Heights University Hospital

All Charges

Charge

Type

Setting

Price

STEM HUMERAL REUNION 6X113MM

Facility

$58,730.00

Service Code	HCPCS C1713
Hospital Charge Code	270700592
Hospital Revenue Code	278
Min. Negotiated Rate	$8,809.50
Max. Negotiated Rate	$29,365.00
Rate for Payer: Aetna Commercial	$17,619.00
Rate for Payer: Aetna Medicare Advantage	$17,619.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,976.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,976.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,746.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,976.15
Rate for Payer: Cigna Commercial	$29,365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,212.66
Rate for Payer: Qualcare PPO/HMO/WC	$8,809.50

STEM HUMERAL REUNION 6X113MM

Facility

$58,730.00

Service Code	HCPCS C1713
Hospital Charge Code	270700592
Hospital Revenue Code	278
Min. Negotiated Rate	$8,809.50
Max. Negotiated Rate	$14,212.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,746.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,212.66
Rate for Payer: Qualcare PPO/HMO/WC	$8,809.50

STEM HUMERAL REVRS MB UNI 5MM

Facility

$6,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270699152
Hospital Revenue Code	278
Min. Negotiated Rate	$931.50
Max. Negotiated Rate	$3,105.00
Rate for Payer: Aetna Commercial	$1,863.00
Rate for Payer: Aetna Medicare Advantage	$1,863.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,583.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,583.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,583.55
Rate for Payer: Cigna Commercial	$3,105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,502.82
Rate for Payer: Qualcare PPO/HMO/WC	$931.50

STEM HUMERAL REVRS MB UNI 5MM

Facility

$6,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270699152
Hospital Revenue Code	278
Min. Negotiated Rate	$931.50
Max. Negotiated Rate	$1,502.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,502.82
Rate for Payer: Qualcare PPO/HMO/WC	$931.50

STEM HUMERAL RVS TM 10X130MM

Facility

$26,600.00

Service Code	HCPCS C1776
Hospital Charge Code	270696616
Hospital Revenue Code	278
Min. Negotiated Rate	$3,990.00
Max. Negotiated Rate	$6,437.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,437.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,990.00

STEM HUMERAL RVS TM 10X130MM

Facility

$26,600.00

Service Code	HCPCS C1776
Hospital Charge Code	270696616
Hospital Revenue Code	278
Min. Negotiated Rate	$3,990.00
Max. Negotiated Rate	$13,300.00
Rate for Payer: Aetna Commercial	$7,980.00
Rate for Payer: Aetna Medicare Advantage	$7,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,783.00
Rate for Payer: Cigna Commercial	$13,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,437.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,990.00

STEM HUMERAL STD 14MMX130

Facility

$11,050.00

Service Code	HCPCS C1776
Hospital Charge Code	270686439
Hospital Revenue Code	278
Min. Negotiated Rate	$1,657.50
Max. Negotiated Rate	$5,525.00
Rate for Payer: Aetna Commercial	$3,315.00
Rate for Payer: Aetna Medicare Advantage	$3,315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,817.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,817.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,817.75
Rate for Payer: Cigna Commercial	$5,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,674.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,657.50

STEM HUMERAL STD 14MMX130

Facility

$11,050.00

Service Code	HCPCS C1776
Hospital Charge Code	270686439
Hospital Revenue Code	278
Min. Negotiated Rate	$1,657.50
Max. Negotiated Rate	$2,674.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,674.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,657.50

STEM HUMERAL SZ 11

Facility

$23,856.25

Service Code	HCPCS C1776
Hospital Charge Code	270671586
Hospital Revenue Code	278
Min. Negotiated Rate	$3,578.44
Max. Negotiated Rate	$5,773.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,771.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,773.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,578.44

STEM HUMERAL SZ 11

Facility

$23,856.25

Service Code	HCPCS C1776
Hospital Charge Code	270671586
Hospital Revenue Code	278
Min. Negotiated Rate	$3,578.44
Max. Negotiated Rate	$11,928.12
Rate for Payer: Aetna Commercial	$7,156.88
Rate for Payer: Aetna Medicare Advantage	$7,156.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,083.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,083.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,771.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,083.34
Rate for Payer: Cigna Commercial	$11,928.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,773.21
Rate for Payer: Qualcare PPO/HMO/WC	$3,578.44

STEM HUMERAL SZ 8

Facility

$33,985.00

Service Code	HCPCS C1776
Hospital Charge Code	270671584
Hospital Revenue Code	278
Min. Negotiated Rate	$5,097.75
Max. Negotiated Rate	$8,224.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,797.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,224.37
Rate for Payer: Qualcare PPO/HMO/WC	$5,097.75

