Heights University Hospital

All Charges

Charge

Type

Setting

Price

DIR-PERC TRANSHEP CHOLANG

Facility

$3,012.00

Hospital Charge Code	2007035
Hospital Revenue Code	320
Min. Negotiated Rate	$451.80
Max. Negotiated Rate	$451.80
Rate for Payer: Qualcare PPO/HMO/WC	$451.80

DISALCID/500MG/TAB

Facility

$3.00

Hospital Charge Code	60632870
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

DISALCID/500MG/TAB

Facility

$3.00

Hospital Charge Code	60632870
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

DISALCID/750MG/TAB

Facility

$3.00

Hospital Charge Code	60632871
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

DISALCID/750MG/TAB

Facility

$3.00

Hospital Charge Code	60632871
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

DISC 10X22X11MM 5DEG CAGE PC

Facility

$8,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270692593
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$2,400.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

DISC 10X22X11MM 5DEG CAGE PC

Facility

$8,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270692593
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

DISC 10 X 22 X 12 5 DEG

Facility

$17,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692722
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$8,750.00
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: Aetna Commercial	$5,250.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

DISC 10 X 22 X 12 5 DEG

Facility

$17,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692722
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

DISC 12X27X13MM 5 DEG CAGE PC

Facility

$16,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270692588
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$3,872.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

DISC 12X27X13MM 5 DEG CAGE PC

Facility

$16,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270692588
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$8,000.00
Rate for Payer: Aetna Commercial	$4,800.00
Rate for Payer: Aetna Medicare Advantage	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,080.00
Rate for Payer: Cigna Commercial	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

DISC CERVICAL 15X15 H5

Facility

$37,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270692518
Hospital Revenue Code	278
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$18,750.00
Rate for Payer: Aetna Commercial	$11,250.00
Rate for Payer: Aetna Medicare Advantage	$11,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,562.50
Rate for Payer: Cigna Commercial	$18,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,075.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

DISC CERVICAL 15X15 H5

Facility

$37,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270692518
Hospital Revenue Code	278
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$9,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,075.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

DISC CERVICAL 17 X17 H7 MOBI-C

Facility

$37,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270692561
Hospital Revenue Code	278
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$9,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,075.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

DISC CERVICAL 17 X17 H7 MOBI-C

Facility

$37,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270692561
Hospital Revenue Code	278
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$18,750.00
Rate for Payer: Aetna Commercial	$11,250.00
Rate for Payer: Aetna Medicare Advantage	$11,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,562.50
Rate for Payer: Cigna Commercial	$18,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,075.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

DISC CERVICAL M6-C 6LL 17X16MM

Facility

$31,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270696757
Hospital Revenue Code	278
Min. Negotiated Rate	$4,650.00
Max. Negotiated Rate	$15,500.00
Rate for Payer: Aetna Commercial	$9,300.00
Rate for Payer: Aetna Medicare Advantage	$9,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,905.00
Rate for Payer: Cigna Commercial	$15,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,502.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,650.00

DISC CERVICAL M6-C 6LL 17X16MM

Facility

$31,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270696757
Hospital Revenue Code	278
Min. Negotiated Rate	$4,650.00
Max. Negotiated Rate	$7,502.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,502.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,650.00

DISC CERVICAL M6-C LF6X17X14MM

Facility

$31,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270696758
Hospital Revenue Code	278
Min. Negotiated Rate	$4,650.00
Max. Negotiated Rate	$7,502.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,502.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,650.00

DISC CERVICAL M6-C LF6X17X14MM

Facility

$31,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270696758
Hospital Revenue Code	278
Min. Negotiated Rate	$4,650.00
Max. Negotiated Rate	$15,500.00
Rate for Payer: Aetna Commercial	$9,300.00
Rate for Payer: Aetna Medicare Advantage	$9,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,905.00
Rate for Payer: Cigna Commercial	$15,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,502.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,650.00

DISC CERVICAL MOBI C 15 X 7

Facility

$37,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270692002
Hospital Revenue Code	278
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$9,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,075.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

DISC CERVICAL MOBI C 15 X 7

Facility

$37,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270692002
Hospital Revenue Code	278
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$18,750.00
Rate for Payer: Aetna Commercial	$11,250.00
Rate for Payer: Aetna Medicare Advantage	$11,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,562.50
Rate for Payer: Cigna Commercial	$18,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,075.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

DISC CERVICAL MOBI-C 17X17 H5

Facility

$37,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270692491
Hospital Revenue Code	278
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$18,750.00
Rate for Payer: Aetna Commercial	$11,250.00
Rate for Payer: Aetna Medicare Advantage	$11,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,562.50
Rate for Payer: Cigna Commercial	$18,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,075.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

DISC CERVICAL MOBI-C 17X17 H5

Facility

$37,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270692491
Hospital Revenue Code	278
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$9,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,075.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

DISC CERV INTERV 7MMX16MM TI

Facility

$44,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693269
Hospital Revenue Code	278
Min. Negotiated Rate	$6,675.00
Max. Negotiated Rate	$22,250.00
Rate for Payer: Aetna Commercial	$13,350.00
Rate for Payer: Aetna Medicare Advantage	$13,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,347.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,347.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,347.50
Rate for Payer: Cigna Commercial	$22,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,769.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,675.00

DISC CERV INTERV 7MMX16MM TI

Facility

$44,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270693269
Hospital Revenue Code	278
Min. Negotiated Rate	$6,675.00
Max. Negotiated Rate	$10,769.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,769.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,675.00

Know your out-of-pocket cost for care.

All Charges