Heights University Hospital

All Charges

Charge

Type

Setting

Price

STEM FINNED 14x80MM

Facility

$6,020.00

Service Code	HCPCS C1776
Hospital Charge Code	270672168
Hospital Revenue Code	278
Min. Negotiated Rate	$903.00
Max. Negotiated Rate	$1,456.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,204.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,456.84
Rate for Payer: Qualcare PPO/HMO/WC	$903.00

STEM FINNED 17MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270672314
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$1,306.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

STEM FINNED 17MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270672314
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$2,700.00
Rate for Payer: Aetna Commercial	$1,620.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

STEM FINNED 24MM

Facility

$6,020.00

Service Code	HCPCS C1776
Hospital Charge Code	270676611
Hospital Revenue Code	278
Min. Negotiated Rate	$903.00
Max. Negotiated Rate	$1,456.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,204.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,456.84
Rate for Payer: Qualcare PPO/HMO/WC	$903.00

STEM FINNED 24MM

Facility

$6,020.00

Service Code	HCPCS C1776
Hospital Charge Code	270676611
Hospital Revenue Code	278
Min. Negotiated Rate	$903.00
Max. Negotiated Rate	$3,010.00
Rate for Payer: Aetna Commercial	$1,806.00
Rate for Payer: Aetna Medicare Advantage	$1,806.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,535.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,535.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,535.10
Rate for Payer: Cigna Commercial	$3,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,456.84
Rate for Payer: Qualcare PPO/HMO/WC	$903.00

STEM FINNED CEMENTLESS 18MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676167
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$2,700.00
Rate for Payer: Aetna Commercial	$1,620.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

STEM FINNED CEMENTLESS 18MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676167
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$1,306.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

STEM FINNED SHOULDER 20MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676365
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$2,700.00
Rate for Payer: Aetna Commercial	$1,620.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

STEM FINNED SHOULDER 20MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676365
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$1,306.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

STEM FINNED SHOULDER 21MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676632
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$1,306.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

STEM FINNED SHOULDER 21MM

Facility

$5,400.00

Service Code	HCPCS C1776
Hospital Charge Code	270676632
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$2,700.00
Rate for Payer: Aetna Commercial	$1,620.00
Rate for Payer: Aetna Medicare Advantage	$1,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,377.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,377.00
Rate for Payer: Cigna Commercial	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,306.80
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

STEM FLUTED EXTENSION 14x40MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270668739
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 FLUTED EXTENSION 14x40MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270668739
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 FML12x140FBR CL ST 784512

Facility

$20,300.20

Hospital Charge Code	270639261
Hospital Revenue Code	278
Min. Negotiated Rate	$3,045.03
Max. Negotiated Rate	$10,150.10
Rate for Payer: Aetna Commercial	$6,090.06
Rate for Payer: Aetna Medicare Advantage	$6,090.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,176.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,176.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,060.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,176.55
Rate for Payer: Cigna Commercial	$10,150.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,912.65
Rate for Payer: Qualcare PPO/HMO/WC	$3,045.03

STEM FML12x140FBR CL ST 784512

Facility

$20,300.20

Hospital Charge Code	270639261
Hospital Revenue Code	278
Min. Negotiated Rate	$3,045.03
Max. Negotiated Rate	$4,912.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,060.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,912.65
Rate for Payer: Qualcare PPO/HMO/WC	$3,045.03

STEM FM MC 13x140 STD 784513

Facility

$19,519.40

Hospital Charge Code	270638550
Hospital Revenue Code	278
Min. Negotiated Rate	$2,927.91
Max. Negotiated Rate	$4,723.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,903.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,723.69
Rate for Payer: Qualcare PPO/HMO/WC	$2,927.91

STEM FM MC 13x140 STD 784513

Facility

$19,519.40

Hospital Charge Code	270638550
Hospital Revenue Code	278
Min. Negotiated Rate	$2,927.91
Max. Negotiated Rate	$9,759.70
Rate for Payer: Aetna Commercial	$5,855.82
Rate for Payer: Aetna Medicare Advantage	$5,855.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,977.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,977.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,903.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,977.45
Rate for Payer: Cigna Commercial	$9,759.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,723.69
Rate for Payer: Qualcare PPO/HMO/WC	$2,927.91

STEM G7 OSSEOTI MULTI 62MM

Facility

$18,980.00

Service Code	HCPCS C1776
Hospital Charge Code	270690941
Hospital Revenue Code	278
Min. Negotiated Rate	$2,847.00
Max. Negotiated Rate	$4,593.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,796.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,593.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,847.00

STEM G7 OSSEOTI MULTI 62MM

Facility

$18,980.00

Service Code	HCPCS C1776
Hospital Charge Code	270690941
Hospital Revenue Code	278
Min. Negotiated Rate	$2,847.00
Max. Negotiated Rate	$9,490.00
Rate for Payer: Aetna Commercial	$5,694.00
Rate for Payer: Aetna Medicare Advantage	$5,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,839.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,839.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,796.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,839.90
Rate for Payer: Cigna Commercial	$9,490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,593.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,847.00

STEM G7 OSSEOTI MULTIHOLE 56 M

Facility

$18,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270688679
Hospital Revenue Code	278
Min. Negotiated Rate	$2,848.50
Max. Negotiated Rate	$9,495.00
Rate for Payer: Aetna Commercial	$5,697.00
Rate for Payer: Aetna Medicare Advantage	$5,697.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,842.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,842.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,842.45
Rate for Payer: Cigna Commercial	$9,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,595.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,848.50

STEM G7 OSSEOTI MULTIHOLE 56 M

Facility

$18,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270688679
Hospital Revenue Code	278
Min. Negotiated Rate	$2,848.50
Max. Negotiated Rate	$4,595.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,798.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,595.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,848.50

STEMHEAD 12X0MMX2.0MM

Facility

$12,165.00

Service Code	HCPCS C1776
Hospital Charge Code	270693318
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.75
Max. Negotiated Rate	$6,082.50
Rate for Payer: Aetna Commercial	$3,649.50
Rate for Payer: Aetna Medicare Advantage	$3,649.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,102.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,102.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,102.07
Rate for Payer: Cigna Commercial	$6,082.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,943.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.75

STEMHEAD 12X0MMX2.0MM

Facility

$12,165.00

Service Code	HCPCS C1776
Hospital Charge Code	270693318
Hospital Revenue Code	278
Min. Negotiated Rate	$1,824.75
Max. Negotiated Rate	$2,943.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,433.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,943.93
Rate for Payer: Qualcare PPO/HMO/WC	$1,824.75

STEM HIGH OFFSET SZ4 36X103MM

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700615
Hospital Revenue Code	278
Min. Negotiated Rate	$1,840.50
Max. Negotiated Rate	$6,135.00
Rate for Payer: Aetna Commercial	$3,681.00
Rate for Payer: Aetna Medicare Advantage	$3,681.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,128.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,128.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,454.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,128.85
Rate for Payer: Cigna Commercial	$6,135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,969.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,840.50

STEM HIGH OFFSET SZ4 36X103MM

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700615
Hospital Revenue Code	278
Min. Negotiated Rate	$1,840.50
Max. Negotiated Rate	$2,969.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,454.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,969.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,840.50

Know your out-of-pocket cost for care.

All Charges