Heights University Hospital

All Charges

Charge

Type

Setting

Price

STEM E1 VNGD PS+TIB BRG

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270681468
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

STEM E1 VNGD PS+TIB BRG

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270681468
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

STEM ECHO B-MTRC MP FP

Facility

$30,810.00

Service Code	HCPCS C1776
Hospital Charge Code	270691088
Hospital Revenue Code	278
Min. Negotiated Rate	$4,621.50
Max. Negotiated Rate	$15,405.00
Rate for Payer: Aetna Commercial	$9,243.00
Rate for Payer: Aetna Medicare Advantage	$9,243.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,856.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,856.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,856.55
Rate for Payer: Cigna Commercial	$15,405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,456.02
Rate for Payer: Qualcare PPO/HMO/WC	$4,621.50

STEM ECHO B-MTRC MP FP

Facility

$30,810.00

Service Code	HCPCS C1776
Hospital Charge Code	270691088
Hospital Revenue Code	278
Min. Negotiated Rate	$4,621.50
Max. Negotiated Rate	$7,456.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,162.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,456.02
Rate for Payer: Qualcare PPO/HMO/WC	$4,621.50

STEM ECHO MTRC 7 X 94

Facility

$30,810.00

Service Code	HCPCS C1776
Hospital Charge Code	270691943
Hospital Revenue Code	278
Min. Negotiated Rate	$4,621.50
Max. Negotiated Rate	$15,405.00
Rate for Payer: Aetna Commercial	$9,243.00
Rate for Payer: Aetna Medicare Advantage	$9,243.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,856.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,856.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,856.55
Rate for Payer: Cigna Commercial	$15,405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,456.02
Rate for Payer: Qualcare PPO/HMO/WC	$4,621.50

STEM ECHO MTRC 7 X 94

Facility

$30,810.00

Service Code	HCPCS C1776
Hospital Charge Code	270691943
Hospital Revenue Code	278
Min. Negotiated Rate	$4,621.50
Max. Negotiated Rate	$7,456.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,162.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,456.02
Rate for Payer: Qualcare PPO/HMO/WC	$4,621.50

STEM ECHO POR FMRL RPP SZ 9

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690981
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 ECHO POR FMRL RPP SZ 9

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690981
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 ELEOS EXT CEMENTED 14 MM

Facility

$5,490.00

Service Code	HCPCS C1776
Hospital Charge Code	270682840
Hospital Revenue Code	278
Min. Negotiated Rate	$823.50
Max. Negotiated Rate	$2,745.00
Rate for Payer: Aetna Commercial	$1,647.00
Rate for Payer: Aetna Medicare Advantage	$1,647.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,399.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,399.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,098.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,399.95
Rate for Payer: Cigna Commercial	$2,745.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,328.58
Rate for Payer: Qualcare PPO/HMO/WC	$823.50

STEM ELEOS EXT CEMENTED 14 MM

Facility

$5,490.00

Service Code	HCPCS C1776
Hospital Charge Code	2706828402
Hospital Revenue Code	278
Min. Negotiated Rate	$823.50
Max. Negotiated Rate	$1,328.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,098.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,328.58
Rate for Payer: Qualcare PPO/HMO/WC	$823.50

STEM ELEOS EXT CEMENTED 14 MM

Facility

$5,490.00

Service Code	HCPCS C1776
Hospital Charge Code	270682840
Hospital Revenue Code	278
Min. Negotiated Rate	$823.50
Max. Negotiated Rate	$1,328.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,098.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,328.58
Rate for Payer: Qualcare PPO/HMO/WC	$823.50

STEM ELEOS EXT CEMENTED 14 MM

Facility

$5,490.00

Service Code	HCPCS C1776
Hospital Charge Code	2706828402
Hospital Revenue Code	278
Min. Negotiated Rate	$823.50
Max. Negotiated Rate	$2,745.00
Rate for Payer: Aetna Commercial	$1,647.00
Rate for Payer: Aetna Medicare Advantage	$1,647.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,399.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,399.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,098.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,399.95
Rate for Payer: Cigna Commercial	$2,745.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,328.58
Rate for Payer: Qualcare PPO/HMO/WC	$823.50

STEM EMPLOR 7x26mm 11210062

Facility

$7,480.00

Hospital Charge Code	270644772
Hospital Revenue Code	278
Min. Negotiated Rate	$1,122.00
Max. Negotiated Rate	$1,810.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,496.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,810.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,122.00

