Heights University Hospital

All Charges

Charge

Type

Setting

Price

STEM COMPLETE XR 123 DEG SZ 8

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270694946
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

STEM COMP PRIMARY 7MM MINI

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690732
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$7,250.00
Rate for Payer: Aetna Commercial	$4,350.00
Rate for Payer: Aetna Medicare Advantage	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,697.50
Rate for Payer: Cigna Commercial	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

STEM COMP PRIMARY 7MM MINI

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690732
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$3,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

STEM COMP PRIMARY STD 12X122MM

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270695586
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$7,250.00
Rate for Payer: Aetna Commercial	$4,350.00
Rate for Payer: Aetna Medicare Advantage	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,697.50
Rate for Payer: Cigna Commercial	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

STEM COMP PRIMARY STD 12X122MM

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270695586
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$3,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

STEM COMP PRIMARY STD 9X122MM

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270694043
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$3,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

STEM COMP PRIMARY STD 9X122MM

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270694043
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$7,250.00
Rate for Payer: Aetna Commercial	$4,350.00
Rate for Payer: Aetna Medicare Advantage	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,697.50
Rate for Payer: Cigna Commercial	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

STEM COMP STD PRIMARY 7X122MM

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270695499
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$7,250.00
Rate for Payer: Aetna Commercial	$4,350.00
Rate for Payer: Aetna Medicare Advantage	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,697.50
Rate for Payer: Cigna Commercial	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

STEM COMP STD PRIMARY 7X122MM

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270695499
Hospital Revenue Code	278
Min. Negotiated Rate	$2,175.00
Max. Negotiated Rate	$3,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,509.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.00

STEM CTRL INTEGRL 9mm 12162609

Facility

$10,255.00

Hospital Charge Code	270625863
Hospital Revenue Code	278
Min. Negotiated Rate	$1,538.25
Max. Negotiated Rate	$5,127.50
Rate for Payer: Aetna Commercial	$3,076.50
Rate for Payer: Aetna Medicare Advantage	$3,076.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,615.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,615.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,051.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,615.03
Rate for Payer: Cigna Commercial	$5,127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,481.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,538.25

STEM CTRL INTEGRL 9mm 12162609

Facility

$10,255.00

Hospital Charge Code	270625863
Hospital Revenue Code	278
Min. Negotiated Rate	$1,538.25
Max. Negotiated Rate	$2,481.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,051.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,481.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,538.25

STEM DEF FEMORAL SZ 4 STD 114

Facility

$9,025.00

Service Code	HCPCS C1776
Hospital Charge Code	270691720
Hospital Revenue Code	278
Min. Negotiated Rate	$1,353.75
Max. Negotiated Rate	$2,184.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,184.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,353.75

STEM DEF FEMORAL SZ 4 STD 114

Facility

$9,025.00

Service Code	HCPCS C1776
Hospital Charge Code	270691720
Hospital Revenue Code	278
Min. Negotiated Rate	$1,353.75
Max. Negotiated Rate	$4,512.50
Rate for Payer: Aetna Commercial	$2,707.50
Rate for Payer: Aetna Medicare Advantage	$2,707.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,301.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,301.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,301.38
Rate for Payer: Cigna Commercial	$4,512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,184.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,353.75

STEM DISL 15 MALRY MD 11108255

Facility

$9,825.85

Hospital Charge Code	270633598
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.88
Max. Negotiated Rate	$4,912.93
Rate for Payer: Aetna Commercial	$2,947.76
Rate for Payer: Aetna Medicare Advantage	$2,947.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,505.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,505.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,505.59
Rate for Payer: Cigna Commercial	$4,912.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.86
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.88

STEM DISL 15 MALRY MD 11108255

Facility

$9,825.85

Hospital Charge Code	270633598
Hospital Revenue Code	278
Min. Negotiated Rate	$1,473.88
Max. Negotiated Rate	$2,377.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,965.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,377.86
Rate for Payer: Qualcare PPO/HMO/WC	$1,473.88

STEM DISTAL BULLET BOWED

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270690937
Hospital Revenue Code	278
Min. Negotiated Rate	$2,799.00
Max. Negotiated Rate	$4,515.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00

STEM DISTAL BULLET BOWED

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270690937
Hospital Revenue Code	278
Min. Negotiated Rate	$2,799.00
Max. Negotiated Rate	$9,330.00
Rate for Payer: Aetna Commercial	$5,598.00
Rate for Payer: Aetna Medicare Advantage	$5,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,758.30
Rate for Payer: Cigna Commercial	$9,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00

STEM DISTAL TAPERLOC 14x148MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675678
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

STEM DISTAL TAPERLOC 14x148MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675678
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

STEM DISTAL TAPERLOC 15X150MM

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270676517
Hospital Revenue Code	278
Min. Negotiated Rate	$1,837.50
Max. Negotiated Rate	$6,125.00
Rate for Payer: Aetna Commercial	$3,675.00
Rate for Payer: Aetna Medicare Advantage	$3,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,123.75
Rate for Payer: Cigna Commercial	$6,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50

STEM DISTAL TAPERLOC 15X150MM

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270676517
Hospital Revenue Code	278
Min. Negotiated Rate	$1,837.50
Max. Negotiated Rate	$2,964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50

STEM DISTAL TAPERLOC 4X128MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270698811
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

STEM DISTAL TAPERLOC 4X128MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270698811
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

STEM DISTAL W/SCREW 16x190mm

Facility

$20,320.00

Hospital Charge Code	270675923
Hospital Revenue Code	278
Min. Negotiated Rate	$3,048.00
Max. Negotiated Rate	$10,160.00
Rate for Payer: Aetna Commercial	$6,096.00
Rate for Payer: Aetna Medicare Advantage	$6,096.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,181.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,181.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,064.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,181.60
Rate for Payer: Cigna Commercial	$10,160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,917.44
Rate for Payer: Qualcare PPO/HMO/WC	$3,048.00

STEM DISTAL W/SCREW 16x190mm

Facility

$20,320.00

Hospital Charge Code	270675923
Hospital Revenue Code	278
Min. Negotiated Rate	$3,048.00
Max. Negotiated Rate	$4,917.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,064.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,917.44
Rate for Payer: Qualcare PPO/HMO/WC	$3,048.00

Know your out-of-pocket cost for care.

All Charges