Heights University Hospital

All Charges

Charge

Type

Setting

Price

FEMORAL HIP ST R-NECK SZ10

Facility

$17,062.50

Service Code	HCPCS C1776
Hospital Charge Code	270692221
Hospital Revenue Code	278
Min. Negotiated Rate	$2,559.38
Max. Negotiated Rate	$4,129.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,129.12
Rate for Payer: Qualcare PPO/HMO/WC	$2,559.38

FEMORAL HIP SYS SZ 1 30x110MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270673999
Hospital Revenue Code	278
Min. Negotiated Rate	$2,227.50
Max. Negotiated Rate	$3,593.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,593.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.50

FEMORAL HIP SYS SZ 1 30x110MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270673999
Hospital Revenue Code	278
Min. Negotiated Rate	$2,227.50
Max. Negotiated Rate	$7,425.00
Rate for Payer: Aetna Commercial	$4,455.00
Rate for Payer: Aetna Medicare Advantage	$4,455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,786.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,786.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,786.75
Rate for Payer: Cigna Commercial	$7,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,593.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.50

FEMORAL HIP SYSTEM SZ 3

Facility

$4,750.00

Hospital Charge Code	270703306
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

FEMORAL HIP SYSTEM SZ 3

Facility

$4,750.00

Hospital Charge Code	270703306
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

FEMORAL HIP TAPERFILL SZ 7

Facility

$17,062.50

Service Code	HCPCS C1776
Hospital Charge Code	270692215
Hospital Revenue Code	278
Min. Negotiated Rate	$2,559.38
Max. Negotiated Rate	$4,129.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,129.12
Rate for Payer: Qualcare PPO/HMO/WC	$2,559.38

FEMORAL HIP TAPERFILL SZ 7

Facility

$17,062.50

Service Code	HCPCS C1776
Hospital Charge Code	270692215
Hospital Revenue Code	278
Min. Negotiated Rate	$2,559.38
Max. Negotiated Rate	$8,531.25
Rate for Payer: Aetna Commercial	$5,118.75
Rate for Payer: Aetna Medicare Advantage	$5,118.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,350.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,350.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,350.94
Rate for Payer: Cigna Commercial	$8,531.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,129.12
Rate for Payer: Qualcare PPO/HMO/WC	$2,559.38

FEMORAL INTERLOK LT 60MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270639169
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$5,000.00
Rate for Payer: Aetna Commercial	$3,000.00
Rate for Payer: Aetna Medicare Advantage	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,550.00
Rate for Payer: Cigna Commercial	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

FEMORAL INTERLOK LT 60MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270639169
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,420.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,500.00

FEMORAL KNEE 60MM CEMENTED

Facility

$14,800.00

Service Code	HCPCS C1776
Hospital Charge Code	270682049
Hospital Revenue Code	278
Min. Negotiated Rate	$2,220.00
Max. Negotiated Rate	$7,400.00
Rate for Payer: Aetna Commercial	$4,440.00
Rate for Payer: Aetna Medicare Advantage	$4,440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,774.00
Rate for Payer: Cigna Commercial	$7,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,581.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,220.00

FEMORAL KNEE 60MM CEMENTED

Facility

$14,800.00

Service Code	HCPCS C1776
Hospital Charge Code	270682049
Hospital Revenue Code	278
Min. Negotiated Rate	$2,220.00
Max. Negotiated Rate	$3,581.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,581.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,220.00

FEMORAL KNEE SZ7 LEFT

Facility

$19,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270693993
Hospital Revenue Code	278
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,598.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

FEMORAL KNEE SZ7 LEFT

Facility

$19,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270693993
Hospital Revenue Code	278
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$4,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,598.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

FEMORAL LCCK SZ G -RT NEXGEN

Facility

$36,900.00

Service Code	HCPCS C1776
Hospital Charge Code	270686835
Hospital Revenue Code	278
Min. Negotiated Rate	$5,535.00
Max. Negotiated Rate	$18,450.00
Rate for Payer: Aetna Commercial	$11,070.00
Rate for Payer: Aetna Medicare Advantage	$11,070.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,409.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,409.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,380.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,409.50
Rate for Payer: Cigna Commercial	$18,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,929.80
Rate for Payer: Qualcare PPO/HMO/WC	$5,535.00

FEMORAL LCCK SZ G -RT NEXGEN

Facility

$36,900.00

Service Code	HCPCS C1776
Hospital Charge Code	270686835
Hospital Revenue Code	278
Min. Negotiated Rate	$5,535.00
Max. Negotiated Rate	$8,929.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,929.80
Rate for Payer: Qualcare PPO/HMO/WC	$5,535.00

