Heights University Hospital

All Charges

Charge

Type

Setting

Price

OSS AVL TI YOKE SET 12 14 16MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684638
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

OSS AVL TI YOKE SET 12 14 16MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270684638
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

OSS BASEPLATE TIBIA 71MM

Facility

$30,343.05

Service Code	HCPCS C1776
Hospital Charge Code	270697108
Hospital Revenue Code	278
Min. Negotiated Rate	$4,551.46
Max. Negotiated Rate	$7,343.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,068.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,343.02
Rate for Payer: Qualcare PPO/HMO/WC	$4,551.46

OSS BASEPLATE TIBIA 71MM

Facility

$30,343.05

Service Code	HCPCS C1776
Hospital Charge Code	270697108
Hospital Revenue Code	278
Min. Negotiated Rate	$4,551.46
Max. Negotiated Rate	$15,171.52
Rate for Payer: Aetna Commercial	$9,102.92
Rate for Payer: Aetna Medicare Advantage	$9,102.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,737.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,737.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,068.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,737.48
Rate for Payer: Cigna Commercial	$15,171.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,343.02
Rate for Payer: Qualcare PPO/HMO/WC	$4,551.46

OSS BASEPLT TIBIA NONMOD 67MM

Facility

$29,804.40

Service Code	HCPCS C1776
Hospital Charge Code	270697106
Hospital Revenue Code	278
Min. Negotiated Rate	$4,470.66
Max. Negotiated Rate	$7,212.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,960.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,212.66
Rate for Payer: Qualcare PPO/HMO/WC	$4,470.66

OSS BASEPLT TIBIA NONMOD 67MM

Facility

$29,804.40

Service Code	HCPCS C1776
Hospital Charge Code	270697106
Hospital Revenue Code	278
Min. Negotiated Rate	$4,470.66
Max. Negotiated Rate	$14,902.20
Rate for Payer: Aetna Commercial	$8,941.32
Rate for Payer: Aetna Medicare Advantage	$8,941.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,600.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,600.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,960.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,600.12
Rate for Payer: Cigna Commercial	$14,902.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,212.66
Rate for Payer: Qualcare PPO/HMO/WC	$4,470.66

OSS BEARING TIBIA ART LS 20MM

Facility

$8,152.25

Service Code	HCPCS C1776
Hospital Charge Code	270697107
Hospital Revenue Code	278
Min. Negotiated Rate	$1,222.84
Max. Negotiated Rate	$4,076.12
Rate for Payer: Aetna Commercial	$2,445.68
Rate for Payer: Aetna Medicare Advantage	$2,445.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,078.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,078.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,630.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,078.82
Rate for Payer: Cigna Commercial	$4,076.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,972.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,222.84

OSS BEARING TIBIA ART LS 20MM

Facility

$8,152.25

Service Code	HCPCS C1776
Hospital Charge Code	270697107
Hospital Revenue Code	278
Min. Negotiated Rate	$1,222.84
Max. Negotiated Rate	$1,972.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,630.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,972.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,222.84

OSS CEMENTED IM STEM 14 X 150

Facility

$9,540.00

Service Code	HCPCS C1776
Hospital Charge Code	270687278
Hospital Revenue Code	278
Min. Negotiated Rate	$1,431.00
Max. Negotiated Rate	$2,308.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,908.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,308.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,431.00

OSS CEMENTED IM STEM 14 X 150

Facility

$9,540.00

Service Code	HCPCS C1776
Hospital Charge Code	270687278
Hospital Revenue Code	278
Min. Negotiated Rate	$1,431.00
Max. Negotiated Rate	$4,770.00
Rate for Payer: Aetna Commercial	$2,862.00
Rate for Payer: Aetna Medicare Advantage	$2,862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,432.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,432.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,908.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,432.70
Rate for Payer: Cigna Commercial	$4,770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,308.68
Rate for Payer: Qualcare PPO/HMO/WC	$1,431.00

