Heights University Hospital

All Charges

Charge

Type

Setting

Price

ATTUNE FEM POST STBL SZ6 L CEM

Facility

$10,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270686574
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

ATTUNE KNEE SYSTEM TIBIAL BASE

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686057
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

ATTUNE KNEE SYSTEM TIBIAL BASE

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686057
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

ATTUNE PATELLA MEDIALIZED DOME

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686020
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

ATTUNE PATELLA MEDIALIZED DOME

Facility

$2,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686020
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

ATTUNE PINNING SYSTEM

Facility

$1,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270686446
Hospital Revenue Code	278
Min. Negotiated Rate	$243.00
Max. Negotiated Rate	$392.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$324.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.04
Rate for Payer: Qualcare PPO/HMO/WC	$243.00

ATTUNE PINNING SYSTEM

Facility

$1,620.00

Service Code	HCPCS C1713
Hospital Charge Code	270686446
Hospital Revenue Code	278
Min. Negotiated Rate	$243.00
Max. Negotiated Rate	$810.00
Rate for Payer: Aetna Commercial	$486.00
Rate for Payer: Aetna Medicare Advantage	$486.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$413.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$413.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$413.10
Rate for Payer: Cigna Commercial	$810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.04
Rate for Payer: Qualcare PPO/HMO/WC	$243.00

ATTUNE TIBAL INSERT FIXED BEAR

Facility

$5,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686058
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

ATTUNE TIBAL INSERT FIXED BEAR

Facility

$5,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686058
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$1,650.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

ATTUN PAT MED DOM 38MM CEM AOX

Facility

$1,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270673974
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

ATTUN PAT MED DOM 38MM CEM AOX

Facility

$1,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270673974
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$525.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

ATTUN SYS TIB BASE FIX BRNG

Facility

$1,621.75

Service Code	HCPCS C1776
Hospital Charge Code	270686564
Hospital Revenue Code	278
Min. Negotiated Rate	$243.26
Max. Negotiated Rate	$392.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$324.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.46
Rate for Payer: Qualcare PPO/HMO/WC	$243.26

ATTUN SYS TIB BASE FIX BRNG

Facility

$1,621.75

Service Code	HCPCS C1776
Hospital Charge Code	270686564
Hospital Revenue Code	278
Min. Negotiated Rate	$243.26
Max. Negotiated Rate	$810.88
Rate for Payer: Aetna Commercial	$486.52
Rate for Payer: Aetna Medicare Advantage	$486.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$413.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$413.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$324.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$413.55
Rate for Payer: Cigna Commercial	$810.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.46
Rate for Payer: Qualcare PPO/HMO/WC	$243.26

ATTUN TIB INS FXD B PST SZ66MM

Facility

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686575
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,350.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

ATTUN TIB INS FXD B PST SZ66MM

Facility

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686575
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

AUDIO METRIC SCREENING

Facility

$267.25

Hospital Charge Code	9000449
Hospital Revenue Code	471
Min. Negotiated Rate	$40.09
Max. Negotiated Rate	$40.09
Rate for Payer: Qualcare PPO/HMO/WC	$40.09

AUDIO METRIC SCREENING

Facility

$267.25

Hospital Charge Code	9000449
Hospital Revenue Code	471
Min. Negotiated Rate	$34.74
Max. Negotiated Rate	$1,180.00
Rate for Payer: Aetna Commercial	$80.17
Rate for Payer: Aetna Medicare Advantage	$80.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.15
Rate for Payer: Cigna Commercial	$133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.74
Rate for Payer: Oxford Commercial	$1,040.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.09
Rate for Payer: UnitedHealthcare Commercial	$1,180.00

AUG BETAMETHASONE OIN 0.5%

Facility

$122.90

Hospital Charge Code	60628815
Hospital Revenue Code	250
Min. Negotiated Rate	$18.43
Max. Negotiated Rate	$18.43
Rate for Payer: Qualcare PPO/HMO/WC	$18.43

AUG BETAMETHASONE OIN 0.5%

Facility

$122.90

Hospital Charge Code	60628815
Hospital Revenue Code	250
Min. Negotiated Rate	$15.98
Max. Negotiated Rate	$61.45
Rate for Payer: Aetna Commercial	$36.87
Rate for Payer: Aetna Medicare Advantage	$36.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.34
Rate for Payer: Cigna Commercial	$61.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.98
Rate for Payer: Oxford Commercial	$61.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.43
Rate for Payer: UnitedHealthcare Commercial	$61.45

AUGMENT 3CC

Facility

$17,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270686745
Hospital Revenue Code	278
Min. Negotiated Rate	$2,621.25
Max. Negotiated Rate	$8,737.50
Rate for Payer: Aetna Commercial	$5,242.50
Rate for Payer: Aetna Medicare Advantage	$5,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,456.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,456.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,456.12
Rate for Payer: Cigna Commercial	$8,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,228.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,621.25

AUGMENT 3CC

Facility

$17,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270686745
Hospital Revenue Code	278
Min. Negotiated Rate	$2,621.25
Max. Negotiated Rate	$4,228.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,228.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,621.25

AUGMENT BONE MATRIX IMPL 3CC

Facility

$20,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270694903
Hospital Revenue Code	278
Min. Negotiated Rate	$3,108.75
Max. Negotiated Rate	$5,015.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,015.45
Rate for Payer: Qualcare PPO/HMO/WC	$3,108.75

AUGMENT BONE MATRIX IMPL 3CC

Facility

$20,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270694903
Hospital Revenue Code	278
Min. Negotiated Rate	$3,108.75
Max. Negotiated Rate	$10,362.50
Rate for Payer: Aetna Commercial	$6,217.50
Rate for Payer: Aetna Medicare Advantage	$6,217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,284.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,284.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,284.88
Rate for Payer: Cigna Commercial	$10,362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,015.45
Rate for Payer: Qualcare PPO/HMO/WC	$3,108.75

AUGMENTIN 125/125MG/5ML

Facility

$131.00

Hospital Charge Code	60632509
Hospital Revenue Code	250
Min. Negotiated Rate	$17.03
Max. Negotiated Rate	$65.50
Rate for Payer: Aetna Commercial	$39.30
Rate for Payer: Aetna Medicare Advantage	$39.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.41
Rate for Payer: Cigna Commercial	$65.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.03
Rate for Payer: Oxford Commercial	$65.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.65
Rate for Payer: UnitedHealthcare Commercial	$65.50

AUGMENTIN 125/125MG/5ML

Facility

$131.00

Hospital Charge Code	60632509
Hospital Revenue Code	250
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$19.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

Know your out-of-pocket cost for care.

All Charges