Heights University Hospital

All Charges

Charge

Type

Setting

Price

POWER PORT VUE MRI 6FR

Facility

$0.01

Hospital Charge Code	270659532
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

POWER PULSE KIT (Y CONNECTOR)

Facility

$170.00

Hospital Charge Code	270645569C
Hospital Revenue Code	272
Min. Negotiated Rate	$22.10
Max. Negotiated Rate	$85.00
Rate for Payer: Aetna Commercial	$51.00
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.10
Rate for Payer: Oxford Commercial	$85.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$85.00

POWER PULSE KIT (Y CONNECTOR)

Facility

$170.00

Hospital Charge Code	270645569C
Hospital Revenue Code	272
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

POWERRASP 4.0 MM x 13 CM

Facility

$725.00

Hospital Charge Code	270682021
Hospital Revenue Code	272
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$108.75
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

POWERRASP 4.0 MM x 13 CM

Facility

$725.00

Hospital Charge Code	270682021
Hospital Revenue Code	272
Min. Negotiated Rate	$94.25
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.25
Rate for Payer: Oxford Commercial	$362.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Commercial	$362.50

POWER RASP SMALL HUM 3.5 MM X

Facility

$725.00

Hospital Charge Code	270691592
Hospital Revenue Code	272
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$108.75
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

POWER RASP SMALL HUM 3.5 MM X

Facility

$725.00

Hospital Charge Code	270691592
Hospital Revenue Code	272
Min. Negotiated Rate	$94.25
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.25
Rate for Payer: Oxford Commercial	$362.50
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Commercial	$362.50

PPA PHENYL CPH DROPS BOT

Facility

$52.50

Hospital Charge Code	6006274
Hospital Revenue Code	251
Min. Negotiated Rate	$7.88
Max. Negotiated Rate	$7.88
Rate for Payer: Qualcare PPO/HMO/WC	$7.88

PPA PHENYL CPH DROPS BOT

Facility

$52.50

Hospital Charge Code	6006274
Hospital Revenue Code	251
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$26.25
Rate for Payer: Aetna Commercial	$15.75
Rate for Payer: Aetna Medicare Advantage	$15.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.39
Rate for Payer: Cigna Commercial	$26.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.83
Rate for Payer: Oxford Commercial	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$7.88
Rate for Payer: UnitedHealthcare Commercial	$26.25

PPA PHENYL CPH SYRUP BOT

Facility

$90.90

Hospital Charge Code	6006266
Hospital Revenue Code	251
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

PPA PHENYL CPH SYRUP BOT

Facility

$90.90

Hospital Charge Code	6006266
Hospital Revenue Code	251
Min. Negotiated Rate	$13.63
Max. Negotiated Rate	$13.63
Rate for Payer: Qualcare PPO/HMO/WC	$13.63

PPD SKIN TEST

Facility

$33.00

Service Code	HCPCS 86580
Hospital Charge Code	84206255
Hospital Revenue Code	302
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

PPD SKIN TEST

Facility

$33.00

Service Code	HCPCS 86580
Hospital Charge Code	84206255
Hospital Revenue Code	302
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$9.90
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: Cigna Medicare Advantage	$6.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.29
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$114.00

PRALIDOXINE CHL INJ 1GM

Facility

$347.50

Hospital Charge Code	6009039
Hospital Revenue Code	250
Min. Negotiated Rate	$52.12
Max. Negotiated Rate	$52.12
Rate for Payer: Qualcare PPO/HMO/WC	$52.12

PRALIDOXINE CHL INJ 1GM

Facility

$347.50

Hospital Charge Code	6009039
Hospital Revenue Code	250
Min. Negotiated Rate	$45.17
Max. Negotiated Rate	$173.75
Rate for Payer: Aetna Commercial	$104.25
Rate for Payer: Aetna Medicare Advantage	$104.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.61
Rate for Payer: Cigna Commercial	$173.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.17
Rate for Payer: Oxford Commercial	$173.75
Rate for Payer: Qualcare PPO/HMO/WC	$52.12
Rate for Payer: UnitedHealthcare Commercial	$173.75