STEM HUMERAL SZ 8

Facility

$33,985.00

Service Code	HCPCS C1776
Hospital Charge Code	270671584
Hospital Revenue Code	278
Min. Negotiated Rate	$5,097.75
Max. Negotiated Rate	$16,992.50
Rate for Payer: Aetna Commercial	$10,195.50
Rate for Payer: Aetna Medicare Advantage	$10,195.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,666.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,666.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,797.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,666.17
Rate for Payer: Cigna Commercial	$16,992.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,224.37
Rate for Payer: Qualcare PPO/HMO/WC	$5,097.75

STEM HUMERAL SZ8

Facility

$23,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700195
Hospital Revenue Code	278
Min. Negotiated Rate	$3,450.00
Max. Negotiated Rate	$5,566.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,566.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,450.00

STEM HUMERAL SZ8

Facility

$23,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270700195
Hospital Revenue Code	278
Min. Negotiated Rate	$3,450.00
Max. Negotiated Rate	$11,500.00
Rate for Payer: Aetna Commercial	$6,900.00
Rate for Payer: Aetna Medicare Advantage	$6,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,865.00
Rate for Payer: Cigna Commercial	$11,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,566.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,450.00

STEM HUMERAL SZ 9

Facility

$33,985.00

Service Code	HCPCS C1776
Hospital Charge Code	270671585
Hospital Revenue Code	278
Min. Negotiated Rate	$5,097.75
Max. Negotiated Rate	$16,992.50
Rate for Payer: Aetna Commercial	$10,195.50
Rate for Payer: Aetna Medicare Advantage	$10,195.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,666.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,666.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,797.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,666.17
Rate for Payer: Cigna Commercial	$16,992.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,224.37
Rate for Payer: Qualcare PPO/HMO/WC	$5,097.75

STEM HUMERAL SZ 9

Facility

$33,985.00

Service Code	HCPCS C1776
Hospital Charge Code	270671585
Hospital Revenue Code	278
Min. Negotiated Rate	$5,097.75
Max. Negotiated Rate	$8,224.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,797.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,224.37
Rate for Payer: Qualcare PPO/HMO/WC	$5,097.75

STEM HUMERAL UNCEMENTED 10.5

Facility

$14,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270683029
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$3,388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00

STEM HUMERAL UNCEMENTED 10.5

Facility

$14,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270683029
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$7,000.00
Rate for Payer: Aetna Commercial	$4,200.00
Rate for Payer: Aetna Medicare Advantage	$4,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,570.00
Rate for Payer: Cigna Commercial	$7,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,388.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,100.00

STEM HUMERL 8mX130m 43000813

Facility

$12,945.65

Hospital Charge Code	270635865
Hospital Revenue Code	278
Min. Negotiated Rate	$1,941.85
Max. Negotiated Rate	$3,132.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,589.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,132.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,941.85

STEM HUMERL 8mX130m 43000813

Facility

$12,945.65

Hospital Charge Code	270635865
Hospital Revenue Code	278
Min. Negotiated Rate	$1,941.85
Max. Negotiated Rate	$6,472.82
Rate for Payer: Aetna Commercial	$3,883.70
Rate for Payer: Aetna Medicare Advantage	$3,883.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,301.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,301.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,589.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,301.14
Rate for Payer: Cigna Commercial	$6,472.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,132.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,941.85

STEM HUMER PRIMARY MINI 6X83MM

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697514
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 HUMER PRIMARY MINI 6X83MM

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697514
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 HUMER TM REVERSE 10X130MM

Facility

$28,975.00

Service Code	HCPCS C1776
Hospital Charge Code	270696094
Hospital Revenue Code	278
Min. Negotiated Rate	$4,346.25
Max. Negotiated Rate	$14,487.50
Rate for Payer: Aetna Commercial	$8,692.50
Rate for Payer: Aetna Medicare Advantage	$8,692.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,388.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,388.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,388.62
Rate for Payer: Cigna Commercial	$14,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,011.95
Rate for Payer: Qualcare PPO/HMO/WC	$4,346.25

STEM HUMER TM REVERSE 10X130MM

Facility

$28,975.00

Service Code	HCPCS C1776
Hospital Charge Code	270696094
Hospital Revenue Code	278
Min. Negotiated Rate	$4,346.25
Max. Negotiated Rate	$7,011.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,011.95
Rate for Payer: Qualcare PPO/HMO/WC	$4,346.25

STEM IM BOWE 14x150 150368

Facility

$6,480.00

Service Code	HCPCS C1776
Hospital Charge Code	270638567
Hospital Revenue Code	278
Min. Negotiated Rate	$972.00
Max. Negotiated Rate	$3,240.00
Rate for Payer: Aetna Commercial	$1,944.00
Rate for Payer: Aetna Medicare Advantage	$1,944.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,652.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,652.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,296.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,652.40
Rate for Payer: Cigna Commercial	$3,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,568.16
Rate for Payer: Qualcare PPO/HMO/WC	$972.00

Know your out-of-pocket cost for care.

All Charges