Heights University Hospital

All Charges

Charge

Type

Setting

Price

PVR SEGMEN PRESS W/STRESS

Facility

$479.00

Service Code	HCPCS 93924
Hospital Charge Code	74116035
Hospital Revenue Code	920
Min. Negotiated Rate	$62.27
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$143.70
Rate for Payer: Aetna Medicare Advantage	$143.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$377.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.14
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.27
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.85
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

PVR SEGMEN PRESS W/STRESS

Facility

$990.45

Service Code	HCPCS 93924
Hospital Charge Code	94053180
Hospital Revenue Code	920
Min. Negotiated Rate	$128.76
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$297.13
Rate for Payer: Aetna Medicare Advantage	$297.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$377.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.56
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.76
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$148.57
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

PVR SEGMEN PRESS W/STRESS

Facility

$479.00

Service Code	HCPCS 93924
Hospital Charge Code	74117035
Hospital Revenue Code	920
Min. Negotiated Rate	$71.85
Max. Negotiated Rate	$71.85
Rate for Payer: Qualcare PPO/HMO/WC	$71.85

PVR SEGMEN PRESS W/STRESS

Facility

$990.45

Service Code	HCPCS 93924
Hospital Charge Code	94053180
Hospital Revenue Code	920
Min. Negotiated Rate	$148.57
Max. Negotiated Rate	$148.57
Rate for Payer: Qualcare PPO/HMO/WC	$148.57

PVR SEGMEN PRESS W/STRESS

Facility

$479.00

Service Code	HCPCS 93924
Hospital Charge Code	74115035
Hospital Revenue Code	920
Min. Negotiated Rate	$62.27
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$143.70
Rate for Payer: Aetna Medicare Advantage	$143.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$377.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.14
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.27
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.85
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

PVR SEGMEN PRESS W/STRESS

Facility

$479.00

Service Code	HCPCS 93924
Hospital Charge Code	74117035
Hospital Revenue Code	920
Min. Negotiated Rate	$62.27
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$143.70
Rate for Payer: Aetna Medicare Advantage	$143.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$377.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.14
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.27
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.85
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

PVR SEGMEN PRESS W/STRESS

Facility

$479.00

Service Code	HCPCS 93924
Hospital Charge Code	74115035
Hospital Revenue Code	920
Min. Negotiated Rate	$71.85
Max. Negotiated Rate	$71.85
Rate for Payer: Qualcare PPO/HMO/WC	$71.85

PYRANTEL PAM SSP 50MG/ML 60ML

Facility

$286.75

Hospital Charge Code	6004733
Hospital Revenue Code	251
Min. Negotiated Rate	$37.28
Max. Negotiated Rate	$143.38
Rate for Payer: Aetna Commercial	$86.03
Rate for Payer: Aetna Medicare Advantage	$86.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.12
Rate for Payer: Cigna Commercial	$143.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.28
Rate for Payer: Oxford Commercial	$143.38
Rate for Payer: Qualcare PPO/HMO/WC	$43.01
Rate for Payer: UnitedHealthcare Commercial	$143.38

PYRANTEL PAM SSP 50MG/ML 60ML

Facility

$286.75

Hospital Charge Code	6004733
Hospital Revenue Code	251
Min. Negotiated Rate	$43.01
Max. Negotiated Rate	$43.01
Rate for Payer: Qualcare PPO/HMO/WC	$43.01

PYRAZINAMIDE

Facility

$309.00

Service Code	HCPCS 80299
Hospital Charge Code	3009821
Hospital Revenue Code	301
Min. Negotiated Rate	$46.35
Max. Negotiated Rate	$46.35
Rate for Payer: Qualcare PPO/HMO/WC	$46.35

PYRAZINAMIDE

Facility

$309.00

Service Code	HCPCS 80299
Hospital Charge Code	3009821
Hospital Revenue Code	301
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

PYRAZINAMIDE 500 MG TAB

Facility

$42.28

Service Code	NDC 61748001206
Hospital Charge Code	60628693
Hospital Revenue Code	250
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$6.34
Rate for Payer: Qualcare PPO/HMO/WC	$6.34

PYRAZINAMIDE 500 MG TAB

Facility

$42.28

Service Code	NDC 61748001206
Hospital Charge Code	60628693
Hospital Revenue Code	250
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$21.14
Rate for Payer: Aetna Commercial	$12.68
Rate for Payer: Aetna Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.78
Rate for Payer: Cigna Commercial	$21.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.50
Rate for Payer: Oxford Commercial	$21.14
Rate for Payer: Qualcare PPO/HMO/WC	$6.34
Rate for Payer: UnitedHealthcare Commercial	$21.14

PYRAZINAMIDE/500MG/TAB

Facility

$7.00

Hospital Charge Code	60633787
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

PYRAZINAMIDE/500MG/TAB

Facility

$7.00

Hospital Charge Code	60633787
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.10
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.91
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$3.50

PYREDIUM COLLAGN CROSS STUDY**

Facility

$205.00

Hospital Charge Code	3010717
Hospital Revenue Code	301
Min. Negotiated Rate	$30.75
Max. Negotiated Rate	$30.75
Rate for Payer: Qualcare PPO/HMO/WC	$30.75

PYREDIUM COLLAGN CROSS STUDY**

Facility

$205.00

Hospital Charge Code	3010717
Hospital Revenue Code	301
Min. Negotiated Rate	$26.65
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$61.50
Rate for Payer: Aetna Medicare Advantage	$61.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.27
Rate for Payer: Cigna Commercial	$102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.65
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.75
Rate for Payer: UnitedHealthcare Commercial	$114.00

PYRIDIUM/100MG/TAB

Facility

$4.00

Hospital Charge Code	60633790
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PYRIDIUM/100MG/TAB

Facility

$4.00

Hospital Charge Code	60633790
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

PYRIDIUM/100MG/TAB

Facility

$4.00

Hospital Charge Code	60633788
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

PYRIDIUM/100MG/TAB

Facility

$4.00

Hospital Charge Code	60633788
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PYRIDIUM/200MG/TAB

Facility

$4.00

Hospital Charge Code	60633791
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PYRIDIUM/200MG/TAB

Facility

$4.00

Hospital Charge Code	60633791
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

PYRIDIUM/200MG/TAB

Facility

$4.00

Hospital Charge Code	60633789
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PYRIDIUM/200MG/TAB

Facility

$4.00

Hospital Charge Code	60633789
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

Know your out-of-pocket cost for care.

All Charges