Heights University Hospital

All Charges

Charge

Type

Setting

Price

ARTIC GEL PAD LARGE 317-09

Facility

$1,150.00

Hospital Charge Code	270639525
Hospital Revenue Code	272
Min. Negotiated Rate	$149.50
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$345.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.50
Rate for Payer: Oxford Commercial	$575.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Commercial	$575.00

ARTIC GEL PAD LARGE 317-09

Facility

$1,150.00

Hospital Charge Code	270639525
Hospital Revenue Code	272
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$172.50
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

ARTIC GEL PAD MEDIUM 317-07

Facility

$1,150.00

Hospital Charge Code	270639524
Hospital Revenue Code	272
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$172.50
Rate for Payer: Qualcare PPO/HMO/WC	$172.50

ARTIC GEL PAD MEDIUM 317-07

Facility

$1,150.00

Hospital Charge Code	270639524
Hospital Revenue Code	272
Min. Negotiated Rate	$149.50
Max. Negotiated Rate	$575.00
Rate for Payer: Aetna Commercial	$345.00
Rate for Payer: Aetna Medicare Advantage	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.25
Rate for Payer: Cigna Commercial	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.50
Rate for Payer: Oxford Commercial	$575.00
Rate for Payer: Qualcare PPO/HMO/WC	$172.50
Rate for Payer: UnitedHealthcare Commercial	$575.00

ARTICLR SURFACE 10 90597004010

Facility

$4,964.55

Hospital Charge Code	270638400
Hospital Revenue Code	270
Min. Negotiated Rate	$645.39
Max. Negotiated Rate	$2,482.28
Rate for Payer: Aetna Commercial	$1,489.37
Rate for Payer: Aetna Medicare Advantage	$1,489.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,265.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,265.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,265.96
Rate for Payer: Cigna Commercial	$2,482.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$645.39
Rate for Payer: Oxford Commercial	$2,482.28
Rate for Payer: Qualcare PPO/HMO/WC	$744.68
Rate for Payer: UnitedHealthcare Commercial	$2,482.28

ARTICLR SURFACE 10 90597004010

Facility

$4,964.55

Hospital Charge Code	270638400
Hospital Revenue Code	270
Min. Negotiated Rate	$744.68
Max. Negotiated Rate	$744.68
Rate for Payer: Qualcare PPO/HMO/WC	$744.68

ARTIC SU 10 C-H/3-4 9059703010

Facility

$4,964.60

Hospital Charge Code	270638275
Hospital Revenue Code	270
Min. Negotiated Rate	$744.69
Max. Negotiated Rate	$744.69
Rate for Payer: Qualcare PPO/HMO/WC	$744.69

ARTIC SU 10 C-H/3-4 9059703010

Facility

$4,964.60

Hospital Charge Code	270638275
Hospital Revenue Code	270
Min. Negotiated Rate	$645.40
Max. Negotiated Rate	$2,482.30
Rate for Payer: Aetna Commercial	$1,489.38
Rate for Payer: Aetna Medicare Advantage	$1,489.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,265.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,265.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,265.97
Rate for Payer: Cigna Commercial	$2,482.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$645.40
Rate for Payer: Oxford Commercial	$2,482.30
Rate for Payer: Qualcare PPO/HMO/WC	$744.69
Rate for Payer: UnitedHealthcare Commercial	$2,482.30

ARTIC SURFACE CCK 12MMH RIGHT

Facility

$19,975.55

Service Code	HCPCS C1713
Hospital Charge Code	270705528
Hospital Revenue Code	278
Min. Negotiated Rate	$2,996.33
Max. Negotiated Rate	$4,834.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,834.08
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.33

ARTIC SURFACE CCK 12MMH RIGHT

Facility

$19,975.55

Service Code	HCPCS C1713
Hospital Charge Code	270705528
Hospital Revenue Code	278
Min. Negotiated Rate	$2,996.33
Max. Negotiated Rate	$9,987.77
Rate for Payer: Aetna Commercial	$5,992.66
Rate for Payer: Aetna Medicare Advantage	$5,992.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,093.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,093.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,995.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,093.77
Rate for Payer: Cigna Commercial	$9,987.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,834.08
Rate for Payer: Qualcare PPO/HMO/WC	$2,996.33

ARTICULAR SURFACE 12MM RT 6-9

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270686535
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,125.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

ARTICULAR SURFACE 12MM RT 6-9

Facility

$3,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270686535
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

ARTICULAR SURFACE FIXED

Facility

$5,860.00

Hospital Charge Code	270658851
Hospital Revenue Code	278
Min. Negotiated Rate	$879.00
Max. Negotiated Rate	$1,418.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.12
Rate for Payer: Qualcare PPO/HMO/WC	$879.00

