Heights University Hospital

All Charges

Charge

Type

Setting

Price

STEM STD COMP 8MMX120MM

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693835
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 STD COMP 8MMX120MM

Facility

$14,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693835
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 STD DISTAL TAPERLOC 14MM

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270675680
Hospital Revenue Code	278
Min. Negotiated Rate	$1,837.50
Max. Negotiated Rate	$2,964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50

STEM STD DISTAL TAPERLOC 14MM

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270675680
Hospital Revenue Code	278
Min. Negotiated Rate	$1,837.50
Max. Negotiated Rate	$6,125.00
Rate for Payer: Aetna Commercial	$3,675.00
Rate for Payer: Aetna Medicare Advantage	$3,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,123.75
Rate for Payer: Cigna Commercial	$6,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50

STEM STD DISTAL TAPERLOC 15MM

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270675787
Hospital Revenue Code	278
Min. Negotiated Rate	$1,837.50
Max. Negotiated Rate	$6,125.00
Rate for Payer: Aetna Commercial	$3,675.00
Rate for Payer: Aetna Medicare Advantage	$3,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,123.75
Rate for Payer: Cigna Commercial	$6,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50

STEM STD DISTAL TAPERLOC 15MM

Facility

$12,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270675787
Hospital Revenue Code	278
Min. Negotiated Rate	$1,837.50
Max. Negotiated Rate	$2,964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,964.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,837.50

STEM STD DISTAL TAPERLOC 16MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270676897
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$2,541.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

STEM STD DISTAL TAPERLOC 16MM

Facility

$10,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270676897
Hospital Revenue Code	278
Min. Negotiated Rate	$1,575.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Aetna Commercial	$3,150.00
Rate for Payer: Aetna Medicare Advantage	$3,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,677.50
Rate for Payer: Cigna Commercial	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,575.00

STEM STD FEMORAL HA SZ 2SN

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270674074
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

STEM STD FEMORAL HA SZ 2SN

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270674074
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$2,400.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

STEM STS DISTAL 15 MM X150MM

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270683724
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 STS DISTAL 15 MM X150MM

Facility

$18,660.00

Service Code	HCPCS C1776
Hospital Charge Code	270683724
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

STEM SZ 15 TSS PRESS

Facility

$7,914.75

Service Code	HCPCS C1776
Hospital Charge Code	270689617
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 SZ 15 TSS PRESS

Facility

$7,914.75

Service Code	HCPCS C1776
Hospital Charge Code	270689617
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 SZ 2 CEMENTRALIZER 8.5 MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270691750
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

STEM SZ 2 CEMENTRALIZER 8.5 MM

Facility

$2,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270691750
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

STEM TALAR 10MM

Facility

$5,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270670887
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

STEM TALAR 10MM

Facility

$5,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270670887
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,575.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

STEM TAPER ARCOS SZ A STD 60MM

Facility

$36,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270694443
Hospital Revenue Code	278
Min. Negotiated Rate	$5,431.50
Max. Negotiated Rate	$18,105.00
Rate for Payer: Aetna Commercial	$10,863.00
Rate for Payer: Aetna Medicare Advantage	$10,863.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,233.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,233.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,233.55
Rate for Payer: Cigna Commercial	$18,105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,762.82
Rate for Payer: Qualcare PPO/HMO/WC	$5,431.50

STEM TAPER ARCOS SZ A STD 60MM

Facility

$36,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270694443
Hospital Revenue Code	278
Min. Negotiated Rate	$5,431.50
Max. Negotiated Rate	$8,762.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,762.82
Rate for Payer: Qualcare PPO/HMO/WC	$5,431.50

STEM TAP SMOT EXT 14X75MM

Facility

$11,672.50

Service Code	HCPCS C1776
Hospital Charge Code	270691597
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.88
Max. Negotiated Rate	$2,824.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,334.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,824.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.88

STEM TAP SMOT EXT 14X75MM

Facility

$11,672.50

Service Code	HCPCS C1776
Hospital Charge Code	270691597
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.88
Max. Negotiated Rate	$5,836.25
Rate for Payer: Aetna Commercial	$3,501.75
Rate for Payer: Aetna Medicare Advantage	$3,501.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,976.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,976.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,334.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,976.49
Rate for Payer: Cigna Commercial	$5,836.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,824.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,750.88

STEM TIBIAL PSN 3 DEG SZ E

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686485
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

STEM TIBIAL PSN 3 DEG SZ E

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270686485
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

STEM TIB PSN SZ C L TIBIAL 5D

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270692329
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Know your out-of-pocket cost for care.

All Charges