FEMORAL LPS-FLEX GSF OPTION

Facility

$12,165.00

Hospital Charge Code	270660823
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.75
Max. Negotiated Rate	$6,082.50
Rate for Payer: Aetna Commercial	$3,649.50
Rate for Payer: Aetna Medicare Advantage	$3,649.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,102.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,102.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,102.07
Rate for Payer: Cigna Commercial	$6,082.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,943.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.75

FEMORAL LPS-FLEX GSF OPTION

Facility

$12,165.00

Hospital Charge Code	270660823
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.75
Max. Negotiated Rate	$2,943.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,943.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.75

FEMORAL MOLD CEMENT 75 MM

Facility

$10,460.00

Service Code	HCPCS C1713
Hospital Charge Code	270684834
Hospital Revenue Code	278
Min. Negotiated Rate	$1,569.00
Max. Negotiated Rate	$2,531.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,092.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,531.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,569.00

FEMORAL MOLD CEMENT 75 MM

Facility

$10,460.00

Service Code	HCPCS C1713
Hospital Charge Code	270684834
Hospital Revenue Code	278
Min. Negotiated Rate	$1,569.00
Max. Negotiated Rate	$5,230.00
Rate for Payer: Aetna Commercial	$3,138.00
Rate for Payer: Aetna Medicare Advantage	$3,138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,667.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,667.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,092.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,667.30
Rate for Payer: Cigna Commercial	$5,230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,531.32
Rate for Payer: Qualcare PPO/HMO/WC	$1,569.00

FEMORAL NAIL EX SPIRAL 70 MM B

Facility

$2,563.85

Service Code	HCPCS C1713
Hospital Charge Code	270688215
Hospital Revenue Code	278
Min. Negotiated Rate	$384.58
Max. Negotiated Rate	$1,281.92
Rate for Payer: Aetna Commercial	$769.15
Rate for Payer: Aetna Medicare Advantage	$769.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$653.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$653.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$512.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$653.78
Rate for Payer: Cigna Commercial	$1,281.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$620.45
Rate for Payer: Qualcare PPO/HMO/WC	$384.58

FEMORAL NAIL EX SPIRAL 70 MM B

Facility

$2,563.85

Service Code	HCPCS C1713
Hospital Charge Code	270688215
Hospital Revenue Code	278
Min. Negotiated Rate	$384.58
Max. Negotiated Rate	$620.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$512.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$620.45
Rate for Payer: Qualcare PPO/HMO/WC	$384.58

FEMORAL NAIL LEFT

Facility

$13,910.00

Hospital Charge Code	27065601
Hospital Revenue Code	278
Min. Negotiated Rate	$2,086.50
Max. Negotiated Rate	$6,955.00
Rate for Payer: Aetna Commercial	$4,173.00
Rate for Payer: Aetna Medicare Advantage	$4,173.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,547.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,547.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,782.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,547.05
Rate for Payer: Cigna Commercial	$6,955.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,366.22
Rate for Payer: Qualcare PPO/HMO/WC	$2,086.50

FEMORAL NAIL LEFT

Facility

$13,910.00

Hospital Charge Code	27065601
Hospital Revenue Code	278
Min. Negotiated Rate	$2,086.50
Max. Negotiated Rate	$3,366.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,782.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,366.22
Rate for Payer: Qualcare PPO/HMO/WC	$2,086.50

FEMORAL N BLOCK SGL RT

Facility

$4,204.50

Service Code	HCPCS 64447
Hospital Charge Code	16000266
Hospital Revenue Code	360
Min. Negotiated Rate	$630.67
Max. Negotiated Rate	$630.67
Rate for Payer: Qualcare PPO/HMO/WC	$630.67

FEMORAL N BLOCK SGL RT

Facility

$4,204.50

Service Code	HCPCS 64447
Hospital Charge Code	16000266
Hospital Revenue Code	360
Min. Negotiated Rate	$546.59
Max. Negotiated Rate	$2,575.00
Rate for Payer: Aetna Commercial	$1,261.35
Rate for Payer: Aetna Medicare Advantage	$1,261.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,072.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,072.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,072.15
Rate for Payer: Cigna Commercial	$1,680.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.59
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$630.67
Rate for Payer: UnitedHealthcare Commercial	$2,575.00

Know your out-of-pocket cost for care.

All Charges