Heights University Hospital

All Charges

Charge

Type

Setting

Price

PROGESTERONE OIL MDV 50MG/10ML

Facility

$14.85

Hospital Charge Code	60629834
Hospital Revenue Code	250
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$2.23
Rate for Payer: Qualcare PPO/HMO/WC	$2.23

PROGESTERONE RECEPTOR ASSAY

Facility

$770.00

Service Code	HCPCS 84234
Hospital Charge Code	38474007
Hospital Revenue Code	301
Min. Negotiated Rate	$32.44
Max. Negotiated Rate	$237.72
Rate for Payer: Aetna Commercial	$210.21
Rate for Payer: Aetna Medicare Advantage	$64.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$64.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.72
Rate for Payer: Cigna Commercial	$64.88
Rate for Payer: Cigna Medicare Advantage	$32.44
Rate for Payer: Clover Medicare Advantage	$61.64
Rate for Payer: EmblemHealth Commercial	$194.64
Rate for Payer: Humana Medicare Advantage	$66.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$115.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$64.88
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$68.77
Rate for Payer: Wellcare Medicare Advantage	$64.88

PROGESTERONE RECEPTOR ASSAY

Facility

$770.00

Service Code	HCPCS 84234
Hospital Charge Code	38474007
Hospital Revenue Code	301
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$115.50
Rate for Payer: Qualcare PPO/HMO/WC	$115.50

PROGESTERONE, SERUM

Facility

$103.25

Service Code	HCPCS 84144
Hospital Charge Code	3002193
Hospital Revenue Code	301
Min. Negotiated Rate	$15.49
Max. Negotiated Rate	$15.49
Rate for Payer: Qualcare PPO/HMO/WC	$15.49

PROGESTERONE, SERUM

Facility

$103.25

Service Code	HCPCS 84144
Hospital Charge Code	3002193
Hospital Revenue Code	301
Min. Negotiated Rate	$10.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$67.59
Rate for Payer: Aetna Medicare Advantage	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.43
Rate for Payer: Cigna Commercial	$20.86
Rate for Payer: Cigna Medicare Advantage	$10.43
Rate for Payer: Clover Medicare Advantage	$19.82
Rate for Payer: EmblemHealth Commercial	$62.58
Rate for Payer: Humana Medicare Advantage	$21.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.42
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.49
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.86
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.11
Rate for Payer: Wellcare Medicare Advantage	$20.86

PROGESTRONE***

Facility

$78.00

Hospital Charge Code	3012192
Hospital Revenue Code	309
Min. Negotiated Rate	$10.14
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$23.40
Rate for Payer: Aetna Medicare Advantage	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.89
Rate for Payer: Cigna Commercial	$39.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.70
Rate for Payer: UnitedHealthcare Commercial	$114.00

PROGESTRONE***

Facility

$78.00

Hospital Charge Code	3012192
Hospital Revenue Code	309
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$11.70
Rate for Payer: Qualcare PPO/HMO/WC	$11.70

PROGESTRONE/50MG/ML

Facility

$56.00

Hospital Charge Code	60634417
Hospital Revenue Code	250
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.40

PROGESTRONE/50MG/ML

Facility

$56.00

Hospital Charge Code	60634417
Hospital Revenue Code	250
Min. Negotiated Rate	$7.28
Max. Negotiated Rate	$28.00
Rate for Payer: Aetna Commercial	$16.80
Rate for Payer: Aetna Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.28
Rate for Payer: Cigna Commercial	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.28
Rate for Payer: Oxford Commercial	$28.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.40
Rate for Payer: UnitedHealthcare Commercial	$28.00

PROGRAF GRANULES 1MG/PKT

Facility

$63.65

Service Code	HCPCS J7507
Hospital Charge Code	606390478
Hospital Revenue Code	636
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$19.09
Rate for Payer: Aetna Commercial	$19.09
Rate for Payer: Aetna Medicare Advantage	$19.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.23
Rate for Payer: Cigna Commercial	$0.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.40
Rate for Payer: Qualcare PPO/HMO/WC	$9.55

PROGRAF GRANULES 1MG/PKT

Facility

$63.65

Service Code	HCPCS J7507
Hospital Charge Code	606390478
Hospital Revenue Code	636
Min. Negotiated Rate	$9.55
Max. Negotiated Rate	$15.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.40
Rate for Payer: Qualcare PPO/HMO/WC	$9.55

