Heights University Hospital

All Charges

Charge

Type

Setting

Price

LINER HUMERAL 39 +3

Facility

$5,075.00

Hospital Charge Code	270672405
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$1,228.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

LINER HUMERAL 39 +3C

Facility

$5,075.00

Hospital Charge Code	270672406
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$1,228.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

LINER HUMERAL 39 +3C

Facility

$5,075.00

Hospital Charge Code	270672406
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$2,537.50
Rate for Payer: Aetna Commercial	$1,522.50
Rate for Payer: Aetna Medicare Advantage	$1,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,294.12
Rate for Payer: Cigna Commercial	$2,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

LINER HUMERAL 39 +6

Facility

$5,075.00

Hospital Charge Code	270672407
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$2,537.50
Rate for Payer: Aetna Commercial	$1,522.50
Rate for Payer: Aetna Medicare Advantage	$1,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,294.12
Rate for Payer: Cigna Commercial	$2,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

LINER HUMERAL 39 +6

Facility

$5,075.00

Hospital Charge Code	270672407
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$1,228.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

LINER HUMERAL 39 +6C

Facility

$5,075.00

Hospital Charge Code	270672408
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$2,537.50
Rate for Payer: Aetna Commercial	$1,522.50
Rate for Payer: Aetna Medicare Advantage	$1,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,294.12
Rate for Payer: Cigna Commercial	$2,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

LINER HUMERAL 39 +6C

Facility

$5,075.00

Hospital Charge Code	270672408
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$1,228.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

LINER HUMERAL 42 +3

Facility

$5,075.00

Hospital Charge Code	270672401
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$2,537.50
Rate for Payer: Aetna Commercial	$1,522.50
Rate for Payer: Aetna Medicare Advantage	$1,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,294.12
Rate for Payer: Cigna Commercial	$2,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

LINER HUMERAL 42 +3

Facility

$5,075.00

Hospital Charge Code	270672401
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$1,228.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

LINER HUMERAL 42 +3C

Facility

$5,075.00

Hospital Charge Code	270672402
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$1,228.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

LINER HUMERAL 42 +3C

Facility

$5,075.00

Hospital Charge Code	270672402
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$2,537.50
Rate for Payer: Aetna Commercial	$1,522.50
Rate for Payer: Aetna Medicare Advantage	$1,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,294.12
Rate for Payer: Cigna Commercial	$2,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

LINER HUMERAL 42 +6

Facility

$5,075.00

Hospital Charge Code	270672403
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$2,537.50
Rate for Payer: Aetna Commercial	$1,522.50
Rate for Payer: Aetna Medicare Advantage	$1,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,294.12
Rate for Payer: Cigna Commercial	$2,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

LINER HUMERAL 42 +6

Facility

$5,075.00

Hospital Charge Code	270672403
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$1,228.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

LINER HUMERAL 42 +6C

Facility

$5,075.00

Hospital Charge Code	270672404
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$2,537.50
Rate for Payer: Aetna Commercial	$1,522.50
Rate for Payer: Aetna Medicare Advantage	$1,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,294.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,294.12
Rate for Payer: Cigna Commercial	$2,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

LINER HUMERAL 42 +6C

Facility

$5,075.00

Hospital Charge Code	270672404
Hospital Revenue Code	278
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$1,228.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,228.15
Rate for Payer: Qualcare PPO/HMO/WC	$761.25

LINER HUMERAL 42MM SHOULDER 0

Facility

$3,694.95

Service Code	HCPCS C1776
Hospital Charge Code	270679729
Hospital Revenue Code	278
Min. Negotiated Rate	$554.24
Max. Negotiated Rate	$1,847.47
Rate for Payer: Aetna Commercial	$1,108.48
Rate for Payer: Aetna Medicare Advantage	$1,108.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$942.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$942.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$738.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$942.21
Rate for Payer: Cigna Commercial	$1,847.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$894.18
Rate for Payer: Qualcare PPO/HMO/WC	$554.24

LINER HUMERAL 42MM SHOULDER 0

Facility

$3,694.95

Service Code	HCPCS C1776
Hospital Charge Code	270679729
Hospital Revenue Code	278
Min. Negotiated Rate	$554.24
Max. Negotiated Rate	$894.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$738.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$894.18
Rate for Payer: Qualcare PPO/HMO/WC	$554.24

LINER HUMERAL PE 36/+0mm

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270698237
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

LINER HUMERAL PE 36/+0mm

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270698237
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,050.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

LINER HUMERAL REVERSE 36 6MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693859
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

LINER HUMERAL REVERSE 36 6MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693859
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,050.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

LINER HUMERAL REVERSE 36MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270691233
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

LINER HUMERAL REVERSE 36MM

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270691233
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,050.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

LINER INNER 36 MM +4 52 MM

Facility

$4,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270688140
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

LINER INNER 36 MM +4 52 MM

Facility

$4,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270688140
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

Know your out-of-pocket cost for care.

All Charges