Heights University Hospital

All Charges

Charge

Type

Setting

Price

PROMETHEUS ANSER IFX

Facility

$340.81

Hospital Charge Code	397073689
Hospital Revenue Code	306
Min. Negotiated Rate	$51.12
Max. Negotiated Rate	$51.12
Rate for Payer: Qualcare PPO/HMO/WC	$51.12

PROMETHEUS ANSER IFX

Facility

$667.59

Service Code	HCPCS 83520
Hospital Charge Code	397080006
Hospital Revenue Code	306
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

PROMETHEUS ANSER IFX

Facility

$340.81

Hospital Charge Code	397073689
Hospital Revenue Code	306
Min. Negotiated Rate	$44.31
Max. Negotiated Rate	$170.41
Rate for Payer: Aetna Commercial	$102.24
Rate for Payer: Aetna Medicare Advantage	$102.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.91
Rate for Payer: Cigna Commercial	$170.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.31
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.12
Rate for Payer: UnitedHealthcare Commercial	$114.00

PROMETHEUS ANSER IFX

Facility

$667.59

Service Code	HCPCS 83520
Hospital Charge Code	397080006
Hospital Revenue Code	306
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$55.95
Rate for Payer: Aetna Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.28
Rate for Payer: Cigna Commercial	$17.27
Rate for Payer: Cigna Medicare Advantage	$8.63
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
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	$17.27
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.31
Rate for Payer: Wellcare Medicare Advantage	$17.27

PROMETHZINE DM12.5MG/10ML

Facility

$2.00

Hospital Charge Code	60635688
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

PROMETHZINE DM12.5MG/10ML

Facility

$2.00

Hospital Charge Code	60635688
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.60
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.26
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$1.00

PROMOD

Facility

$21.00

Hospital Charge Code	60634859
Hospital Revenue Code	250
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$10.50
Rate for Payer: Aetna Commercial	$6.30
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$10.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$10.50

PROMOD

Facility

$21.00

Hospital Charge Code	60634859
Hospital Revenue Code	250
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

PROPAFENONE 150 MG TAB

Facility

$21.17

Service Code	NDC 173079220
Hospital Charge Code	60628853
Hospital Revenue Code	250
Min. Negotiated Rate	$3.18
Max. Negotiated Rate	$3.18
Rate for Payer: Qualcare PPO/HMO/WC	$3.18

PROPAFENONE 150 MG TAB

Facility

$21.17

Service Code	NDC 173079220
Hospital Charge Code	60628853
Hospital Revenue Code	250
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$10.59
Rate for Payer: Aetna Commercial	$6.35
Rate for Payer: Aetna Medicare Advantage	$6.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.40
Rate for Payer: Cigna Commercial	$10.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.75
Rate for Payer: Oxford Commercial	$10.59
Rate for Payer: Qualcare PPO/HMO/WC	$3.18
Rate for Payer: UnitedHealthcare Commercial	$10.59

PROPAFENONE HCL 225 MG TAB

Facility

$15.61

Service Code	NDC 591058301
Hospital Charge Code	606390056
Hospital Revenue Code	250
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$2.34
Rate for Payer: Qualcare PPO/HMO/WC	$2.34

PROPAFENONE HCL 225 MG TAB

Facility

$15.61

Service Code	NDC 591058301
Hospital Charge Code	606390056
Hospital Revenue Code	250
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$7.80
Rate for Payer: Aetna Commercial	$4.68
Rate for Payer: Aetna Medicare Advantage	$4.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.98
Rate for Payer: Cigna Commercial	$7.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.03
Rate for Payer: Oxford Commercial	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.34
Rate for Payer: UnitedHealthcare Commercial	$7.80

PROPANOLOL TAB 10MG

Facility

$1.95

Hospital Charge Code	6022800
Hospital Revenue Code	251
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.29

PROPANOLOL TAB 10MG

Facility

$1.95

Hospital Charge Code	6022800
Hospital Revenue Code	251
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.98
Rate for Payer: Aetna Commercial	$0.59
Rate for Payer: Aetna Medicare Advantage	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.50
Rate for Payer: Cigna Commercial	$0.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.25
Rate for Payer: Oxford Commercial	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.29
Rate for Payer: UnitedHealthcare Commercial	$0.98

