Heights University Hospital

All Charges

Charge

Type

Setting

Price

PRAVACHOL 20MG TAB U/D

Facility

$15.00

Hospital Charge Code	60635197
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

PRAVACHOL 40MG TAB BULK

Facility

$18.00

Hospital Charge Code	60635198
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

PRAVACHOL 40MG TAB BULK

Facility

$18.00

Hospital Charge Code	60635198
Hospital Revenue Code	250
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$9.00
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	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$9.00

PRAVASTATIN 10 MG TAB

Facility

$13.50

Hospital Charge Code	60629278
Hospital Revenue Code	250
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$6.75
Rate for Payer: Aetna Commercial	$4.05
Rate for Payer: Aetna Medicare Advantage	$4.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.44
Rate for Payer: Cigna Commercial	$6.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.75
Rate for Payer: Oxford Commercial	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$2.02
Rate for Payer: UnitedHealthcare Commercial	$6.75

PRAVASTATIN 10 MG TAB

Facility

$13.50

Hospital Charge Code	60629278
Hospital Revenue Code	250
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$2.02
Rate for Payer: Qualcare PPO/HMO/WC	$2.02

PRAVASTATIN 20 MG TAB

Facility

$22.45

Hospital Charge Code	60627621
Hospital Revenue Code	250
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$6.74
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$11.22
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$11.22

PRAVASTATIN 20 MG TAB

Facility

$22.45

Hospital Charge Code	60627621
Hospital Revenue Code	250
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

PRAVASTATIN NA 20MG TAB UD

Facility

$20.98

Hospital Charge Code	60631959
Hospital Revenue Code	250
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

PRAVASTATIN NA 20MG TAB UD

Facility

$20.98

Hospital Charge Code	60631959
Hospital Revenue Code	250
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$10.49
Rate for Payer: Aetna Commercial	$6.29
Rate for Payer: Aetna Medicare Advantage	$6.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.35
Rate for Payer: Cigna Commercial	$10.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$10.49
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$10.49

PRAVASTATIN SODIUM 10 MG TAB

Facility

$19.36

Service Code	NDC 904589161
Hospital Charge Code	6063943235
Hospital Revenue Code	250
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$9.68
Rate for Payer: Aetna Commercial	$5.81
Rate for Payer: Aetna Medicare Advantage	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.94
Rate for Payer: Cigna Commercial	$9.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.52
Rate for Payer: Oxford Commercial	$9.68
Rate for Payer: Qualcare PPO/HMO/WC	$2.90
Rate for Payer: UnitedHealthcare Commercial	$9.68

PRAVASTATIN SODIUM 10 MG TAB

Facility

$19.36

Service Code	NDC 904589161
Hospital Charge Code	6063943235
Hospital Revenue Code	250
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$2.90
Rate for Payer: Qualcare PPO/HMO/WC	$2.90

PRAVASTATIN SODIUM 20 MG TAB

Facility

$4.00

Service Code	NDC 43063044330
Hospital Charge Code	6063943236
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PRAVASTATIN SODIUM 20 MG TAB

Facility

$4.00

Service Code	NDC 43063044330
Hospital Charge Code	6063943236
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

PRAVASTATIN SODIUM 40 MG TAB

Facility

$45.49

Service Code	NDC 3519410
Hospital Charge Code	6063943237
Hospital Revenue Code	250
Min. Negotiated Rate	$5.91
Max. Negotiated Rate	$22.75
Rate for Payer: Aetna Commercial	$13.65
Rate for Payer: Aetna Medicare Advantage	$13.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.60
Rate for Payer: Cigna Commercial	$22.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.91
Rate for Payer: Oxford Commercial	$22.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.82
Rate for Payer: UnitedHealthcare Commercial	$22.75

PRAVASTATIN SODIUM 40 MG TAB

Facility

$45.49

Service Code	NDC 3519410
Hospital Charge Code	6063943237
Hospital Revenue Code	250
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$6.82
Rate for Payer: Qualcare PPO/HMO/WC	$6.82

PRAZOSIN 1 MG CAP

Facility

$4.00

Hospital Charge Code	60627641
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PRAZOSIN 1 MG CAP

Facility

$4.00

Hospital Charge Code	60627641
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

PRAZOSIN 2 MG

Facility

$16.88

Service Code	NDC 51079063120
Hospital Charge Code	606390180
Hospital Revenue Code	250
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$8.44
Rate for Payer: Aetna Commercial	$5.06
Rate for Payer: Aetna Medicare Advantage	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.19
Rate for Payer: Oxford Commercial	$8.44
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$8.44

PRAZOSIN 2 MG

Facility

$16.88

Service Code	NDC 51079063120
Hospital Charge Code	606390180
Hospital Revenue Code	250
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

PRAZOSIN 5 MG CAP

Facility

$10.45

Hospital Charge Code	60627642
Hospital Revenue Code	250
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$5.22
Rate for Payer: Aetna Commercial	$3.13
Rate for Payer: Aetna Medicare Advantage	$3.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.66
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.36
Rate for Payer: Oxford Commercial	$5.22
Rate for Payer: Qualcare PPO/HMO/WC	$1.57
Rate for Payer: UnitedHealthcare Commercial	$5.22

PRAZOSIN 5 MG CAP

Facility

$10.45

Hospital Charge Code	60627642
Hospital Revenue Code	250
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$1.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.57

PRAZOSIN 5 MG/MINIPRESS

Facility

$12.19

Service Code	NDC 51079063201
Hospital Charge Code	606390133
Hospital Revenue Code	250
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$6.09
Rate for Payer: Aetna Commercial	$3.66
Rate for Payer: Aetna Medicare Advantage	$3.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.11
Rate for Payer: Cigna Commercial	$6.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.58
Rate for Payer: Oxford Commercial	$6.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.83
Rate for Payer: UnitedHealthcare Commercial	$6.09

PRAZOSIN 5 MG/MINIPRESS

Facility

$12.19

Service Code	NDC 51079063201
Hospital Charge Code	606390133
Hospital Revenue Code	250
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$1.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.83

PRAZOSIN HYDROCHLORIDE 1 MG CA

Facility

$5.03

Service Code	NDC 51079063001
Hospital Charge Code	6063943238
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.52
Rate for Payer: Aetna Commercial	$1.51
Rate for Payer: Aetna Medicare Advantage	$1.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.28
Rate for Payer: Cigna Commercial	$2.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.52
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.52

PRAZOSIN HYDROCHLORIDE 1 MG CA

Facility

$5.03

Service Code	NDC 51079063001
Hospital Charge Code	6063943238
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

Know your out-of-pocket cost for care.

All Charges