Heights University Hospital

All Charges

Charge

Type

Setting

Price

PROTHROMBIN TIME (PT)

Facility

$176.40

Service Code	HCPCS 85610
Hospital Charge Code	38478008
Hospital Revenue Code	305
Min. Negotiated Rate	$26.46
Max. Negotiated Rate	$26.46
Rate for Payer: Qualcare PPO/HMO/WC	$26.46

PROTHROMB ISOLAT EXTRAC

Facility

$99.00

Service Code	HCPCS 83891
Hospital Charge Code	38479507
Hospital Revenue Code	301
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$14.85
Rate for Payer: Qualcare PPO/HMO/WC	$14.85

PROTHROMB ISOLAT EXTRAC

Facility

$99.00

Service Code	HCPCS 83891
Hospital Charge Code	38479507
Hospital Revenue Code	301
Min. Negotiated Rate	$12.87
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$29.70
Rate for Payer: Aetna Medicare Advantage	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.25
Rate for Payer: Cigna Commercial	$49.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.87
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.85
Rate for Payer: UnitedHealthcare Commercial	$114.00

PROTHRO MOLECULAR DIAG & INTER

Facility

$85.00

Service Code	HCPCS 83912
Hospital Charge Code	38479509
Hospital Revenue Code	301
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$25.50
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

PROTHRO MOLECULAR DIAG & INTER

Facility

$85.00

Service Code	HCPCS 83912
Hospital Charge Code	38479509
Hospital Revenue Code	301
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

PROTIEN S,TOTAL

Facility

$410.00

Service Code	HCPCS 85305
Hospital Charge Code	38479111
Hospital Revenue Code	305
Min. Negotiated Rate	$5.80
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$37.62
Rate for Payer: Aetna Medicare Advantage	$11.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.54
Rate for Payer: Cigna Commercial	$11.61
Rate for Payer: Cigna Medicare Advantage	$5.80
Rate for Payer: Clover Medicare Advantage	$11.03
Rate for Payer: EmblemHealth Commercial	$34.83
Rate for Payer: Humana Medicare Advantage	$11.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.61
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$12.31
Rate for Payer: Wellcare Medicare Advantage	$11.61

PROTIEN S,TOTAL

Facility

$410.00

Service Code	HCPCS 85305
Hospital Charge Code	38479111
Hospital Revenue Code	305
Min. Negotiated Rate	$61.50
Max. Negotiated Rate	$61.50
Rate for Payer: Qualcare PPO/HMO/WC	$61.50

PROTIME (PT)

Facility

$661.89

Service Code	HCPCS 85610
Hospital Charge Code	3002284
Hospital Revenue Code	305
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.90
Rate for Payer: Aetna Medicare Advantage	$4.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.72
Rate for Payer: Cigna Commercial	$4.29
Rate for Payer: Cigna Medicare Advantage	$2.15
Rate for Payer: Clover Medicare Advantage	$4.08
Rate for Payer: EmblemHealth Commercial	$12.87
Rate for Payer: Humana Medicare Advantage	$4.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$99.28
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.29
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.55
Rate for Payer: Wellcare Medicare Advantage	$4.29

PROTIME (PT)

Facility

$661.89

Service Code	HCPCS 85610
Hospital Charge Code	3002284
Hospital Revenue Code	305
Min. Negotiated Rate	$99.28
Max. Negotiated Rate	$99.28
Rate for Payer: Qualcare PPO/HMO/WC	$99.28

PROTIRELIN AMP 500MG/ML

Facility

$30.10

Hospital Charge Code	6007587
Hospital Revenue Code	250
Min. Negotiated Rate	$3.91
Max. Negotiated Rate	$15.05
Rate for Payer: Aetna Commercial	$9.03
Rate for Payer: Aetna Medicare Advantage	$9.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.68
Rate for Payer: Cigna Commercial	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.91
Rate for Payer: Oxford Commercial	$15.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.51
Rate for Payer: UnitedHealthcare Commercial	$15.05

PROTIRELIN AMP 500MG/ML

Facility

$30.10

Hospital Charge Code	6007587
Hospital Revenue Code	250
Min. Negotiated Rate	$4.51
Max. Negotiated Rate	$4.51
Rate for Payer: Qualcare PPO/HMO/WC	$4.51

PROTOE SIZE SMALL

Facility

$3,440.00

Hospital Charge Code	270663473
Hospital Revenue Code	270
Min. Negotiated Rate	$516.00
Max. Negotiated Rate	$516.00
Rate for Payer: Qualcare PPO/HMO/WC	$516.00

