Heights University Hospital

All Charges

Charge

Type

Setting

Price

MAT ECOSUCTIONER

Facility

$2,760.00

Hospital Charge Code	270675433
Hospital Revenue Code	272
Min. Negotiated Rate	$414.00
Max. Negotiated Rate	$414.00
Rate for Payer: Qualcare PPO/HMO/WC	$414.00

MATERNITY PROFILE***

Facility

$276.00

Hospital Charge Code	3008034
Hospital Revenue Code	300
Min. Negotiated Rate	$35.88
Max. Negotiated Rate	$138.00
Rate for Payer: Aetna Commercial	$82.80
Rate for Payer: Aetna Medicare Advantage	$82.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.38
Rate for Payer: Cigna Commercial	$138.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.88
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.40
Rate for Payer: UnitedHealthcare Commercial	$114.00

MATERNITY PROFILE***

Facility

$276.00

Hospital Charge Code	3008034
Hospital Revenue Code	300
Min. Negotiated Rate	$41.40
Max. Negotiated Rate	$41.40
Rate for Payer: Qualcare PPO/HMO/WC	$41.40

MATRISTEM MATRIX PLUS 7x10CM

Facility

$9,870.00

Service Code	HCPCS Q4166
Hospital Charge Code	270677281
Hospital Revenue Code	278
Min. Negotiated Rate	$1,480.50
Max. Negotiated Rate	$2,388.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,974.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,388.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,480.50

MATRISTEM MATRIX PLUS 7x10CM

Facility

$9,870.00

Service Code	HCPCS Q4166
Hospital Charge Code	270677281
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$2,961.00
Rate for Payer: Aetna Commercial	$2,961.00
Rate for Payer: Aetna Medicare Advantage	$2,961.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,516.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,516.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,974.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,516.85
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,388.54
Rate for Payer: Qualcare PPO/HMO/WC	$1,480.50

MATRISTEM SURG MATRIX 10X15CM

Facility

$15,750.00

Service Code	HCPCS C1781
Hospital Charge Code	270651272
Hospital Revenue Code	278
Min. Negotiated Rate	$2,362.50
Max. Negotiated Rate	$3,811.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,811.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,362.50

MATRISTEM SURG MATRIX 10X15CM

Facility

$15,750.00

Service Code	HCPCS C1781
Hospital Charge Code	270651272
Hospital Revenue Code	278
Min. Negotiated Rate	$2,362.50
Max. Negotiated Rate	$7,875.00
Rate for Payer: Aetna Commercial	$4,725.00
Rate for Payer: Aetna Medicare Advantage	$4,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,016.25
Rate for Payer: Cigna Commercial	$7,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,811.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,362.50

MATRISTIM PSM 7X10 CM

Facility

$9,967.50

Service Code	HCPCS Q4166
Hospital Charge Code	270662112
Hospital Revenue Code	278
Min. Negotiated Rate	$1,495.12
Max. Negotiated Rate	$2,412.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,993.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,412.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.12

MATRISTIM PSM 7X10 CM

Facility

$9,967.50

Service Code	HCPCS Q4166
Hospital Charge Code	270662112
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$2,990.25
Rate for Payer: Aetna Commercial	$2,990.25
Rate for Payer: Aetna Medicare Advantage	$2,990.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,541.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,541.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,993.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,541.71
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,412.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,495.12

MATRIX 200mg MM0200

Facility

$3,008.00

Service Code	HCPCS Q4118
Hospital Charge Code	270644124
Hospital Revenue Code	278
Min. Negotiated Rate	$451.20
Max. Negotiated Rate	$727.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$601.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$727.94
Rate for Payer: Qualcare PPO/HMO/WC	$451.20

MATRIX 200mg MM0200

Facility

$3,008.00

Service Code	HCPCS Q4118
Hospital Charge Code	270644124
Hospital Revenue Code	278
Min. Negotiated Rate	$451.20
Max. Negotiated Rate	$1,504.00
Rate for Payer: Aetna Commercial	$902.40
Rate for Payer: Aetna Medicare Advantage	$902.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$767.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$767.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$601.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$767.04
Rate for Payer: Cigna Commercial	$1,504.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$727.94
Rate for Payer: Qualcare PPO/HMO/WC	$451.20

MATRIX 200mg MM0200/1MGJW

Facility

$16.00

Hospital Charge Code	270644124W
Hospital Revenue Code	636
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$8.00
Rate for Payer: Aetna Commercial	$4.80
Rate for Payer: Aetna Medicare Advantage	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.08
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.87
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

MATRIX 200mg MM0200/1MGJW

Facility

$16.00

Hospital Charge Code	270644124W
Hospital Revenue Code	636
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$3.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.87
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

MATRIX BILAYER MESHED 4x10

Facility

$26,845.00

Service Code	HCPCS C1781
Hospital Charge Code	270651359
Hospital Revenue Code	278
Min. Negotiated Rate	$4,026.75
Max. Negotiated Rate	$6,496.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,369.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,496.49
Rate for Payer: Qualcare PPO/HMO/WC	$4,026.75