OSSEOGEN CELLULAR BONE MATRIX

Facility

$9,750.00

Service Code	HCPCS C1765
Hospital Charge Code	270706025
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$4,875.00
Rate for Payer: Aetna Commercial	$2,925.00
Rate for Payer: Aetna Medicare Advantage	$2,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,486.25
Rate for Payer: Cigna Commercial	$4,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

OSSEOGEN CELLULAR BONE MATRIX

Facility

$17,750.00

Service Code	HCPCS C1765
Hospital Charge Code	270706026
Hospital Revenue Code	278
Min. Negotiated Rate	$2,662.50
Max. Negotiated Rate	$8,875.00
Rate for Payer: Aetna Commercial	$5,325.00
Rate for Payer: Aetna Medicare Advantage	$5,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,526.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,526.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,526.25
Rate for Payer: Cigna Commercial	$8,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,295.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,662.50

OSSEOGEN CELLULAR BONE MATRIX

Facility

$17,750.00

Service Code	HCPCS C1765
Hospital Charge Code	270706026
Hospital Revenue Code	278
Min. Negotiated Rate	$2,662.50
Max. Negotiated Rate	$4,295.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,295.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,662.50

OSSEOGEN CELLULAR BONE MATRIX

Facility

$9,750.00

Service Code	HCPCS C1765
Hospital Charge Code	270706025
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$2,359.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

OSSFX

Facility

$7,125.00

Hospital Charge Code	270704259
Hospital Revenue Code	278
Min. Negotiated Rate	$1,068.75
Max. Negotiated Rate	$1,724.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,724.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,068.75

OSSFX

Facility

$7,125.00

Hospital Charge Code	270704259
Hospital Revenue Code	278
Min. Negotiated Rate	$1,068.75
Max. Negotiated Rate	$3,562.50
Rate for Payer: Aetna Commercial	$2,137.50
Rate for Payer: Aetna Medicare Advantage	$2,137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,816.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,816.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,816.88
Rate for Payer: Cigna Commercial	$3,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,724.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,068.75

OSSFX MOLDABLE 12CC

Facility

$16,375.00

Hospital Charge Code	270702344
Hospital Revenue Code	278
Min. Negotiated Rate	$2,456.25
Max. Negotiated Rate	$3,962.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,962.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,456.25

OSSFX MOLDABLE 12CC

Facility

$16,375.00

Hospital Charge Code	270702344
Hospital Revenue Code	278
Min. Negotiated Rate	$2,456.25
Max. Negotiated Rate	$8,187.50
Rate for Payer: Aetna Commercial	$4,912.50
Rate for Payer: Aetna Medicare Advantage	$4,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,175.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,175.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,175.62
Rate for Payer: Cigna Commercial	$8,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,962.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,456.25

OSSIFUSE FLOWABLE FIBER BONE G

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270704710
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$3,737.50
Rate for Payer: Aetna Commercial	$2,242.50
Rate for Payer: Aetna Medicare Advantage	$2,242.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,906.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,906.12
Rate for Payer: Cigna Commercial	$3,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

OSSIFUSE FLOWABLE FIBER BONE G

Facility

$7,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270704710
Hospital Revenue Code	278
Min. Negotiated Rate	$1,121.25
Max. Negotiated Rate	$1,808.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,808.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,121.25

OSSIFY CORTICAL DBM FIBER 10CC

Facility

$8,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691875
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$2,550.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

OSSIFY CORTICAL DBM FIBER 10CC

Facility

$8,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270691875
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

OSSIFY CORTICAL FIBER 5CC

Facility

$8,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696783
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$2,550.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

OSSIFY CORTICAL FIBER 5CC

Facility

$8,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696783
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

OSSIMATRIX SMALL PRFM

Facility

$6,475.00

Hospital Charge Code	270702458
Hospital Revenue Code	278
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$1,942.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

Know your out-of-pocket cost for care.

All Charges