Heights University Hospital

All Charges

Charge

Type

Setting

Price

PROSTAGLANDIN E2 JELLY 2MG/3ML

Facility

$736.00

Hospital Charge Code	6007405
Hospital Revenue Code	252
Min. Negotiated Rate	$110.40
Max. Negotiated Rate	$110.40
Rate for Payer: Qualcare PPO/HMO/WC	$110.40

PROSTAGLANDIN E2 JELLY 2MG/3ML

Facility

$736.00

Hospital Charge Code	6007405
Hospital Revenue Code	252
Min. Negotiated Rate	$95.68
Max. Negotiated Rate	$368.00
Rate for Payer: Aetna Commercial	$220.80
Rate for Payer: Aetna Medicare Advantage	$220.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$187.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$187.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$187.68
Rate for Payer: Cigna Commercial	$368.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.68
Rate for Payer: Oxford Commercial	$368.00
Rate for Payer: Qualcare PPO/HMO/WC	$110.40
Rate for Payer: UnitedHealthcare Commercial	$368.00

PROSTAGLANDIN E2 SUPP 20MG

Facility

$765.45

Hospital Charge Code	6007413
Hospital Revenue Code	252
Min. Negotiated Rate	$99.51
Max. Negotiated Rate	$382.73
Rate for Payer: Aetna Commercial	$229.63
Rate for Payer: Aetna Medicare Advantage	$229.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.19
Rate for Payer: Cigna Commercial	$382.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.51
Rate for Payer: Oxford Commercial	$382.73
Rate for Payer: Qualcare PPO/HMO/WC	$114.82
Rate for Payer: UnitedHealthcare Commercial	$382.73

PROSTAGLANDIN E2 SUPP 20MG

Facility

$765.45

Hospital Charge Code	6007413
Hospital Revenue Code	252
Min. Negotiated Rate	$114.82
Max. Negotiated Rate	$114.82
Rate for Payer: Qualcare PPO/HMO/WC	$114.82

PROSTAGLANDIN,EACH

Facility

$176.74

Service Code	HCPCS 84150
Hospital Charge Code	38477177
Hospital Revenue Code	301
Min. Negotiated Rate	$26.51
Max. Negotiated Rate	$26.51
Rate for Payer: Qualcare PPO/HMO/WC	$26.51

PROSTAGLANDIN,EACH

Facility

$176.74

Service Code	HCPCS 84150
Hospital Charge Code	38477177
Hospital Revenue Code	301
Min. Negotiated Rate	$20.89
Max. Negotiated Rate	$153.05
Rate for Payer: Aetna Commercial	$135.33
Rate for Payer: Aetna Medicare Advantage	$41.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.05
Rate for Payer: Cigna Commercial	$41.77
Rate for Payer: Cigna Medicare Advantage	$20.89
Rate for Payer: Clover Medicare Advantage	$39.68
Rate for Payer: EmblemHealth Commercial	$125.31
Rate for Payer: Humana Medicare Advantage	$43.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.51
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$41.77
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$44.28
Rate for Payer: Wellcare Medicare Advantage	$41.77

PROSTATECTOMY CONE 18CM

Facility

$304.00

Hospital Charge Code	6017685
Hospital Revenue Code	250
Min. Negotiated Rate	$45.60
Max. Negotiated Rate	$45.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.60

PROSTATECTOMY CONE 18CM

Facility

$304.00

Hospital Charge Code	6017685
Hospital Revenue Code	250
Min. Negotiated Rate	$39.52
Max. Negotiated Rate	$152.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$91.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.52
Rate for Payer: Cigna Commercial	$152.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.52
Rate for Payer: Oxford Commercial	$152.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.60
Rate for Payer: UnitedHealthcare Commercial	$152.00

PROSTATECTOMY WITH CC

Facility

$62,596.95

Service Code	MSDRG 666
Min. Negotiated Rate	$19,089.38
Max. Negotiated Rate	$62,596.95
Rate for Payer: Aetna Commercial	$58,986.18
Rate for Payer: Aetna Medicare Advantage	$19,089.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47,415.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47,415.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,865.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47,415.24
Rate for Payer: Cigna Commercial	$37,646.69
Rate for Payer: Cigna Medicare Advantage	$20,865.65
Rate for Payer: Clover Medicare Advantage	$19,822.37
Rate for Payer: EmblemHealth Commercial	$62,596.95
Rate for Payer: Humana Medicare Advantage	$21,491.62
Rate for Payer: Oxford Commercial	$23,528.08
Rate for Payer: UnitedHealthcare Commercial	$26,706.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,865.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22,117.59
Rate for Payer: Wellcare Medicare Advantage	$20,865.65

PROSTATECTOMY WITH MCC

Facility

$105,246.48

Service Code	MSDRG 665
Min. Negotiated Rate	$32,432.16
Max. Negotiated Rate	$105,246.48
Rate for Payer: Cigna Medicare Advantage	$34,139.12
Rate for Payer: Clover Medicare Advantage	$32,432.16
Rate for Payer: Aetna Commercial	$105,246.48
Rate for Payer: Aetna Medicare Advantage	$34,060.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85,182.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85,182.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34,139.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85,182.03
Rate for Payer: Cigna Commercial	$67,171.35
Rate for Payer: EmblemHealth Commercial	$102,417.36
Rate for Payer: Humana Medicare Advantage	$35,163.29
Rate for Payer: Oxford Commercial	$41,980.14
Rate for Payer: UnitedHealthcare Commercial	$47,651.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$34,139.12
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$36,187.47
Rate for Payer: Wellcare Medicare Advantage	$34,139.12

