

$803.25

Hospital Charge Code	2708001497
Hospital Revenue Code	270
Min. Negotiated Rate	$120.49
Max. Negotiated Rate	$120.49
Rate for Payer: Qualcare PPO/HMO/WC	$120.49

PLEURAL DR ESSENTL KIT 4992505

Facility

$1,150.00

Hospital Charge Code	270661650
Hospital Revenue Code	272
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$172.50
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

PLEURAL DR ESSENTL KIT 4992505

Facility

$1,150.00

Hospital Charge Code	270661650
Hospital Revenue Code	272
Min. Negotiated Rate	$149.50
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$345.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.50
Rate for Payer: Oxford Commercial	$575.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Commercial	$575.00

PLEURAL EFFUSION WITH CC

Facility

$40,531.59

Service Code	MSDRG 187
Min. Negotiated Rate	$10,793.64
Max. Negotiated Rate	$40,531.59
Rate for Payer: Aetna Commercial	$33,352.35
Rate for Payer: Aetna Medicare Advantage	$10,793.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,567.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,567.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,510.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,567.00
Rate for Payer: Cigna Commercial	$21,286.42
Rate for Payer: Cigna Medicare Advantage	$13,510.53
Rate for Payer: Clover Medicare Advantage	$12,835.00
Rate for Payer: EmblemHealth Commercial	$40,531.59
Rate for Payer: Humana Medicare Advantage	$13,915.85
Rate for Payer: Oxford Commercial	$13,303.40
Rate for Payer: UnitedHealthcare Commercial	$15,100.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,510.53
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14,321.16
Rate for Payer: Wellcare Medicare Advantage	$13,510.53

PLEURAL EFFUSION WITH MCC

Facility

$57,058.83

Service Code	MSDRG 186
Min. Negotiated Rate	$17,007.26
Max. Negotiated Rate	$57,058.83
Rate for Payer: Aetna Commercial	$52,552.43
Rate for Payer: Aetna Medicare Advantage	$17,007.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42,728.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42,728.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,019.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42,728.85
Rate for Payer: Cigna Commercial	$33,540.48
Rate for Payer: Cigna Medicare Advantage	$19,019.61
Rate for Payer: Clover Medicare Advantage	$18,068.63
Rate for Payer: EmblemHealth Commercial	$57,058.83
Rate for Payer: Humana Medicare Advantage	$19,590.20
Rate for Payer: Oxford Commercial	$20,961.83
Rate for Payer: UnitedHealthcare Commercial	$23,793.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,019.61
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20,160.79
Rate for Payer: Wellcare Medicare Advantage	$19,019.61

PLEURAL EFFUSION WITHOUT CC/MCC

Facility

$32,639.49

Service Code	MSDRG 188
Min. Negotiated Rate	$7,826.50
Max. Negotiated Rate	$32,639.49
Rate for Payer: Aetna Commercial	$24,183.88
Rate for Payer: Aetna Medicare Advantage	$7,826.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,675.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,675.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10,879.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20,675.25
Rate for Payer: Cigna Commercial	$15,434.86
Rate for Payer: Cigna Medicare Advantage	$10,879.83
Rate for Payer: Clover Medicare Advantage	$10,335.84
Rate for Payer: EmblemHealth Commercial	$32,639.49
Rate for Payer: Humana Medicare Advantage	$11,206.22
Rate for Payer: Oxford Commercial	$9,646.34
Rate for Payer: UnitedHealthcare Commercial	$10,949.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$10,879.83
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$11,532.62
Rate for Payer: Wellcare Medicare Advantage	$10,879.83

PLEURAL FLUID CYTOLOGY

Facility

$264.85

Service Code	HCPCS 88104
Hospital Charge Code	3005351
Hospital Revenue Code	311
Min. Negotiated Rate	$34.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$79.45
Rate for Payer: Aetna Medicare Advantage	$79.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.54
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$47.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.73
Rate for Payer: UnitedHealthcare Commercial	$114.00

PLEURAL FLUID CYTOLOGY

Facility

$264.85

Service Code	HCPCS 88104
Hospital Charge Code	3005351
Hospital Revenue Code	311
Min. Negotiated Rate	$39.73
Max. Negotiated Rate	$39.73
Rate for Payer: Qualcare PPO/HMO/WC	$39.73

PLEUR-A-VAC *******

Facility

$1,670.00

Hospital Charge Code	1603125
Hospital Revenue Code	272
Min. Negotiated Rate	$250.50
Max. Negotiated Rate	$250.50
Rate for Payer: Qualcare PPO/HMO/WC	$250.50

