Heights University Hospital

All Charges

Charge

Type

Setting

Price

HUMERAL BODY FINNED REV SHORT

Facility

$17,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270680552
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.50
Max. Negotiated Rate	$4,164.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,442.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,164.82
Rate for Payer: Qualcare PPO/HMO/WC	$2,581.50

HUMERAL BODY FINNED REV SHORT

Facility

$17,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270680552
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.50
Max. Negotiated Rate	$8,605.00
Rate for Payer: Aetna Commercial	$5,163.00
Rate for Payer: Aetna Medicare Advantage	$5,163.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,388.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,388.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,442.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,388.55
Rate for Payer: Cigna Commercial	$8,605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,164.82
Rate for Payer: Qualcare PPO/HMO/WC	$2,581.50

HUMERAL BODY FINNED W/SCREW

Facility

$14,670.00

Service Code	HCPCS C1776
Hospital Charge Code	270672313
Hospital Revenue Code	278
Min. Negotiated Rate	$2,200.50
Max. Negotiated Rate	$7,335.00
Rate for Payer: Aetna Commercial	$4,401.00
Rate for Payer: Aetna Medicare Advantage	$4,401.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,740.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,740.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,934.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,740.85
Rate for Payer: Cigna Commercial	$7,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,550.14
Rate for Payer: Qualcare PPO/HMO/WC	$2,200.50

HUMERAL BODY FINNED W/SCREW

Facility

$14,670.00

Service Code	HCPCS C1776
Hospital Charge Code	270672313
Hospital Revenue Code	278
Min. Negotiated Rate	$2,200.50
Max. Negotiated Rate	$3,550.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,934.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,550.14
Rate for Payer: Qualcare PPO/HMO/WC	$2,200.50

HUMERAL BODYLONG

Facility

$20,000.00

Hospital Charge Code	270669577
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$6,000.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

HUMERAL BODYLONG

Facility

$20,000.00

Hospital Charge Code	270669577
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

HUMERAL BODY SMR SHOULDER HUME

Facility

$17,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270678402
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.50
Max. Negotiated Rate	$8,605.00
Rate for Payer: Aetna Commercial	$5,163.00
Rate for Payer: Aetna Medicare Advantage	$5,163.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,388.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,388.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,442.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,388.55
Rate for Payer: Cigna Commercial	$8,605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,164.82
Rate for Payer: Qualcare PPO/HMO/WC	$2,581.50

HUMERAL BODY SMR SHOULDER HUME

Facility

$17,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270678402
Hospital Revenue Code	278
Min. Negotiated Rate	$2,581.50
Max. Negotiated Rate	$4,164.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,442.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,164.82
Rate for Payer: Qualcare PPO/HMO/WC	$2,581.50

HUMERAL BODY TRAUMA MEDIUM

Facility

$14,670.00

Service Code	HCPCS C1776
Hospital Charge Code	270666201
Hospital Revenue Code	278
Min. Negotiated Rate	$2,200.50
Max. Negotiated Rate	$7,335.00
Rate for Payer: Aetna Commercial	$4,401.00
Rate for Payer: Aetna Medicare Advantage	$4,401.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,740.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,740.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,934.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,740.85
Rate for Payer: Cigna Commercial	$7,335.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,550.14
Rate for Payer: Qualcare PPO/HMO/WC	$2,200.50

HUMERAL BODY TRAUMA MEDIUM

Facility

$14,670.00

Service Code	HCPCS C1776
Hospital Charge Code	270666201
Hospital Revenue Code	278
Min. Negotiated Rate	$2,200.50
Max. Negotiated Rate	$3,550.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,934.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,550.14
Rate for Payer: Qualcare PPO/HMO/WC	$2,200.50

HUMERAL BODY TRAUMA SHORT

Facility

$20,000.00

Hospital Charge Code	270666204
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$6,000.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

HUMERAL BODY TRAUMA SHORT

Facility

$20,000.00

Hospital Charge Code	270666204
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

HUMERAL BODY TRAY STD 5

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270693795
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

HUMERAL BODY TRAY STD 5

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270693795
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

