Heights University Hospital

All Charges

Charge

Type

Setting

Price

RESTORIL/15MG/CAP

Facility

$6.00

Hospital Charge Code	60634336
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

RESTORIL/15MG/CAP

Facility

$6.00

Hospital Charge Code	60634336
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

RESTORIL/30MG/CAP

Facility

$6.00

Hospital Charge Code	60634337
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.00

RESTORIL/30MG/CAP

Facility

$6.00

Hospital Charge Code	60634337
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

RESTORIS MCK BI INLAY

Facility

$22,770.00

Hospital Charge Code	270668065
Hospital Revenue Code	278
Min. Negotiated Rate	$3,415.50
Max. Negotiated Rate	$5,510.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,554.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,510.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,415.50

RESTORIS MCK BI INLAY

Facility

$22,770.00

Hospital Charge Code	270668065
Hospital Revenue Code	278
Min. Negotiated Rate	$3,415.50
Max. Negotiated Rate	$11,385.00
Rate for Payer: Aetna Commercial	$6,831.00
Rate for Payer: Aetna Medicare Advantage	$6,831.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,806.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,806.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,554.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,806.35
Rate for Payer: Cigna Commercial	$11,385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,510.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,415.50

RESTORIS MCK BI ONLAY PRE PLOY

Facility

$28,845.00

Hospital Charge Code	270668067
Hospital Revenue Code	278
Min. Negotiated Rate	$4,326.75
Max. Negotiated Rate	$14,422.50
Rate for Payer: Aetna Commercial	$8,653.50
Rate for Payer: Aetna Medicare Advantage	$8,653.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,355.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,355.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,769.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,355.48
Rate for Payer: Cigna Commercial	$14,422.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,980.49
Rate for Payer: Qualcare PPO/HMO/WC	$4,326.75

RESTORIS MCK BI ONLAY PRE PLOY

Facility

$28,845.00

Hospital Charge Code	270668067
Hospital Revenue Code	278
Min. Negotiated Rate	$4,326.75
Max. Negotiated Rate	$6,980.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,769.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,980.49
Rate for Payer: Qualcare PPO/HMO/WC	$4,326.75

RESTORIS MCK BI ONLAY STD PLOY

Facility

$27,270.00

Hospital Charge Code	270668066
Hospital Revenue Code	278
Min. Negotiated Rate	$4,090.50
Max. Negotiated Rate	$6,599.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,454.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,599.34
Rate for Payer: Qualcare PPO/HMO/WC	$4,090.50

RESTORIS MCK BI ONLAY STD PLOY

Facility

$27,270.00

Hospital Charge Code	270668066
Hospital Revenue Code	278
Min. Negotiated Rate	$4,090.50
Max. Negotiated Rate	$13,635.00
Rate for Payer: Aetna Commercial	$8,181.00
Rate for Payer: Aetna Medicare Advantage	$8,181.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,953.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,953.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,454.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,953.85
Rate for Payer: Cigna Commercial	$13,635.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,599.34
Rate for Payer: Qualcare PPO/HMO/WC	$4,090.50

RESTORIS MCK CONSUMABLES

Facility

$4,330.00

Hospital Charge Code	270668070
Hospital Revenue Code	278
Min. Negotiated Rate	$649.50
Max. Negotiated Rate	$1,047.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$866.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.86
Rate for Payer: Qualcare PPO/HMO/WC	$649.50

RESTORIS MCK CONSUMABLES

Facility

$4,330.00

Hospital Charge Code	270668070
Hospital Revenue Code	278
Min. Negotiated Rate	$649.50
Max. Negotiated Rate	$2,165.00
Rate for Payer: Aetna Commercial	$1,299.00
Rate for Payer: Aetna Medicare Advantage	$1,299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,104.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,104.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$866.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,104.15
Rate for Payer: Cigna Commercial	$2,165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,047.86
Rate for Payer: Qualcare PPO/HMO/WC	$649.50

RESTORIS MCK PFJ

Facility

$16,350.00

Hospital Charge Code	270668064
Hospital Revenue Code	278
Min. Negotiated Rate	$2,452.50
Max. Negotiated Rate	$3,956.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,956.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,452.50

RESTORIS MCK PFJ

Facility

$16,350.00

Hospital Charge Code	270668064
Hospital Revenue Code	278
Min. Negotiated Rate	$2,452.50
Max. Negotiated Rate	$8,175.00
Rate for Payer: Aetna Commercial	$4,905.00
Rate for Payer: Aetna Medicare Advantage	$4,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,169.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,169.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,169.25
Rate for Payer: Cigna Commercial	$8,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,956.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,452.50

