Heights University Hospital

All Charges

Charge

Type

Setting

Price

PREGNENOLONE

Facility

$142.10

Service Code	HCPCS 84140
Hospital Charge Code	39900121
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$66.97
Rate for Payer: Aetna Medicare Advantage	$20.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.73
Rate for Payer: Cigna Commercial	$20.67
Rate for Payer: Cigna Medicare Advantage	$10.34
Rate for Payer: Clover Medicare Advantage	$19.64
Rate for Payer: EmblemHealth Commercial	$62.01
Rate for Payer: Humana Medicare Advantage	$21.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.47
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.32
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.67
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$21.91
Rate for Payer: Wellcare Medicare Advantage	$20.67

PREGNENOLONE

Facility

$147.00

Hospital Charge Code	3010550
Hospital Revenue Code	301
Min. Negotiated Rate	$19.11
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$44.10
Rate for Payer: Aetna Medicare Advantage	$44.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.48
Rate for Payer: Cigna Commercial	$73.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.11
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.05
Rate for Payer: UnitedHealthcare Commercial	$114.00

PREGNENOLONE

Facility

$141.65

Service Code	HCPCS 84140
Hospital Charge Code	3000551
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$66.97
Rate for Payer: Aetna Medicare Advantage	$20.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.73
Rate for Payer: Cigna Commercial	$20.67
Rate for Payer: Cigna Medicare Advantage	$10.34
Rate for Payer: Clover Medicare Advantage	$19.64
Rate for Payer: EmblemHealth Commercial	$62.01
Rate for Payer: Humana Medicare Advantage	$21.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.67
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$21.91
Rate for Payer: Wellcare Medicare Advantage	$20.67

PREGNENOLONE

Facility

$146.00

Service Code	HCPCS 84140
Hospital Charge Code	38477168
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$66.97
Rate for Payer: Aetna Medicare Advantage	$20.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.73
Rate for Payer: Cigna Commercial	$20.67
Rate for Payer: Cigna Medicare Advantage	$10.34
Rate for Payer: Clover Medicare Advantage	$19.64
Rate for Payer: EmblemHealth Commercial	$62.01
Rate for Payer: Humana Medicare Advantage	$21.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.67
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$21.91
Rate for Payer: Wellcare Medicare Advantage	$20.67

PREGNENOLONE

Facility

$141.65

Service Code	HCPCS 84140
Hospital Charge Code	3000551
Hospital Revenue Code	301
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

PREGNENOLONE

Facility

$146.00

Service Code	HCPCS 84140
Hospital Charge Code	38477168
Hospital Revenue Code	301
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

PREGNENOLONE

Facility

$147.00

Hospital Charge Code	3010550
Hospital Revenue Code	301
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$22.05
Rate for Payer: Qualcare PPO/HMO/WC	$22.05

PREGNENOLONE

Facility

$142.10

Service Code	HCPCS 84140
Hospital Charge Code	39900121
Hospital Revenue Code	301
Min. Negotiated Rate	$21.32
Max. Negotiated Rate	$21.32
Rate for Payer: Qualcare PPO/HMO/WC	$21.32

PREGNYL/10000U

Facility

$152.00

Hospital Charge Code	60633705
Hospital Revenue Code	636
Min. Negotiated Rate	$22.80
Max. Negotiated Rate	$36.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.78
Rate for Payer: Qualcare PPO/HMO/WC	$22.80

PREGNYL/10000U

Facility

$152.00

Hospital Charge Code	60633705
Hospital Revenue Code	636
Min. Negotiated Rate	$22.80
Max. Negotiated Rate	$76.00
Rate for Payer: Aetna Commercial	$45.60
Rate for Payer: Aetna Medicare Advantage	$45.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.76
Rate for Payer: Cigna Commercial	$76.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.78
Rate for Payer: Qualcare PPO/HMO/WC	$22.80

PREG TEST (SERUM HCG QUAL)

