Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 OFFSET HIGH SZ7 109MM

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700466
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 OFFSET HIGH SZ7 109MM

Facility

$12,270.00

Service Code	HCPCS C1776
Hospital Charge Code	270700466
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 SECURE FIT #7 30x130M

Facility

$12,957.00

Service Code	HCPCS C1776
Hospital Charge Code	270676938
Hospital Revenue Code	278
Min. Negotiated Rate	$1,943.55
Max. Negotiated Rate	$3,135.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,591.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,135.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,943.55

STEM HIP SECURE FIT #7 30x130M

Facility

$12,957.00

Service Code	HCPCS C1776
Hospital Charge Code	270676938
Hospital Revenue Code	278
Min. Negotiated Rate	$1,943.55
Max. Negotiated Rate	$6,478.50
Rate for Payer: Aetna Commercial	$3,887.10
Rate for Payer: Aetna Medicare Advantage	$3,887.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,304.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,304.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,591.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,304.03
Rate for Payer: Cigna Commercial	$6,478.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,135.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,943.55

STEM HIP SZ10 35X46X160X16MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270670749
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 SZ10 35X46X160X16MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270670749
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 SZ10 40MM

Facility

$33,007.00

Service Code	HCPCS C1776
Hospital Charge Code	270677226
Hospital Revenue Code	278
Min. Negotiated Rate	$4,951.05
Max. Negotiated Rate	$16,503.50
Rate for Payer: Aetna Commercial	$9,902.10
Rate for Payer: Aetna Medicare Advantage	$9,902.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,416.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,416.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,601.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,416.78
Rate for Payer: Cigna Commercial	$16,503.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,987.69
Rate for Payer: Qualcare PPO/HMO/WC	$4,951.05

STEM HIP SZ10 40MM

Facility

$33,007.00

Service Code	HCPCS C1776
Hospital Charge Code	270677226
Hospital Revenue Code	278
Min. Negotiated Rate	$4,951.05
Max. Negotiated Rate	$7,987.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,601.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,987.69
Rate for Payer: Qualcare PPO/HMO/WC	$4,951.05

STEM HIP SZ10 C-TPR 35x155MM

Facility

$20,948.95

Service Code	HCPCS C1776
Hospital Charge Code	270680586
Hospital Revenue Code	278
Min. Negotiated Rate	$3,142.34
Max. Negotiated Rate	$5,069.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,189.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,069.65
Rate for Payer: Qualcare PPO/HMO/WC	$3,142.34

STEM HIP SZ10 C-TPR 35x155MM

Facility

$20,948.95

Service Code	HCPCS C1776
Hospital Charge Code	270680586
Hospital Revenue Code	278
Min. Negotiated Rate	$3,142.34
Max. Negotiated Rate	$10,474.48
Rate for Payer: Aetna Commercial	$6,284.69
Rate for Payer: Aetna Medicare Advantage	$6,284.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,341.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,341.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,189.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,341.98
Rate for Payer: Cigna Commercial	$10,474.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,069.65
Rate for Payer: Qualcare PPO/HMO/WC	$3,142.34

STEM HIP SZ10 C-TPR 40x155MM

Facility

$34,213.50

Service Code	HCPCS C1776
Hospital Charge Code	270672696
Hospital Revenue Code	278
Min. Negotiated Rate	$5,132.02
Max. Negotiated Rate	$8,279.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,842.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,279.67
Rate for Payer: Qualcare PPO/HMO/WC	$5,132.02

STEM HIP SZ10 C-TPR 40x155MM

Facility

$34,213.50

Service Code	HCPCS C1776
Hospital Charge Code	270672696
Hospital Revenue Code	278
Min. Negotiated Rate	$5,132.02
Max. Negotiated Rate	$17,106.75
Rate for Payer: Aetna Commercial	$10,264.05
Rate for Payer: Aetna Medicare Advantage	$10,264.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,724.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,724.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,842.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,724.44
Rate for Payer: Cigna Commercial	$17,106.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,279.67
Rate for Payer: Qualcare PPO/HMO/WC	$5,132.02