PROGRAMMER

Facility

$8,125.00

Service Code	HCPCS C1787
Hospital Charge Code	270675088
Hospital Revenue Code	272
Min. Negotiated Rate	$1,056.25
Max. Negotiated Rate	$4,062.50
Rate for Payer: Aetna Commercial	$2,437.50
Rate for Payer: Aetna Medicare Advantage	$2,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,071.88
Rate for Payer: Cigna Commercial	$4,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,056.25
Rate for Payer: Oxford Commercial	$4,062.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75
Rate for Payer: UnitedHealthcare Commercial	$4,062.50

PROGRAMMER

Facility

$8,125.00

Service Code	HCPCS C1787
Hospital Charge Code	270675088
Hospital Revenue Code	272
Min. Negotiated Rate	$1,218.75
Max. Negotiated Rate	$1,218.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75

PROGRAMMER PATIENT

Facility

$4,500.00

Hospital Charge Code	270648830
Hospital Revenue Code	272
Min. Negotiated Rate	$585.00
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.00
Rate for Payer: Oxford Commercial	$2,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Commercial	$2,250.00

PROGRAMMER PATIENT

Facility

$4,500.00

Hospital Charge Code	270648830
Hospital Revenue Code	272
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

PROGRAMMER PATIENT

Facility

$11,975.00

Service Code	HCPCS C1787
Hospital Charge Code	270683893
Hospital Revenue Code	272
Min. Negotiated Rate	$1,556.75
Max. Negotiated Rate	$5,987.50
Rate for Payer: Aetna Commercial	$3,592.50
Rate for Payer: Aetna Medicare Advantage	$3,592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,053.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,053.62
Rate for Payer: Cigna Commercial	$5,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,556.75
Rate for Payer: Oxford Commercial	$5,987.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25
Rate for Payer: UnitedHealthcare Commercial	$5,987.50

PROGRAMMER PATIENT

Facility

$11,975.00

Service Code	HCPCS C1787
Hospital Charge Code	270683893
Hospital Revenue Code	272
Min. Negotiated Rate	$1,796.25
Max. Negotiated Rate	$1,796.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,796.25

PROGRAMMER PATIENT 37744

Facility

$4,500.00

Hospital Charge Code	270647430
Hospital Revenue Code	272
Min. Negotiated Rate	$585.00
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.00
Rate for Payer: Oxford Commercial	$2,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Commercial	$2,250.00

PROGRAMMER PATIENT 37744

Facility

$4,500.00

Hospital Charge Code	270647430
Hospital Revenue Code	272
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

PROGRAMMER PATIENT EON MINI

Facility

$8,125.00

Service Code	HCPCS C1787
Hospital Charge Code	270642325
Hospital Revenue Code	278
Min. Negotiated Rate	$1,218.75
Max. Negotiated Rate	$4,062.50
Rate for Payer: Aetna Commercial	$2,437.50
Rate for Payer: Aetna Medicare Advantage	$2,437.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,071.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,071.88
Rate for Payer: Cigna Commercial	$4,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,966.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75

PROGRAMMER PATIENT EON MINI

Facility

$8,125.00

Service Code	HCPCS C1787
Hospital Charge Code	270642325
Hospital Revenue Code	278
Min. Negotiated Rate	$1,218.75
Max. Negotiated Rate	$1,966.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,966.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,218.75

PROGRAMMER POCKET

Facility

$7,500.00

Service Code	HCPCS C1787
Hospital Charge Code	270683892
Hospital Revenue Code	272
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,250.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$975.00
Rate for Payer: Oxford Commercial	$3,750.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Commercial	$3,750.00

PROGRAMMER POCKET

Facility

$7,500.00

Service Code	HCPCS C1787
Hospital Charge Code	270683892
Hospital Revenue Code	272
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

PROGRAMMER PT SYNERGY 7435

Facility

$4,935.25

Hospital Charge Code	270632006
Hospital Revenue Code	272
Min. Negotiated Rate	$641.58
Max. Negotiated Rate	$2,467.62
Rate for Payer: Aetna Commercial	$1,480.58
Rate for Payer: Aetna Medicare Advantage	$1,480.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,258.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,258.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,258.49
Rate for Payer: Cigna Commercial	$2,467.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$641.58
Rate for Payer: Oxford Commercial	$2,467.62
Rate for Payer: Qualcare PPO/HMO/WC	$740.29
Rate for Payer: UnitedHealthcare Commercial	$2,467.62

PROGRAMMER PT SYNERGY 7435

Facility

$4,935.25

Hospital Charge Code	270632006
Hospital Revenue Code	272
Min. Negotiated Rate	$740.29
Max. Negotiated Rate	$740.29
Rate for Payer: Qualcare PPO/HMO/WC	$740.29

Know your out-of-pocket cost for care.

All Charges