Heights University Hospital

All Charges

Charge

Type

Setting

Price

POTASSIUM HYDROXIDE 1N (235ML)

Facility

$123.00

Hospital Charge Code	270331771
Hospital Revenue Code	272
Min. Negotiated Rate	$15.99
Max. Negotiated Rate	$61.50
Rate for Payer: Aetna Commercial	$36.90
Rate for Payer: Aetna Medicare Advantage	$36.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.36
Rate for Payer: Cigna Commercial	$61.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.99
Rate for Payer: Oxford Commercial	$61.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.45
Rate for Payer: UnitedHealthcare Commercial	$61.50

POTASSIUM HYDROXIDE 1N (235ML)

Facility

$123.00

Hospital Charge Code	270331771
Hospital Revenue Code	272
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$18.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

POTASSIUM IODIDE LQ 100% 30ML

Facility

$53.80

Hospital Charge Code	6004535
Hospital Revenue Code	251
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

POTASSIUM IODIDE LQ 100% 30ML

Facility

$53.80

Hospital Charge Code	6004535
Hospital Revenue Code	251
Min. Negotiated Rate	$6.99
Max. Negotiated Rate	$26.90
Rate for Payer: Aetna Commercial	$16.14
Rate for Payer: Aetna Medicare Advantage	$16.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.72
Rate for Payer: Cigna Commercial	$26.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.99
Rate for Payer: Oxford Commercial	$26.90
Rate for Payer: Qualcare PPO/HMO/WC	$8.07
Rate for Payer: UnitedHealthcare Commercial	$26.90

POTASSIUM IODIDE LQ 100% 8OZ

Facility

$265.60

Hospital Charge Code	6004543
Hospital Revenue Code	251
Min. Negotiated Rate	$34.53
Max. Negotiated Rate	$132.80
Rate for Payer: Aetna Commercial	$79.68
Rate for Payer: Aetna Medicare Advantage	$79.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.73
Rate for Payer: Cigna Commercial	$132.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.53
Rate for Payer: Oxford Commercial	$132.80
Rate for Payer: Qualcare PPO/HMO/WC	$39.84
Rate for Payer: UnitedHealthcare Commercial	$132.80

POTASSIUM IODIDE LQ 100% 8OZ

Facility

$265.60

Hospital Charge Code	6004543
Hospital Revenue Code	251
Min. Negotiated Rate	$39.84
Max. Negotiated Rate	$39.84
Rate for Payer: Qualcare PPO/HMO/WC	$39.84

POTASSIUM NITRATE/SILV NIT SWB

Facility

$4.76

Service Code	NDC 54569235700
Hospital Charge Code	60630079
Hospital Revenue Code	250
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$2.38
Rate for Payer: Aetna Commercial	$1.43
Rate for Payer: Aetna Medicare Advantage	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.21
Rate for Payer: Cigna Commercial	$2.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.62
Rate for Payer: Oxford Commercial	$2.38
Rate for Payer: Qualcare PPO/HMO/WC	$0.71
Rate for Payer: UnitedHealthcare Commercial	$2.38

POTASSIUM NITRATE/SILV NIT SWB

Facility

$4.76

Service Code	NDC 54569235700
Hospital Charge Code	60630079
Hospital Revenue Code	250
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$0.71
Rate for Payer: Qualcare PPO/HMO/WC	$0.71

POTASSIUM PHOSPH 15ML/66MEGK+

Facility

$10.90

Hospital Charge Code	6009047
Hospital Revenue Code	250
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

POTASSIUM PHOSPH 15ML/66MEGK+

Facility

$10.90

Hospital Charge Code	6009047
Hospital Revenue Code	250
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$5.45
Rate for Payer: Aetna Commercial	$3.27
Rate for Payer: Aetna Medicare Advantage	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.78
Rate for Payer: Cigna Commercial	$5.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.42
Rate for Payer: Oxford Commercial	$5.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Commercial	$5.45

POTASSIUM PHOSPHATE

Facility

$33.50

Service Code	NDC 409729501
Hospital Charge Code	60627930
Hospital Revenue Code	250
Min. Negotiated Rate	$4.36
Max. Negotiated Rate	$16.75
Rate for Payer: Aetna Commercial	$10.05
Rate for Payer: Aetna Medicare Advantage	$10.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.54
Rate for Payer: Cigna Commercial	$16.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.36
Rate for Payer: Oxford Commercial	$16.75
Rate for Payer: Qualcare PPO/HMO/WC	$5.03
Rate for Payer: UnitedHealthcare Commercial	$16.75