STEM HIP SZ6 DEG 127 28MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270673425
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 SZ6 DEG 127 28MM

Facility

$14,850.00

Service Code	HCPCS C1776
Hospital Charge Code	270673425
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 SZ7 C-TPR 30x155MM

Facility

$30,917.25

Service Code	HCPCS C1776
Hospital Charge Code	270678035
Hospital Revenue Code	278
Min. Negotiated Rate	$4,637.59
Max. Negotiated Rate	$15,458.62
Rate for Payer: Aetna Commercial	$9,275.17
Rate for Payer: Aetna Medicare Advantage	$9,275.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,883.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,883.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,183.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,883.90
Rate for Payer: Cigna Commercial	$15,458.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,481.97
Rate for Payer: Qualcare PPO/HMO/WC	$4,637.59

STEM HIP SZ7 C-TPR 30x155MM

Facility

$30,917.25

Service Code	HCPCS C1776
Hospital Charge Code	270678035
Hospital Revenue Code	278
Min. Negotiated Rate	$4,637.59
Max. Negotiated Rate	$7,481.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,183.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,481.97
Rate for Payer: Qualcare PPO/HMO/WC	$4,637.59

STEM HIP SZ8 C-TPR 30x155MM

Facility

$30,917.25

Service Code	HCPCS C1776
Hospital Charge Code	270678226
Hospital Revenue Code	278
Min. Negotiated Rate	$4,637.59
Max. Negotiated Rate	$15,458.62
Rate for Payer: Aetna Commercial	$9,275.17
Rate for Payer: Aetna Medicare Advantage	$9,275.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,883.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,883.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,183.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,883.90
Rate for Payer: Cigna Commercial	$15,458.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,481.97
Rate for Payer: Qualcare PPO/HMO/WC	$4,637.59

STEM HIP SZ8 C-TPR 30x155MM

Facility

$30,917.25

Service Code	HCPCS C1776
Hospital Charge Code	270678226
Hospital Revenue Code	278
Min. Negotiated Rate	$4,637.59
Max. Negotiated Rate	$7,481.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,183.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,481.97
Rate for Payer: Qualcare PPO/HMO/WC	$4,637.59

STEM HIP SZ 9 C-TPR 40x205MM

Facility

$16,826.25

Hospital Charge Code	270676953
Hospital Revenue Code	278
Min. Negotiated Rate	$2,523.94
Max. Negotiated Rate	$8,413.12
Rate for Payer: Aetna Commercial	$5,047.88
Rate for Payer: Aetna Medicare Advantage	$5,047.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,290.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,290.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,365.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,290.69
Rate for Payer: Cigna Commercial	$8,413.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,071.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,523.94

STEM HIP SZ 9 C-TPR 40x205MM

Facility

$16,826.25

Hospital Charge Code	270676953
Hospital Revenue Code	278
Min. Negotiated Rate	$2,523.94
Max. Negotiated Rate	$4,071.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,365.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,071.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,523.94

STEM HUM 8MM COMP STD

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693793
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 HUM 8MM COMP STD

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693793
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 HUM BIOMOD 6x115 11113700

Facility

$15,585.00

Hospital Charge Code	270641367
Hospital Revenue Code	278
Min. Negotiated Rate	$2,337.75
Max. Negotiated Rate	$3,771.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,771.57
Rate for Payer: Qualcare PPO/HMO/WC	$2,337.75

STEM HUM BIOMOD 6x115 11113700

Facility

$15,585.00

Hospital Charge Code	270641367
Hospital Revenue Code	278
Min. Negotiated Rate	$2,337.75
Max. Negotiated Rate	$7,792.50
Rate for Payer: Aetna Commercial	$4,675.50
Rate for Payer: Aetna Medicare Advantage	$4,675.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,974.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,974.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,974.18
Rate for Payer: Cigna Commercial	$7,792.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,771.57
Rate for Payer: Qualcare PPO/HMO/WC	$2,337.75

Know your out-of-pocket cost for care.

All Charges