Heights University Hospital

All Charges

Charge

Type

Setting

Price

STNT XPRT BLRY 4X60X80 2051601

Facility

$8,500.00

Hospital Charge Code	270638224V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

STNT XPRT BLRY 4X60X80 2051601

Facility

$8,500.00

Hospital Charge Code	270638224V
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$2,550.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

STOCK ANTI-EM KNEE ALL SZES***

Facility

$10.00

Hospital Charge Code	8000069
Hospital Revenue Code	279
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$3.00
Rate for Payer: Aetna Medicare Advantage	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.55
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$5.00

STOCK ANTI-EM KNEE ALL SZES***

Facility

$10.00

Hospital Charge Code	8000069
Hospital Revenue Code	279
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

STOCK ANTI-EM KNEE LG L

Facility

$18.71

Hospital Charge Code	270302986
Hospital Revenue Code	270
Min. Negotiated Rate	$2.43
Max. Negotiated Rate	$9.36
Rate for Payer: Aetna Commercial	$5.61
Rate for Payer: Aetna Medicare Advantage	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.77
Rate for Payer: Cigna Commercial	$9.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.43
Rate for Payer: Oxford Commercial	$9.36
Rate for Payer: Qualcare PPO/HMO/WC	$2.81
Rate for Payer: UnitedHealthcare Commercial	$9.36

STOCK ANTI-EM KNEE LG L

Facility

$18.71

Hospital Charge Code	270302986
Hospital Revenue Code	270
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$2.81
Rate for Payer: Qualcare PPO/HMO/WC	$2.81

STOCK ANTI-EM KNEE LG R

Facility

$22.45

Hospital Charge Code	270302985
Hospital Revenue Code	270
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$6.74
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$11.22
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$11.22

STOCK ANTI-EM KNEE LG R

Facility

$22.45

Hospital Charge Code	270302985
Hospital Revenue Code	270
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

STOCK ANTI-EM KNEE MD L

Facility

$22.45

Hospital Charge Code	270302980
Hospital Revenue Code	270
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

STOCK ANTI-EM KNEE MD L

Facility

$22.45

Hospital Charge Code	270302980
Hospital Revenue Code	270
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$6.74
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$11.22
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$11.22

STOCK ANTI-EM KNEE MED

Facility

$22.45

Hospital Charge Code	270302975
Hospital Revenue Code	270
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

STOCK ANTI-EM KNEE MED

Facility

$22.45

Hospital Charge Code	270302975
Hospital Revenue Code	270
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$6.74
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$11.22
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$11.22

STOCK ANTI-EM KNEE SM L

Facility

$22.45

Hospital Charge Code	270302974
Hospital Revenue Code	270
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$6.74
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$11.22
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$11.22

STOCK ANTI-EM KNEE SM L

Facility

$22.45

Hospital Charge Code	270302974
Hospital Revenue Code	270
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

STOCK ANTI-EM KNEE SM R

Facility

$22.45

Hospital Charge Code	270302973
Hospital Revenue Code	270
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$6.74
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$11.22
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$11.22

STOCK ANTI-EM KNEE SM R

Facility

$22.45

Hospital Charge Code	270302973
Hospital Revenue Code	270
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

STOCK ANTI-EM KNEE XLG

Facility

$22.45

Hospital Charge Code	270302988
Hospital Revenue Code	270
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$6.74
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$11.22
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$11.22

STOCK ANTI-EM KNEE XLG

Facility

$22.45

Hospital Charge Code	270302988
Hospital Revenue Code	270
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

STOCK ANTI-EM KNEE XL R

Facility

$18.53

Hospital Charge Code	270302987
Hospital Revenue Code	270
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$2.78
Rate for Payer: Qualcare PPO/HMO/WC	$2.78

STOCK ANTI-EM KNEE XL R

Facility

$18.53

Hospital Charge Code	270302987
Hospital Revenue Code	270
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$9.27
Rate for Payer: Aetna Commercial	$5.56
Rate for Payer: Aetna Medicare Advantage	$5.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.73
Rate for Payer: Cigna Commercial	$9.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.41
Rate for Payer: Oxford Commercial	$9.27
Rate for Payer: Qualcare PPO/HMO/WC	$2.78
Rate for Payer: UnitedHealthcare Commercial	$9.27

STOCK ANTI-EM THIGH

Facility

$34.46

Hospital Charge Code	270303010
Hospital Revenue Code	270
Min. Negotiated Rate	$4.48
Max. Negotiated Rate	$17.23
Rate for Payer: Aetna Commercial	$10.34
Rate for Payer: Aetna Medicare Advantage	$10.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.79
Rate for Payer: Cigna Commercial	$17.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.48
Rate for Payer: Oxford Commercial	$17.23
Rate for Payer: Qualcare PPO/HMO/WC	$5.17
Rate for Payer: UnitedHealthcare Commercial	$17.23

STOCK ANTI-EM THIGH

Facility

$34.46

Hospital Charge Code	270303010
Hospital Revenue Code	270
Min. Negotiated Rate	$5.17
Max. Negotiated Rate	$5.17
Rate for Payer: Qualcare PPO/HMO/WC	$5.17

STOCK ANTI-EM THIGH ALL SZS***

Facility

$20.00

Hospital Charge Code	8000077
Hospital Revenue Code	279
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$6.00
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$10.00

STOCK ANTI-EM THIGH ALL SZS***

Facility

$20.00

Hospital Charge Code	8000077
Hospital Revenue Code	279
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

STOCK ANTI-EM THIGH L R

Facility

$35.14

Hospital Charge Code	270303021
Hospital Revenue Code	270
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$17.57
Rate for Payer: Aetna Commercial	$10.54
Rate for Payer: Aetna Medicare Advantage	$10.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.96
Rate for Payer: Cigna Commercial	$17.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.57
Rate for Payer: Oxford Commercial	$17.57
Rate for Payer: Qualcare PPO/HMO/WC	$5.27
Rate for Payer: UnitedHealthcare Commercial	$17.57

Know your out-of-pocket cost for care.

All Charges