Facility

$667.59

Service Code	HCPCS 84703
Hospital Charge Code	3006350
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

PREG TEST (SERUM HCG QUAL)

Facility

$667.59

Service Code	HCPCS 84703
Hospital Charge Code	3006350
Hospital Revenue Code	301
Min. Negotiated Rate	$3.76
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$24.36
Rate for Payer: Aetna Medicare Advantage	$7.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.55
Rate for Payer: Cigna Commercial	$7.52
Rate for Payer: Cigna Medicare Advantage	$3.76
Rate for Payer: Clover Medicare Advantage	$7.14
Rate for Payer: EmblemHealth Commercial	$22.56
Rate for Payer: Humana Medicare Advantage	$7.75
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	$7.52
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$7.97
Rate for Payer: Wellcare Medicare Advantage	$7.52

PREKALLIKREIN ACTIVITY

Facility

$131.25

Service Code	HCPCS 85292
Hospital Charge Code	3032350
Hospital Revenue Code	300
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$61.33
Rate for Payer: Aetna Medicare Advantage	$18.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.36
Rate for Payer: Cigna Commercial	$18.93
Rate for Payer: Cigna Medicare Advantage	$9.46
Rate for Payer: Clover Medicare Advantage	$17.98
Rate for Payer: EmblemHealth Commercial	$56.79
Rate for Payer: Humana Medicare Advantage	$19.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.06
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.93
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.07
Rate for Payer: Wellcare Medicare Advantage	$18.93

PREKALLIKREIN ACTIVITY

Facility

$131.25

Service Code	HCPCS 85292
Hospital Charge Code	3032350
Hospital Revenue Code	300
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$19.69
Rate for Payer: Qualcare PPO/HMO/WC	$19.69

PREKALLIKREIN(FLETCHER FACTOR)

Facility

$233.00

Service Code	HCPCS 85292
Hospital Charge Code	401385292
Hospital Revenue Code	305
Min. Negotiated Rate	$34.95
Max. Negotiated Rate	$34.95
Rate for Payer: Qualcare PPO/HMO/WC	$34.95

PREKALLIKREIN(FLETCHER FACTOR)

Facility

$233.00

Service Code	HCPCS 85292
Hospital Charge Code	401385292
Hospital Revenue Code	305
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$61.33
Rate for Payer: Aetna Medicare Advantage	$18.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.36
Rate for Payer: Cigna Commercial	$18.93
Rate for Payer: Cigna Medicare Advantage	$9.46
Rate for Payer: Clover Medicare Advantage	$17.98
Rate for Payer: EmblemHealth Commercial	$56.79
Rate for Payer: Humana Medicare Advantage	$19.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.29
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.93
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$20.07
Rate for Payer: Wellcare Medicare Advantage	$18.93

PRELONE 15MG/ML LIQ

Facility

$18.00

Hospital Charge Code	60635184
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

PRELONE 15MG/ML LIQ

Facility

$18.00

Hospital Charge Code	60635184
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

PRELUDE SYNC EVO DEVICE

Facility

$125.00

Service Code	HCPCS A4649
Hospital Charge Code	270692530S
Hospital Revenue Code	272
Min. Negotiated Rate	$16.25
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$62.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Commercial	$62.50

PRELUDE SYNC EVO DEVICE

Facility

$125.00

Service Code	HCPCS A4649
Hospital Charge Code	270692530S
Hospital Revenue Code	272
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$18.75
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

PREMARIN/0.625MG/TAB

Facility

$3.00

Hospital Charge Code	60633706
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PREMARIN/0.625MG/TAB

Facility

$3.00

Hospital Charge Code	60633707
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

PREMARIN/0.625MG/TAB

Facility

$3.00

Hospital Charge Code	60633707
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PREMARIN/0.625MG/TAB

Facility

$3.00

Hospital Charge Code	60633706
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

PREMARIN/1.25MG/TAB

Facility

$3.00

Hospital Charge Code	60633708
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

Know your out-of-pocket cost for care.

All Charges