Heights University Hospital

All Charges

Charge

Type

Setting

Price

MATRIX STIMULAN RAP CURE 10CC

Facility

$8,975.00

Hospital Charge Code	270668279
Hospital Revenue Code	278
Min. Negotiated Rate	$1,346.25
Max. Negotiated Rate	$2,171.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,171.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,346.25

MATRIX STIMULAN RAPIDCURE 20CC

Facility

$14,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270694567
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$7,250.00
Rate for Payer: Aetna Commercial	$4,350.00
Rate for Payer: Aetna Medicare Advantage	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,697.50
Rate for Payer: Cigna Commercial	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

MATRIX STIMULAN RAPIDCURE 20CC

Facility

$14,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270694567
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$3,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

MATRIX SURGICAL MATRIX PLUS

Facility

$4,935.00

Service Code	HCPCS C1781
Hospital Charge Code	270677085
Hospital Revenue Code	278
Min. Negotiated Rate	$740.25
Max. Negotiated Rate	$1,194.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$987.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,194.27
Rate for Payer: Qualcare PPO/HMO/WC	$740.25

MATRIX SURGICAL MATRIX PLUS

Facility

$4,935.00

Service Code	HCPCS C1781
Hospital Charge Code	270677085
Hospital Revenue Code	278
Min. Negotiated Rate	$740.25
Max. Negotiated Rate	$2,467.50
Rate for Payer: Aetna Commercial	$1,480.50
Rate for Payer: Aetna Medicare Advantage	$1,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,258.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,258.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$987.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,258.42
Rate for Payer: Cigna Commercial	$2,467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,194.27
Rate for Payer: Qualcare PPO/HMO/WC	$740.25

MATRIX V92 CELLULAR BN 2.5CC

Facility

$9,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270699358
Hospital Revenue Code	278
Min. Negotiated Rate	$1,406.25
Max. Negotiated Rate	$2,268.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,268.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,406.25

MATRIX V92 CELLULAR BN 2.5CC

Facility

$9,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270699358
Hospital Revenue Code	278
Min. Negotiated Rate	$1,406.25
Max. Negotiated Rate	$4,687.50
Rate for Payer: Aetna Commercial	$2,812.50
Rate for Payer: Aetna Medicare Advantage	$2,812.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,390.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,390.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,390.62
Rate for Payer: Cigna Commercial	$4,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,268.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,406.25

MATRIX WOUND 10X15CM

Facility

$3,712.50

Service Code	HCPCS Q4166
Hospital Charge Code	270662124
Hospital Revenue Code	278
Min. Negotiated Rate	$556.88
Max. Negotiated Rate	$898.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$742.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$898.42
Rate for Payer: Qualcare PPO/HMO/WC	$556.88

MATRIX WOUND 10X15CM

Facility

$3,712.50

Service Code	HCPCS Q4166
Hospital Charge Code	270662124
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$1,113.75
Rate for Payer: Aetna Commercial	$1,113.75
Rate for Payer: Aetna Medicare Advantage	$1,113.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$946.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$946.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$946.69
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$898.42
Rate for Payer: Qualcare PPO/HMO/WC	$556.88

MATRIX WOUND 10X15CM/SQCMJW

Facility

$24.75

Hospital Charge Code	270662124W
Hospital Revenue Code	636
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$12.38
Rate for Payer: Aetna Commercial	$7.42
Rate for Payer: Aetna Medicare Advantage	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.31
Rate for Payer: Cigna Commercial	$12.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.99
Rate for Payer: Qualcare PPO/HMO/WC	$3.71

MATRIX WOUND 10X15CM/SQCMJW

Facility

$24.75

Hospital Charge Code	270662124W
Hospital Revenue Code	636
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$5.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.99
Rate for Payer: Qualcare PPO/HMO/WC	$3.71

MATRIX WOUND 1-LAYER 3x3.5CM

Facility

$352.50

Service Code	HCPCS Q4166
Hospital Charge Code	270651027
Hospital Revenue Code	278
Min. Negotiated Rate	$52.88
Max. Negotiated Rate	$296.35
Rate for Payer: Aetna Commercial	$105.75
Rate for Payer: Aetna Medicare Advantage	$105.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.89
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.31
Rate for Payer: Qualcare PPO/HMO/WC	$52.88

MATRIX WOUND 1-LAYER 3x3.5CM

Facility

$352.50

Service Code	HCPCS Q4166
Hospital Charge Code	270651027
Hospital Revenue Code	278
Min. Negotiated Rate	$52.88
Max. Negotiated Rate	$85.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$70.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.31
Rate for Payer: Qualcare PPO/HMO/WC	$52.88

