Heights University Hospital

All Charges

Charge

Type

Setting

Price

FLEET PHOSPHO SODA 90ML

Facility

$18.00

Hospital Charge Code	60634769
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

FLEXBAND DYNAMIC MATRIX

Facility

$16,150.00

Service Code	HCPCS C1889
Hospital Charge Code	270704270
Hospital Revenue Code	278
Min. Negotiated Rate	$2,422.50
Max. Negotiated Rate	$8,075.00
Rate for Payer: Aetna Commercial	$4,845.00
Rate for Payer: Aetna Medicare Advantage	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,118.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,118.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,230.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,118.25
Rate for Payer: Cigna Commercial	$8,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,908.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,422.50

FLEXBAND DYNAMIC MATRIX

Facility

$16,150.00

Service Code	HCPCS C1889
Hospital Charge Code	270704270
Hospital Revenue Code	278
Min. Negotiated Rate	$2,422.50
Max. Negotiated Rate	$3,908.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,908.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,422.50

FLEXBAND DYNAMIC MATRIX 0.5X8C

Facility

$15,238.90

Service Code	HCPCS C1713
Hospital Charge Code	270704739
Hospital Revenue Code	278
Min. Negotiated Rate	$2,285.84
Max. Negotiated Rate	$7,619.45
Rate for Payer: Aetna Commercial	$4,571.67
Rate for Payer: Aetna Medicare Advantage	$4,571.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,885.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,885.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,047.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,885.92
Rate for Payer: Cigna Commercial	$7,619.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,687.81
Rate for Payer: Qualcare PPO/HMO/WC	$2,285.84

FLEXBAND DYNAMIC MATRIX 0.5X8C

Facility

$15,238.90

Service Code	HCPCS C1713
Hospital Charge Code	270704739
Hospital Revenue Code	278
Min. Negotiated Rate	$2,285.84
Max. Negotiated Rate	$3,687.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,047.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,687.81
Rate for Payer: Qualcare PPO/HMO/WC	$2,285.84

FLEXBAND PLUS MATRIX GFT .3X16

Facility

$15,930.00

Service Code	HCPCS C1763
Hospital Charge Code	270700040
Hospital Revenue Code	278
Min. Negotiated Rate	$2,389.50
Max. Negotiated Rate	$7,965.00
Rate for Payer: Aetna Commercial	$4,779.00
Rate for Payer: Aetna Medicare Advantage	$4,779.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,062.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,062.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,062.15
Rate for Payer: Cigna Commercial	$7,965.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,855.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,389.50

FLEXBAND PLUS MATRIX GFT .3X16

Facility

$15,930.00

Service Code	HCPCS C1763
Hospital Charge Code	270700040
Hospital Revenue Code	278
Min. Negotiated Rate	$2,389.50
Max. Negotiated Rate	$3,855.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,855.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,389.50

FLEXBAND TWIST.12

Facility

$26,101.25

Service Code	HCPCS C1713
Hospital Charge Code	270705115
Hospital Revenue Code	278
Min. Negotiated Rate	$3,915.19
Max. Negotiated Rate	$6,316.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,220.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,316.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,915.19

FLEXBAND TWIST.12

Facility

$26,101.25

Service Code	HCPCS C1713
Hospital Charge Code	270705115
Hospital Revenue Code	278
Min. Negotiated Rate	$3,915.19
Max. Negotiated Rate	$13,050.62
Rate for Payer: Aetna Commercial	$7,830.38
Rate for Payer: Aetna Medicare Advantage	$7,830.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,655.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,655.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,220.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,655.82
Rate for Payer: Cigna Commercial	$13,050.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,316.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,915.19

FLEXBAND TWIST .30

Facility

$25,478.75

Hospital Charge Code	270702754
Hospital Revenue Code	278
Min. Negotiated Rate	$3,821.81
Max. Negotiated Rate	$12,739.38
Rate for Payer: Aetna Commercial	$7,643.62
Rate for Payer: Aetna Medicare Advantage	$7,643.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,497.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,497.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,095.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,497.08
Rate for Payer: Cigna Commercial	$12,739.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,165.86
Rate for Payer: Qualcare PPO/HMO/WC	$3,821.81

FLEXBAND TWIST .30

Facility

$25,478.75

Hospital Charge Code	270702754
Hospital Revenue Code	278
Min. Negotiated Rate	$3,821.81
Max. Negotiated Rate	$6,165.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,095.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,165.86
Rate for Payer: Qualcare PPO/HMO/WC	$3,821.81

FLEXBAND TWIST DRIVE 3.85

Facility

$3,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270706007
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$1,662.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$997.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$847.88
Rate for Payer: Cigna Commercial	$1,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

FLEXBAND TWIST DRIVE 3.85

Facility

$3,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270706007
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$804.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

FLEXBAND TWIST DRIVE 5.0

Facility

$3,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270706048
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$1,662.50
Rate for Payer: Aetna Commercial	$997.50
Rate for Payer: Aetna Medicare Advantage	$997.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$847.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$847.88
Rate for Payer: Cigna Commercial	$1,662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

FLEXBAND TWIST DRIVE 5.0

Facility

$3,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270706048
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$804.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

FLEXCEL CAROT SHUNT

Facility

$270.00

Hospital Charge Code	270683757
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$65.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

FLEXCEL CAROT SHUNT

Facility

$270.00

Hospital Charge Code	270683757
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$81.00
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.34
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

FLEX DRILL

Facility

$2,670.00

Hospital Charge Code	270683740
Hospital Revenue Code	272
Min. Negotiated Rate	$400.50
Max. Negotiated Rate	$400.50
Rate for Payer: Qualcare PPO/HMO/WC	$400.50

FLEX DRILL

Facility

$2,670.00

Hospital Charge Code	270683740
Hospital Revenue Code	272
Min. Negotiated Rate	$347.10
Max. Negotiated Rate	$1,335.00
Rate for Payer: UnitedHealthcare Commercial	$1,335.00
Rate for Payer: Aetna Commercial	$801.00
Rate for Payer: Aetna Medicare Advantage	$801.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$680.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$680.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$680.85
Rate for Payer: Cigna Commercial	$1,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$347.10
Rate for Payer: Oxford Commercial	$1,335.00
Rate for Payer: Qualcare PPO/HMO/WC	$400.50

FLEX DYNAM NATRIX 0.5X16CM

Facility

$21,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704501
Hospital Revenue Code	279
Min. Negotiated Rate	$2,788.50
Max. Negotiated Rate	$10,725.00
Rate for Payer: Aetna Commercial	$6,435.00
Rate for Payer: Aetna Medicare Advantage	$6,435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,469.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,469.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,469.75
Rate for Payer: Cigna Commercial	$10,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,788.50
Rate for Payer: Oxford Commercial	$10,725.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,217.50
Rate for Payer: UnitedHealthcare Commercial	$10,725.00

FLEX DYNAM NATRIX 0.5X16CM

Facility

$21,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704501
Hospital Revenue Code	279
Min. Negotiated Rate	$3,217.50
Max. Negotiated Rate	$3,217.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,217.50

FLEXERIL/10MG/TAB

Facility

$7.00

Hospital Charge Code	60632996
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

FLEXERIL/10MG/TAB

Facility

$7.00

Hospital Charge Code	60632996
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

FLEXERIL/10MG/TAB

Facility

$7.00

Hospital Charge Code	60632995
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

FLEXERIL/10MG/TAB

Facility

$7.00

Hospital Charge Code	60632995
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

Know your out-of-pocket cost for care.

All Charges