Heights University Hospital

All Charges

Charge

Type

Setting

Price

CERVICAL SPINE TRUSS SYSTEM

Facility

$20,000.00

Hospital Charge Code	270702551
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

CERVICAL SPINE TRUSS SYSTEM

Facility

$20,000.00

Hospital Charge Code	270702551
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$10,000.00
Rate for Payer: Aetna Commercial	$6,000.00
Rate for Payer: Aetna Medicare Advantage	$6,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,100.00
Rate for Payer: Cigna Commercial	$10,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,000.00

CERVICAL SPINE W/CONTRAST

Facility

$9,500.00

Service Code	HCPCS 72126
Hospital Charge Code	2200138
Hospital Revenue Code	352
Min. Negotiated Rate	$318.24
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Better Health Medicaid	$1,512.95
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$318.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$830.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,235.00
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$2,773.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,543.21

CERVICAL SPINE W/CONTRAST

Facility

$9,500.00

Service Code	HCPCS 72126
Hospital Charge Code	2200138
Hospital Revenue Code	352
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CERVICAL SPINE W/O CONTRAST

Facility

$9,500.00

Service Code	HCPCS 72125
Hospital Charge Code	2200137
Hospital Revenue Code	352
Min. Negotiated Rate	$233.75
Max. Negotiated Rate	$2,850.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$233.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,235.00
Rate for Payer: Oxford Commercial	$2,443.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$2,773.00

CERVICAL SPINE W/O CONTRAST

Facility

$9,500.00

Service Code	HCPCS 72125
Hospital Charge Code	2200137
Hospital Revenue Code	352
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

CERV INTERBIYD SYS 16X14X7MM

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692740
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

CERV INTERBIYD SYS 16X14X7MM

Facility

$12,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692740
Hospital Revenue Code	278
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$3,600.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,904.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

CERV PLT LEV 1 PYRENEES 40MM

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270691147
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$3,260.00
Rate for Payer: Aetna Commercial	$1,956.00
Rate for Payer: Aetna Medicare Advantage	$1,956.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,662.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,662.60
Rate for Payer: Cigna Commercial	$3,260.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

CERV PLT LEV 1 PYRENEES 40MM

Facility

$6,520.00

Service Code	HCPCS C1713
Hospital Charge Code	270691147
Hospital Revenue Code	278
Min. Negotiated Rate	$978.00
Max. Negotiated Rate	$1,577.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,304.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,577.84
Rate for Payer: Qualcare PPO/HMO/WC	$978.00

CERV POROUS SPACER 8X16XX14MM

Facility

$8,675.00

Service Code	HCPCS C1889
Hospital Charge Code	270703878
Hospital Revenue Code	278
Min. Negotiated Rate	$1,301.25
Max. Negotiated Rate	$4,337.50
Rate for Payer: Aetna Commercial	$2,602.50
Rate for Payer: Aetna Medicare Advantage	$2,602.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,212.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,212.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,212.12
Rate for Payer: Cigna Commercial	$4,337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,099.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,301.25

CERV POROUS SPACER 8X16XX14MM

Facility

$8,675.00

Service Code	HCPCS C1889
Hospital Charge Code	270703878
Hospital Revenue Code	278
Min. Negotiated Rate	$1,301.25
Max. Negotiated Rate	$2,099.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,735.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,099.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,301.25

CERV POROUS SPACER 9X16X14MM

Facility

$8,675.00

Service Code	HCPCS C1889
Hospital Charge Code	270703877
Hospital Revenue Code	278
Min. Negotiated Rate	$1,301.25
Max. Negotiated Rate	$2,099.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,735.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,099.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,301.25

CERV POROUS SPACER 9X16X14MM

Facility

$8,675.00

Service Code	HCPCS C1889
Hospital Charge Code	270703877
Hospital Revenue Code	278
Min. Negotiated Rate	$1,301.25
Max. Negotiated Rate	$4,337.50
Rate for Payer: Aetna Commercial	$2,602.50
Rate for Payer: Aetna Medicare Advantage	$2,602.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,212.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,212.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,212.12
Rate for Payer: Cigna Commercial	$4,337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,099.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,301.25

CERV POROUS TI SPACER 7X16X14M

Facility

$8,500.00

Hospital Charge Code	270703560
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

CERV POROUS TI SPACER 7X16X14M

Facility

$8,500.00

Hospital Charge Code	270703567
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

CERV POROUS TI SPACER 7X16X14M

Facility

$8,500.00

Hospital Charge Code	270703567
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

CERV POROUS TI SPACER 7X16X14M

Facility

$5,225.00

Hospital Charge Code	270703562
Hospital Revenue Code	278
Min. Negotiated Rate	$783.75
Max. Negotiated Rate	$1,264.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,045.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,264.45
Rate for Payer: Qualcare PPO/HMO/WC	$783.75

CERV POROUS TI SPACER 7X16X14M

Facility

$5,225.00

Hospital Charge Code	270703562
Hospital Revenue Code	278
Min. Negotiated Rate	$783.75
Max. Negotiated Rate	$2,612.50
Rate for Payer: Aetna Commercial	$1,567.50
Rate for Payer: Aetna Medicare Advantage	$1,567.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,332.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,332.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,045.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,332.38
Rate for Payer: Cigna Commercial	$2,612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,264.45
Rate for Payer: Qualcare PPO/HMO/WC	$783.75

CERV POROUS TI SPACER 7X16X14M

Facility

$8,500.00

Hospital Charge Code	270703560
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

CERV POROUS TI SPACER 8X16X14M

Facility

$7,875.00

Hospital Charge Code	270703566
Hospital Revenue Code	278
Min. Negotiated Rate	$1,181.25
Max. Negotiated Rate	$1,905.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25

CERV POROUS TI SPACER 8X16X14M

Facility

$7,875.00

Hospital Charge Code	270703566
Hospital Revenue Code	278
Min. Negotiated Rate	$1,181.25
Max. Negotiated Rate	$3,937.50
Rate for Payer: Aetna Commercial	$2,362.50
Rate for Payer: Aetna Medicare Advantage	$2,362.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,008.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,008.12
Rate for Payer: Cigna Commercial	$3,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25

CERV SPINE 1 VIEW

Facility

$5,100.00

Service Code	HCPCS 72020
Hospital Charge Code	94061053
Hospital Revenue Code	320
Min. Negotiated Rate	$22.80
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Better Health Medicaid	$212.34
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$207.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$216.59

CERV SPINE 1 VIEW

Facility

$5,100.00

Service Code	HCPCS 72020
Hospital Charge Code	94061053
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

CERV STANDALONE 16X14X8H

Facility

$18,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270703790
Hospital Revenue Code	278
Min. Negotiated Rate	$2,737.50
Max. Negotiated Rate	$4,416.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50

Know your out-of-pocket cost for care.

All Charges