MATRIX WOUND 3 LAYER

Facility

$10,465.00

Service Code	HCPCS Q4166
Hospital Charge Code	270680147
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$3,139.50
Rate for Payer: Aetna Commercial	$3,139.50
Rate for Payer: Aetna Medicare Advantage	$3,139.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,668.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,668.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,093.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,668.57
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,532.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,569.75

MATRIX WOUND 3 LAYER

Facility

$10,465.00

Service Code	HCPCS Q4166
Hospital Charge Code	270680147
Hospital Revenue Code	278
Min. Negotiated Rate	$1,569.75
Max. Negotiated Rate	$2,532.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,093.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,532.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,569.75

MATRIX WOUND 6X3CM

Facility

$15,966.50

Hospital Charge Code	270673886
Hospital Revenue Code	636
Min. Negotiated Rate	$2,394.97
Max. Negotiated Rate	$7,983.25
Rate for Payer: Aetna Commercial	$4,789.95
Rate for Payer: Aetna Medicare Advantage	$4,789.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,071.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,071.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,071.46
Rate for Payer: Cigna Commercial	$7,983.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,863.89
Rate for Payer: Qualcare PPO/HMO/WC	$2,394.97

MATRIX WOUND 6X3CM

Facility

$15,966.50

Hospital Charge Code	270673886
Hospital Revenue Code	636
Min. Negotiated Rate	$2,394.97
Max. Negotiated Rate	$3,863.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,863.89
Rate for Payer: Qualcare PPO/HMO/WC	$2,394.97

MATRIX WOUND 6X3CM/SQCM JW

Facility

$887.03

Hospital Charge Code	270673886W
Hospital Revenue Code	636
Min. Negotiated Rate	$133.05
Max. Negotiated Rate	$443.51
Rate for Payer: Aetna Commercial	$266.11
Rate for Payer: Aetna Medicare Advantage	$266.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.19
Rate for Payer: Cigna Commercial	$443.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.66
Rate for Payer: Qualcare PPO/HMO/WC	$133.05

MATRIX WOUND 6X3CM/SQCM JW

Facility

$887.03

Hospital Charge Code	270673886W
Hospital Revenue Code	636
Min. Negotiated Rate	$133.05
Max. Negotiated Rate	$214.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.66
Rate for Payer: Qualcare PPO/HMO/WC	$133.05

MATRIX WOUND 7CM X 10CM

Facility

$1,732.50

Service Code	HCPCS C1762
Hospital Charge Code	270662126
Hospital Revenue Code	278
Min. Negotiated Rate	$259.88
Max. Negotiated Rate	$866.25
Rate for Payer: Aetna Commercial	$519.75
Rate for Payer: Aetna Medicare Advantage	$519.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$441.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$441.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$346.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$441.79
Rate for Payer: Cigna Commercial	$866.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$419.26
Rate for Payer: Qualcare PPO/HMO/WC	$259.88

MATRIX WOUND 7CM X 10CM

Facility

$1,732.50

Service Code	HCPCS C1762
Hospital Charge Code	270662126
Hospital Revenue Code	278
Min. Negotiated Rate	$259.88
Max. Negotiated Rate	$419.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$346.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$419.26
Rate for Payer: Qualcare PPO/HMO/WC	$259.88

MATRIX WOUND FENESTR 7x10CM

Facility

$6,730.50

Service Code	HCPCS Q4166
Hospital Charge Code	270662125
Hospital Revenue Code	278
Min. Negotiated Rate	$1,009.58
Max. Negotiated Rate	$1,628.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,346.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,628.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,009.58

MATRIX WOUND FENESTR 7x10CM

Facility

$6,730.50

Service Code	HCPCS Q4166
Hospital Charge Code	270662125
Hospital Revenue Code	278
Min. Negotiated Rate	$296.35
Max. Negotiated Rate	$2,019.15
Rate for Payer: Aetna Commercial	$2,019.15
Rate for Payer: Aetna Medicare Advantage	$2,019.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,716.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,716.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,346.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,716.28
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,628.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,009.58

MATTRESS BARTON ATLAS 660

Facility

$615.00

Hospital Charge Code	270641165
Hospital Revenue Code	272
Min. Negotiated Rate	$79.95
Max. Negotiated Rate	$307.50
Rate for Payer: Aetna Commercial	$184.50
Rate for Payer: Aetna Medicare Advantage	$184.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.82
Rate for Payer: Cigna Commercial	$307.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.95
Rate for Payer: Oxford Commercial	$307.50
Rate for Payer: Qualcare PPO/HMO/WC	$92.25
Rate for Payer: UnitedHealthcare Commercial	$307.50

MATTRESS BARTON ATLAS 660

Facility

$615.00

Hospital Charge Code	270641165
Hospital Revenue Code	272
Min. Negotiated Rate	$92.25
Max. Negotiated Rate	$92.25
Rate for Payer: Qualcare PPO/HMO/WC	$92.25

Know your out-of-pocket cost for care.

All Charges