Heights University Hospital

All Charges

Charge

Type

Setting

Price

STEM ZIM KNE EX 15 30 59881215

Facility

$4,099.25

Hospital Charge Code	270616165
Hospital Revenue Code	278
Min. Negotiated Rate	$614.89
Max. Negotiated Rate	$2,049.62
Rate for Payer: Aetna Commercial	$1,229.78
Rate for Payer: Aetna Medicare Advantage	$1,229.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,045.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,045.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$819.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,045.31
Rate for Payer: Cigna Commercial	$2,049.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$992.02
Rate for Payer: Qualcare PPO/HMO/WC	$614.89

STEM ZIM KNE EX 15 30 59881215

Facility

$4,099.25

Hospital Charge Code	270616165
Hospital Revenue Code	278
Min. Negotiated Rate	$614.89
Max. Negotiated Rate	$992.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$819.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$992.02
Rate for Payer: Qualcare PPO/HMO/WC	$614.89

STEM ZIM TIBIAL PLATE SZ3 5980

Facility

$8,017.25

Hospital Charge Code	270607655
Hospital Revenue Code	278
Min. Negotiated Rate	$1,202.59
Max. Negotiated Rate	$1,940.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,603.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,940.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,202.59

STEM ZIM TIBIAL PLATE SZ3 5980

Facility

$8,017.25

Hospital Charge Code	270607655
Hospital Revenue Code	278
Min. Negotiated Rate	$1,202.59
Max. Negotiated Rate	$4,008.62
Rate for Payer: Aetna Commercial	$2,405.18
Rate for Payer: Aetna Medicare Advantage	$2,405.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,044.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,044.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,603.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,044.40
Rate for Payer: Cigna Commercial	$4,008.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,940.17
Rate for Payer: Qualcare PPO/HMO/WC	$1,202.59

STEN LIB MON 3.0X20M38934-2030

Facility

$4,375.00

Hospital Charge Code	270642255C
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$2,187.50
Rate for Payer: Aetna Commercial	$1,312.50
Rate for Payer: Aetna Medicare Advantage	$1,312.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,115.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,115.62
Rate for Payer: Cigna Commercial	$2,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STEN LIB MON 3.0X20M38934-2030

Facility

$4,375.00

Hospital Charge Code	270642255C
Hospital Revenue Code	278
Min. Negotiated Rate	$656.25
Max. Negotiated Rate	$1,058.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,058.75
Rate for Payer: Qualcare PPO/HMO/WC	$656.25

STEN PROM RX 2.5X18M100953918B

Facility

$10,250.00

Hospital Charge Code	270641889C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,075.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STEN PROM RX 2.5X18M100953918B

Facility

$10,250.00

Hospital Charge Code	270641889C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STEN PROM RX 2.75X8M100954008B

Facility

$10,250.00

Hospital Charge Code	270642004C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,075.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STEN PROM RX 2.75X8M100954008B

Facility

$10,250.00

Hospital Charge Code	270642004C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STEN PROM RX 3.0X28M100954128B

Facility

$10,250.00

Hospital Charge Code	270641996C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,075.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STEN PROM RX 3.0X28M100954128B

Facility

$10,250.00

Hospital Charge Code	270641996C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STEN PROM RX 3.5X18M100954218B

Facility

$10,250.00

Hospital Charge Code	270641905C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STEN PROM RX 3.5X18M100954218B

Facility

$10,250.00

Hospital Charge Code	270641905C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,075.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STEN PROM RX 3.5X23M100954223B

Facility

$10,250.00

Hospital Charge Code	270641928C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,075.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STEN PROM RX 3.5X23M100954223B

Facility

$10,250.00

Hospital Charge Code	270641928C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STEN PROM RX 4.0X28M100954328B

Facility

$10,250.00

Hospital Charge Code	270641997C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$5,125.00
Rate for Payer: Aetna Commercial	$3,075.00
Rate for Payer: Aetna Medicare Advantage	$3,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,613.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,613.75
Rate for Payer: Cigna Commercial	$5,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STEN PROM RX 4.0X28M100954328B

Facility

$10,250.00

Hospital Charge Code	270641997C
Hospital Revenue Code	278
Min. Negotiated Rate	$1,537.50
Max. Negotiated Rate	$2,480.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,480.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,537.50

STENT 10X30X80 1012532-30

Facility

$4,750.00

Hospital Charge Code	270647801C
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

STENT 10X30X80 1012532-30

Facility

$4,750.00

Hospital Charge Code	270647801C
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

STENT 10X40X80 1012532-40

Facility

$4,750.00

Hospital Charge Code	270647826C
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

STENT 10X40X80 1012532-40

Facility

$4,750.00

Hospital Charge Code	270647826C
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

STENT 10X60X80 1012532-60

Facility

$3,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270647802C
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$1,937.50
Rate for Payer: Aetna Commercial	$1,162.50
Rate for Payer: Aetna Medicare Advantage	$1,162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$988.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$988.12
Rate for Payer: Cigna Commercial	$1,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

STENT 10X60X80 1012532-60

Facility

$3,875.00

Service Code	HCPCS C1876
Hospital Charge Code	270647802C
Hospital Revenue Code	278
Min. Negotiated Rate	$581.25
Max. Negotiated Rate	$937.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.75
Rate for Payer: Qualcare PPO/HMO/WC	$581.25

STENT 10x80x80 1012532-80

Facility

$4,750.00

Hospital Charge Code	270647804
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

Know your out-of-pocket cost for care.

All Charges