Heights University Hospital

All Charges

Charge

Type

Setting

Price

SPACER 5.0MM WITH BOLT 10495

Facility

$139.25

Hospital Charge Code	270621623
Hospital Revenue Code	272
Min. Negotiated Rate	$20.89
Max. Negotiated Rate	$20.89
Rate for Payer: Qualcare PPO/HMO/WC	$20.89

SPACER 5.0MM WITH BOLT 10495

Facility

$139.25

Hospital Charge Code	270621623
Hospital Revenue Code	272
Min. Negotiated Rate	$18.10
Max. Negotiated Rate	$69.62
Rate for Payer: Aetna Commercial	$41.77
Rate for Payer: Aetna Medicare Advantage	$41.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.51
Rate for Payer: Cigna Commercial	$69.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.10
Rate for Payer: Oxford Commercial	$69.62
Rate for Payer: Qualcare PPO/HMO/WC	$20.89
Rate for Payer: UnitedHealthcare Commercial	$69.62

SPACER 6X18X60MM 10DEG

Facility

$36,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270706233
Hospital Revenue Code	278
Min. Negotiated Rate	$5,418.75
Max. Negotiated Rate	$8,742.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,742.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,418.75

SPACER 6X18X60MM 10DEG

Facility

$36,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270706233
Hospital Revenue Code	278
Min. Negotiated Rate	$5,418.75
Max. Negotiated Rate	$18,062.50
Rate for Payer: Aetna Commercial	$10,837.50
Rate for Payer: Aetna Medicare Advantage	$10,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,211.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,211.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,211.88
Rate for Payer: Cigna Commercial	$18,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,742.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,418.75

SPACER 8X18X55MM 10D

Facility

$36,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270703546
Hospital Revenue Code	278
Min. Negotiated Rate	$5,418.75
Max. Negotiated Rate	$18,062.50
Rate for Payer: Aetna Commercial	$10,837.50
Rate for Payer: Aetna Medicare Advantage	$10,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,211.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,211.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,211.88
Rate for Payer: Cigna Commercial	$18,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,742.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,418.75

SPACER 8X18X55MM 10D

Facility

$36,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270703546
Hospital Revenue Code	278
Min. Negotiated Rate	$5,418.75
Max. Negotiated Rate	$8,742.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,742.25
Rate for Payer: Qualcare PPO/HMO/WC	$5,418.75

SPACER 8X34X24MM 10DEG

Facility

$33,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270704557
Hospital Revenue Code	278
Min. Negotiated Rate	$4,968.75
Max. Negotiated Rate	$8,016.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,016.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,968.75

SPACER 8X34X24MM 10DEG

Facility

$33,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270704557
Hospital Revenue Code	278
Min. Negotiated Rate	$4,968.75
Max. Negotiated Rate	$16,562.50
Rate for Payer: Aetna Commercial	$9,937.50
Rate for Payer: Aetna Medicare Advantage	$9,937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,446.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,446.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,446.88
Rate for Payer: Cigna Commercial	$16,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,016.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,968.75

SPACER ALTERA 10X26 9-13MM 15D

Facility

$32,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698396
Hospital Revenue Code	278
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$16,000.00
Rate for Payer: Aetna Commercial	$9,600.00
Rate for Payer: Aetna Medicare Advantage	$9,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,160.00
Rate for Payer: Cigna Commercial	$16,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,744.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

SPACER ALTERA 10X26 9-13MM 15D

Facility

$32,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698396
Hospital Revenue Code	278
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$7,744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,744.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

SPACERALTERA10X31 10 14MM15DEG

Facility

$32,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270694881
Hospital Revenue Code	278
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$16,000.00
Rate for Payer: Aetna Commercial	$9,600.00
Rate for Payer: Aetna Medicare Advantage	$9,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,160.00
Rate for Payer: Cigna Commercial	$16,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,744.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

SPACERALTERA10X31 10 14MM15DEG

Facility

$32,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270694881
Hospital Revenue Code	278
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$7,744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,744.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

SPACER ALTERA 10X31 12-16MM15D

Facility

$32,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270695755
Hospital Revenue Code	278
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$7,744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,744.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

SPACER ALTERA 10X31 12-16MM15D

Facility

$32,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270695755
Hospital Revenue Code	278
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$16,000.00
Rate for Payer: Aetna Commercial	$9,600.00
Rate for Payer: Aetna Medicare Advantage	$9,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,160.00
Rate for Payer: Cigna Commercial	$16,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,744.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

SPACER ALTERA 10X31 8-12MM 8D

Facility

$32,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697430
Hospital Revenue Code	278
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$16,000.00
Rate for Payer: Aetna Commercial	$9,600.00
Rate for Payer: Aetna Medicare Advantage	$9,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,160.00
Rate for Payer: Cigna Commercial	$16,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,744.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

SPACER ALTERA 10X31 8-12MM 8D

Facility

$32,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697430
Hospital Revenue Code	278
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$7,744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,744.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

SPACER ALTERA 10X31MM

Facility

$32,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270692200
Hospital Revenue Code	278
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$16,000.00
Rate for Payer: Aetna Commercial	$9,600.00
Rate for Payer: Aetna Medicare Advantage	$9,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,160.00
Rate for Payer: Cigna Commercial	$16,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,744.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

SPACER ALTERA 10X31MM

Facility

$32,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270692200
Hospital Revenue Code	278
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$7,744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,744.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

SPACER ALTER LORDOT 8D10X26MM

Facility

$32,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270695397
Hospital Revenue Code	278
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$7,744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,744.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

SPACER ALTER LORDOT 8D10X26MM

Facility

$32,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270695397
Hospital Revenue Code	278
Min. Negotiated Rate	$4,800.00
Max. Negotiated Rate	$16,000.00
Rate for Payer: Aetna Commercial	$9,600.00
Rate for Payer: Aetna Medicare Advantage	$9,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,160.00
Rate for Payer: Cigna Commercial	$16,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,744.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,800.00

SPACER ANT CERV 12X14X6MM 6D

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695486
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$12,125.00
Rate for Payer: Aetna Commercial	$7,275.00
Rate for Payer: Aetna Medicare Advantage	$7,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,183.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,183.75
Rate for Payer: Cigna Commercial	$12,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

SPACER ANT CERV 12X14X6MM 6D

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695486
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$5,868.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,868.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50

SPACER BLACKHAWK 14X12X6MM 7H

Facility

$23,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270696317
Hospital Revenue Code	278
Min. Negotiated Rate	$3,562.50
Max. Negotiated Rate	$11,875.00
Rate for Payer: Aetna Commercial	$7,125.00
Rate for Payer: Aetna Medicare Advantage	$7,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,056.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,056.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,056.25
Rate for Payer: Cigna Commercial	$11,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,747.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,562.50

SPACER BLACKHAWK 14X12X6MM 7H

Facility

$23,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270696317
Hospital Revenue Code	278
Min. Negotiated Rate	$3,562.50
Max. Negotiated Rate	$5,747.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,747.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,562.50

SPACER BLACKHAWK TI 14X12X6MM

Facility

$23,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270693531
Hospital Revenue Code	278
Min. Negotiated Rate	$3,562.50
Max. Negotiated Rate	$5,747.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,747.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,562.50

Know your out-of-pocket cost for care.

All Charges