Heights University Hospital

All Charges

Charge

Type

Setting

Price

STAYFUSE ZIM IMPLANT 22270202

Facility

$694.45

Hospital Charge Code	270625622
Hospital Revenue Code	272
Min. Negotiated Rate	$90.28
Max. Negotiated Rate	$347.23
Rate for Payer: Aetna Commercial	$208.34
Rate for Payer: Aetna Medicare Advantage	$208.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.08
Rate for Payer: Cigna Commercial	$347.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.28
Rate for Payer: Oxford Commercial	$347.23
Rate for Payer: Qualcare PPO/HMO/WC	$104.17
Rate for Payer: UnitedHealthcare Commercial	$347.23

STAYFUSE ZIM IMPLANT 22270202

Facility

$694.45

Hospital Charge Code	270625622
Hospital Revenue Code	272
Min. Negotiated Rate	$104.17
Max. Negotiated Rate	$104.17
Rate for Payer: Qualcare PPO/HMO/WC	$104.17

STAYFUSE ZIM IMPLANT 22270301

Facility

$619.25

Hospital Charge Code	270625957
Hospital Revenue Code	272
Min. Negotiated Rate	$92.89
Max. Negotiated Rate	$92.89
Rate for Payer: Qualcare PPO/HMO/WC	$92.89

STAYFUSE ZIM IMPLANT 22270301

Facility

$619.25

Hospital Charge Code	270625957
Hospital Revenue Code	272
Min. Negotiated Rate	$80.50
Max. Negotiated Rate	$309.62
Rate for Payer: Qualcare PPO/HMO/WC	$92.89
Rate for Payer: Aetna Commercial	$185.78
Rate for Payer: Aetna Medicare Advantage	$185.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.91
Rate for Payer: Cigna Commercial	$309.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.50
Rate for Payer: Oxford Commercial	$309.62
Rate for Payer: UnitedHealthcare Commercial	$309.62

STAYFUSE ZIM IMPLANT 22270401

Facility

$619.25

Hospital Charge Code	270625623
Hospital Revenue Code	272
Min. Negotiated Rate	$92.89
Max. Negotiated Rate	$92.89
Rate for Payer: Qualcare PPO/HMO/WC	$92.89

STAYFUSE ZIM IMPLANT 22270401

Facility

$619.25

Hospital Charge Code	270625623
Hospital Revenue Code	272
Min. Negotiated Rate	$80.50
Max. Negotiated Rate	$309.62
Rate for Payer: Aetna Commercial	$185.78
Rate for Payer: Aetna Medicare Advantage	$185.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.91
Rate for Payer: Cigna Commercial	$309.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.50
Rate for Payer: Oxford Commercial	$309.62
Rate for Payer: Qualcare PPO/HMO/WC	$92.89
Rate for Payer: UnitedHealthcare Commercial	$309.62

STAYS 5MM 3311-8G

Facility

$41.46

Hospital Charge Code	270608601
Hospital Revenue Code	272
Min. Negotiated Rate	$5.39
Max. Negotiated Rate	$20.73
Rate for Payer: Aetna Commercial	$12.44
Rate for Payer: Aetna Medicare Advantage	$12.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.57
Rate for Payer: Cigna Commercial	$20.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.39
Rate for Payer: Oxford Commercial	$20.73
Rate for Payer: Qualcare PPO/HMO/WC	$6.22
Rate for Payer: UnitedHealthcare Commercial	$20.73

STAYS 5MM 3311-8G

Facility

$41.46

Hospital Charge Code	270608601
Hospital Revenue Code	272
Min. Negotiated Rate	$6.22
Max. Negotiated Rate	$6.22
Rate for Payer: Qualcare PPO/HMO/WC	$6.22

ST BEH QUAL ANALY VOICE & RESO

Facility

$2,400.00

Service Code	HCPCS 92524GN
Hospital Charge Code	74204045
Hospital Revenue Code	444
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$1,200.00
Rate for Payer: Aetna Commercial	$720.00
Rate for Payer: Aetna Medicare Advantage	$720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$612.00
Rate for Payer: Cigna Commercial	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00
Rate for Payer: UnitedHealthcare Commercial	$686.00

ST BEH QUAL ANALY VOICE & RESO

Facility

$2,400.00

Service Code	HCPCS 92524GN
Hospital Charge Code	74204045
Hospital Revenue Code	444
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$360.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.00

STD1 COLLARED

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686976
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$2,400.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

STD1 COLLARED

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686976
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

STD FEMORAL HEAD

Facility

$11,480.00

Service Code	HCPCS C1776
Hospital Charge Code	270667471
Hospital Revenue Code	278
Min. Negotiated Rate	$1,722.00
Max. Negotiated Rate	$2,778.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,296.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,778.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,722.00

STD FEMORAL HEAD

Facility

$11,480.00

Service Code	HCPCS C1776
Hospital Charge Code	270667471
Hospital Revenue Code	278
Min. Negotiated Rate	$1,722.00
Max. Negotiated Rate	$5,740.00
Rate for Payer: Aetna Commercial	$3,444.00
Rate for Payer: Aetna Medicare Advantage	$3,444.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,927.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,927.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,296.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,927.40
Rate for Payer: Cigna Commercial	$5,740.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,778.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,722.00

STD FEM STEM ECHO SZ 10

Facility

$15,000.00

Hospital Charge Code	270702516
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$4,500.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

STD FEM STEM ECHO SZ 10

Facility

$15,000.00

Hospital Charge Code	270702516
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

STD HUMERAL DIAPH 0 CEMENT SZ8

Facility

$17,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270696739
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

STD HUMERAL DIAPH 0 CEMENT SZ8

Facility

$17,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270696739
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$5,250.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

STD TULIP

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705533
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

STD TULIP

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270705533
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$450.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

STEALTH FIXATOR ANKLE

Facility

$36,170.00

Hospital Charge Code	270656826
Hospital Revenue Code	278
Min. Negotiated Rate	$5,425.50
Max. Negotiated Rate	$8,753.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,234.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,753.14
Rate for Payer: Qualcare PPO/HMO/WC	$5,425.50

STEALTH FIXATOR ANKLE

Facility

$36,170.00

Hospital Charge Code	270656826
Hospital Revenue Code	278
Min. Negotiated Rate	$5,425.50
Max. Negotiated Rate	$18,085.00
Rate for Payer: Aetna Commercial	$10,851.00
Rate for Payer: Aetna Medicare Advantage	$10,851.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,223.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,223.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,223.35
Rate for Payer: Cigna Commercial	$18,085.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,753.14
Rate for Payer: Qualcare PPO/HMO/WC	$5,425.50

STEAM STATION REPAIRS

Facility

$11,750.00

Hospital Charge Code	270659135
Hospital Revenue Code	278
Min. Negotiated Rate	$1,762.50
Max. Negotiated Rate	$2,843.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,843.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,762.50

STEAM STATION REPAIRS

Facility

$11,750.00

Hospital Charge Code	270659135
Hospital Revenue Code	278
Min. Negotiated Rate	$1,762.50
Max. Negotiated Rate	$5,875.00
Rate for Payer: Aetna Commercial	$3,525.00
Rate for Payer: Aetna Medicare Advantage	$3,525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,996.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,996.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,996.25
Rate for Payer: Cigna Commercial	$5,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,843.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,762.50

STEBT MULTI-LINK RX 4.0X28MM

Facility

$3,000.00

Service Code	HCPCS C1876
Hospital Charge Code	270643627C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

Know your out-of-pocket cost for care.

All Charges