HUMERAL CUP RVRS SZ 3/4 36MM

Facility

$20,700.00

Service Code	HCPCS C1776
Hospital Charge Code	270700531
Hospital Revenue Code	278
Min. Negotiated Rate	$3,105.00
Max. Negotiated Rate	$5,009.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,009.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,105.00

HUMERAL CUP RVRS SZ 3/4 36MM

Facility

$20,700.00

Service Code	HCPCS C1776
Hospital Charge Code	270700531
Hospital Revenue Code	278
Min. Negotiated Rate	$3,105.00
Max. Negotiated Rate	$10,350.00
Rate for Payer: Aetna Commercial	$6,210.00
Rate for Payer: Aetna Medicare Advantage	$6,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,278.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,278.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,278.50
Rate for Payer: Cigna Commercial	$10,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,009.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,105.00

HUMERAL CUP RVRS SZ3/4 6X42MM

Facility

$25,875.00

Service Code	HCPCS C1776
Hospital Charge Code	270700524
Hospital Revenue Code	278
Min. Negotiated Rate	$3,881.25
Max. Negotiated Rate	$12,937.50
Rate for Payer: Aetna Commercial	$7,762.50
Rate for Payer: Aetna Medicare Advantage	$7,762.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,598.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,598.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,598.12
Rate for Payer: Cigna Commercial	$12,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,261.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,881.25

HUMERAL CUP RVRS SZ3/4 6X42MM

Facility

$25,875.00

Service Code	HCPCS C1776
Hospital Charge Code	270700524
Hospital Revenue Code	278
Min. Negotiated Rate	$3,881.25
Max. Negotiated Rate	$6,261.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,261.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,881.25

HUMERAL EXTENSION +9MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270672166
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

HUMERAL EXTENSION +9MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270672166
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

HUMERAL FRACTURE STEM 6MMX122M

Facility

$24,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270705443
Hospital Revenue Code	278
Min. Negotiated Rate	$3,691.50
Max. Negotiated Rate	$5,955.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,922.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,955.62
Rate for Payer: Qualcare PPO/HMO/WC	$3,691.50

HUMERAL FRACTURE STEM 6MMX122M

Facility

$24,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270705443
Hospital Revenue Code	278
Min. Negotiated Rate	$3,691.50
Max. Negotiated Rate	$12,305.00
Rate for Payer: Aetna Commercial	$7,383.00
Rate for Payer: Aetna Medicare Advantage	$7,383.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,275.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,275.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,922.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,275.55
Rate for Payer: Cigna Commercial	$12,305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,955.62
Rate for Payer: Qualcare PPO/HMO/WC	$3,691.50

HUMERAL FX ORTHOSIS - BONEL

Facility

$1,480.85

Hospital Charge Code	270614723
Hospital Revenue Code	274
Min. Negotiated Rate	$222.13
Max. Negotiated Rate	$358.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.37
Rate for Payer: Qualcare PPO/HMO/WC	$222.13

HUMERAL FX ORTHOSIS - BONEL

Facility

$1,480.85

Hospital Charge Code	270614723
Hospital Revenue Code	274
Min. Negotiated Rate	$222.13
Max. Negotiated Rate	$740.42
Rate for Payer: Aetna Commercial	$444.25
Rate for Payer: Aetna Medicare Advantage	$444.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$377.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$377.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$377.62
Rate for Payer: Cigna Commercial	$740.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.37
Rate for Payer: Qualcare PPO/HMO/WC	$222.13

HUMERAL GUIDE PIN 3.5 NON

Facility

$865.00

Hospital Charge Code	270703972
Hospital Revenue Code	279
Min. Negotiated Rate	$112.45
Max. Negotiated Rate	$432.50
Rate for Payer: Aetna Commercial	$259.50
Rate for Payer: Aetna Medicare Advantage	$259.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$220.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$220.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$220.57
Rate for Payer: Cigna Commercial	$432.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.45
Rate for Payer: Oxford Commercial	$432.50
Rate for Payer: Qualcare PPO/HMO/WC	$129.75
Rate for Payer: UnitedHealthcare Commercial	$432.50

Know your out-of-pocket cost for care.

All Charges