Heights University Hospital

All Charges

Charge

Type

Setting

Price

FEMORAL NECK SYS PLT 2 H STERI

Facility

$3,231.35

Service Code	HCPCS C1713
Hospital Charge Code	270690899
Hospital Revenue Code	278
Min. Negotiated Rate	$484.70
Max. Negotiated Rate	$1,615.67
Rate for Payer: Aetna Commercial	$969.40
Rate for Payer: Aetna Medicare Advantage	$969.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$823.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$823.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$823.99
Rate for Payer: Cigna Commercial	$1,615.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.99
Rate for Payer: Qualcare PPO/HMO/WC	$484.70

FEMORAL NECK SYS PLT 2 H STERI

Facility

$3,231.35

Service Code	HCPCS C1713
Hospital Charge Code	270690899
Hospital Revenue Code	278
Min. Negotiated Rate	$484.70
Max. Negotiated Rate	$781.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.99
Rate for Payer: Qualcare PPO/HMO/WC	$484.70

FEMORAL NECK SYSTEM PLATE 1 HO

Facility

$4,005.00

Service Code	HCPCS C1713
Hospital Charge Code	270686942
Hospital Revenue Code	278
Min. Negotiated Rate	$600.75
Max. Negotiated Rate	$2,002.50
Rate for Payer: Aetna Commercial	$1,201.50
Rate for Payer: Aetna Medicare Advantage	$1,201.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,021.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,021.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$801.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,021.27
Rate for Payer: Cigna Commercial	$2,002.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$969.21
Rate for Payer: Qualcare PPO/HMO/WC	$600.75

FEMORAL NECK SYSTEM PLATE 1 HO

Facility

$4,005.00

Service Code	HCPCS C1713
Hospital Charge Code	270686942
Hospital Revenue Code	278
Min. Negotiated Rate	$600.75
Max. Negotiated Rate	$969.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$801.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$969.21
Rate for Payer: Qualcare PPO/HMO/WC	$600.75

FEMORAL NEXGEN LCCK, SZ D-LT

Facility

$28,661.45

Hospital Charge Code	270669762
Hospital Revenue Code	278
Min. Negotiated Rate	$4,299.22
Max. Negotiated Rate	$6,936.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,732.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,936.07
Rate for Payer: Qualcare PPO/HMO/WC	$4,299.22

FEMORAL NEXGEN LCCK, SZ D-LT

Facility

$28,661.45

Hospital Charge Code	270669762
Hospital Revenue Code	278
Min. Negotiated Rate	$4,299.22
Max. Negotiated Rate	$14,330.73
Rate for Payer: Aetna Commercial	$8,598.43
Rate for Payer: Aetna Medicare Advantage	$8,598.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,308.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,308.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,732.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,308.67
Rate for Payer: Cigna Commercial	$14,330.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,936.07
Rate for Payer: Qualcare PPO/HMO/WC	$4,299.22

FEMORAL OSS POROUS 3cm RIGHT

Facility

$17,470.00

Service Code	HCPCS C1776
Hospital Charge Code	270673543
Hospital Revenue Code	278
Min. Negotiated Rate	$2,620.50
Max. Negotiated Rate	$4,227.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,494.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,227.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,620.50

FEMORAL OSS POROUS 3cm RIGHT

Facility

$17,470.00

Service Code	HCPCS C1776
Hospital Charge Code	270673543
Hospital Revenue Code	278
Min. Negotiated Rate	$2,620.50
Max. Negotiated Rate	$8,735.00
Rate for Payer: Aetna Commercial	$5,241.00
Rate for Payer: Aetna Medicare Advantage	$5,241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,454.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,454.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,494.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,454.85
Rate for Payer: Cigna Commercial	$8,735.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,227.74
Rate for Payer: Qualcare PPO/HMO/WC	$2,620.50

FEMORAL POLY OSS SET 12

Facility

$3,333.30

Service Code	HCPCS C1776
Hospital Charge Code	270667951
Hospital Revenue Code	278
Min. Negotiated Rate	$500.00
Max. Negotiated Rate	$806.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$666.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$806.66
Rate for Payer: Qualcare PPO/HMO/WC	$500.00

FEMORAL POLY OSS SET 12

Facility

$3,333.30

Service Code	HCPCS C1776
Hospital Charge Code	270667951
Hospital Revenue Code	278
Min. Negotiated Rate	$500.00
Max. Negotiated Rate	$1,666.65
Rate for Payer: Aetna Commercial	$999.99
Rate for Payer: Aetna Medicare Advantage	$999.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$849.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$849.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$666.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$849.99
Rate for Payer: Cigna Commercial	$1,666.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$806.66
Rate for Payer: Qualcare PPO/HMO/WC	$500.00

