Heights University Hospital

All Charges

Charge

Type

Setting

Price

HIP STEM NECK ANGLE SZ4

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270671315
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

HIP STEM NECK ANGLE SZ4

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270671315
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

HIP STEM NECK ANG V40 SZ 4.5

Facility

$14,850.00

Hospital Charge Code	270669750
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

HIP STEM NECK ANG V40 SZ 4.5

Facility

$14,850.00

Hospital Charge Code	270669750
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

HIP STEM SZ 10/14 DISTAL DIA.

Facility

$36,738.00

Service Code	HCPCS C1776
Hospital Charge Code	270673915
Hospital Revenue Code	278
Min. Negotiated Rate	$5,510.70
Max. Negotiated Rate	$8,890.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,347.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,890.60
Rate for Payer: Qualcare PPO/HMO/WC	$5,510.70

HIP STEM SZ 10/14 DISTAL DIA.

Facility

$36,738.00

Service Code	HCPCS C1776
Hospital Charge Code	270673915
Hospital Revenue Code	278
Min. Negotiated Rate	$5,510.70
Max. Negotiated Rate	$18,369.00
Rate for Payer: Aetna Commercial	$11,021.40
Rate for Payer: Aetna Medicare Advantage	$11,021.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,368.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,368.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,347.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,368.19
Rate for Payer: Cigna Commercial	$18,369.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,890.60
Rate for Payer: Qualcare PPO/HMO/WC	$5,510.70

HIP STEM SZ 3 NK LNTH 35MM

Facility

$14,850.00

Hospital Charge Code	270669391
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

HIP STEM SZ 3 NK LNTH 35MM

Facility

$14,850.00

Hospital Charge Code	270669391
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

HIP STEM SZ6 35 X 107 MM STD

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270700800
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

HIP STEM SZ6 35 X 107 MM STD

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270700800
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,500.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

HIP STEM SZ6 STD 132 DEG NECK

Facility

$2,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270701915
Hospital Revenue Code	278
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$653.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.40
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

HIP STEM SZ6 STD 132 DEG NECK

Facility

$2,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270701915
Hospital Revenue Code	278
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$810.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.40
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

HIP STRPPING

Facility

$468.75

Service Code	HCPCS 29520
Hospital Charge Code	5780155
Hospital Revenue Code	450
Min. Negotiated Rate	$70.31
Max. Negotiated Rate	$70.31
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

HIP STRPPING

Facility

$468.75

Service Code	HCPCS 29520
Hospital Charge Code	5780155
Hospital Revenue Code	450
Min. Negotiated Rate	$27.73
Max. Negotiated Rate	$316.85
Rate for Payer: Aetna Commercial	$140.62
Rate for Payer: Aetna Medicare Advantage	$140.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.53
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.94
Rate for Payer: Qualcare PPO/HMO/WC	$70.31

HIP SYS 132 DEG NECK ANGLE V40

Facility

$16,659.00

Service Code	HCPCS C1776
Hospital Charge Code	270646335
Hospital Revenue Code	278
Min. Negotiated Rate	$2,498.85
Max. Negotiated Rate	$4,031.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,331.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,031.48
Rate for Payer: Qualcare PPO/HMO/WC	$2,498.85

HIP SYS 132 DEG NECK ANGLE V40

Facility

$16,659.00

Service Code	HCPCS C1776
Hospital Charge Code	270646335
Hospital Revenue Code	278
Min. Negotiated Rate	$2,498.85
Max. Negotiated Rate	$8,329.50
Rate for Payer: Aetna Commercial	$4,997.70
Rate for Payer: Aetna Medicare Advantage	$4,997.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,331.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,248.05
Rate for Payer: Cigna Commercial	$8,329.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,031.48
Rate for Payer: Qualcare PPO/HMO/WC	$2,498.85

HIP SYST ACCOLADE C 132D TPR

Facility

$23,825.00

Service Code	HCPCS C1776
Hospital Charge Code	270664953
Hospital Revenue Code	278
Min. Negotiated Rate	$3,573.75
Max. Negotiated Rate	$11,912.50
Rate for Payer: Aetna Commercial	$7,147.50
Rate for Payer: Aetna Medicare Advantage	$7,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,075.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,075.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,075.38
Rate for Payer: Cigna Commercial	$11,912.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,765.65
Rate for Payer: Qualcare PPO/HMO/WC	$3,573.75

HIP SYST ACCOLADE C 132D TPR

Facility

$23,825.00

Service Code	HCPCS C1776
Hospital Charge Code	270664953
Hospital Revenue Code	278
Min. Negotiated Rate	$3,573.75
Max. Negotiated Rate	$5,765.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,765.65
Rate for Payer: Qualcare PPO/HMO/WC	$3,573.75

HIP SYSTEM 28x46MM

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677119
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

HIP SYSTEM 28x46MM

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677119
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

HIP SYSTEM AVENIR

Facility

$14,785.00

Service Code	HCPCS C1776
Hospital Charge Code	270688346
Hospital Revenue Code	278
Min. Negotiated Rate	$2,217.75
Max. Negotiated Rate	$7,392.50
Rate for Payer: Aetna Commercial	$4,435.50
Rate for Payer: Aetna Medicare Advantage	$4,435.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,770.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,770.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,770.18
Rate for Payer: Cigna Commercial	$7,392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,577.97
Rate for Payer: Qualcare PPO/HMO/WC	$2,217.75

HIP SYSTEM AVENIR

Facility

$14,785.00

Service Code	HCPCS C1776
Hospital Charge Code	270688346
Hospital Revenue Code	278
Min. Negotiated Rate	$2,217.75
Max. Negotiated Rate	$3,577.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,957.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,577.97
Rate for Payer: Qualcare PPO/HMO/WC	$2,217.75

HIP SYSTEM BIPOLAR 28MM X 43MM

Facility

$12,250.00

Hospital Charge Code	270668544
Hospital Revenue Code	278
Min. Negotiated Rate	$1,837.50
Max. Negotiated Rate	$2,964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50

HIP SYSTEM BIPOLAR 28MM X 43MM

Facility

$12,250.00

Hospital Charge Code	270668544
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

HIP SYSTEM GENERAL

Facility

$4,975.00

Hospital Charge Code	270670486
Hospital Revenue Code	272
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$746.25
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

Know your out-of-pocket cost for care.

All Charges