Heights University Hospital

All Charges

Charge

Type

Setting

Price

STEM MOD COMPR 14X150MM

Facility

$18,180.00

Service Code	HCPCS C1776
Hospital Charge Code	270697379
Hospital Revenue Code	278
Min. Negotiated Rate	$2,727.00
Max. Negotiated Rate	$4,399.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,636.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,399.56
Rate for Payer: Qualcare PPO/HMO/WC	$2,727.00

STEM MOD COMPR 14X150MM

Facility

$18,180.00

Service Code	HCPCS C1776
Hospital Charge Code	270697379
Hospital Revenue Code	278
Min. Negotiated Rate	$2,727.00
Max. Negotiated Rate	$9,090.00
Rate for Payer: Aetna Commercial	$5,454.00
Rate for Payer: Aetna Medicare Advantage	$5,454.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,635.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,635.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,636.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,635.90
Rate for Payer: Cigna Commercial	$9,090.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,399.56
Rate for Payer: Qualcare PPO/HMO/WC	$2,727.00

STEM MODULAR 40mm WITH SCREW

Facility

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270646503
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$450.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

STEM MODULAR 40mm WITH SCREW

Facility

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270646503
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

STEM MOLD 13mmX145mm W/REINFO

Facility

$8,495.00

Hospital Charge Code	270646449
Hospital Revenue Code	278
Min. Negotiated Rate	$1,274.25
Max. Negotiated Rate	$2,055.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,699.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,055.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.25

STEM MOLD 13mmX145mm W/REINFO

Facility

$8,495.00

Hospital Charge Code	270646449
Hospital Revenue Code	278
Min. Negotiated Rate	$1,274.25
Max. Negotiated Rate	$4,247.50
Rate for Payer: Aetna Commercial	$2,548.50
Rate for Payer: Aetna Medicare Advantage	$2,548.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,166.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,166.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,699.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,166.22
Rate for Payer: Cigna Commercial	$4,247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,055.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.25

STEM MOLD 15 MM x 155MM W/REIN

Facility

$8,495.00

Service Code	HCPCS C1776
Hospital Charge Code	270686605
Hospital Revenue Code	278
Min. Negotiated Rate	$1,274.25
Max. Negotiated Rate	$2,055.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,699.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,055.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.25

STEM MOLD 15 MM x 155MM W/REIN

Facility

$8,495.00

Service Code	HCPCS C1776
Hospital Charge Code	270686605
Hospital Revenue Code	278
Min. Negotiated Rate	$1,274.25
Max. Negotiated Rate	$4,247.50
Rate for Payer: Aetna Commercial	$2,548.50
Rate for Payer: Aetna Medicare Advantage	$2,548.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,166.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,166.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,699.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,166.22
Rate for Payer: Cigna Commercial	$4,247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,055.79
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.25

STEM MOLD 48MM WITH INSERT

Facility

$6,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270646450
Hospital Revenue Code	278
Min. Negotiated Rate	$1,019.25
Max. Negotiated Rate	$1,644.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,359.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,644.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,019.25

STEM MOLD 48MM WITH INSERT

Facility

$6,795.00

Service Code	HCPCS C1776
Hospital Charge Code	270646450
Hospital Revenue Code	278
Min. Negotiated Rate	$1,019.25
Max. Negotiated Rate	$3,397.50
Rate for Payer: Aetna Commercial	$2,038.50
Rate for Payer: Aetna Medicare Advantage	$2,038.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,732.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,732.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,359.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,732.72
Rate for Payer: Cigna Commercial	$3,397.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,644.39
Rate for Payer: Qualcare PPO/HMO/WC	$1,019.25

STEM MP 180x14MM

Facility

$12,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677767
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

STEM MP 180x14MM

Facility

$12,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677767
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$3,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

STEM MUMERAL 14MM

Facility

$18,885.00

Hospital Charge Code	270649257
Hospital Revenue Code	278
Min. Negotiated Rate	$2,832.75
Max. Negotiated Rate	$9,442.50
Rate for Payer: Aetna Commercial	$5,665.50
Rate for Payer: Aetna Medicare Advantage	$5,665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,815.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,815.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,777.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,815.68
Rate for Payer: Cigna Commercial	$9,442.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,570.17
Rate for Payer: Qualcare PPO/HMO/WC	$2,832.75

STEM MUMERAL 14MM

Facility

$18,885.00

Hospital Charge Code	270649257
Hospital Revenue Code	278
Min. Negotiated Rate	$2,832.75
Max. Negotiated Rate	$4,570.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,777.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,570.17
Rate for Payer: Qualcare PPO/HMO/WC	$2,832.75

STEM NECK ANG SZ7 32X130MM127D

Facility

$11,954.55

Service Code	HCPCS C1776
Hospital Charge Code	270695187
Hospital Revenue Code	278
Min. Negotiated Rate	$1,793.18
Max. Negotiated Rate	$2,893.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,893.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,793.18

