Heights University Hospital

All Charges

Charge

Type

Setting

Price

HEAD HEMI METASARSAL CANN 22mm

Facility

$12,250.00

Hospital Charge Code	270676440
Hospital Revenue Code	278
Min. Negotiated Rate	$1,837.50
Max. Negotiated Rate	$6,125.00
Rate for Payer: Aetna Commercial	$3,675.00
Rate for Payer: Aetna Medicare Advantage	$3,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,123.75
Rate for Payer: Cigna Commercial	$6,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50

HEAD HUM ARTIC BIO-MOD 54X22MM

Facility

$9,200.00

Service Code	HCPCS C1776
Hospital Charge Code	270698840
Hospital Revenue Code	278
Min. Negotiated Rate	$1,380.00
Max. Negotiated Rate	$4,600.00
Rate for Payer: Aetna Commercial	$2,760.00
Rate for Payer: Aetna Medicare Advantage	$2,760.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,346.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,346.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,346.00
Rate for Payer: Cigna Commercial	$4,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,226.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,380.00

HEAD HUM ARTIC BIO-MOD 54X22MM

Facility

$9,200.00

Service Code	HCPCS C1776
Hospital Charge Code	270698840
Hospital Revenue Code	278
Min. Negotiated Rate	$1,380.00
Max. Negotiated Rate	$2,226.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,226.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,380.00

HEAD HUM ECCENTRIC SZ 52x18mm

Facility

$7,200.00

Service Code	HCPCS C1776
Hospital Charge Code	270685584
Hospital Revenue Code	278
Min. Negotiated Rate	$1,080.00
Max. Negotiated Rate	$3,600.00
Rate for Payer: Aetna Commercial	$2,160.00
Rate for Payer: Aetna Medicare Advantage	$2,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,836.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,836.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,836.00
Rate for Payer: Cigna Commercial	$3,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,742.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,080.00

HEAD HUM ECCENTRIC SZ 52x18mm

Facility

$7,200.00

Service Code	HCPCS C1776
Hospital Charge Code	270685584
Hospital Revenue Code	278
Min. Negotiated Rate	$1,080.00
Max. Negotiated Rate	$1,742.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,440.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,742.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,080.00

HEAD HUMERAL 18MM BF 52MM

Facility

$7,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270683032
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,100.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

HEAD HUMERAL 18MM BF 52MM

Facility

$7,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270683032
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

HEAD HUMERAL 18X46 43004618

Facility

$7,390.00

Hospital Charge Code	270637944
Hospital Revenue Code	278
Min. Negotiated Rate	$1,108.50
Max. Negotiated Rate	$3,695.00
Rate for Payer: Aetna Commercial	$2,217.00
Rate for Payer: Aetna Medicare Advantage	$2,217.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,884.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,884.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,478.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,884.45
Rate for Payer: Cigna Commercial	$3,695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,788.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,108.50

HEAD HUMERAL 18X46 43004618

Facility

$7,390.00

Hospital Charge Code	270637944
Hospital Revenue Code	278
Min. Negotiated Rate	$1,108.50
Max. Negotiated Rate	$1,788.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,478.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,788.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,108.50

HEAD HUMERAL 24X52cm 43005224

Facility

$7,390.00

Hospital Charge Code	270637580
Hospital Revenue Code	278
Min. Negotiated Rate	$1,108.50
Max. Negotiated Rate	$1,788.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,478.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,788.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,108.50

HEAD HUMERAL 24X52cm 43005224

Facility

$7,390.00

Hospital Charge Code	270637580
Hospital Revenue Code	278
Min. Negotiated Rate	$1,108.50
Max. Negotiated Rate	$3,695.00
Rate for Payer: Aetna Commercial	$2,217.00
Rate for Payer: Aetna Medicare Advantage	$2,217.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,884.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,884.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,478.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,884.45
Rate for Payer: Cigna Commercial	$3,695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,788.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,108.50

HEAD HUMERAL 33X46 43004633

Facility

$7,390.00

Hospital Charge Code	270637265
Hospital Revenue Code	278
Min. Negotiated Rate	$1,108.50
Max. Negotiated Rate	$1,788.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,478.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,788.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,108.50