PROTOE SIZE SMALL

Facility

$3,440.00

Hospital Charge Code	270663473
Hospital Revenue Code	270
Min. Negotiated Rate	$447.20
Max. Negotiated Rate	$1,720.00
Rate for Payer: Aetna Commercial	$1,032.00
Rate for Payer: Aetna Medicare Advantage	$1,032.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$877.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$877.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$877.20
Rate for Payer: Cigna Commercial	$1,720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.20
Rate for Payer: Oxford Commercial	$1,720.00
Rate for Payer: Qualcare PPO/HMO/WC	$516.00
Rate for Payer: UnitedHealthcare Commercial	$1,720.00

PRO-TOE VO INSTRUMENT KIT

Facility

$1,300.00

Hospital Charge Code	270663199
Hospital Revenue Code	270
Min. Negotiated Rate	$169.00
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$390.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.00
Rate for Payer: Oxford Commercial	$650.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00
Rate for Payer: UnitedHealthcare Commercial	$650.00

PRO-TOE VO INSTRUMENT KIT

Facility

$1,300.00

Hospital Charge Code	270663199
Hospital Revenue Code	270
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

PROTONIX 40MG SUSP.

Facility

$67.13

Service Code	NDC 8084402
Hospital Charge Code	60635725
Hospital Revenue Code	250
Min. Negotiated Rate	$8.73
Max. Negotiated Rate	$33.56
Rate for Payer: Aetna Commercial	$20.14
Rate for Payer: Aetna Medicare Advantage	$20.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.12
Rate for Payer: Cigna Commercial	$33.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.73
Rate for Payer: Oxford Commercial	$33.56
Rate for Payer: Qualcare PPO/HMO/WC	$10.07
Rate for Payer: UnitedHealthcare Commercial	$33.56

PROTONIX 40MG SUSP.

Facility

$67.13

Service Code	NDC 8084402
Hospital Charge Code	60635725
Hospital Revenue Code	250
Min. Negotiated Rate	$10.07
Max. Negotiated Rate	$10.07
Rate for Payer: Qualcare PPO/HMO/WC	$10.07

PROTONIX 40MG TAB

Facility

$23.00

Hospital Charge Code	60635726
Hospital Revenue Code	250
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

PROTONIX 40MG TAB

Facility

$23.00

Hospital Charge Code	60635726
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

PROTONIX IV 40MG

Facility

$57.60

Hospital Charge Code	60635761
Hospital Revenue Code	250
Min. Negotiated Rate	$7.49
Max. Negotiated Rate	$28.80
Rate for Payer: Aetna Commercial	$17.28
Rate for Payer: Aetna Medicare Advantage	$17.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.69
Rate for Payer: Cigna Commercial	$28.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.49
Rate for Payer: Oxford Commercial	$28.80
Rate for Payer: Qualcare PPO/HMO/WC	$8.64
Rate for Payer: UnitedHealthcare Commercial	$28.80

PROTONIX IV 40MG

Facility

$57.60

Hospital Charge Code	60635761
Hospital Revenue Code	250
Min. Negotiated Rate	$8.64
Max. Negotiated Rate	$8.64
Rate for Payer: Qualcare PPO/HMO/WC	$8.64

PROTRACTOR ENDO MED 100201

Facility

$729.65

Hospital Charge Code	270609589
Hospital Revenue Code	272
Min. Negotiated Rate	$109.45
Max. Negotiated Rate	$109.45
Rate for Payer: Qualcare PPO/HMO/WC	$109.45

PROTRACTOR ENDO MED 100201

Facility

$729.65

Hospital Charge Code	270609589
Hospital Revenue Code	272
Min. Negotiated Rate	$94.85
Max. Negotiated Rate	$364.82
Rate for Payer: Aetna Commercial	$218.90
Rate for Payer: Aetna Medicare Advantage	$218.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.06
Rate for Payer: Cigna Commercial	$364.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.85
Rate for Payer: Oxford Commercial	$364.82
Rate for Payer: Qualcare PPO/HMO/WC	$109.45
Rate for Payer: UnitedHealthcare Commercial	$364.82

PROTRACTOR ENDO SM 100101

Facility

$729.65

Hospital Charge Code	270609588
Hospital Revenue Code	272
Min. Negotiated Rate	$94.85
Max. Negotiated Rate	$364.82
Rate for Payer: Aetna Commercial	$218.90
Rate for Payer: Aetna Medicare Advantage	$218.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.06
Rate for Payer: Cigna Commercial	$364.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.85
Rate for Payer: Oxford Commercial	$364.82
Rate for Payer: Qualcare PPO/HMO/WC	$109.45
Rate for Payer: UnitedHealthcare Commercial	$364.82

PROTRACTOR ENDO SM 100101

Facility

$729.65

Hospital Charge Code	270609588
Hospital Revenue Code	272
Min. Negotiated Rate	$109.45
Max. Negotiated Rate	$109.45
Rate for Payer: Qualcare PPO/HMO/WC	$109.45

Know your out-of-pocket cost for care.

All Charges