Heights University Hospital

All Charges

Charge

Type

Setting

Price

STEM KNEE SMTH W/SCREW 18x80mm

Facility

$8,565.00

Service Code	HCPCS C1776
Hospital Charge Code	270669893
Hospital Revenue Code	278
Min. Negotiated Rate	$1,284.75
Max. Negotiated Rate	$2,072.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,713.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,072.73
Rate for Payer: Qualcare PPO/HMO/WC	$1,284.75

STEM KNEE SMTH W/SCREW 20x120m

Facility

$8,480.00

Hospital Charge Code	270669894
Hospital Revenue Code	278
Min. Negotiated Rate	$1,272.00
Max. Negotiated Rate	$2,052.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,696.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,052.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,272.00

STEM KNEE SMTH W/SCREW 20x120m

Facility

$8,480.00

Hospital Charge Code	270669894
Hospital Revenue Code	278
Min. Negotiated Rate	$1,272.00
Max. Negotiated Rate	$4,240.00
Rate for Payer: Aetna Commercial	$2,544.00
Rate for Payer: Aetna Medicare Advantage	$2,544.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,162.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,162.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,696.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,162.40
Rate for Payer: Cigna Commercial	$4,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,052.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,272.00

STEM KNEE SPLINDE 12X120

Facility

$6,080.00

Hospital Charge Code	270638753
Hospital Revenue Code	278
Min. Negotiated Rate	$912.00
Max. Negotiated Rate	$3,040.00
Rate for Payer: Aetna Commercial	$1,824.00
Rate for Payer: Aetna Medicare Advantage	$1,824.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,550.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,550.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,550.40
Rate for Payer: Cigna Commercial	$3,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,471.36
Rate for Payer: Qualcare PPO/HMO/WC	$912.00

STEM KNEE SPLINDE 12X120

Facility

$6,080.00

Hospital Charge Code	270638753
Hospital Revenue Code	278
Min. Negotiated Rate	$912.00
Max. Negotiated Rate	$1,471.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,216.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,471.36
Rate for Payer: Qualcare PPO/HMO/WC	$912.00

STEM KNEE SPLINDE 16X120

Facility

$6,080.00

Hospital Charge Code	270638754
Hospital Revenue Code	278
Min. Negotiated Rate	$912.00
Max. Negotiated Rate	$1,471.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,216.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,471.36
Rate for Payer: Qualcare PPO/HMO/WC	$912.00

STEM KNEE SPLINDE 16X120

Facility

$6,080.00

Hospital Charge Code	270638754
Hospital Revenue Code	278
Min. Negotiated Rate	$912.00
Max. Negotiated Rate	$3,040.00
Rate for Payer: Aetna Commercial	$1,824.00
Rate for Payer: Aetna Medicare Advantage	$1,824.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,550.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,550.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,550.40
Rate for Payer: Cigna Commercial	$3,040.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,471.36
Rate for Payer: Qualcare PPO/HMO/WC	$912.00

STEM MAL HEAD CALC LT 11104950

Facility

$39,555.00

Hospital Charge Code	270641514
Hospital Revenue Code	278
Min. Negotiated Rate	$5,933.25
Max. Negotiated Rate	$19,777.50
Rate for Payer: Aetna Commercial	$11,866.50
Rate for Payer: Aetna Medicare Advantage	$11,866.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,086.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,086.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,911.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,086.52
Rate for Payer: Cigna Commercial	$19,777.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,572.31
Rate for Payer: Qualcare PPO/HMO/WC	$5,933.25

STEM MAL HEAD CALC LT 11104950

Facility

$39,555.00

Hospital Charge Code	270641514
Hospital Revenue Code	278
Min. Negotiated Rate	$5,933.25
Max. Negotiated Rate	$9,572.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,911.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,572.31
Rate for Payer: Qualcare PPO/HMO/WC	$5,933.25

STEM MALLORY MODULAR DIST 15mm

Facility

$14,225.00

Hospital Charge Code	270645040
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$7,112.50
Rate for Payer: Aetna Commercial	$4,267.50
Rate for Payer: Aetna Medicare Advantage	$4,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,627.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,627.38
Rate for Payer: Cigna Commercial	$7,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

STEM MALLORY MODULAR DIST 15mm

Facility

$14,225.00

Hospital Charge Code	270645040
Hospital Revenue Code	278
Min. Negotiated Rate	$2,133.75
Max. Negotiated Rate	$3,442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,442.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,133.75

STEM MALLORY MODULR CALCAR 34B

Facility

$33,545.00

Hospital Charge Code	270645039
Hospital Revenue Code	278
Min. Negotiated Rate	$5,031.75
Max. Negotiated Rate	$8,117.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,709.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,117.89
Rate for Payer: Qualcare PPO/HMO/WC	$5,031.75

