Heights University Hospital

All Charges

Charge

Type

Setting

Price

TOCOPHEROL CAP 1000U

Facility

$3.20

Hospital Charge Code	60628725
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.48
Rate for Payer: Qualcare PPO/HMO/WC	$0.48

TOCOPHEROL CAP 1000U

Facility

$3.20

Hospital Charge Code	60628725
Hospital Revenue Code	250
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$1.60
Rate for Payer: Aetna Commercial	$0.96
Rate for Payer: Aetna Medicare Advantage	$0.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.82
Rate for Payer: Cigna Commercial	$1.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.42
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.48
Rate for Payer: UnitedHealthcare Commercial	$1.60

TODDLER MASK

Facility

$39.00

Hospital Charge Code	270332339
Hospital Revenue Code	272
Min. Negotiated Rate	$5.07
Max. Negotiated Rate	$19.50
Rate for Payer: Aetna Commercial	$11.70
Rate for Payer: Aetna Medicare Advantage	$11.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.95
Rate for Payer: Cigna Commercial	$19.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.07
Rate for Payer: Oxford Commercial	$19.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.85
Rate for Payer: UnitedHealthcare Commercial	$19.50

TODDLER MASK

Facility

$39.00

Hospital Charge Code	270332339
Hospital Revenue Code	272
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$5.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.85

TOE ARTIC COMP 15MM 2.5X4.5MM

Facility

$15,030.00

Service Code	HCPCS L8641
Hospital Charge Code	270696339
Hospital Revenue Code	278
Min. Negotiated Rate	$257.13
Max. Negotiated Rate	$4,509.00
Rate for Payer: Aetna Commercial	$4,509.00
Rate for Payer: Aetna Medicare Advantage	$4,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,832.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,832.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,006.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,832.65
Rate for Payer: Cigna Commercial	$428.55
Rate for Payer: Cigna Medicare Advantage	$257.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,637.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,254.50

TOE ARTIC COMP 15MM 2.5X4.5MM

Facility

$15,030.00

Service Code	HCPCS L8641
Hospital Charge Code	270696339
Hospital Revenue Code	278
Min. Negotiated Rate	$2,254.50
Max. Negotiated Rate	$3,637.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,006.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,637.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,254.50

TOE FLEX HINGE W/GR G426-0010

Facility

$2,681.65

Hospital Charge Code	270611667
Hospital Revenue Code	278
Min. Negotiated Rate	$402.25
Max. Negotiated Rate	$1,340.83
Rate for Payer: Aetna Commercial	$804.50
Rate for Payer: Aetna Medicare Advantage	$804.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$683.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$683.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$536.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$683.82
Rate for Payer: Cigna Commercial	$1,340.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.96
Rate for Payer: Qualcare PPO/HMO/WC	$402.25

TOE FLEX HINGE W/GR G426-0010

Facility

$2,681.65

Hospital Charge Code	270611667
Hospital Revenue Code	278
Min. Negotiated Rate	$402.25
Max. Negotiated Rate	$648.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$536.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.96
Rate for Payer: Qualcare PPO/HMO/WC	$402.25

TOE FLEX HINGE W/GRMT #0

Facility

$6,280.00

Hospital Charge Code	270644931
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$1,884.00
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #0

Facility

$6,280.00

Hospital Charge Code	270644931
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #1

Facility

$6,280.00

Service Code	HCPCS C1776
Hospital Charge Code	270668530
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #1

Facility

$6,280.00

Service Code	HCPCS C1776
Hospital Charge Code	270668530
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$1,884.00
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #2

Facility

$6,280.00

Hospital Charge Code	270611669
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #2

Facility

$6,280.00

Hospital Charge Code	270611669
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$1,884.00
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #3

Facility

$6,280.00

Service Code	HCPCS C1776
Hospital Charge Code	270611670
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$1,884.00
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #3

Facility

$6,280.00

Service Code	HCPCS C1776
Hospital Charge Code	270611670
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #4

Facility

$6,280.00

Service Code	HCPCS C1776
Hospital Charge Code	270675527
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$1,884.00
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #4

Facility

$6,280.00

Service Code	HCPCS C1776
Hospital Charge Code	270675527
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #5

Facility

$6,280.00

Hospital Charge Code	270611672
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$1,884.00
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/GRMT #5

Facility

$6,280.00

Hospital Charge Code	270611672
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/O GRMT #3

Facility

$6,280.00

Hospital Charge Code	270645984
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/O GRMT #3

Facility

$6,280.00

Hospital Charge Code	270645984
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$1,884.00
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/O GRMT #6

Facility

$6,280.00

Hospital Charge Code	270675545
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$3,140.00
Rate for Payer: Aetna Commercial	$1,884.00
Rate for Payer: Aetna Medicare Advantage	$1,884.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,601.40
Rate for Payer: Cigna Commercial	$3,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLEX HINGE W/O GRMT #6

Facility

$6,280.00

Hospital Charge Code	270675545
Hospital Revenue Code	278
Min. Negotiated Rate	$942.00
Max. Negotiated Rate	$1,519.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,256.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.76
Rate for Payer: Qualcare PPO/HMO/WC	$942.00

TOE FLXBL HNGE SWNSN#6 4260006

Facility

$1,736.00

Service Code	HCPCS C1776
Hospital Charge Code	270611673
Hospital Revenue Code	278
Min. Negotiated Rate	$260.40
Max. Negotiated Rate	$420.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$347.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.11
Rate for Payer: Qualcare PPO/HMO/WC	$260.40

Know your out-of-pocket cost for care.

All Charges