Heights University Hospital

All Charges

Charge

Type

Setting

Price

STEM FEMORAL 17X160MM STD

Facility

$20,300.35

Hospital Charge Code	270638745
Hospital Revenue Code	278
Min. Negotiated Rate	$3,045.05
Max. Negotiated Rate	$4,912.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,060.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,912.68
Rate for Payer: Qualcare PPO/HMO/WC	$3,045.05

STEM FEMORAL 45mm SHELL7833-11

Facility

$6,395.65

Hospital Charge Code	270628991
Hospital Revenue Code	278
Min. Negotiated Rate	$959.35
Max. Negotiated Rate	$1,547.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,279.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,547.75
Rate for Payer: Qualcare PPO/HMO/WC	$959.35

STEM FEMORAL 45mm SHELL7833-11

Facility

$6,395.65

Hospital Charge Code	270628991
Hospital Revenue Code	278
Min. Negotiated Rate	$959.35
Max. Negotiated Rate	$3,197.82
Rate for Payer: Aetna Commercial	$1,918.69
Rate for Payer: Aetna Medicare Advantage	$1,918.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,630.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,630.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,279.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,630.89
Rate for Payer: Cigna Commercial	$3,197.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,547.75
Rate for Payer: Qualcare PPO/HMO/WC	$959.35

STEM FEMORAL CRUCIATE RT SZ4

Facility

$7,845.00

Service Code	HCPCS C1776
Hospital Charge Code	270692203
Hospital Revenue Code	278
Min. Negotiated Rate	$1,176.75
Max. Negotiated Rate	$3,922.50
Rate for Payer: Aetna Commercial	$2,353.50
Rate for Payer: Aetna Medicare Advantage	$2,353.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,000.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,000.47
Rate for Payer: Cigna Commercial	$3,922.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75

STEM FEMORAL CRUCIATE RT SZ4

Facility

$7,845.00

Service Code	HCPCS C1776
Hospital Charge Code	270692203
Hospital Revenue Code	278
Min. Negotiated Rate	$1,176.75
Max. Negotiated Rate	$1,898.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,569.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,898.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,176.75

STEM FEMORAL EXT OSS 11X150MM

Facility

$10,390.00

Service Code	HCPCS C1776
Hospital Charge Code	270667950
Hospital Revenue Code	278
Min. Negotiated Rate	$1,558.50
Max. Negotiated Rate	$2,514.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,078.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,514.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,558.50

STEM FEMORAL EXT OSS 11X150MM

Facility

$10,390.00

Service Code	HCPCS C1776
Hospital Charge Code	270667950
Hospital Revenue Code	278
Min. Negotiated Rate	$1,558.50
Max. Negotiated Rate	$5,195.00
Rate for Payer: Aetna Commercial	$3,117.00
Rate for Payer: Aetna Medicare Advantage	$3,117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,649.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,649.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,078.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,649.45
Rate for Payer: Cigna Commercial	$5,195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,514.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,558.50

STEM FEMORAL EXT TIB 10x80MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270677686
Hospital Revenue Code	278
Min. Negotiated Rate	$624.71
Max. Negotiated Rate	$2,082.38
Rate for Payer: Aetna Commercial	$1,249.42
Rate for Payer: Aetna Medicare Advantage	$1,249.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,062.01
Rate for Payer: Cigna Commercial	$2,082.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: Qualcare PPO/HMO/WC	$624.71

STEM FEMORAL EXT TIB 10x80MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270677686
Hospital Revenue Code	278
Min. Negotiated Rate	$624.71
Max. Negotiated Rate	$1,007.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: Qualcare PPO/HMO/WC	$624.71

STEM FEMORAL EXT TIB 14X25MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270678639
Hospital Revenue Code	278
Min. Negotiated Rate	$624.71
Max. Negotiated Rate	$2,082.38
Rate for Payer: Aetna Commercial	$1,249.42
Rate for Payer: Aetna Medicare Advantage	$1,249.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,062.01
Rate for Payer: Cigna Commercial	$2,082.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: Qualcare PPO/HMO/WC	$624.71

STEM FEMORAL EXT TIB 14X25MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270678639
Hospital Revenue Code	278
Min. Negotiated Rate	$624.71
Max. Negotiated Rate	$1,007.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: Qualcare PPO/HMO/WC	$624.71

STEM FEMORAL EXT TIB 16x120MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270678640
Hospital Revenue Code	278
Min. Negotiated Rate	$624.71
Max. Negotiated Rate	$1,007.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: Qualcare PPO/HMO/WC	$624.71

STEM FEMORAL EXT TIB 16x120MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270678640
Hospital Revenue Code	278
Min. Negotiated Rate	$624.71
Max. Negotiated Rate	$2,082.38
Rate for Payer: Aetna Commercial	$1,249.42
Rate for Payer: Aetna Medicare Advantage	$1,249.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,062.01
Rate for Payer: Cigna Commercial	$2,082.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: Qualcare PPO/HMO/WC	$624.71