HEAD HUMERAL 33X46 43004633

Facility

$7,390.00

Hospital Charge Code	270637265
Hospital Revenue Code	278
Min. Negotiated Rate	$1,108.50
Max. Negotiated Rate	$3,695.00
Rate for Payer: Aetna Commercial	$2,217.00
Rate for Payer: Aetna Medicare Advantage	$2,217.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,884.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,884.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,478.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,884.45
Rate for Payer: Cigna Commercial	$3,695.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,788.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,108.50

HEAD HUMERAL 42MM

Facility

$5,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270672315
Hospital Revenue Code	278
Min. Negotiated Rate	$877.50
Max. Negotiated Rate	$2,925.00
Rate for Payer: Aetna Commercial	$1,755.00
Rate for Payer: Aetna Medicare Advantage	$1,755.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,491.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,491.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,491.75
Rate for Payer: Cigna Commercial	$2,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,415.70
Rate for Payer: Qualcare PPO/HMO/WC	$877.50

HEAD HUMERAL 42MM

Facility

$5,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270672315
Hospital Revenue Code	278
Min. Negotiated Rate	$877.50
Max. Negotiated Rate	$1,415.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,415.70
Rate for Payer: Qualcare PPO/HMO/WC	$877.50

HEAD HUMERAL 44 MM

Facility

$8,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270666203
Hospital Revenue Code	278
Min. Negotiated Rate	$1,225.50
Max. Negotiated Rate	$4,085.00
Rate for Payer: Aetna Commercial	$2,451.00
Rate for Payer: Aetna Medicare Advantage	$2,451.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,083.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,083.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,634.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,083.35
Rate for Payer: Cigna Commercial	$4,085.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,977.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,225.50

HEAD HUMERAL 44 MM

Facility

$8,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270666203
Hospital Revenue Code	278
Min. Negotiated Rate	$1,225.50
Max. Negotiated Rate	$1,977.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,634.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,977.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,225.50

HEAD HUMERAL 48MMDx27MM 113771

Facility

$7,180.00

Hospital Charge Code	270647569
Hospital Revenue Code	278
Min. Negotiated Rate	$1,077.00
Max. Negotiated Rate	$1,737.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,436.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,737.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,077.00

HEAD HUMERAL 48MMDx27MM 113771

Facility

$7,180.00

Hospital Charge Code	270647569
Hospital Revenue Code	278
Min. Negotiated Rate	$1,077.00
Max. Negotiated Rate	$3,590.00
Rate for Payer: Aetna Commercial	$2,154.00
Rate for Payer: Aetna Medicare Advantage	$2,154.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,830.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,830.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,436.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,830.90
Rate for Payer: Cigna Commercial	$3,590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,737.56
Rate for Payer: Qualcare PPO/HMO/WC	$1,077.00

HEAD HUMERAL 50MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270678170
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

HEAD HUMERAL 50MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270678170
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

HEAD HUMERAL 52MM

Facility

$5,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270680037
Hospital Revenue Code	278
Min. Negotiated Rate	$877.50
Max. Negotiated Rate	$1,415.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,415.70
Rate for Payer: Qualcare PPO/HMO/WC	$877.50

HEAD HUMERAL 52MM

Facility

$5,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270680037
Hospital Revenue Code	278
Min. Negotiated Rate	$877.50
Max. Negotiated Rate	$2,925.00
Rate for Payer: Aetna Commercial	$1,755.00
Rate for Payer: Aetna Medicare Advantage	$1,755.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,491.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,491.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,491.75
Rate for Payer: Cigna Commercial	$2,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,415.70
Rate for Payer: Qualcare PPO/HMO/WC	$877.50

HEAD HUMERAL 54MM

Facility

$6,020.00

Service Code	HCPCS C1776
Hospital Charge Code	270676518
Hospital Revenue Code	278
Min. Negotiated Rate	$903.00
Max. Negotiated Rate	$3,010.00
Rate for Payer: Aetna Commercial	$1,806.00
Rate for Payer: Aetna Medicare Advantage	$1,806.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,535.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,535.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,535.10
Rate for Payer: Cigna Commercial	$3,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,456.84
Rate for Payer: Qualcare PPO/HMO/WC	$903.00

HEAD HUMERAL 54MM

Facility

$6,020.00

Service Code	HCPCS C1776
Hospital Charge Code	270676518
Hospital Revenue Code	278
Min. Negotiated Rate	$903.00
Max. Negotiated Rate	$1,456.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,204.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,456.84
Rate for Payer: Qualcare PPO/HMO/WC	$903.00

Know your out-of-pocket cost for care.

All Charges