PLEUR-A-VAC *******

Facility

$1,670.00

Hospital Charge Code	1603125
Hospital Revenue Code	272
Min. Negotiated Rate	$217.10
Max. Negotiated Rate	$835.00
Rate for Payer: Aetna Commercial	$501.00
Rate for Payer: Aetna Medicare Advantage	$501.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$425.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$425.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$425.85
Rate for Payer: Cigna Commercial	$835.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.10
Rate for Payer: Oxford Commercial	$835.00
Rate for Payer: Qualcare PPO/HMO/WC	$250.50
Rate for Payer: UnitedHealthcare Commercial	$835.00

PLEUR EVAC W/ FLOOR STAND

Facility

$99.73

Hospital Charge Code	270652701
Hospital Revenue Code	270
Min. Negotiated Rate	$12.96
Max. Negotiated Rate	$49.87
Rate for Payer: Aetna Commercial	$29.92
Rate for Payer: Aetna Medicare Advantage	$29.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.43
Rate for Payer: Cigna Commercial	$49.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.96
Rate for Payer: Oxford Commercial	$49.87
Rate for Payer: Qualcare PPO/HMO/WC	$14.96
Rate for Payer: UnitedHealthcare Commercial	$49.87

PLEUR EVAC W/ FLOOR STAND

Facility

$99.73

Hospital Charge Code	270652701
Hospital Revenue Code	270
Min. Negotiated Rate	$14.96
Max. Negotiated Rate	$14.96
Rate for Payer: Qualcare PPO/HMO/WC	$14.96

PLEUR-EVAC W/FLOOR STAND

Facility

$850.00

Hospital Charge Code	270331014
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

PLEUR-EVAC W/FLOOR STAND

Facility

$850.00

Hospital Charge Code	270331014
Hospital Revenue Code	272
Min. Negotiated Rate	$110.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$425.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$425.00

PLEURX DRAINAGE KIT

Facility

$372.44

Service Code	HCPCS C1729
Hospital Charge Code	270629873
Hospital Revenue Code	278
Min. Negotiated Rate	$55.87
Max. Negotiated Rate	$90.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.13
Rate for Payer: Qualcare PPO/HMO/WC	$55.87

PLEURX DRAINAGE KIT

Facility

$372.44

Service Code	HCPCS C1729
Hospital Charge Code	270629873
Hospital Revenue Code	278
Min. Negotiated Rate	$55.87
Max. Negotiated Rate	$186.22
Rate for Payer: Aetna Commercial	$111.73
Rate for Payer: Aetna Medicare Advantage	$111.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.97
Rate for Payer: Cigna Commercial	$186.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.13
Rate for Payer: Qualcare PPO/HMO/WC	$55.87

PLEURX PERITONEAL KIT

Facility

$6,073.60

Hospital Charge Code	270657046
Hospital Revenue Code	272
Min. Negotiated Rate	$789.57
Max. Negotiated Rate	$3,036.80
Rate for Payer: Aetna Commercial	$1,822.08
Rate for Payer: Aetna Medicare Advantage	$1,822.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,548.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,548.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,548.77
Rate for Payer: Cigna Commercial	$3,036.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$789.57
Rate for Payer: Oxford Commercial	$3,036.80
Rate for Payer: Qualcare PPO/HMO/WC	$911.04
Rate for Payer: UnitedHealthcare Commercial	$3,036.80

PLEURX PERITONEAL KIT

Facility

$6,073.60

Hospital Charge Code	270657046
Hospital Revenue Code	272
Min. Negotiated Rate	$911.04
Max. Negotiated Rate	$911.04
Rate for Payer: Qualcare PPO/HMO/WC	$911.04

PLEURX PLEURAL CATH. & PATI

Facility

$4,125.00

Hospital Charge Code	270666217
Hospital Revenue Code	278
Min. Negotiated Rate	$618.75
Max. Negotiated Rate	$2,062.50
Rate for Payer: Aetna Commercial	$1,237.50
Rate for Payer: Aetna Medicare Advantage	$1,237.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,051.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,051.88
Rate for Payer: Cigna Commercial	$2,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.25
Rate for Payer: Qualcare PPO/HMO/WC	$618.75

PLEURX PLEURAL CATH. & PATI

Facility

$4,125.00

Hospital Charge Code	270666217
Hospital Revenue Code	278
Min. Negotiated Rate	$618.75
Max. Negotiated Rate	$998.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$998.25
Rate for Payer: Qualcare PPO/HMO/WC	$618.75

PLEURX PLEURL CATH KIT 507000B

Facility

$2,625.00

Hospital Charge Code	270643278
Hospital Revenue Code	278
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$787.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

PLEURX PLEURL CATH KIT 507000B

Facility

$2,625.00

Hospital Charge Code	270643278
Hospital Revenue Code	278
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

Know your out-of-pocket cost for care.

All Charges