STEM FEMORAL EXT TIB 16x80MM

Facility

$4,164.50

Service Code	HCPCS C1776
Hospital Charge Code	270676557
Hospital Revenue Code	278
Min. Negotiated Rate	$624.67
Max. Negotiated Rate	$2,082.25
Rate for Payer: Aetna Commercial	$1,249.35
Rate for Payer: Aetna Medicare Advantage	$1,249.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,061.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,061.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,061.95
Rate for Payer: Cigna Commercial	$2,082.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.81
Rate for Payer: Qualcare PPO/HMO/WC	$624.67

STEM FEMORAL EXT TIB 16x80MM

Facility

$4,164.50

Service Code	HCPCS C1776
Hospital Charge Code	270676557
Hospital Revenue Code	278
Min. Negotiated Rate	$624.67
Max. Negotiated Rate	$1,007.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.81
Rate for Payer: Qualcare PPO/HMO/WC	$624.67

STEM FEMORAL EXT TIB 20x80MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270676683
Hospital Revenue Code	278
Min. Negotiated Rate	$624.71
Max. Negotiated Rate	$1,007.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: Qualcare PPO/HMO/WC	$624.71

STEM FEMORAL EXT TIB 20x80MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270676683
Hospital Revenue Code	278
Min. Negotiated Rate	$624.71
Max. Negotiated Rate	$2,082.38
Rate for Payer: Aetna Commercial	$1,249.42
Rate for Payer: Aetna Medicare Advantage	$1,249.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,062.01
Rate for Payer: Cigna Commercial	$2,082.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: Qualcare PPO/HMO/WC	$624.71

STEM - FEMORAL FIBR.METL TAPER

Facility

$15,948.55

Hospital Charge Code	270657119
Hospital Revenue Code	278
Min. Negotiated Rate	$2,392.28
Max. Negotiated Rate	$7,974.27
Rate for Payer: Aetna Commercial	$4,784.56
Rate for Payer: Aetna Medicare Advantage	$4,784.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,066.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,066.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,189.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,066.88
Rate for Payer: Cigna Commercial	$7,974.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,859.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,392.28

STEM - FEMORAL FIBR.METL TAPER

Facility

$15,948.55

Hospital Charge Code	270657119
Hospital Revenue Code	278
Min. Negotiated Rate	$2,392.28
Max. Negotiated Rate	$3,859.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,189.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,859.55
Rate for Payer: Qualcare PPO/HMO/WC	$2,392.28

STEM FEMORAL FX HIP 11X140MM

Facility

$6,275.00

Service Code	HCPCS C1776
Hospital Charge Code	270640212
Hospital Revenue Code	278
Min. Negotiated Rate	$941.25
Max. Negotiated Rate	$1,518.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,255.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,518.55
Rate for Payer: Qualcare PPO/HMO/WC	$941.25

STEM FEMORAL FX HIP 11X140MM

Facility

$6,275.00

Service Code	HCPCS C1776
Hospital Charge Code	270640212
Hospital Revenue Code	278
Min. Negotiated Rate	$941.25
Max. Negotiated Rate	$3,137.50
Rate for Payer: Aetna Commercial	$1,882.50
Rate for Payer: Aetna Medicare Advantage	$1,882.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,600.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,600.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,600.12
Rate for Payer: Cigna Commercial	$3,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,518.55
Rate for Payer: Qualcare PPO/HMO/WC	$941.25

STEM FEMORAL INTEGRL 12X180mm

Facility

$41,815.00

Hospital Charge Code	270665224
Hospital Revenue Code	278
Min. Negotiated Rate	$6,272.25
Max. Negotiated Rate	$20,907.50
Rate for Payer: Aetna Commercial	$12,544.50
Rate for Payer: Aetna Medicare Advantage	$12,544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,662.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,662.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,662.83
Rate for Payer: Cigna Commercial	$20,907.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,119.23
Rate for Payer: Qualcare PPO/HMO/WC	$6,272.25

STEM FEMORAL INTEGRL 12X180mm

Facility

$41,815.00

Hospital Charge Code	270665224
Hospital Revenue Code	278
Min. Negotiated Rate	$6,272.25
Max. Negotiated Rate	$10,119.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,363.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,119.23
Rate for Payer: Qualcare PPO/HMO/WC	$6,272.25

STEM FEMORAL INTEGRL 160x180MM

Facility

$40,205.00

Hospital Charge Code	270651664
Hospital Revenue Code	278
Min. Negotiated Rate	$6,030.75
Max. Negotiated Rate	$20,102.50
Rate for Payer: Aetna Commercial	$12,061.50
Rate for Payer: Aetna Medicare Advantage	$12,061.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,252.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,252.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,041.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,252.27
Rate for Payer: Cigna Commercial	$20,102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,729.61
Rate for Payer: Qualcare PPO/HMO/WC	$6,030.75

STEM FEMORAL INTEGRL 160x180MM

Facility

$40,205.00

Hospital Charge Code	270651664
Hospital Revenue Code	278
Min. Negotiated Rate	$6,030.75
Max. Negotiated Rate	$9,729.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,041.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,729.61
Rate for Payer: Qualcare PPO/HMO/WC	$6,030.75

Know your out-of-pocket cost for care.

All Charges