Heights University Hospital

All Charges

Charge

Type

Setting

Price

STEM PRESS FIT SZ 13 TSS

Facility

$9,535.50

Service Code	HCPCS C1776
Hospital Charge Code	270689214
Hospital Revenue Code	278
Min. Negotiated Rate	$1,430.33
Max. Negotiated Rate	$4,767.75
Rate for Payer: Aetna Commercial	$2,860.65
Rate for Payer: Aetna Medicare Advantage	$2,860.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,431.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,431.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,907.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,431.55
Rate for Payer: Cigna Commercial	$4,767.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,307.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,430.33

STEM PRESS FT SZ 12 TSS

Facility

$7,914.75

Service Code	HCPCS C1776
Hospital Charge Code	270690434
Hospital Revenue Code	278
Min. Negotiated Rate	$1,187.21
Max. Negotiated Rate	$1,915.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.21

STEM PRESS FT SZ 12 TSS

Facility

$7,914.75

Service Code	HCPCS C1776
Hospital Charge Code	270690434
Hospital Revenue Code	278
Min. Negotiated Rate	$1,187.21
Max. Negotiated Rate	$3,957.38
Rate for Payer: Aetna Commercial	$2,374.43
Rate for Payer: Aetna Medicare Advantage	$2,374.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,018.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,018.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,582.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,018.26
Rate for Payer: Cigna Commercial	$3,957.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,915.37
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.21

STEM PRESS TSS SZ 11

Facility

$7,711.70

Service Code	HCPCS C1776
Hospital Charge Code	270689674
Hospital Revenue Code	278
Min. Negotiated Rate	$1,156.76
Max. Negotiated Rate	$1,866.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,542.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,866.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,156.76

STEM PRESS TSS SZ 11

Facility

$7,711.70

Service Code	HCPCS C1776
Hospital Charge Code	270689674
Hospital Revenue Code	278
Min. Negotiated Rate	$1,156.76
Max. Negotiated Rate	$3,855.85
Rate for Payer: Aetna Commercial	$2,313.51
Rate for Payer: Aetna Medicare Advantage	$2,313.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,966.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,966.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,542.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,966.48
Rate for Payer: Cigna Commercial	$3,855.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,866.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,156.76

STEM PRIMARY EXTEN 11MM L65MM

Facility

$2,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270683577
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

STEM PRIMARY EXTEN 11MM L65MM

Facility

$2,750.00

Service Code	HCPCS C1776
Hospital Charge Code	270683577
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$825.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

STEM PRIM I BEAM ANG *******

Facility

$954.00

Hospital Charge Code	270606320
Hospital Revenue Code	272
Min. Negotiated Rate	$124.02
Max. Negotiated Rate	$477.00
Rate for Payer: Aetna Commercial	$286.20
Rate for Payer: Aetna Medicare Advantage	$286.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$243.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$243.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$243.27
Rate for Payer: Cigna Commercial	$477.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.02
Rate for Payer: Oxford Commercial	$477.00
Rate for Payer: Qualcare PPO/HMO/WC	$143.10
Rate for Payer: UnitedHealthcare Commercial	$477.00

STEM PRIM I BEAM ANG *******

Facility

$954.00

Hospital Charge Code	270606320
Hospital Revenue Code	272
Min. Negotiated Rate	$143.10
Max. Negotiated Rate	$143.10
Rate for Payer: Qualcare PPO/HMO/WC	$143.10

STEM PROFEMUR TI 127D SZ1

Facility

$16,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270697656
Hospital Revenue Code	278
Min. Negotiated Rate	$2,431.50
Max. Negotiated Rate	$3,922.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,922.82
Rate for Payer: Qualcare PPO/HMO/WC	$2,431.50

STEM PROFEMUR TI 127D SZ1

Facility

$16,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270697656
Hospital Revenue Code	278
Min. Negotiated Rate	$2,431.50
Max. Negotiated Rate	$8,105.00
Rate for Payer: Aetna Commercial	$4,863.00
Rate for Payer: Aetna Medicare Advantage	$4,863.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,133.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,133.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,133.55
Rate for Payer: Cigna Commercial	$8,105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,922.82
Rate for Payer: Qualcare PPO/HMO/WC	$2,431.50

STEM PROLINE EVOLVE 7.5MM

Facility

$9,225.00

Service Code	HCPCS C1776
Hospital Charge Code	270686806
Hospital Revenue Code	278
Min. Negotiated Rate	$1,383.75
Max. Negotiated Rate	$2,232.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,232.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,383.75

STEM PROLINE EVOLVE 7.5MM

Facility

$9,225.00

Service Code	HCPCS C1776
Hospital Charge Code	270686806
Hospital Revenue Code	278
Min. Negotiated Rate	$1,383.75
Max. Negotiated Rate	$4,612.50
Rate for Payer: Aetna Commercial	$2,767.50
Rate for Payer: Aetna Medicare Advantage	$2,767.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,352.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,352.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,352.38
Rate for Payer: Cigna Commercial	$4,612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,232.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,383.75