STEM NECK ANG SZ7 32X130MM127D

Facility

$11,954.55

Service Code	HCPCS C1776
Hospital Charge Code	270695187
Hospital Revenue Code	278
Min. Negotiated Rate	$1,793.18
Max. Negotiated Rate	$5,977.27
Rate for Payer: Aetna Commercial	$3,586.36
Rate for Payer: Aetna Medicare Advantage	$3,586.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,048.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,048.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,390.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,048.41
Rate for Payer: Cigna Commercial	$5,977.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,893.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,793.18

STEM NEXGEN OFFSET EXT 14MM

Facility

$2,427.25

Hospital Charge Code	270626696
Hospital Revenue Code	278
Min. Negotiated Rate	$364.09
Max. Negotiated Rate	$587.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$485.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$587.39
Rate for Payer: Qualcare PPO/HMO/WC	$364.09

STEM NEXGEN OFFSET EXT 14MM

Facility

$2,427.25

Hospital Charge Code	270626696
Hospital Revenue Code	278
Min. Negotiated Rate	$364.09
Max. Negotiated Rate	$1,213.62
Rate for Payer: Aetna Commercial	$728.17
Rate for Payer: Aetna Medicare Advantage	$728.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$485.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.95
Rate for Payer: Cigna Commercial	$1,213.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$587.39
Rate for Payer: Qualcare PPO/HMO/WC	$364.09

STEM NEXGEN ST EXT 16X145MM

Facility

$6,690.00

Service Code	HCPCS C1776
Hospital Charge Code	270660881
Hospital Revenue Code	278
Min. Negotiated Rate	$1,003.50
Max. Negotiated Rate	$3,345.00
Rate for Payer: Aetna Commercial	$2,007.00
Rate for Payer: Aetna Medicare Advantage	$2,007.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,705.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,705.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,338.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,705.95
Rate for Payer: Cigna Commercial	$3,345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,618.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,003.50

STEM NEXGEN ST EXT 16X145MM

Facility

$6,690.00

Service Code	HCPCS C1776
Hospital Charge Code	270660881
Hospital Revenue Code	278
Min. Negotiated Rate	$1,003.50
Max. Negotiated Rate	$1,618.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,338.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,618.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,003.50

STEM NEXGEN STRAIGHT 15X145MM

Facility

$5,245.85

Service Code	HCPCS C1776
Hospital Charge Code	270686914
Hospital Revenue Code	278
Min. Negotiated Rate	$786.88
Max. Negotiated Rate	$2,622.93
Rate for Payer: Aetna Commercial	$1,573.76
Rate for Payer: Aetna Medicare Advantage	$1,573.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,337.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,337.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,049.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,337.69
Rate for Payer: Cigna Commercial	$2,622.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,269.50
Rate for Payer: Qualcare PPO/HMO/WC	$786.88

STEM NEXGEN STRAIGHT 15X145MM

Facility

$5,245.85

Service Code	HCPCS C1776
Hospital Charge Code	270686914
Hospital Revenue Code	278
Min. Negotiated Rate	$786.88
Max. Negotiated Rate	$1,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,049.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,269.50
Rate for Payer: Qualcare PPO/HMO/WC	$786.88

STEM NEXGEN STRAIGHT EXT 14MM

Facility

$2,427.25

Hospital Charge Code	270626697
Hospital Revenue Code	278
Min. Negotiated Rate	$364.09
Max. Negotiated Rate	$1,213.62
Rate for Payer: Aetna Commercial	$728.17
Rate for Payer: Aetna Medicare Advantage	$728.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$618.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$618.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$485.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$618.95
Rate for Payer: Cigna Commercial	$1,213.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$587.39
Rate for Payer: Qualcare PPO/HMO/WC	$364.09

STEM NEXGEN STRAIGHT EXT 14MM

Facility

$2,427.25

Hospital Charge Code	270626697
Hospital Revenue Code	278
Min. Negotiated Rate	$364.09
Max. Negotiated Rate	$587.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$485.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$587.39
Rate for Payer: Qualcare PPO/HMO/WC	$364.09

STEM NXG TIBIAL PLATE SZ4 5970

Facility

$8,235.30

Hospital Charge Code	270607473
Hospital Revenue Code	278
Min. Negotiated Rate	$1,235.30
Max. Negotiated Rate	$4,117.65
Rate for Payer: Aetna Commercial	$2,470.59
Rate for Payer: Aetna Medicare Advantage	$2,470.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,647.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,100.00
Rate for Payer: Cigna Commercial	$4,117.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,992.94
Rate for Payer: Qualcare PPO/HMO/WC	$1,235.30

Know your out-of-pocket cost for care.

All Charges