Heights University Hospital

All Charges

Charge

Type

Setting

Price

CEMENT FEMORAL RESTRICTOR SZ4

Facility

$397.50

Hospital Charge Code	270655658
Hospital Revenue Code	278
Min. Negotiated Rate	$59.62
Max. Negotiated Rate	$96.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.19
Rate for Payer: Qualcare PPO/HMO/WC	$59.62

CEMENT FEMORAL RESTRICTOR SZ4

Facility

$397.50

Hospital Charge Code	270655658
Hospital Revenue Code	278
Min. Negotiated Rate	$59.62
Max. Negotiated Rate	$198.75
Rate for Payer: Aetna Commercial	$119.25
Rate for Payer: Aetna Medicare Advantage	$119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.36
Rate for Payer: Cigna Commercial	$198.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.19
Rate for Payer: Qualcare PPO/HMO/WC	$59.62

CEMENT FEMORAL RESTRICTOR SZ5

Facility

$397.50

Hospital Charge Code	270655660
Hospital Revenue Code	278
Min. Negotiated Rate	$59.62
Max. Negotiated Rate	$96.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.19
Rate for Payer: Qualcare PPO/HMO/WC	$59.62

CEMENT FEMORAL RESTRICTOR SZ5

Facility

$397.50

Hospital Charge Code	270655660
Hospital Revenue Code	278
Min. Negotiated Rate	$59.62
Max. Negotiated Rate	$198.75
Rate for Payer: Aetna Commercial	$119.25
Rate for Payer: Aetna Medicare Advantage	$119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.36
Rate for Payer: Cigna Commercial	$198.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.19
Rate for Payer: Qualcare PPO/HMO/WC	$59.62

CEMENT FEMORAL RESTRICTOR SZ6

Facility

$397.50

Hospital Charge Code	270655663
Hospital Revenue Code	278
Min. Negotiated Rate	$59.62
Max. Negotiated Rate	$198.75
Rate for Payer: Aetna Commercial	$119.25
Rate for Payer: Aetna Medicare Advantage	$119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.36
Rate for Payer: Cigna Commercial	$198.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.19
Rate for Payer: Qualcare PPO/HMO/WC	$59.62

CEMENT FEMORAL RESTRICTOR SZ6

Facility

$397.50

Hospital Charge Code	270655663
Hospital Revenue Code	278
Min. Negotiated Rate	$59.62
Max. Negotiated Rate	$96.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.19
Rate for Payer: Qualcare PPO/HMO/WC	$59.62

CEMENT FEMORAL RESTRICTOR SZ7

Facility

$397.50

Hospital Charge Code	270655665
Hospital Revenue Code	278
Min. Negotiated Rate	$59.62
Max. Negotiated Rate	$96.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.19
Rate for Payer: Qualcare PPO/HMO/WC	$59.62

CEMENT FEMORAL RESTRICTOR SZ7

Facility

$397.50

Hospital Charge Code	270655665
Hospital Revenue Code	278
Min. Negotiated Rate	$59.62
Max. Negotiated Rate	$198.75
Rate for Payer: Aetna Commercial	$119.25
Rate for Payer: Aetna Medicare Advantage	$119.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.36
Rate for Payer: Cigna Commercial	$198.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.19
Rate for Payer: Qualcare PPO/HMO/WC	$59.62

CEMENT HMD BONE RDPQ 6191010

Facility

$544.85

Hospital Charge Code	270629334
Hospital Revenue Code	278
Min. Negotiated Rate	$81.73
Max. Negotiated Rate	$131.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.85
Rate for Payer: Qualcare PPO/HMO/WC	$81.73

CEMENT HMD BONE RDPQ 6191010

Facility

$544.85

Hospital Charge Code	270629334
Hospital Revenue Code	278
Min. Negotiated Rate	$81.73
Max. Negotiated Rate	$272.43
Rate for Payer: Aetna Commercial	$163.46
Rate for Payer: Aetna Medicare Advantage	$163.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.94
Rate for Payer: Cigna Commercial	$272.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.85
Rate for Payer: Qualcare PPO/HMO/WC	$81.73

CEMENT HMD BONE RDPQ 61911001

Facility

$839.25

Hospital Charge Code	270609404
Hospital Revenue Code	278
Min. Negotiated Rate	$125.89
Max. Negotiated Rate	$419.62
Rate for Payer: Aetna Commercial	$251.78
Rate for Payer: Aetna Medicare Advantage	$251.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$167.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.01
Rate for Payer: Cigna Commercial	$419.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.10
Rate for Payer: Qualcare PPO/HMO/WC	$125.89

CEMENT HMD BONE RDPQ 61911001

Facility

$839.25

Hospital Charge Code	270609404
Hospital Revenue Code	278
Min. Negotiated Rate	$125.89
Max. Negotiated Rate	$203.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$167.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.10
Rate for Payer: Qualcare PPO/HMO/WC	$125.89

CEMENTLESS ACETAB SHELL 56MM.