PROPANTHELINE 7.5 MG TAB

Facility

$5.65

Hospital Charge Code	60627438
Hospital Revenue Code	252
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

PROPANTHELINE 7.5 MG TAB

Facility

$5.65

Hospital Charge Code	60627438
Hospital Revenue Code	252
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

PROPHECY ALIGNMENT GUIDE SET

Facility

$2,500.00

Hospital Charge Code	270697650
Hospital Revenue Code	272
Min. Negotiated Rate	$325.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$1,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$1,250.00

PROPHECY ALIGNMENT GUIDE SET

Facility

$2,500.00

Hospital Charge Code	270697650
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

PROPHECY INFINITY SET

Facility

$6,095.00

Hospital Charge Code	270676383
Hospital Revenue Code	272
Min. Negotiated Rate	$914.25
Max. Negotiated Rate	$914.25
Rate for Payer: Qualcare PPO/HMO/WC	$914.25

PROPHECY INFINITY SET

Facility

$6,095.00

Hospital Charge Code	270676383
Hospital Revenue Code	272
Min. Negotiated Rate	$792.35
Max. Negotiated Rate	$3,047.50
Rate for Payer: Aetna Commercial	$1,828.50
Rate for Payer: Aetna Medicare Advantage	$1,828.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,554.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,554.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,554.22
Rate for Payer: Cigna Commercial	$3,047.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$792.35
Rate for Payer: Oxford Commercial	$3,047.50
Rate for Payer: Qualcare PPO/HMO/WC	$914.25
Rate for Payer: UnitedHealthcare Commercial	$3,047.50

PROPHECY REPORT

Facility

$15,480.90

Hospital Charge Code	270704976
Hospital Revenue Code	272
Min. Negotiated Rate	$2,012.52
Max. Negotiated Rate	$7,740.45
Rate for Payer: Aetna Commercial	$4,644.27
Rate for Payer: Aetna Medicare Advantage	$4,644.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,947.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,947.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,947.63
Rate for Payer: Cigna Commercial	$7,740.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,012.52
Rate for Payer: Oxford Commercial	$7,740.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,322.14
Rate for Payer: UnitedHealthcare Commercial	$7,740.45

PROPHECY REPORT

Facility

$15,480.90

Hospital Charge Code	270704976
Hospital Revenue Code	272
Min. Negotiated Rate	$2,322.14
Max. Negotiated Rate	$2,322.14
Rate for Payer: Qualcare PPO/HMO/WC	$2,322.14

PROPHYRINS,FRAC,QUAN,RAND

Facility

$101.10

Service Code	HCPCS 84120
Hospital Charge Code	39900120
Hospital Revenue Code	301
Min. Negotiated Rate	$15.16
Max. Negotiated Rate	$15.16
Rate for Payer: Qualcare PPO/HMO/WC	$15.16

PROPHYRINS,FRAC,QUAN,RAND

Facility

$101.10

Service Code	HCPCS 84120
Hospital Charge Code	39900120
Hospital Revenue Code	301
Min. Negotiated Rate	$7.36
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.66
Rate for Payer: Aetna Medicare Advantage	$14.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.90
Rate for Payer: Cigna Commercial	$14.71
Rate for Payer: Cigna Medicare Advantage	$7.36
Rate for Payer: Clover Medicare Advantage	$13.97
Rate for Payer: EmblemHealth Commercial	$44.13
Rate for Payer: Humana Medicare Advantage	$15.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.16
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.71
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.59
Rate for Payer: Wellcare Medicare Advantage	$14.71

PROPINE 0.1% OPHTH/5ML

Facility

$71.00

Hospital Charge Code	60633763
Hospital Revenue Code	250
Min. Negotiated Rate	$9.23
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	$9.23
Rate for Payer: Oxford Commercial	$35.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$35.50

Know your out-of-pocket cost for care.

All Charges