FEMORAL POR ECHO LAT 15X155MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690735
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

FEMORAL POR ECHO LAT 15X155MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690735
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

FEMORAL POROUS

Facility

$17,230.00

Hospital Charge Code	270666952
Hospital Revenue Code	278
Min. Negotiated Rate	$2,584.50
Max. Negotiated Rate	$8,615.00
Rate for Payer: Aetna Commercial	$5,169.00
Rate for Payer: Aetna Medicare Advantage	$5,169.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,393.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,393.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,446.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,393.65
Rate for Payer: Cigna Commercial	$8,615.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,169.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,584.50

FEMORAL POROUS

Facility

$17,230.00

Hospital Charge Code	270666952
Hospital Revenue Code	278
Min. Negotiated Rate	$2,584.50
Max. Negotiated Rate	$4,169.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,446.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,169.66
Rate for Payer: Qualcare PPO/HMO/WC	$2,584.50

FEMORAL POROUS COVERED STEM 4X

Facility

$10,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703973
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,075.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

FEMORAL POROUS COVERED STEM 4X

Facility

$10,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703973
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

FEMORAL POST ASYM STAB SZ2 RT

Facility

$9,475.20

Service Code	HCPCS C1776
Hospital Charge Code	270670752
Hospital Revenue Code	278
Min. Negotiated Rate	$1,421.28
Max. Negotiated Rate	$4,737.60
Rate for Payer: Aetna Commercial	$2,842.56
Rate for Payer: Aetna Medicare Advantage	$2,842.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,416.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,416.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,895.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,416.18
Rate for Payer: Cigna Commercial	$4,737.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,293.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,421.28

FEMORAL POST ASYM STAB SZ2 RT

Facility

$9,475.20

Service Code	HCPCS C1776
Hospital Charge Code	270670752
Hospital Revenue Code	278
Min. Negotiated Rate	$1,421.28
Max. Negotiated Rate	$2,293.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,895.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,293.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,421.28

FEMORAL POST BLK SCW SZ4 10MM

Facility

$3,861.00

Service Code	HCPCS C1776
Hospital Charge Code	270670652
Hospital Revenue Code	278
Min. Negotiated Rate	$579.15
Max. Negotiated Rate	$1,930.50
Rate for Payer: Aetna Commercial	$1,158.30
Rate for Payer: Aetna Medicare Advantage	$1,158.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$984.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$984.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$772.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$984.55
Rate for Payer: Cigna Commercial	$1,930.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$934.36
Rate for Payer: Qualcare PPO/HMO/WC	$579.15

FEMORAL POST BLK SCW SZ4 10MM

Facility

$3,861.00

Service Code	HCPCS C1776
Hospital Charge Code	270670652
Hospital Revenue Code	278
Min. Negotiated Rate	$579.15
Max. Negotiated Rate	$934.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$772.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$934.36
Rate for Payer: Qualcare PPO/HMO/WC	$579.15

FEMORAL POST BLK SCW SZ4 5MM

Facility

$3,861.00

Hospital Charge Code	270670653
Hospital Revenue Code	278
Min. Negotiated Rate	$579.15
Max. Negotiated Rate	$1,930.50
Rate for Payer: Aetna Commercial	$1,158.30
Rate for Payer: Aetna Medicare Advantage	$1,158.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$984.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$984.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$772.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$984.55
Rate for Payer: Cigna Commercial	$1,930.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$934.36
Rate for Payer: Qualcare PPO/HMO/WC	$579.15

FEMORAL POST BLK SCW SZ4 5MM

Facility

$3,861.00

Hospital Charge Code	270670653
Hospital Revenue Code	278
Min. Negotiated Rate	$579.15
Max. Negotiated Rate	$934.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$772.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$934.36
Rate for Payer: Qualcare PPO/HMO/WC	$579.15

FEMORAL POSTERIOR

Facility

$7,237.90

Service Code	HCPCS C1776
Hospital Charge Code	270691267
Hospital Revenue Code	278
Min. Negotiated Rate	$1,085.68
Max. Negotiated Rate	$1,751.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,447.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,751.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,085.68

FEMORAL POSTERIOR

Facility

$7,237.90

Service Code	HCPCS C1776
Hospital Charge Code	270691267
Hospital Revenue Code	278
Min. Negotiated Rate	$1,085.68
Max. Negotiated Rate	$3,618.95
Rate for Payer: Aetna Commercial	$2,171.37
Rate for Payer: Aetna Medicare Advantage	$2,171.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,845.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,845.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,447.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,845.66
Rate for Payer: Cigna Commercial	$3,618.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,751.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,085.68

FEMORAL POSTERIOR SIZE 4 N

Facility

$10,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270688759
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

Know your out-of-pocket cost for care.

All Charges