Facility

$9,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270703600
Hospital Revenue Code	278
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$4,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$4,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CEMENTLESS ACETAB SHELL 56MM.

Facility

$9,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270703600
Hospital Revenue Code	278
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$2,299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CEMENTLESS EXTENSION STEM 15M

Facility

$8,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270687677
Hospital Revenue Code	278
Min. Negotiated Rate	$1,348.50
Max. Negotiated Rate	$4,495.00
Rate for Payer: Aetna Commercial	$2,697.00
Rate for Payer: Aetna Medicare Advantage	$2,697.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,292.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,292.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,292.45
Rate for Payer: Cigna Commercial	$4,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,175.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,348.50

CEMENTLESS EXTENSION STEM 15M

Facility

$8,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270687677
Hospital Revenue Code	278
Min. Negotiated Rate	$1,348.50
Max. Negotiated Rate	$2,175.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,798.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,175.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,348.50

CEMENT MIXING BOWL COMPACT VAC

Facility

$1,425.00

Hospital Charge Code	270678378
Hospital Revenue Code	272
Min. Negotiated Rate	$185.25
Max. Negotiated Rate	$712.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$427.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$363.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$363.38
Rate for Payer: Cigna Commercial	$712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.25
Rate for Payer: Oxford Commercial	$712.50
Rate for Payer: Qualcare PPO/HMO/WC	$213.75
Rate for Payer: UnitedHealthcare Commercial	$712.50

CEMENT MIXING BOWL COMPACT VAC

Facility

$1,425.00

Hospital Charge Code	270678378
Hospital Revenue Code	272
Min. Negotiated Rate	$213.75
Max. Negotiated Rate	$213.75
Rate for Payer: Qualcare PPO/HMO/WC	$213.75

CEMENT MIXING/DELIVERY SYSTEM

Facility

$568.75

Service Code	HCPCS C1713
Hospital Charge Code	270677293
Hospital Revenue Code	278
Min. Negotiated Rate	$85.31
Max. Negotiated Rate	$284.38
Rate for Payer: Aetna Commercial	$170.62
Rate for Payer: Aetna Medicare Advantage	$170.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.03
Rate for Payer: Cigna Commercial	$284.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.64
Rate for Payer: Qualcare PPO/HMO/WC	$85.31

CEMENT MIXING/DELIVERY SYSTEM

Facility

$568.75

Service Code	HCPCS C1713
Hospital Charge Code	270677293
Hospital Revenue Code	278
Min. Negotiated Rate	$85.31
Max. Negotiated Rate	$137.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.64
Rate for Payer: Qualcare PPO/HMO/WC	$85.31

CEMENT MIXING SYSTEM

Facility

$352.00

Hospital Charge Code	270335504
Hospital Revenue Code	272
Min. Negotiated Rate	$45.76
Max. Negotiated Rate	$176.00
Rate for Payer: Aetna Commercial	$105.60
Rate for Payer: Aetna Medicare Advantage	$105.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.76
Rate for Payer: Cigna Commercial	$176.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.76
Rate for Payer: Oxford Commercial	$176.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.80
Rate for Payer: UnitedHealthcare Commercial	$176.00

CEMENT MIXING SYSTEM

Facility

$352.00

Hospital Charge Code	270335504
Hospital Revenue Code	272
Min. Negotiated Rate	$52.80
Max. Negotiated Rate	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$52.80

CEMENT MVX PLUS 10CC

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699969
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CEMENT MVX PLUS 10CC

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270699969
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CEMENT OSSILIX FIL 10CC

Facility

$11,985.00

Service Code	HCPCS C1713
Hospital Charge Code	270682056
Hospital Revenue Code	278
Min. Negotiated Rate	$1,797.75
Max. Negotiated Rate	$2,900.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,397.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,900.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,797.75

Know your out-of-pocket cost for care.

All Charges