POTASSIUM PHOSPHATE

Facility

$33.50

Service Code	NDC 409729501
Hospital Charge Code	60627930
Hospital Revenue Code	250
Min. Negotiated Rate	$5.03
Max. Negotiated Rate	$5.03
Rate for Payer: Qualcare PPO/HMO/WC	$5.03

POTASSIUM PHOSPHATE, MONOBAS 5

Facility

$4.00

Service Code	NDC 486111105
Hospital Charge Code	6063943269
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.20
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.00

POTASSIUM PHOSPHATE, MONOBAS 5

Facility

$4.00

Service Code	NDC 486111105
Hospital Charge Code	6063943269
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

POTASSIUM PHOSPH INJ 5ML

Facility

$7.25

Hospital Charge Code	60627931
Hospital Revenue Code	250
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

POTASSIUM PHOSPH INJ 5ML

Facility

$7.25

Hospital Charge Code	60627931
Hospital Revenue Code	250
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

POTASSIUM, PLASMA

Facility

$45.25

Service Code	HCPCS 84132
Hospital Charge Code	3008943
Hospital Revenue Code	301
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.42
Rate for Payer: Aetna Medicare Advantage	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.44
Rate for Payer: Cigna Commercial	$4.76
Rate for Payer: Cigna Medicare Advantage	$2.38
Rate for Payer: Clover Medicare Advantage	$4.52
Rate for Payer: EmblemHealth Commercial	$14.28
Rate for Payer: Humana Medicare Advantage	$4.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.88
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.79
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.76
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.05
Rate for Payer: Wellcare Medicare Advantage	$4.76

POTASSIUM, PLASMA

Facility

$45.25

Service Code	HCPCS 84132
Hospital Charge Code	3008943
Hospital Revenue Code	301
Min. Negotiated Rate	$6.79
Max. Negotiated Rate	$6.79
Rate for Payer: Qualcare PPO/HMO/WC	$6.79

POTASSIUM, SERUM

Facility

$390.00

Service Code	HCPCS 84132
Hospital Charge Code	3002151
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

POTASSIUM, SERUM

Facility

$390.00

Service Code	HCPCS 84132
Hospital Charge Code	3002151
Hospital Revenue Code	301
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.42
Rate for Payer: Aetna Medicare Advantage	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.44
Rate for Payer: Cigna Commercial	$4.76
Rate for Payer: Cigna Medicare Advantage	$2.38
Rate for Payer: Clover Medicare Advantage	$4.52
Rate for Payer: EmblemHealth Commercial	$14.28
Rate for Payer: Humana Medicare Advantage	$4.90
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	$4.76
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.05
Rate for Payer: Wellcare Medicare Advantage	$4.76

POTASSIUM,SERUM K

Facility

$117.00

Service Code	HCPCS 84132
Hospital Charge Code	38472551
Hospital Revenue Code	301
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.42
Rate for Payer: Aetna Medicare Advantage	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.44
Rate for Payer: Cigna Commercial	$4.76
Rate for Payer: Cigna Medicare Advantage	$2.38
Rate for Payer: Clover Medicare Advantage	$4.52
Rate for Payer: EmblemHealth Commercial	$14.28
Rate for Payer: Humana Medicare Advantage	$4.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.21
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.76
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.05
Rate for Payer: Wellcare Medicare Advantage	$4.76

POTASSIUM,SERUM K

Facility

$117.00

Service Code	HCPCS 84132
Hospital Charge Code	38472551
Hospital Revenue Code	301
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$17.55
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

POTASSIUM, SERUM PANEL***

Facility

$59.00

Service Code	HCPCS 84702
Hospital Charge Code	3002151P
Hospital Revenue Code	301
Min. Negotiated Rate	$8.85
Max. Negotiated Rate	$8.85
Rate for Payer: Qualcare PPO/HMO/WC	$8.85

POTASSIUM, SERUM PANEL***

Facility

$59.00

Service Code	HCPCS 84702
Hospital Charge Code	3002151P
Hospital Revenue Code	301
Min. Negotiated Rate	$7.53
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$48.76
Rate for Payer: Aetna Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.14
Rate for Payer: Cigna Commercial	$15.05
Rate for Payer: Cigna Medicare Advantage	$7.53
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.95
Rate for Payer: Wellcare Medicare Advantage	$15.05

POTASSIUM SODIUM CITRATE SOL

Facility

$30.15

Service Code	NDC 60258000216
Hospital Charge Code	60627886
Hospital Revenue Code	250
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$4.52
Rate for Payer: Qualcare PPO/HMO/WC	$4.52

Know your out-of-pocket cost for care.

All Charges