Heights University Hospital

All Charges

Charge

Type

Setting

Price

SPACER DISTAL MED

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	270660303
Hospital Revenue Code	278
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$395.00
Rate for Payer: Aetna Commercial	$237.00
Rate for Payer: Aetna Medicare Advantage	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.45
Rate for Payer: Cigna Commercial	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

SPACER DPY W/BOLT 2.5MM 10492

Facility

$147.25

Hospital Charge Code	270612486
Hospital Revenue Code	272
Min. Negotiated Rate	$22.09
Max. Negotiated Rate	$22.09
Rate for Payer: Qualcare PPO/HMO/WC	$22.09

SPACER DPY W/BOLT 2.5MM 10492

Facility

$147.25

Hospital Charge Code	270612486
Hospital Revenue Code	272
Min. Negotiated Rate	$19.14
Max. Negotiated Rate	$73.62
Rate for Payer: Aetna Commercial	$44.17
Rate for Payer: Aetna Medicare Advantage	$44.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.55
Rate for Payer: Cigna Commercial	$73.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.14
Rate for Payer: Oxford Commercial	$73.62
Rate for Payer: Qualcare PPO/HMO/WC	$22.09
Rate for Payer: UnitedHealthcare Commercial	$73.62

SPACER EVO SYNFIX 10.5MM 10D

Facility

$45,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698975
Hospital Revenue Code	278
Min. Negotiated Rate	$6,750.00
Max. Negotiated Rate	$10,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,890.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,750.00

SPACER EVO SYNFIX 10.5MM 10D

Facility

$45,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698975
Hospital Revenue Code	278
Min. Negotiated Rate	$6,750.00
Max. Negotiated Rate	$22,500.00
Rate for Payer: Aetna Commercial	$13,500.00
Rate for Payer: Aetna Medicare Advantage	$13,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,475.00
Rate for Payer: Cigna Commercial	$22,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,890.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,750.00

SPACER FLAT CERV 14X12X5MM 6D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698828
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

SPACER FLAT CERV 14X12X5MM 6D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698828
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

SPACER FLAT CERVICAL 14X12X6MM

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697657
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

SPACER FLAT CERVICAL 14X12X6MM

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697657
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

SPACER FORTICORE 14X12X7MM 6D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697215
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

SPACER FORTICORE 14X12X7MM 6D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697215
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

SPACERFORTICORECERV8X12X14MM6D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698377
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

SPACERFORTICORECERV8X12X14MM6D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698377
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

SPACER HAMMERTOE 2.8MM X 10MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270695045
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

SPACER HAMMERTOE 2.8MM X 10MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270695045
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$742.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

SPACER HUMERAL 36MM +12

Facility

$2,450.00

Hospital Charge Code	270672434
Hospital Revenue Code	278
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$592.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

SPACER HUMERAL 36MM +12

Facility

$2,450.00

Hospital Charge Code	270672434
Hospital Revenue Code	278
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$1,225.00
Rate for Payer: Aetna Commercial	$735.00
Rate for Payer: Aetna Medicare Advantage	$735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$624.75
Rate for Payer: Cigna Commercial	$1,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

SPACER HUMERAL 36MM +15

Facility

$2,450.00

Hospital Charge Code	270672435
Hospital Revenue Code	278
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$1,225.00
Rate for Payer: Aetna Commercial	$735.00
Rate for Payer: Aetna Medicare Advantage	$735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$624.75
Rate for Payer: Cigna Commercial	$1,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

SPACER HUMERAL 36MM +15

Facility

$2,450.00

Hospital Charge Code	270672435
Hospital Revenue Code	278
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$592.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

SPACER HUMERAL 36MM +6

Facility

$2,450.00

Hospital Charge Code	270672432
Hospital Revenue Code	278
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$1,225.00
Rate for Payer: Aetna Commercial	$735.00
Rate for Payer: Aetna Medicare Advantage	$735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$624.75
Rate for Payer: Cigna Commercial	$1,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

SPACER HUMERAL 36MM +6

Facility

$2,450.00

Hospital Charge Code	270672432
Hospital Revenue Code	278
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$592.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

SPACER HUMERAL 36MM +9

Facility

$2,450.00

Hospital Charge Code	270672433
Hospital Revenue Code	278
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$592.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

SPACER HUMERAL 36MM +9

Facility

$2,450.00

Hospital Charge Code	270672433
Hospital Revenue Code	278
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$1,225.00
Rate for Payer: Aetna Commercial	$735.00
Rate for Payer: Aetna Medicare Advantage	$735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$624.75
Rate for Payer: Cigna Commercial	$1,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

SPACER HUMERAL 39MM +12

Facility

$2,450.00

Hospital Charge Code	270672438
Hospital Revenue Code	278
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$1,225.00
Rate for Payer: Aetna Commercial	$735.00
Rate for Payer: Aetna Medicare Advantage	$735.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$624.75
Rate for Payer: Cigna Commercial	$1,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

SPACER HUMERAL 39MM +12

Facility

$2,450.00

Hospital Charge Code	270672438
Hospital Revenue Code	278
Min. Negotiated Rate	$367.50
Max. Negotiated Rate	$592.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.90
Rate for Payer: Qualcare PPO/HMO/WC	$367.50

Know your out-of-pocket cost for care.

All Charges