Heights University Hospital

All Charges

Charge

Type

Setting

Price

PROCAINAMIDE

Facility

$118.59

Service Code	HCPCS 80190
Hospital Charge Code	38472559
Hospital Revenue Code	301
Min. Negotiated Rate	$15.42
Max. Negotiated Rate	$219.84
Rate for Payer: Aetna Commercial	$194.40
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.84
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: Cigna Medicare Advantage	$30.00
Rate for Payer: Clover Medicare Advantage	$57.00
Rate for Payer: EmblemHealth Commercial	$180.00
Rate for Payer: Humana Medicare Advantage	$61.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.42
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.79
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$60.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$63.60
Rate for Payer: Wellcare Medicare Advantage	$60.00

PROCAINAMIDE

Facility

$118.59

Service Code	HCPCS 80190
Hospital Charge Code	38472559
Hospital Revenue Code	301
Min. Negotiated Rate	$17.79
Max. Negotiated Rate	$17.79
Rate for Payer: Qualcare PPO/HMO/WC	$17.79

PROCAINAMIDE 1000MG/2ML INJ

Facility

$365.75

Service Code	HCPCS J2690
Hospital Charge Code	60627590
Hospital Revenue Code	636
Min. Negotiated Rate	$54.86
Max. Negotiated Rate	$109.72
Rate for Payer: Aetna Commercial	$109.72
Rate for Payer: Aetna Medicare Advantage	$109.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.51
Rate for Payer: Qualcare PPO/HMO/WC	$54.86

PROCAINAMIDE 1000MG/2ML INJ

Facility

$365.75

Service Code	HCPCS J2690
Hospital Charge Code	60627590
Hospital Revenue Code	636
Min. Negotiated Rate	$54.86
Max. Negotiated Rate	$88.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.51
Rate for Payer: Qualcare PPO/HMO/WC	$54.86

PROCAINAMIDE/100MG/1ML

Facility

$71.00

Hospital Charge Code	60633733
Hospital Revenue Code	636
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$35.50
Rate for Payer: Aetna Commercial	$21.30
Rate for Payer: Aetna Medicare Advantage	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.11
Rate for Payer: Cigna Commercial	$35.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.18
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

PROCAINAMIDE/100MG/1ML

Facility

$53.00

Hospital Charge Code	60633732
Hospital Revenue Code	636
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$26.50
Rate for Payer: Aetna Commercial	$15.90
Rate for Payer: Aetna Medicare Advantage	$15.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.52
Rate for Payer: Cigna Commercial	$26.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.83
Rate for Payer: Qualcare PPO/HMO/WC	$7.95

PROCAINAMIDE/100MG/1ML

Facility

$53.00

Hospital Charge Code	60633732
Hospital Revenue Code	636
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$12.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.83
Rate for Payer: Qualcare PPO/HMO/WC	$7.95

PROCAINAMIDE/100MG/1ML

Facility

$71.00

Hospital Charge Code	60633733
Hospital Revenue Code	636
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$17.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.18
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

PROCAINAMIDE/250MG/CAP

Facility

$3.00

Hospital Charge Code	60633728
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PROCAINAMIDE/250MG/CAP

Facility

$3.00

Hospital Charge Code	60633728
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

PROCAINAMIDE 250 MG ER TAB

Facility

$4.00

Hospital Charge Code	60627592
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

PROCAINAMIDE 250 MG ER TAB

Facility

$4.00

Hospital Charge Code	60627592
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PROCAINAMIDE 375 MG CAP

Facility

$4.00

Hospital Charge Code	60627593
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PROCAINAMIDE 375 MG CAP

Facility

$4.00

Hospital Charge Code	60627593
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

PROCAINAMIDE/375MG/CAP

Facility

$3.00

Hospital Charge Code	60633730
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PROCAINAMIDE/375MG/CAP

Facility

$3.00

Hospital Charge Code	60633730
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

PROCAINAMIDE/500MG/1ML

Facility

$53.00

Hospital Charge Code	60633731
Hospital Revenue Code	636
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$12.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.83
Rate for Payer: Qualcare PPO/HMO/WC	$7.95

PROCAINAMIDE/500MG/1ML

Facility

$53.00

Hospital Charge Code	60633731
Hospital Revenue Code	636
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$26.50
Rate for Payer: Aetna Commercial	$15.90
Rate for Payer: Aetna Medicare Advantage	$15.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.52
Rate for Payer: Cigna Commercial	$26.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.83
Rate for Payer: Qualcare PPO/HMO/WC	$7.95

PROCAINAMIDE/500MG/CAP

Facility

$3.00

Hospital Charge Code	60633729
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PROCAINAMIDE/500MG/CAP

Facility

$3.00

Hospital Charge Code	60633729
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

PROCAINAMIDE 500 MG ER TAB

Facility

$4.00

Hospital Charge Code	60627595
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

PROCAINAMIDE 500 MG ER TAB

Facility

$4.00

Hospital Charge Code	60627595
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PROCAINAMIDE/500MG/TAB

Facility

$3.00

Hospital Charge Code	60633727
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

PROCAINAMIDE/500MG/TAB

Facility

$3.00

Hospital Charge Code	60633727
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PROCAINAMIDE CAP 250MG

Facility

$3.20

Hospital Charge Code	60627591
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

Know your out-of-pocket cost for care.

All Charges