Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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

STEMUBLAST GEL 10CC

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270686754
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

STEMUBLAST GEL 10CC

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270686754
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

STE MULLIN RX 3.5X23M100784923

Facility

$4,860.00

Service Code	HCPCS C1894
Hospital Charge Code	270643219N
Hospital Revenue Code	278
Min. Negotiated Rate	$729.00
Max. Negotiated Rate	$1,176.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$972.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,176.12
Rate for Payer: Qualcare PPO/HMO/WC	$729.00

STE MULLIN RX 3.5X23M100784923

Facility

$4,860.00

Service Code	HCPCS C1894
Hospital Charge Code	270643219N
Hospital Revenue Code	278
Min. Negotiated Rate	$729.00
Max. Negotiated Rate	$2,430.00
Rate for Payer: Aetna Commercial	$1,458.00
Rate for Payer: Aetna Medicare Advantage	$1,458.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,239.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,239.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$972.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,239.30
Rate for Payer: Cigna Commercial	$2,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,176.12
Rate for Payer: Qualcare PPO/HMO/WC	$729.00

STE MULLIN RX 3.5X23M100784923

Facility

$3,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270643219C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STE MULLIN RX 3.5X23M100784923

Facility

$3,000.00

Service Code	HCPCS C1874
Hospital Charge Code	270643219C
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

STEM UTF #8 144MM

Facility

$11,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677117
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$2,662.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

STEM UTF #8 144MM

Facility

$11,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677117
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$5,500.00
Rate for Payer: Aetna Commercial	$3,300.00
Rate for Payer: Aetna Medicare Advantage	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,805.00
Rate for Payer: Cigna Commercial	$5,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

STEM V40 132 DEG 30 MM SZ 8

Facility

$11,954.55

Service Code	HCPCS C1776
Hospital Charge Code	270691036
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 V40 132 DEG 30 MM SZ 8

Facility

$11,954.55

Service Code	HCPCS C1776
Hospital Charge Code	270691036
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 VERSA DIAL 6MM GLEN

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270697934
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

STEM VERSA DIAL 6MM GLEN

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270697934
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

STEM VIVACIT-E HIGHLY CROSSED

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690938
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

STEM VIVACIT-E HIGHLY CROSSED

Facility

$13,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270690938
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$6,750.00
Rate for Payer: Aetna Commercial	$4,050.00
Rate for Payer: Aetna Medicare Advantage	$4,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,442.50
Rate for Payer: Cigna Commercial	$6,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

STEM ZIM FEM 11 120MM 7853-11

Facility

$11,316.75

Hospital Charge Code	270616638
Hospital Revenue Code	278
Min. Negotiated Rate	$1,697.51
Max. Negotiated Rate	$5,658.38
Rate for Payer: Aetna Commercial	$3,395.03
Rate for Payer: Aetna Medicare Advantage	$3,395.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,885.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,885.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,263.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,885.77
Rate for Payer: Cigna Commercial	$5,658.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,738.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,697.51

STEM ZIM FEM 11 120MM 7853-11

Facility

$11,316.75

Hospital Charge Code	270616638
Hospital Revenue Code	278
Min. Negotiated Rate	$1,697.51
Max. Negotiated Rate	$2,738.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,263.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,738.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,697.51

STEM ZIM FEM 11 130MM 7841-11

Facility

$26,378.45

Hospital Charge Code	270621552
Hospital Revenue Code	278
Min. Negotiated Rate	$3,956.77
Max. Negotiated Rate	$6,383.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,275.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,383.58
Rate for Payer: Qualcare PPO/HMO/WC	$3,956.77

STEM ZIM FEM 11 130MM 7841-11

Facility

$26,378.45

Hospital Charge Code	270621552
Hospital Revenue Code	278
Min. Negotiated Rate	$3,956.77
Max. Negotiated Rate	$13,189.23
Rate for Payer: Aetna Commercial	$7,913.53
Rate for Payer: Aetna Medicare Advantage	$7,913.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,726.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,726.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,275.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,726.50
Rate for Payer: Cigna Commercial	$13,189.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,383.58
Rate for Payer: Qualcare PPO/HMO/WC	$3,956.77

STEM ZIM FEM 12 125MM 7833-12

Facility

$4,017.65

Hospital Charge Code	270628372
Hospital Revenue Code	278
Min. Negotiated Rate	$602.65
Max. Negotiated Rate	$972.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$803.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$972.27
Rate for Payer: Qualcare PPO/HMO/WC	$602.65

STEM ZIM FEM 12 125MM 7833-12

Facility

$4,017.65

Hospital Charge Code	270628372
Hospital Revenue Code	278
Min. Negotiated Rate	$602.65
Max. Negotiated Rate	$2,008.83
Rate for Payer: Aetna Commercial	$1,205.30
Rate for Payer: Aetna Medicare Advantage	$1,205.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,024.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,024.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$803.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,024.50
Rate for Payer: Cigna Commercial	$2,008.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$972.27
Rate for Payer: Qualcare PPO/HMO/WC	$602.65

STEM ZIM FEM 12 125MM 7853-12

Facility

$11,316.75

Hospital Charge Code	270616592
Hospital Revenue Code	278
Min. Negotiated Rate	$1,697.51
Max. Negotiated Rate	$5,658.38
Rate for Payer: Aetna Commercial	$3,395.03
Rate for Payer: Aetna Medicare Advantage	$3,395.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,885.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,885.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,263.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,885.77
Rate for Payer: Cigna Commercial	$5,658.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,738.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,697.51

STEM ZIM FEM 12 125MM 7853-12

Facility

$11,316.75

Hospital Charge Code	270616592
Hospital Revenue Code	278
Min. Negotiated Rate	$1,697.51
Max. Negotiated Rate	$2,738.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,263.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,738.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,697.51

STEM ZIM FEM 12 140MM 7841-12

Facility

$19,519.40

Hospital Charge Code	270611864
Hospital Revenue Code	278
Min. Negotiated Rate	$2,927.91
Max. Negotiated Rate	$4,723.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,903.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,723.69
Rate for Payer: Qualcare PPO/HMO/WC	$2,927.91

STEM ZIM FEM 12 140MM 7841-12

Facility

$19,519.40

Hospital Charge Code	270611864
Hospital Revenue Code	278
Min. Negotiated Rate	$2,927.91
Max. Negotiated Rate	$9,759.70
Rate for Payer: Aetna Commercial	$5,855.82
Rate for Payer: Aetna Medicare Advantage	$5,855.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,977.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,977.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,903.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,977.45
Rate for Payer: Cigna Commercial	$9,759.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,723.69
Rate for Payer: Qualcare PPO/HMO/WC	$2,927.91

Know your out-of-pocket cost for care.

All Charges