ARTICULAR SURFACE FIXED

Facility

$5,860.00

Hospital Charge Code	270658861
Hospital Revenue Code	278
Min. Negotiated Rate	$879.00
Max. Negotiated Rate	$1,418.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.12
Rate for Payer: Qualcare PPO/HMO/WC	$879.00

ARTICULAR SURFACE FIXED

Facility

$5,860.00

Hospital Charge Code	270658861
Hospital Revenue Code	278
Min. Negotiated Rate	$879.00
Max. Negotiated Rate	$2,930.00
Rate for Payer: Aetna Commercial	$1,758.00
Rate for Payer: Aetna Medicare Advantage	$1,758.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,494.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,494.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,494.30
Rate for Payer: Cigna Commercial	$2,930.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.12
Rate for Payer: Qualcare PPO/HMO/WC	$879.00

ARTICULAR SURFACE FIXED

Facility

$5,860.00

Hospital Charge Code	270658851
Hospital Revenue Code	278
Min. Negotiated Rate	$879.00
Max. Negotiated Rate	$2,930.00
Rate for Payer: Aetna Commercial	$1,758.00
Rate for Payer: Aetna Medicare Advantage	$1,758.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,494.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,494.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,494.30
Rate for Payer: Cigna Commercial	$2,930.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.12
Rate for Payer: Qualcare PPO/HMO/WC	$879.00

ARTICULAR SURFACE FIXED

Facility

$5,862.10

Hospital Charge Code	270656972
Hospital Revenue Code	278
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$2,931.05
Rate for Payer: Aetna Commercial	$1,758.63
Rate for Payer: Aetna Medicare Advantage	$1,758.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,494.84
Rate for Payer: Cigna Commercial	$2,931.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: Qualcare PPO/HMO/WC	$879.32

ARTICULAR SURFACE FIXED

Facility

$5,862.10

Hospital Charge Code	270656972
Hospital Revenue Code	278
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$1,418.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: Qualcare PPO/HMO/WC	$879.32

ARTICULAR SURFACE POLYETHYLENE

Facility

$5,862.10

Hospital Charge Code	270657833
Hospital Revenue Code	278
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$2,931.05
Rate for Payer: Aetna Commercial	$1,758.63
Rate for Payer: Aetna Medicare Advantage	$1,758.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,494.84
Rate for Payer: Cigna Commercial	$2,931.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: Qualcare PPO/HMO/WC	$879.32

ARTICULAR SURFACE POLYETHYLENE

Facility

$5,862.10

Hospital Charge Code	270657833
Hospital Revenue Code	278
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$1,418.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: Qualcare PPO/HMO/WC	$879.32

ARTICULAR SUR SZ3,8MM 58422308

Facility

$2,868.15

Hospital Charge Code	270635700
Hospital Revenue Code	270
Min. Negotiated Rate	$430.22
Max. Negotiated Rate	$430.22
Rate for Payer: Qualcare PPO/HMO/WC	$430.22

ARTICULAR SUR SZ3,8MM 58422308

Facility

$2,868.15

Hospital Charge Code	270635700
Hospital Revenue Code	270
Min. Negotiated Rate	$372.86
Max. Negotiated Rate	$1,434.08
Rate for Payer: Aetna Commercial	$860.45
Rate for Payer: Aetna Medicare Advantage	$860.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$731.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$731.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$731.38
Rate for Payer: Cigna Commercial	$1,434.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$372.86
Rate for Payer: Oxford Commercial	$1,434.08
Rate for Payer: Qualcare PPO/HMO/WC	$430.22
Rate for Payer: UnitedHealthcare Commercial	$1,434.08

ARTICULARTRE C/D STRUT

Facility

$7,625.00

Hospital Charge Code	270656642
Hospital Revenue Code	278
Min. Negotiated Rate	$1,143.75
Max. Negotiated Rate	$1,845.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,845.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.75

ARTICULARTRE C/D STRUT

Facility

$7,625.00

Hospital Charge Code	270656642
Hospital Revenue Code	278
Min. Negotiated Rate	$1,143.75
Max. Negotiated Rate	$3,812.50
Rate for Payer: Aetna Commercial	$2,287.50
Rate for Payer: Aetna Medicare Advantage	$2,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,944.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,944.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,944.38
Rate for Payer: Cigna Commercial	$3,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,845.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,143.75

ARTICULARY CLAMP

Facility

$1,650.00

Hospital Charge Code	270656644
Hospital Revenue Code	272
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$825.00
Rate for Payer: Aetna Commercial	$495.00
Rate for Payer: Aetna Medicare Advantage	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.75
Rate for Payer: Cigna Commercial	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.50
Rate for Payer: Oxford Commercial	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.50
Rate for Payer: UnitedHealthcare Commercial	$825.00

Know your out-of-pocket cost for care.

All Charges