Heights University Hospital

All Charges

Charge

Type

Setting

Price

STEM HIP 127 DEG SZ9 DIST 15MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270673478
Hospital Revenue Code	278
Min. Negotiated Rate	$2,227.50
Max. Negotiated Rate	$3,593.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,593.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.50

STEM HIP 127 DEG SZ9 DIST 15MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270673478
Hospital Revenue Code	278
Min. Negotiated Rate	$2,227.50
Max. Negotiated Rate	$7,425.00
Rate for Payer: Aetna Commercial	$4,455.00
Rate for Payer: Aetna Medicare Advantage	$4,455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,786.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,786.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,786.75
Rate for Payer: Cigna Commercial	$7,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,593.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.50

STEM HIP ACCO 127D NCK ANG SZ8

Facility

$9,831.20

Service Code	HCPCS C1776
Hospital Charge Code	270699505
Hospital Revenue Code	278
Min. Negotiated Rate	$1,474.68
Max. Negotiated Rate	$2,379.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,966.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,379.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,474.68

STEM HIP ACCO 127D NCK ANG SZ8

Facility

$9,831.20

Service Code	HCPCS C1776
Hospital Charge Code	270699505
Hospital Revenue Code	278
Min. Negotiated Rate	$1,474.68
Max. Negotiated Rate	$4,915.60
Rate for Payer: Aetna Commercial	$2,949.36
Rate for Payer: Aetna Medicare Advantage	$2,949.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,506.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,506.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,966.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,506.96
Rate for Payer: Cigna Commercial	$4,915.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,379.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,474.68

STEM HIP AMCA 16 x 200MM

Facility

$28,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270683438
Hospital Revenue Code	278
Min. Negotiated Rate	$4,200.00
Max. Negotiated Rate	$6,776.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00

STEM HIP AMCA 16 x 200MM

Facility

$28,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270683438
Hospital Revenue Code	278
Min. Negotiated Rate	$4,200.00
Max. Negotiated Rate	$14,000.00
Rate for Payer: Aetna Commercial	$8,400.00
Rate for Payer: Aetna Medicare Advantage	$8,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,140.00
Rate for Payer: Cigna Commercial	$14,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00

STEM HIP AMCA 18 x 40MM

Facility

$28,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270682863
Hospital Revenue Code	278
Min. Negotiated Rate	$4,200.00
Max. Negotiated Rate	$6,776.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00

STEM HIP AMCA 18 x 40MM

Facility

$28,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270682863
Hospital Revenue Code	278
Min. Negotiated Rate	$4,200.00
Max. Negotiated Rate	$14,000.00
Rate for Payer: Aetna Commercial	$8,400.00
Rate for Payer: Aetna Medicare Advantage	$8,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,140.00
Rate for Payer: Cigna Commercial	$14,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00

STEM HIP ANGL SZ2 30x99MM

Facility

$11,921.55

Service Code	HCPCS C1776
Hospital Charge Code	270680956
Hospital Revenue Code	278
Min. Negotiated Rate	$1,788.23
Max. Negotiated Rate	$5,960.77
Rate for Payer: Aetna Commercial	$3,576.47
Rate for Payer: Aetna Medicare Advantage	$3,576.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,384.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,040.00
Rate for Payer: Cigna Commercial	$5,960.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,885.02
Rate for Payer: Qualcare PPO/HMO/WC	$1,788.23

STEM HIP ANGL SZ2 30x99MM

Facility

$11,921.55

Service Code	HCPCS C1776
Hospital Charge Code	270680956
Hospital Revenue Code	278
Min. Negotiated Rate	$1,788.23
Max. Negotiated Rate	$2,885.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,384.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,885.02
Rate for Payer: Qualcare PPO/HMO/WC	$1,788.23

STEM HIP ANGL SZ3 30x102MM

Facility

$25,265.50

Service Code	HCPCS C1776
Hospital Charge Code	270676775
Hospital Revenue Code	278
Min. Negotiated Rate	$3,789.82
Max. Negotiated Rate	$6,114.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,053.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,114.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,789.82

