Heights University Hospital

All Charges

Charge

Type

Setting

Price

BEARING INST RING HARD G7

Facility

$1,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270693755
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$266.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

BEARING MENISCAL LT 6mm THICK

Facility

$6,425.00

Hospital Charge Code	270645450
Hospital Revenue Code	278
Min. Negotiated Rate	$963.75
Max. Negotiated Rate	$3,212.50
Rate for Payer: Aetna Commercial	$1,927.50
Rate for Payer: Aetna Medicare Advantage	$1,927.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,638.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,638.38
Rate for Payer: Cigna Commercial	$3,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.85
Rate for Payer: Qualcare PPO/HMO/WC	$963.75

BEARING MENISCAL LT 6mm THICK

Facility

$6,425.00

Hospital Charge Code	270645450
Hospital Revenue Code	278
Min. Negotiated Rate	$963.75
Max. Negotiated Rate	$1,554.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,554.85
Rate for Payer: Qualcare PPO/HMO/WC	$963.75

BEARING OSS 12MM 150410

Facility

$4,060.00

Hospital Charge Code	270638568
Hospital Revenue Code	278
Min. Negotiated Rate	$609.00
Max. Negotiated Rate	$982.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$812.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$982.52
Rate for Payer: Qualcare PPO/HMO/WC	$609.00

BEARING OSS 12MM 150410

Facility

$4,060.00

Hospital Charge Code	270638568
Hospital Revenue Code	278
Min. Negotiated Rate	$609.00
Max. Negotiated Rate	$2,030.00
Rate for Payer: Aetna Commercial	$1,218.00
Rate for Payer: Aetna Medicare Advantage	$1,218.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,035.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,035.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$812.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,035.30
Rate for Payer: Cigna Commercial	$2,030.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$982.52
Rate for Payer: Qualcare PPO/HMO/WC	$609.00

BEARING OSS 16mm TIBIAL

Facility

$6,205.00

Service Code	HCPCS C1776
Hospital Charge Code	270664282
Hospital Revenue Code	278
Min. Negotiated Rate	$930.75
Max. Negotiated Rate	$1,501.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,501.61
Rate for Payer: Qualcare PPO/HMO/WC	$930.75

BEARING OSS 16mm TIBIAL

Facility

$6,205.00

Service Code	HCPCS C1776
Hospital Charge Code	270664282
Hospital Revenue Code	278
Min. Negotiated Rate	$930.75
Max. Negotiated Rate	$3,102.50
Rate for Payer: Aetna Commercial	$1,861.50
Rate for Payer: Aetna Medicare Advantage	$1,861.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,582.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,582.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,582.28
Rate for Payer: Cigna Commercial	$3,102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,501.61
Rate for Payer: Qualcare PPO/HMO/WC	$930.75

BEARING OXFORD SZ B 8 MM RM/LL

Facility

$9,900.00

Service Code	HCPCS C1776
Hospital Charge Code	270684004
Hospital Revenue Code	278
Min. Negotiated Rate	$1,485.00
Max. Negotiated Rate	$2,395.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,395.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.00

BEARING OXFORD SZ B 8 MM RM/LL

Facility

$9,900.00

Service Code	HCPCS C1776
Hospital Charge Code	270684004
Hospital Revenue Code	278
Min. Negotiated Rate	$1,485.00
Max. Negotiated Rate	$4,950.00
Rate for Payer: Aetna Commercial	$2,970.00
Rate for Payer: Aetna Medicare Advantage	$2,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,524.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,524.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,524.50
Rate for Payer: Cigna Commercial	$4,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,395.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,485.00

BEARING OXFRD LFT 9 MED 159553

Facility

$3,605.00

Hospital Charge Code	270639276
Hospital Revenue Code	278
Min. Negotiated Rate	$540.75
Max. Negotiated Rate	$1,802.50
Rate for Payer: Aetna Commercial	$1,081.50
Rate for Payer: Aetna Medicare Advantage	$1,081.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$721.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.27
Rate for Payer: Cigna Commercial	$1,802.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.41
Rate for Payer: Qualcare PPO/HMO/WC	$540.75

BEARING OXFRD LFT 9 MED 159553

Facility

$3,605.00

Hospital Charge Code	270639276
Hospital Revenue Code	278
Min. Negotiated Rate	$540.75
Max. Negotiated Rate	$872.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$721.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.41
Rate for Payer: Qualcare PPO/HMO/WC	$540.75

BEARING PHALANGEAL XSML METAL

Facility

$4,215.00

Hospital Charge Code	270642725
Hospital Revenue Code	278
Min. Negotiated Rate	$632.25
Max. Negotiated Rate	$2,107.50
Rate for Payer: Aetna Commercial	$1,264.50
Rate for Payer: Aetna Medicare Advantage	$1,264.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,074.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,074.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$843.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,074.83
Rate for Payer: Cigna Commercial	$2,107.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,020.03
Rate for Payer: Qualcare PPO/HMO/WC	$632.25