PRAME-GEL 4 OZ

Facility

$53.80

Hospital Charge Code	6007280
Hospital Revenue Code	252
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

PRAME-GEL 4 OZ

Facility

$53.80

Hospital Charge Code	6007280
Hospital Revenue Code	252
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.07

PRAMIPEXOLE 0.125 MG TAB

Facility

$19.77

Service Code	NDC 13668009190
Hospital Charge Code	60628688
Hospital Revenue Code	250
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$9.88
Rate for Payer: Aetna Commercial	$5.93
Rate for Payer: Aetna Medicare Advantage	$5.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.04
Rate for Payer: Cigna Commercial	$9.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.57
Rate for Payer: Oxford Commercial	$9.88
Rate for Payer: Qualcare PPO/HMO/WC	$2.97
Rate for Payer: UnitedHealthcare Commercial	$9.88

PRAMIPEXOLE 0.125 MG TAB

Facility

$19.77

Service Code	NDC 13668009190
Hospital Charge Code	60628688
Hospital Revenue Code	250
Min. Negotiated Rate	$2.97
Max. Negotiated Rate	$2.97
Rate for Payer: Qualcare PPO/HMO/WC	$2.97

PRAMIPEXOLE 0.25 MG TAB

Facility

$8.44

Service Code	NDC 597018461
Hospital Charge Code	60628689
Hospital Revenue Code	250
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$4.22
Rate for Payer: Aetna Commercial	$2.53
Rate for Payer: Aetna Medicare Advantage	$2.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.15
Rate for Payer: Cigna Commercial	$4.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.10
Rate for Payer: Oxford Commercial	$4.22
Rate for Payer: Qualcare PPO/HMO/WC	$1.27
Rate for Payer: UnitedHealthcare Commercial	$4.22

PRAMIPEXOLE 0.25 MG TAB

Facility

$8.44

Service Code	NDC 597018461
Hospital Charge Code	60628689
Hospital Revenue Code	250
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$1.27
Rate for Payer: Qualcare PPO/HMO/WC	$1.27

PRAMIPEXOLE 0.5 MG TAB

Facility

$19.77

Service Code	NDC 13668009390
Hospital Charge Code	60629058
Hospital Revenue Code	250
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$9.88
Rate for Payer: Aetna Commercial	$5.93
Rate for Payer: Aetna Medicare Advantage	$5.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.04
Rate for Payer: Cigna Commercial	$9.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.57
Rate for Payer: Oxford Commercial	$9.88
Rate for Payer: Qualcare PPO/HMO/WC	$2.97
Rate for Payer: UnitedHealthcare Commercial	$9.88

PRAMIPEXOLE 0.5 MG TAB

Facility

$19.77

Service Code	NDC 13668009390
Hospital Charge Code	60629058
Hospital Revenue Code	250
Min. Negotiated Rate	$2.97
Max. Negotiated Rate	$2.97
Rate for Payer: Qualcare PPO/HMO/WC	$2.97

PRAMIPEXOLE 1.5 MG TAB

Facility

$19.77

Service Code	NDC 13668009590
Hospital Charge Code	60629030
Hospital Revenue Code	250
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$9.88
Rate for Payer: Aetna Commercial	$5.93
Rate for Payer: Aetna Medicare Advantage	$5.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.04
Rate for Payer: Cigna Commercial	$9.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.57
Rate for Payer: Oxford Commercial	$9.88
Rate for Payer: Qualcare PPO/HMO/WC	$2.97
Rate for Payer: UnitedHealthcare Commercial	$9.88

PRAMIPEXOLE 1.5 MG TAB

Facility

$19.77

Service Code	NDC 13668009590
Hospital Charge Code	60629030
Hospital Revenue Code	250
Min. Negotiated Rate	$2.97
Max. Negotiated Rate	$2.97
Rate for Payer: Qualcare PPO/HMO/WC	$2.97

Know your out-of-pocket cost for care.

All Charges