PROSTATECTOMY WITHOUT CC/MCC

Facility

$43,930.50

Service Code	MSDRG 667
Min. Negotiated Rate	$12,071.50
Max. Negotiated Rate	$43,930.50
Rate for Payer: Aetna Commercial	$37,300.93
Rate for Payer: Aetna Medicare Advantage	$12,071.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,945.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,945.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,643.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28,945.35
Rate for Payer: Cigna Commercial	$23,806.53
Rate for Payer: Cigna Medicare Advantage	$14,643.50
Rate for Payer: Clover Medicare Advantage	$13,911.33
Rate for Payer: EmblemHealth Commercial	$43,930.50
Rate for Payer: Humana Medicare Advantage	$15,082.81
Rate for Payer: Oxford Commercial	$14,878.39
Rate for Payer: UnitedHealthcare Commercial	$16,888.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,643.50
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15,522.11
Rate for Payer: Wellcare Medicare Advantage	$14,643.50

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55710
Hospital Charge Code	1600000833
Hospital Revenue Code	360
Min. Negotiated Rate	$854.73
Max. Negotiated Rate	$854.73
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55711
Hospital Charge Code	404155711
Hospital Revenue Code	361
Min. Negotiated Rate	$740.77
Max. Negotiated Rate	$8,394.37
Rate for Payer: Aetna Commercial	$1,709.46
Rate for Payer: Aetna Medicare Advantage	$1,709.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.04
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.77
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55710
Hospital Charge Code	404155710
Hospital Revenue Code	361
Min. Negotiated Rate	$740.77
Max. Negotiated Rate	$8,394.37
Rate for Payer: Aetna Commercial	$1,709.46
Rate for Payer: Aetna Medicare Advantage	$1,709.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.04
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.77
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55714
Hospital Charge Code	1600000846
Hospital Revenue Code	360
Min. Negotiated Rate	$740.77
Max. Negotiated Rate	$12,768.54
Rate for Payer: Aetna Commercial	$1,709.46
Rate for Payer: Aetna Medicare Advantage	$1,709.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.04
Rate for Payer: Cigna Commercial	$12,768.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.77
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55705
Hospital Charge Code	1600000829
Hospital Revenue Code	360
Min. Negotiated Rate	$740.77
Max. Negotiated Rate	$8,394.37
Rate for Payer: Aetna Commercial	$1,709.46
Rate for Payer: Aetna Medicare Advantage	$1,709.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.04
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.77
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$854.73
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55710
Hospital Charge Code	1600000833
Hospital Revenue Code	360
Min. Negotiated Rate	$740.77
Max. Negotiated Rate	$8,394.37
Rate for Payer: Aetna Commercial	$1,709.46
Rate for Payer: Aetna Medicare Advantage	$1,709.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.04
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.77
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55708
Hospital Charge Code	404155708
Hospital Revenue Code	361
Min. Negotiated Rate	$854.73
Max. Negotiated Rate	$854.73
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55705
Hospital Charge Code	160000213
Hospital Revenue Code	360
Min. Negotiated Rate	$740.77
Max. Negotiated Rate	$8,394.37
Rate for Payer: Aetna Commercial	$1,709.46
Rate for Payer: Aetna Medicare Advantage	$1,709.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.04
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.77
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$854.73
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55709
Hospital Charge Code	1600000832
Hospital Revenue Code	360
Min. Negotiated Rate	$740.77
Max. Negotiated Rate	$8,394.37
Rate for Payer: Aetna Commercial	$1,709.46
Rate for Payer: Aetna Medicare Advantage	$1,709.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.04
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.77
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55709
Hospital Charge Code	1600000832
Hospital Revenue Code	360
Min. Negotiated Rate	$854.73
Max. Negotiated Rate	$854.73
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55707
Hospital Charge Code	1600000830
Hospital Revenue Code	360
Min. Negotiated Rate	$740.77
Max. Negotiated Rate	$8,394.37
Rate for Payer: Aetna Commercial	$1,709.46
Rate for Payer: Aetna Medicare Advantage	$1,709.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,453.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,453.04
Rate for Payer: Cigna Commercial	$8,394.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.77
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55709
Hospital Charge Code	404155709
Hospital Revenue Code	361
Min. Negotiated Rate	$854.73
Max. Negotiated Rate	$854.73
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55712
Hospital Charge Code	1600000845
Hospital Revenue Code	360
Min. Negotiated Rate	$854.73
Max. Negotiated Rate	$854.73
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55714
Hospital Charge Code	1600000846
Hospital Revenue Code	360
Min. Negotiated Rate	$854.73
Max. Negotiated Rate	$854.73
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

Know your out-of-pocket cost for care.

All Charges