STEM HIP ANGL SZ3 30x102MM

Facility

$25,265.50

Service Code	HCPCS C1776
Hospital Charge Code	270676775
Hospital Revenue Code	278
Min. Negotiated Rate	$3,789.82
Max. Negotiated Rate	$12,632.75
Rate for Payer: Aetna Commercial	$7,579.65
Rate for Payer: Aetna Medicare Advantage	$7,579.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,442.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,442.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,053.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,442.70
Rate for Payer: Cigna Commercial	$12,632.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,114.25
Rate for Payer: Qualcare PPO/HMO/WC	$3,789.82

STEM HIP ANGL SZ5 35x108MM

Facility

$26,022.75

Service Code	HCPCS C1776
Hospital Charge Code	270678863
Hospital Revenue Code	278
Min. Negotiated Rate	$3,903.41
Max. Negotiated Rate	$13,011.38
Rate for Payer: Aetna Commercial	$7,806.82
Rate for Payer: Aetna Medicare Advantage	$7,806.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,635.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,635.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,204.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,635.80
Rate for Payer: Cigna Commercial	$13,011.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,297.51
Rate for Payer: Qualcare PPO/HMO/WC	$3,903.41

STEM HIP ANGL SZ5 35x108MM

Facility

$26,022.75

Service Code	HCPCS C1776
Hospital Charge Code	270678863
Hospital Revenue Code	278
Min. Negotiated Rate	$3,903.41
Max. Negotiated Rate	$6,297.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,204.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,297.51
Rate for Payer: Qualcare PPO/HMO/WC	$3,903.41

STEM HIP ANGL SZ6 35x111MM

Facility

$38,733.95

Service Code	HCPCS C1776
Hospital Charge Code	270677352
Hospital Revenue Code	278
Min. Negotiated Rate	$5,810.09
Max. Negotiated Rate	$9,373.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,746.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,373.62
Rate for Payer: Qualcare PPO/HMO/WC	$5,810.09

STEM HIP ANGL SZ6 35x111MM

Facility

$38,733.95

Service Code	HCPCS C1776
Hospital Charge Code	270677352
Hospital Revenue Code	278
Min. Negotiated Rate	$5,810.09
Max. Negotiated Rate	$19,366.97
Rate for Payer: Aetna Commercial	$11,620.18
Rate for Payer: Aetna Medicare Advantage	$11,620.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,877.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,877.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,746.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,877.16
Rate for Payer: Cigna Commercial	$19,366.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,373.62
Rate for Payer: Qualcare PPO/HMO/WC	$5,810.09

STEM HIP ANGL SZ9 37x120MM

Facility

$12,033.00

Service Code	HCPCS C1776
Hospital Charge Code	270677484
Hospital Revenue Code	278
Min. Negotiated Rate	$1,804.95
Max. Negotiated Rate	$2,911.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,406.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,911.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,804.95

STEM HIP ANGL SZ9 37x120MM

Facility

$12,033.00

Service Code	HCPCS C1776
Hospital Charge Code	270677484
Hospital Revenue Code	278
Min. Negotiated Rate	$1,804.95
Max. Negotiated Rate	$6,016.50
Rate for Payer: Aetna Commercial	$3,609.90
Rate for Payer: Aetna Medicare Advantage	$3,609.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,068.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,068.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,406.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,068.41
Rate for Payer: Cigna Commercial	$6,016.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,911.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,804.95

STEM HIP HIGH OFFSET SZ2 99MM

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700712
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

STEM HIP HIGH OFFSET SZ2 99MM

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700712
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,500.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

STEM HIP INSIGINIA OFFSET SZ6

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700625
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 HIP INSIGINIA OFFSET SZ6

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700625
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

STEM HIP INSIGNIA SZ7 38X109MM

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700768
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,500.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

STEM HIP INSIGNIA SZ7 38X109MM

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700768
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

STEM HIP NECK ANGLE 30MM SZ2

Facility

$38,733.95

Service Code	HCPCS C1776
Hospital Charge Code	270677398
Hospital Revenue Code	278
Min. Negotiated Rate	$5,810.09
Max. Negotiated Rate	$9,373.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,746.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,373.62
Rate for Payer: Qualcare PPO/HMO/WC	$5,810.09

Know your out-of-pocket cost for care.

All Charges