Heights University Hospital

All Charges

Charge

Type

Setting

Price

PROCAINAMIDE CAP 250MG

Facility

$3.20

Hospital Charge Code	60627591
Hospital Revenue Code	250
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$1.60
Rate for Payer: Aetna Commercial	$0.96
Rate for Payer: Aetna Medicare Advantage	$0.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.82
Rate for Payer: Cigna Commercial	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.42
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.48
Rate for Payer: UnitedHealthcare Commercial	$1.60

PROCAINAMIDE HCL 100MG/ML 10ML

Facility

$4.00

Service Code	HCPCS J2690
Hospital Charge Code	6063943312
Hospital Revenue Code	636
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PROCAINAMIDE HCL 100MG/ML 10ML

Facility

$4.00

Service Code	HCPCS J2690
Hospital Charge Code	6063943312
Hospital Revenue Code	636
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$1.20
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: MagnaCare PPO/Direct Plus/Exchange/WC	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PROCAINAMIDE & NAPA

Facility

$115.15

Service Code	HCPCS 80192
Hospital Charge Code	39900009
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$114.00
Rate for Payer: Humana Medicare Advantage	$17.25
Rate for Payer: Aetna Commercial	$54.27
Rate for Payer: Aetna Medicare Advantage	$16.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.75
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	$61.37
Rate for Payer: Cigna Commercial	$16.75
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.91
Rate for Payer: EmblemHealth Commercial	$50.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.27
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.75
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.75
Rate for Payer: Wellcare Medicare Advantage	$16.75

PROCAINAMIDE & NAPA

Facility

$115.15

Service Code	HCPCS 80192
Hospital Charge Code	39900009
Hospital Revenue Code	301
Min. Negotiated Rate	$17.27
Max. Negotiated Rate	$17.27
Rate for Payer: Qualcare PPO/HMO/WC	$17.27

PROCAINAMIDE (PRONESTYL)

Facility

$217.00

Service Code	HCPCS 80192
Hospital Charge Code	38472560
Hospital Revenue Code	301
Min. Negotiated Rate	$8.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$54.27
Rate for Payer: Aetna Medicare Advantage	$16.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.75
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	$61.37
Rate for Payer: Cigna Commercial	$16.75
Rate for Payer: Cigna Medicare Advantage	$8.38
Rate for Payer: Clover Medicare Advantage	$15.91
Rate for Payer: EmblemHealth Commercial	$50.25
Rate for Payer: Humana Medicare Advantage	$17.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.21
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.75
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.75
Rate for Payer: Wellcare Medicare Advantage	$16.75

PROCAINAMIDE (PRONESTYL)

Facility

$217.00

Service Code	HCPCS 80192
Hospital Charge Code	38472560
Hospital Revenue Code	301
Min. Negotiated Rate	$32.55
Max. Negotiated Rate	$32.55
Rate for Payer: Qualcare PPO/HMO/WC	$32.55

PROCAINAMIDE TAB 500 MG CR

Facility

$4.50

Hospital Charge Code	60629035
Hospital Revenue Code	250
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$2.25
Rate for Payer: Aetna Commercial	$1.35
Rate for Payer: Aetna Medicare Advantage	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.15
Rate for Payer: Cigna Commercial	$2.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.59
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$0.68
Rate for Payer: UnitedHealthcare Commercial	$2.25

PROCAINAMIDE TAB 500 MG CR

Facility

$4.50

Hospital Charge Code	60629035
Hospital Revenue Code	250
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$0.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.68

PROCAINAMIDE TAB SR 750MG

Facility

$5.65

Hospital Charge Code	60627596
Hospital Revenue Code	250
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$1.70
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.73
Rate for Payer: Oxford Commercial	$2.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$2.83

PROCAINAMIDE TAB SR 750MG

Facility

$5.65

Hospital Charge Code	60627596
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

PROCAINE HYDROCH INJ 1% 30ML

Facility

$2.45

Hospital Charge Code	6004659
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

PROCAINE HYDROCH INJ 1% 30ML

Facility

$2.45

Hospital Charge Code	6004659
Hospital Revenue Code	250
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$0.74
Rate for Payer: Aetna Medicare Advantage	$0.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.62
Rate for Payer: Cigna Commercial	$1.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.32
Rate for Payer: Oxford Commercial	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$1.23

PROCAINE HYDROCH INJ 2% 30ML

Facility

$109.45

Hospital Charge Code	6004667
Hospital Revenue Code	250
Min. Negotiated Rate	$14.23
Max. Negotiated Rate	$54.73
Rate for Payer: Aetna Commercial	$32.84
Rate for Payer: Aetna Medicare Advantage	$32.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.91
Rate for Payer: Cigna Commercial	$54.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.23
Rate for Payer: Oxford Commercial	$54.73
Rate for Payer: Qualcare PPO/HMO/WC	$16.42
Rate for Payer: UnitedHealthcare Commercial	$54.73

