Heights University Hospital

All Charges

Charge

Type

Setting

Price

PROCALCITONIN

Facility

$189.65

Service Code	HCPCS 84145
Hospital Charge Code	38472078
Hospital Revenue Code	301
Min. Negotiated Rate	$28.45
Max. Negotiated Rate	$28.45
Rate for Payer: Qualcare PPO/HMO/WC	$28.45

PROCALCITONIN

Facility

$184.10

Service Code	HCPCS 84145
Hospital Charge Code	39900123
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 IN HOUSE TEST

Facility

$377.00

Service Code	HCPCS 84145
Hospital Charge Code	401116223
Hospital Revenue Code	301
Min. Negotiated Rate	$56.55
Max. Negotiated Rate	$56.55
Rate for Payer: Qualcare PPO/HMO/WC	$56.55

PROCALCITONIN IN HOUSE TEST

Facility

$377.00

Service Code	HCPCS 84145
Hospital Charge Code	401116223
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	$49.01
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.55
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-QUEST

Facility

$200.00

Service Code	HCPCS 84145
Hospital Charge Code	401384145
Hospital Revenue Code	301
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

PROCALCITONIN-QUEST

Facility

$200.00

Service Code	HCPCS 84145
Hospital Charge Code	401384145
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	$26.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
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

PROCAN SR/250MG/TAB

Facility

$3.00

Hospital Charge Code	60633739
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PROCAN SR/250MG/TAB

Facility

$3.00

Hospital Charge Code	60633735
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PROCAN SR/250MG/TAB

Facility

$3.00

Hospital Charge Code	60633735
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

PROCAN SR/250MG/TAB

Facility

$3.00

Hospital Charge Code	60633739
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

PROCAN SR/250MG/TAB

Facility

$3.00

Hospital Charge Code	60633738
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

PROCAN SR/250MG/TAB

Facility

$3.00

Hospital Charge Code	60633738
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PROCAN SR/500MG/TAB

Facility

$3.00

Hospital Charge Code	60633736
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PROCAN SR/500MG/TAB

Facility

$3.00

Hospital Charge Code	60633737
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

PROCAN SR/500MG/TAB

Facility

$3.00

Hospital Charge Code	60633736
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

PROCAN SR/500MG/TAB

Facility

$3.00

Hospital Charge Code	60633737
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PROCAN SR/750MG/TAB

Facility

$3.00

Hospital Charge Code	60633734
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

PROCAN SR/750MG/TAB

Facility

$3.00

Hospital Charge Code	60633734
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

PROCARBAINE CAP 50MG

Facility

$9.65

Hospital Charge Code	60627406
Hospital Revenue Code	250
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

PROCARBAINE CAP 50MG

Facility

$9.65

Hospital Charge Code	60627406
Hospital Revenue Code	250
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$2.90
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.25
Rate for Payer: Oxford Commercial	$4.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$4.83

PROCARDIA/10MG/CAP

Facility

$4.00

Hospital Charge Code	60633740
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

PROCARDIA/10MG/CAP

Facility

$4.00

Hospital Charge Code	60633740
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PROCARDIA XL/30MG/TAB

Facility

$5.00

Hospital Charge Code	60633741
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.50
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.65
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$2.50

PROCARDIA XL/30MG/TAB

Facility

$23.00

Hospital Charge Code	60633744
Hospital Revenue Code	250
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$6.90
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Oxford Commercial	$11.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$11.50

PROCARDIA XL/30MG/TAB

Facility

$23.00

Hospital Charge Code	60633744
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

Know your out-of-pocket cost for care.

All Charges