STEM PROLINE IMPLANT 6.5MM

Facility

$11,720.00

Hospital Charge Code	270669852
Hospital Revenue Code	278
Min. Negotiated Rate	$1,758.00
Max. Negotiated Rate	$2,836.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,344.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,836.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,758.00

STEM PROLINE IMPLANT 6.5MM

Facility

$11,720.00

Hospital Charge Code	270669852
Hospital Revenue Code	278
Min. Negotiated Rate	$1,758.00
Max. Negotiated Rate	$5,860.00
Rate for Payer: Aetna Commercial	$3,516.00
Rate for Payer: Aetna Medicare Advantage	$3,516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,988.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,988.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,344.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,988.60
Rate for Payer: Cigna Commercial	$5,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,836.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,758.00

STEM PROLINE IMPLANT 8.5MM

Facility

$11,720.00

Hospital Charge Code	270639548
Hospital Revenue Code	278
Min. Negotiated Rate	$1,758.00
Max. Negotiated Rate	$5,860.00
Rate for Payer: Aetna Commercial	$3,516.00
Rate for Payer: Aetna Medicare Advantage	$3,516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,988.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,988.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,344.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,988.60
Rate for Payer: Cigna Commercial	$5,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,836.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,758.00

STEM PROLINE IMPLANT 8.5MM

Facility

$11,720.00

Hospital Charge Code	270639548
Hospital Revenue Code	278
Min. Negotiated Rate	$1,758.00
Max. Negotiated Rate	$2,836.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,344.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,836.24
Rate for Payer: Qualcare PPO/HMO/WC	$1,758.00

STEM PSA STR 14x30MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270677131
Hospital Revenue Code	278
Min. Negotiated Rate	$624.71
Max. Negotiated Rate	$2,082.38
Rate for Payer: Aetna Commercial	$1,249.42
Rate for Payer: Aetna Medicare Advantage	$1,249.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,062.01
Rate for Payer: Cigna Commercial	$2,082.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: Qualcare PPO/HMO/WC	$624.71

STEM PSA STR 14x30MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270677131
Hospital Revenue Code	278
Min. Negotiated Rate	$624.71
Max. Negotiated Rate	$1,007.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: Qualcare PPO/HMO/WC	$624.71

STEM PSA STR 14x75MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270676882
Hospital Revenue Code	278
Min. Negotiated Rate	$624.71
Max. Negotiated Rate	$2,082.38
Rate for Payer: Aetna Commercial	$1,249.42
Rate for Payer: Aetna Medicare Advantage	$1,249.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,062.01
Rate for Payer: Cigna Commercial	$2,082.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: Qualcare PPO/HMO/WC	$624.71

STEM PSA STR 14x75MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270676882
Hospital Revenue Code	278
Min. Negotiated Rate	$624.71
Max. Negotiated Rate	$1,007.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: Qualcare PPO/HMO/WC	$624.71

STEM PSA STR 18x100MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270676875
Hospital Revenue Code	278
Min. Negotiated Rate	$624.71
Max. Negotiated Rate	$2,082.38
Rate for Payer: Aetna Commercial	$1,249.42
Rate for Payer: Aetna Medicare Advantage	$1,249.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,062.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,062.01
Rate for Payer: Cigna Commercial	$2,082.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: Qualcare PPO/HMO/WC	$624.71

STEM PSA STR 18x100MM

Facility

$4,164.75

Service Code	HCPCS C1776
Hospital Charge Code	270676875
Hospital Revenue Code	278
Min. Negotiated Rate	$624.71
Max. Negotiated Rate	$1,007.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$832.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,007.87
Rate for Payer: Qualcare PPO/HMO/WC	$624.71

STEM PSN LINE 13X135MM

Facility

$12,905.00

Service Code	HCPCS C1776
Hospital Charge Code	270700043
Hospital Revenue Code	278
Min. Negotiated Rate	$1,935.75
Max. Negotiated Rate	$6,452.50
Rate for Payer: Aetna Commercial	$3,871.50
Rate for Payer: Aetna Medicare Advantage	$3,871.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,290.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,290.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,290.78
Rate for Payer: Cigna Commercial	$6,452.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,123.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,935.75

STEM PSN LINE 13X135MM

Facility

$12,905.00

Service Code	HCPCS C1776
Hospital Charge Code	270700043
Hospital Revenue Code	278
Min. Negotiated Rate	$1,935.75
Max. Negotiated Rate	$3,123.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,581.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,123.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,935.75

Know your out-of-pocket cost for care.

All Charges