PROCAINE HYDROCH INJ 2% 30ML

Facility

$109.45

Hospital Charge Code	6004667
Hospital Revenue Code	250
Min. Negotiated Rate	$16.42
Max. Negotiated Rate	$16.42
Rate for Payer: Qualcare PPO/HMO/WC	$16.42

PROCAINE INJ 2%

Facility

$38.45

Hospital Charge Code	60628279
Hospital Revenue Code	250
Min. Negotiated Rate	$5.77
Max. Negotiated Rate	$5.77
Rate for Payer: Qualcare PPO/HMO/WC	$5.77

PROCAINE INJ 2%

Facility

$38.45

Hospital Charge Code	60628279
Hospital Revenue Code	250
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$19.23
Rate for Payer: Aetna Commercial	$11.54
Rate for Payer: Aetna Medicare Advantage	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.80
Rate for Payer: Cigna Commercial	$19.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.00
Rate for Payer: Oxford Commercial	$19.23
Rate for Payer: Qualcare PPO/HMO/WC	$5.77
Rate for Payer: UnitedHealthcare Commercial	$19.23

PROCAINE VL 1% 30ML

Facility

$4.50

Hospital Charge Code	6013163
Hospital Revenue Code	250
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$0.68
Rate for Payer: Qualcare PPO/HMO/WC	$0.68

PROCAINE VL 1% 30ML

Facility

$4.50

Hospital Charge Code	6013163
Hospital Revenue Code	250
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$2.25
Rate for Payer: Aetna Commercial	$1.35
Rate for Payer: Aetna Medicare Advantage	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.15
Rate for Payer: Cigna Commercial	$2.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.59
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$0.68
Rate for Payer: UnitedHealthcare Commercial	$2.25

PROCALAMINE/1000ML

Facility

$131.00

Hospital Charge Code	60634539
Hospital Revenue Code	250
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$19.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

PROCALAMINE/1000ML

Facility

$131.00

Hospital Charge Code	60634539
Hospital Revenue Code	250
Min. Negotiated Rate	$17.03
Max. Negotiated Rate	$65.50
Rate for Payer: Aetna Commercial	$39.30
Rate for Payer: Aetna Medicare Advantage	$39.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.41
Rate for Payer: Cigna Commercial	$65.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.03
Rate for Payer: Oxford Commercial	$65.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.65
Rate for Payer: UnitedHealthcare Commercial	$65.50

PROCALCITONIN

Facility

$184.10

Service Code	HCPCS 84145
Hospital Charge Code	3038135
Hospital Revenue Code	301
Min. Negotiated Rate	$27.61
Max. Negotiated Rate	$27.61
Rate for Payer: Qualcare PPO/HMO/WC	$27.61

PROCALCITONIN

Facility

$184.10

Service Code	HCPCS 84145
Hospital Charge Code	3038135
Hospital Revenue Code	301
Min. Negotiated Rate	$13.61
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$88.19
Rate for Payer: Aetna Medicare Advantage	$27.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.73
Rate for Payer: Cigna Commercial	$27.22
Rate for Payer: Cigna Medicare Advantage	$13.61
Rate for Payer: Clover Medicare Advantage	$25.86
Rate for Payer: EmblemHealth Commercial	$81.66
Rate for Payer: Humana Medicare Advantage	$28.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.61
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28.85
Rate for Payer: Wellcare Medicare Advantage	$27.22

PROCALCITONIN

Facility

$189.65

Service Code	HCPCS 84145
Hospital Charge Code	38472078
Hospital Revenue Code	301
Min. Negotiated Rate	$13.61
Max. Negotiated Rate	$114.00
Rate for Payer: Humana Medicare Advantage	$28.04
Rate for Payer: Aetna Commercial	$88.19
Rate for Payer: Aetna Medicare Advantage	$27.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.73
Rate for Payer: Cigna Commercial	$27.22
Rate for Payer: Cigna Medicare Advantage	$13.61
Rate for Payer: Clover Medicare Advantage	$25.86
Rate for Payer: EmblemHealth Commercial	$81.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.65
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.45
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28.85
Rate for Payer: Wellcare Medicare Advantage	$27.22

PROCALCITONIN

Facility

$184.10

Service Code	HCPCS 84145
Hospital Charge Code	39900123
Hospital Revenue Code	301
Min. Negotiated Rate	$27.61
Max. Negotiated Rate	$27.61
Rate for Payer: Qualcare PPO/HMO/WC	$27.61

Know your out-of-pocket cost for care.

All Charges