BEARING PHALANGEAL XSML METAL

Facility

$4,215.00

Hospital Charge Code	270642725
Hospital Revenue Code	278
Min. Negotiated Rate	$632.25
Max. Negotiated Rate	$1,020.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$843.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,020.03
Rate for Payer: Qualcare PPO/HMO/WC	$632.25

BEARING PST TB 20x71/75 183750

Facility

$5,875.00

Hospital Charge Code	270639356
Hospital Revenue Code	278
Min. Negotiated Rate	$881.25
Max. Negotiated Rate	$1,421.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: Qualcare PPO/HMO/WC	$881.25

BEARING PST TB 20x71/75 183750

Facility

$5,875.00

Hospital Charge Code	270639356
Hospital Revenue Code	278
Min. Negotiated Rate	$881.25
Max. Negotiated Rate	$2,937.50
Rate for Payer: Aetna Commercial	$1,762.50
Rate for Payer: Aetna Medicare Advantage	$1,762.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,498.12
Rate for Payer: Cigna Commercial	$2,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: Qualcare PPO/HMO/WC	$881.25

BEARING PS VAN 10x63/67 183620

Facility

$5,135.00

Service Code	HCPCS C1776
Hospital Charge Code	270639768
Hospital Revenue Code	278
Min. Negotiated Rate	$770.25
Max. Negotiated Rate	$2,567.50
Rate for Payer: Aetna Commercial	$1,540.50
Rate for Payer: Aetna Medicare Advantage	$1,540.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,309.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,309.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,027.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,309.42
Rate for Payer: Cigna Commercial	$2,567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,242.67
Rate for Payer: Qualcare PPO/HMO/WC	$770.25

BEARING PS VAN 10x63/67 183620

Facility

$5,135.00

Service Code	HCPCS C1776
Hospital Charge Code	270639768
Hospital Revenue Code	278
Min. Negotiated Rate	$770.25
Max. Negotiated Rate	$1,242.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,027.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,242.67
Rate for Payer: Qualcare PPO/HMO/WC	$770.25

BEARING SHOULDER 40MM 3 VITE

Facility

$12,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697962
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$6,250.00
Rate for Payer: Aetna Commercial	$3,750.00
Rate for Payer: Aetna Medicare Advantage	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,187.50
Rate for Payer: Cigna Commercial	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

BEARING SHOULDER 40MM 3 VITE

Facility

$12,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697962
Hospital Revenue Code	278
Min. Negotiated Rate	$1,875.00
Max. Negotiated Rate	$3,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,025.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,875.00

BEARING SSK TIBIA 10X63/67

Facility

$9,200.00

Hospital Charge Code	270638756
Hospital Revenue Code	278
Min. Negotiated Rate	$1,380.00
Max. Negotiated Rate	$2,226.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,226.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,380.00

BEARING SSK TIBIA 10X63/67

Facility

$9,200.00

Hospital Charge Code	270638756
Hospital Revenue Code	278
Min. Negotiated Rate	$1,380.00
Max. Negotiated Rate	$4,600.00
Rate for Payer: Aetna Commercial	$2,760.00
Rate for Payer: Aetna Medicare Advantage	$2,760.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,346.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,346.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,346.00
Rate for Payer: Cigna Commercial	$4,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,226.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,380.00

BEARING TBIAL VNGRD PS10X71/75

Facility

$5,135.00

Service Code	HCPCS C1776
Hospital Charge Code	270642310
Hospital Revenue Code	278
Min. Negotiated Rate	$770.25
Max. Negotiated Rate	$1,242.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,027.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,242.67
Rate for Payer: Qualcare PPO/HMO/WC	$770.25

BEARING TBIAL VNGRD PS10X71/75

Facility

$5,135.00

Service Code	HCPCS C1776
Hospital Charge Code	270642310
Hospital Revenue Code	278
Min. Negotiated Rate	$770.25
Max. Negotiated Rate	$2,567.50
Rate for Payer: Aetna Commercial	$1,540.50
Rate for Payer: Aetna Medicare Advantage	$1,540.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,309.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,309.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,027.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,309.42
Rate for Payer: Cigna Commercial	$2,567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,242.67
Rate for Payer: Qualcare PPO/HMO/WC	$770.25

BEARING TIBIAL 10mmk X 183520

Facility

$5,260.00

Hospital Charge Code	270640544
Hospital Revenue Code	278
Min. Negotiated Rate	$789.00
Max. Negotiated Rate	$1,272.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,052.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,272.92
Rate for Payer: Qualcare PPO/HMO/WC	$789.00

BEARING TIBIAL 10mmk X 183520

Facility

$5,260.00

Hospital Charge Code	270640544
Hospital Revenue Code	278
Min. Negotiated Rate	$789.00
Max. Negotiated Rate	$2,630.00
Rate for Payer: Aetna Commercial	$1,578.00
Rate for Payer: Aetna Medicare Advantage	$1,578.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,341.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,341.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,052.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,341.30
Rate for Payer: Cigna Commercial	$2,630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,272.92
Rate for Payer: Qualcare PPO/HMO/WC	$789.00

Know your out-of-pocket cost for care.

All Charges