MATRIX BILAYER MESHED 4x10

Facility

$26,845.00

Service Code	HCPCS C1781
Hospital Charge Code	270651359
Hospital Revenue Code	278
Min. Negotiated Rate	$4,026.75
Max. Negotiated Rate	$13,422.50
Rate for Payer: Aetna Commercial	$8,053.50
Rate for Payer: Aetna Medicare Advantage	$8,053.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,845.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,845.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,369.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,845.48
Rate for Payer: Cigna Commercial	$13,422.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,496.49
Rate for Payer: Qualcare PPO/HMO/WC	$4,026.75

MATRIX BN FIB AERIDYAN 12.5CC

Facility

$27,169.20

Service Code	HCPCS C1713
Hospital Charge Code	270698973
Hospital Revenue Code	278
Min. Negotiated Rate	$4,075.38
Max. Negotiated Rate	$13,584.60
Rate for Payer: Aetna Commercial	$8,150.76
Rate for Payer: Aetna Medicare Advantage	$8,150.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,928.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,928.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,433.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,928.15
Rate for Payer: Cigna Commercial	$13,584.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,574.95
Rate for Payer: Qualcare PPO/HMO/WC	$4,075.38

MATRIX BN FIB AERIDYAN 12.5CC

Facility

$27,169.20

Service Code	HCPCS C1713
Hospital Charge Code	270698973
Hospital Revenue Code	278
Min. Negotiated Rate	$4,075.38
Max. Negotiated Rate	$6,574.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,433.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,574.95
Rate for Payer: Qualcare PPO/HMO/WC	$4,075.38

MATRIX BURN 10CM X 15CM

Facility

$10,575.00

Service Code	HCPCS Q4166
Hospital Charge Code	270662120
Hospital Revenue Code	636
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$3,172.50
Rate for Payer: Aetna Commercial	$3,172.50
Rate for Payer: Aetna Medicare Advantage	$3,172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,696.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,696.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,696.62
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,559.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,586.25

MATRIX BURN 10CM X 15CM

Facility

$10,575.00

Service Code	HCPCS Q4166
Hospital Charge Code	270662120
Hospital Revenue Code	636
Min. Negotiated Rate	$1,586.25
Max. Negotiated Rate	$2,559.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,559.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,586.25

MATRIX BURN 5X5CM/SQCM JW

Facility

$153.00

Hospital Charge Code	270662122W
Hospital Revenue Code	636
Min. Negotiated Rate	$22.95
Max. Negotiated Rate	$37.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.03
Rate for Payer: Qualcare PPO/HMO/WC	$22.95

MATRIX BURN 5X5CM/SQCM JW

Facility

$153.00

Hospital Charge Code	270662122W
Hospital Revenue Code	636
Min. Negotiated Rate	$22.95
Max. Negotiated Rate	$76.50
Rate for Payer: Aetna Commercial	$45.90
Rate for Payer: Aetna Medicare Advantage	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.02
Rate for Payer: Cigna Commercial	$76.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.03
Rate for Payer: Qualcare PPO/HMO/WC	$22.95

MATRIX BURN 7CM X 10CM

Facility

$5,625.00

Service Code	HCPCS Q4166
Hospital Charge Code	270662121
Hospital Revenue Code	636
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$1,687.50
Rate for Payer: Aetna Commercial	$1,687.50
Rate for Payer: Aetna Medicare Advantage	$1,687.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,434.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,434.38
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,361.25
Rate for Payer: Qualcare PPO/HMO/WC	$843.75

MATRIX BURN 7CM X 10CM

Facility

$5,625.00

Service Code	HCPCS Q4166
Hospital Charge Code	270662121
Hospital Revenue Code	636
Min. Negotiated Rate	$843.75
Max. Negotiated Rate	$1,361.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,361.25
Rate for Payer: Qualcare PPO/HMO/WC	$843.75

MATRIX CONNECTOR 30-33MM SZ4

Facility

$5,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270691917
Hospital Revenue Code	278
Min. Negotiated Rate	$888.94
Max. Negotiated Rate	$2,963.12
Rate for Payer: Aetna Commercial	$1,777.88
Rate for Payer: Aetna Medicare Advantage	$1,777.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,511.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,511.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,185.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,511.19
Rate for Payer: Cigna Commercial	$2,963.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,434.15
Rate for Payer: Qualcare PPO/HMO/WC	$888.94

MATRIX CONNECTOR 30-33MM SZ4

Facility

$5,926.25

Service Code	HCPCS C1713
Hospital Charge Code	270691917
Hospital Revenue Code	278
Min. Negotiated Rate	$888.94
Max. Negotiated Rate	$1,434.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,185.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,434.15
Rate for Payer: Qualcare PPO/HMO/WC	$888.94

Know your out-of-pocket cost for care.

All Charges