STEM MALLORY MODULR CALCAR 34B

Facility

$33,545.00

Hospital Charge Code	270645039
Hospital Revenue Code	278
Min. Negotiated Rate	$5,031.75
Max. Negotiated Rate	$16,772.50
Rate for Payer: Aetna Commercial	$10,063.50
Rate for Payer: Aetna Medicare Advantage	$10,063.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,553.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,553.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,709.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,553.98
Rate for Payer: Cigna Commercial	$16,772.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,117.89
Rate for Payer: Qualcare PPO/HMO/WC	$5,031.75

STEM MALRY 45B MOD PROX 108132

Facility

$23,188.00

Hospital Charge Code	270633599
Hospital Revenue Code	278
Min. Negotiated Rate	$3,478.20
Max. Negotiated Rate	$11,594.00
Rate for Payer: Aetna Commercial	$6,956.40
Rate for Payer: Aetna Medicare Advantage	$6,956.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,912.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,912.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,637.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,912.94
Rate for Payer: Cigna Commercial	$11,594.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,611.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,478.20

STEM MALRY 45B MOD PROX 108132

Facility

$23,188.00

Hospital Charge Code	270633599
Hospital Revenue Code	278
Min. Negotiated Rate	$3,478.20
Max. Negotiated Rate	$5,611.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,637.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,611.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,478.20

STEM METATARSAL LARGE

Facility

$8,750.00

Hospital Charge Code	270672046
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$4,375.00
Rate for Payer: Aetna Commercial	$2,625.00
Rate for Payer: Aetna Medicare Advantage	$2,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,231.25
Rate for Payer: Cigna Commercial	$4,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

STEM METATARSAL LARGE

Facility

$8,750.00

Hospital Charge Code	270672046
Hospital Revenue Code	278
Min. Negotiated Rate	$1,312.50
Max. Negotiated Rate	$2,117.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,117.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,312.50

STEM METATARSEL SML POROUS CTD

Facility

$7,225.00

Hospital Charge Code	270642724
Hospital Revenue Code	278
Min. Negotiated Rate	$1,083.75
Max. Negotiated Rate	$1,748.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,445.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,748.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.75

STEM METATARSEL SML POROUS CTD

Facility

$7,225.00

Hospital Charge Code	270642724
Hospital Revenue Code	278
Min. Negotiated Rate	$1,083.75
Max. Negotiated Rate	$3,612.50
Rate for Payer: Aetna Commercial	$2,167.50
Rate for Payer: Aetna Medicare Advantage	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,842.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,842.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,842.38
Rate for Payer: Cigna Commercial	$3,612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,748.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.75

STEM MINI COMP PRIMARY 14MM

Facility

$14,935.00

Service Code	HCPCS C1776
Hospital Charge Code	270700041
Hospital Revenue Code	278
Min. Negotiated Rate	$2,240.25
Max. Negotiated Rate	$3,614.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,987.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,614.27
Rate for Payer: Qualcare PPO/HMO/WC	$2,240.25

STEM MINI COMP PRIMARY 14MM

Facility

$14,935.00

Service Code	HCPCS C1776
Hospital Charge Code	270700041
Hospital Revenue Code	278
Min. Negotiated Rate	$2,240.25
Max. Negotiated Rate	$7,467.50
Rate for Payer: Aetna Commercial	$4,480.50
Rate for Payer: Aetna Medicare Advantage	$4,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,808.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,808.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,987.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,808.43
Rate for Payer: Cigna Commercial	$7,467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,614.27
Rate for Payer: Qualcare PPO/HMO/WC	$2,240.25

STEM MINI HUMERAL

Facility

$660.00

Service Code	HCPCS C1776
Hospital Charge Code	270692525
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$330.00
Rate for Payer: Aetna Commercial	$198.00
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

STEM MINI HUMERAL

Facility

$660.00

Service Code	HCPCS C1776
Hospital Charge Code	270692525
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$159.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

STEM MOD ARCOS 17X150MM

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270694444
Hospital Revenue Code	278
Min. Negotiated Rate	$2,799.00
Max. Negotiated Rate	$9,330.00
Rate for Payer: Aetna Commercial	$5,598.00
Rate for Payer: Aetna Medicare Advantage	$5,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,758.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,758.30
Rate for Payer: Cigna Commercial	$9,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00

STEM MOD ARCOS 17X150MM

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270694444
Hospital Revenue Code	278
Min. Negotiated Rate	$2,799.00
Max. Negotiated Rate	$4,515.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,732.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,515.72
Rate for Payer: Qualcare PPO/HMO/WC	$2,799.00

Know your out-of-pocket cost for care.

All Charges