Heights University Hospital

All Charges

Charge

Type

Setting

Price

HUMERAL GUIDE PIN 3.5 NON

Facility

$865.00

Hospital Charge Code	270703972
Hospital Revenue Code	279
Min. Negotiated Rate	$129.75
Max. Negotiated Rate	$129.75
Rate for Payer: Qualcare PPO/HMO/WC	$129.75

HUMERAL HD CENTR GLENO 36MM

Facility

$6,982.50

Service Code	HCPCS C1776
Hospital Charge Code	270695303
Hospital Revenue Code	278
Min. Negotiated Rate	$1,047.38
Max. Negotiated Rate	$1,689.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,396.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.77
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.38

HUMERAL HD CENTR GLENO 36MM

Facility

$6,982.50

Service Code	HCPCS C1776
Hospital Charge Code	270695303
Hospital Revenue Code	278
Min. Negotiated Rate	$1,047.38
Max. Negotiated Rate	$3,491.25
Rate for Payer: Aetna Commercial	$2,094.75
Rate for Payer: Aetna Medicare Advantage	$2,094.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,780.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,780.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,396.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,780.54
Rate for Payer: Cigna Commercial	$3,491.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,689.77
Rate for Payer: Qualcare PPO/HMO/WC	$1,047.38

HUMERAL HEAD 40MM 18MM

Facility

$13,760.00

Hospital Charge Code	270660704
Hospital Revenue Code	278
Min. Negotiated Rate	$2,064.00
Max. Negotiated Rate	$3,329.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,752.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,329.92
Rate for Payer: Qualcare PPO/HMO/WC	$2,064.00

HUMERAL HEAD 40MM 18MM

Facility

$13,760.00

Hospital Charge Code	270660704
Hospital Revenue Code	278
Min. Negotiated Rate	$2,064.00
Max. Negotiated Rate	$6,880.00
Rate for Payer: Aetna Commercial	$4,128.00
Rate for Payer: Aetna Medicare Advantage	$4,128.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,508.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,508.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,752.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,508.80
Rate for Payer: Cigna Commercial	$6,880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,329.92
Rate for Payer: Qualcare PPO/HMO/WC	$2,064.00

HUMERAL HEAD 40MMx21MM SOLAR

Facility

$14,750.00

Hospital Charge Code	270663621
Hospital Revenue Code	278
Min. Negotiated Rate	$2,212.50
Max. Negotiated Rate	$3,569.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,569.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,212.50

HUMERAL HEAD 40MMx21MM SOLAR

Facility

$14,750.00

Hospital Charge Code	270663621
Hospital Revenue Code	278
Min. Negotiated Rate	$2,212.50
Max. Negotiated Rate	$7,375.00
Rate for Payer: Aetna Commercial	$4,425.00
Rate for Payer: Aetna Medicare Advantage	$4,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,761.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,761.25
Rate for Payer: Cigna Commercial	$7,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,569.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,212.50

HUMERAL HEAD 40X14MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700459
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 HEAD 40X14MM

Facility

$10,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700459
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 HEAD 45MM

Facility

$5,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270669576
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

HUMERAL HEAD 45MM

Facility

$5,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270669576
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

HUMERAL HEAD 52x20MM STERILE

Facility

$8,750.00

Hospital Charge Code	270675694
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$2,625.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

HUMERAL HEAD 52x20MM STERILE

Facility

$8,750.00

Hospital Charge Code	270675694
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

HUMERAL HEAD DIA. 48MM

Facility

$4,800.00

Service Code	HCPCS C1776
Hospital Charge Code	270675414
Hospital Revenue Code	278
Min. Negotiated Rate	$720.00
Max. Negotiated Rate	$2,400.00
Rate for Payer: Aetna Commercial	$1,440.00
Rate for Payer: Aetna Medicare Advantage	$1,440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,224.00
Rate for Payer: Cigna Commercial	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$720.00

HUMERAL HEAD DIA. 48MM

Facility

$4,800.00

Service Code	HCPCS C1776
Hospital Charge Code	270675414
Hospital Revenue Code	278
Min. Negotiated Rate	$720.00
Max. Negotiated Rate	$1,161.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$720.00

HUMERAL HEAD EXPANDED 47MM

Facility

$7,725.00

Hospital Charge Code	270669868
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.75
Max. Negotiated Rate	$3,862.50
Rate for Payer: Aetna Commercial	$2,317.50
Rate for Payer: Aetna Medicare Advantage	$2,317.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,969.88
Rate for Payer: Cigna Commercial	$3,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75

HUMERAL HEAD EXPANDED 47MM

Facility

$7,725.00

Hospital Charge Code	270669868
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.75
Max. Negotiated Rate	$1,869.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75

HUMERAL HEAD TALL 41X20MM

Facility

$7,725.00

Service Code	HCPCS C1776
Hospital Charge Code	270670756
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.75
Max. Negotiated Rate	$1,869.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75

HUMERAL HEAD TALL 41X20MM

Facility

$7,725.00

Service Code	HCPCS C1776
Hospital Charge Code	270670756
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.75
Max. Negotiated Rate	$3,862.50
Rate for Payer: Aetna Commercial	$2,317.50
Rate for Payer: Aetna Medicare Advantage	$2,317.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,969.88
Rate for Payer: Cigna Commercial	$3,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75

HUMERAL HEAD TALL 50MM

Facility

$7,725.00

Hospital Charge Code	270675724
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.75
Max. Negotiated Rate	$3,862.50
Rate for Payer: Aetna Commercial	$2,317.50
Rate for Payer: Aetna Medicare Advantage	$2,317.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,969.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,969.88
Rate for Payer: Cigna Commercial	$3,862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75

HUMERAL HEAD TALL 50MM

Facility

$7,725.00

Hospital Charge Code	270675724
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.75
Max. Negotiated Rate	$1,869.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,869.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,158.75

HUMERAL INSERT RVRS SZ3/436MM

Facility

$20,700.00

Service Code	HCPCS C1776
Hospital Charge Code	270700533
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 INSERT RVRS SZ3/436MM

Facility

$20,700.00

Service Code	HCPCS C1776
Hospital Charge Code	270700533
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 MIDDLE SEGMENT 25MM

Facility

$47,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270679730
Hospital Revenue Code	278
Min. Negotiated Rate	$7,125.00
Max. Negotiated Rate	$23,750.00
Rate for Payer: Aetna Commercial	$14,250.00
Rate for Payer: Aetna Medicare Advantage	$14,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,112.50
Rate for Payer: Cigna Commercial	$23,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,495.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,125.00

HUMERAL MIDDLE SEGMENT 25MM

Facility

$47,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270679730
Hospital Revenue Code	278
Min. Negotiated Rate	$7,125.00
Max. Negotiated Rate	$11,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,495.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,125.00

Know your out-of-pocket cost for care.

All Charges