STEM EMPLOR 7x26mm 11210062

Facility

$7,480.00

Hospital Charge Code	270644772
Hospital Revenue Code	278
Min. Negotiated Rate	$1,122.00
Max. Negotiated Rate	$3,740.00
Rate for Payer: Aetna Commercial	$2,244.00
Rate for Payer: Aetna Medicare Advantage	$2,244.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,907.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,907.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,496.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,907.40
Rate for Payer: Cigna Commercial	$3,740.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,810.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,122.00

STEM EMPOWER LEFT COATED SZ 7

Facility

$18,900.00

Service Code	HCPCS C1776
Hospital Charge Code	270691776
Hospital Revenue Code	278
Min. Negotiated Rate	$2,835.00
Max. Negotiated Rate	$9,450.00
Rate for Payer: Aetna Commercial	$5,670.00
Rate for Payer: Aetna Medicare Advantage	$5,670.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,819.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,819.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,780.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,819.50
Rate for Payer: Cigna Commercial	$9,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,573.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,835.00

STEM EMPOWER LEFT COATED SZ 7

Facility

$18,900.00

Service Code	HCPCS C1776
Hospital Charge Code	270691776
Hospital Revenue Code	278
Min. Negotiated Rate	$2,835.00
Max. Negotiated Rate	$4,573.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,573.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,835.00

STEM EXPLOR RADIAL 8x28mm

Facility

$15,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270680736
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

STEM EXPLOR RADIAL 8x28mm

Facility

$15,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270680736
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

STEM EXT 10 MM

Facility

$19,430.00

Hospital Charge Code	270703332
Hospital Revenue Code	278
Min. Negotiated Rate	$2,914.50
Max. Negotiated Rate	$4,702.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,886.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,702.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,914.50

STEM EXT 10 MM

Facility

$19,430.00

Hospital Charge Code	270703332
Hospital Revenue Code	278
Min. Negotiated Rate	$2,914.50
Max. Negotiated Rate	$9,715.00
Rate for Payer: Aetna Commercial	$5,829.00
Rate for Payer: Aetna Medicare Advantage	$5,829.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,954.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,954.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,886.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,954.65
Rate for Payer: Cigna Commercial	$9,715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,702.06
Rate for Payer: Qualcare PPO/HMO/WC	$2,914.50

STEM EXTEN FEM AND TI 14X40MM

Facility

$11,010.00

Service Code	HCPCS C1776
Hospital Charge Code	270683942
Hospital Revenue Code	278
Min. Negotiated Rate	$1,651.50
Max. Negotiated Rate	$5,505.00
Rate for Payer: Aetna Commercial	$3,303.00
Rate for Payer: Aetna Medicare Advantage	$3,303.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,202.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,807.55
Rate for Payer: Cigna Commercial	$5,505.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,664.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,651.50

STEM EXTEN FEM AND TI 14X40MM

Facility

$11,010.00

Service Code	HCPCS C1776
Hospital Charge Code	270683937
Hospital Revenue Code	278
Min. Negotiated Rate	$1,651.50
Max. Negotiated Rate	$2,664.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,202.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,664.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,651.50

STEM EXTEN FEM AND TI 14X40MM

Facility

$11,010.00

Service Code	HCPCS C1776
Hospital Charge Code	270683937
Hospital Revenue Code	278
Min. Negotiated Rate	$1,651.50
Max. Negotiated Rate	$5,505.00
Rate for Payer: Aetna Commercial	$3,303.00
Rate for Payer: Aetna Medicare Advantage	$3,303.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,202.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,807.55
Rate for Payer: Cigna Commercial	$5,505.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,664.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,651.50

STEM EXTEN FEM AND TI 14X40MM

Facility

$11,010.00

Service Code	HCPCS C1776
Hospital Charge Code	270683942
Hospital Revenue Code	278
Min. Negotiated Rate	$1,651.50
Max. Negotiated Rate	$2,664.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,202.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,664.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,651.50

STEM EXTEN. FEM AND TIB 14X80m

Facility

$11,010.00

Service Code	HCPCS C1776
Hospital Charge Code	270682016
Hospital Revenue Code	278
Min. Negotiated Rate	$1,651.50
Max. Negotiated Rate	$5,505.00
Rate for Payer: Aetna Commercial	$3,303.00
Rate for Payer: Aetna Medicare Advantage	$3,303.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,807.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,202.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,807.55
Rate for Payer: Cigna Commercial	$5,505.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,664.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,651.50

Know your out-of-pocket cost for care.

All Charges