RESTORIS MCK UNI INLAY

Facility

$16,055.00

Hospital Charge Code	270668060
Hospital Revenue Code	278
Min. Negotiated Rate	$2,408.25
Max. Negotiated Rate	$8,027.50
Rate for Payer: Aetna Commercial	$4,816.50
Rate for Payer: Aetna Medicare Advantage	$4,816.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,094.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,094.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,211.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,094.03
Rate for Payer: Cigna Commercial	$8,027.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,885.31
Rate for Payer: Qualcare PPO/HMO/WC	$2,408.25

RESTORIS MCK UNI INLAY

Facility

$16,055.00

Hospital Charge Code	270668060
Hospital Revenue Code	278
Min. Negotiated Rate	$2,408.25
Max. Negotiated Rate	$3,885.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,211.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,885.31
Rate for Payer: Qualcare PPO/HMO/WC	$2,408.25

RESTORIS MCK UNI ONLAY PLOY PR

Facility

$23,980.00

Hospital Charge Code	270668063
Hospital Revenue Code	278
Min. Negotiated Rate	$3,597.00
Max. Negotiated Rate	$11,990.00
Rate for Payer: Aetna Commercial	$7,194.00
Rate for Payer: Aetna Medicare Advantage	$7,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,114.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,114.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,796.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,114.90
Rate for Payer: Cigna Commercial	$11,990.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,803.16
Rate for Payer: Qualcare PPO/HMO/WC	$3,597.00

RESTORIS MCK UNI ONLAY PLOY PR

Facility

$23,980.00

Hospital Charge Code	270668063
Hospital Revenue Code	278
Min. Negotiated Rate	$3,597.00
Max. Negotiated Rate	$5,803.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,796.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,803.16
Rate for Payer: Qualcare PPO/HMO/WC	$3,597.00

RESTORIS MCK UNI ONLAY PLOY ST

Facility

$22,480.00

Hospital Charge Code	270668062
Hospital Revenue Code	278
Min. Negotiated Rate	$3,372.00
Max. Negotiated Rate	$11,240.00
Rate for Payer: Aetna Commercial	$6,744.00
Rate for Payer: Aetna Medicare Advantage	$6,744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,732.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,732.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,496.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,732.40
Rate for Payer: Cigna Commercial	$11,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,440.16
Rate for Payer: Qualcare PPO/HMO/WC	$3,372.00

RESTORIS MCK UNI ONLAY PLOY ST

Facility

$22,480.00

Hospital Charge Code	270668062
Hospital Revenue Code	278
Min. Negotiated Rate	$3,372.00
Max. Negotiated Rate	$5,440.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,496.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,440.16
Rate for Payer: Qualcare PPO/HMO/WC	$3,372.00

RESTORIS PF CONSUMABLES

Facility

$3,415.00

Hospital Charge Code	270668071
Hospital Revenue Code	278
Min. Negotiated Rate	$512.25
Max. Negotiated Rate	$1,707.50
Rate for Payer: Aetna Commercial	$1,024.50
Rate for Payer: Aetna Medicare Advantage	$1,024.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$870.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$870.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$870.83
Rate for Payer: Cigna Commercial	$1,707.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$826.43
Rate for Payer: Qualcare PPO/HMO/WC	$512.25

RESTORIS PF CONSUMABLES

Facility

$3,415.00

Hospital Charge Code	270668071
Hospital Revenue Code	278
Min. Negotiated Rate	$512.25
Max. Negotiated Rate	$826.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$683.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$826.43
Rate for Payer: Qualcare PPO/HMO/WC	$512.25

RESTORIS PST CERAMIC HEAD

Facility

$28,425.00

Hospital Charge Code	270668069
Hospital Revenue Code	278
Min. Negotiated Rate	$4,263.75
Max. Negotiated Rate	$6,878.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,878.85
Rate for Payer: Qualcare PPO/HMO/WC	$4,263.75

RESTORIS PST CERAMIC HEAD

Facility

$28,425.00

Hospital Charge Code	270668069
Hospital Revenue Code	278
Min. Negotiated Rate	$4,263.75
Max. Negotiated Rate	$14,212.50
Rate for Payer: Aetna Commercial	$8,527.50
Rate for Payer: Aetna Medicare Advantage	$8,527.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,248.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,248.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,685.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,248.38
Rate for Payer: Cigna Commercial	$14,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,878.85
Rate for Payer: Qualcare PPO/HMO/WC	$4,263.75

RESTORIS PST METAL HEAD

Facility

$25,615.00

Hospital Charge Code	270668068
Hospital Revenue Code	278
Min. Negotiated Rate	$3,842.25
Max. Negotiated Rate	$12,807.50
Rate for Payer: Aetna Commercial	$7,684.50
Rate for Payer: Aetna Medicare Advantage	$7,684.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,531.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,531.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,123.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,531.82
Rate for Payer: Cigna Commercial	$12,807.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,198.83
Rate for Payer: Qualcare PPO/HMO/WC	$3,842.25

Know your out-of-pocket cost for care.

All Charges