Heights University Hospital

All Charges

Charge

Type

Setting

Price

SPACER KNEE COPAL XCHANGE G LT

Facility

$20,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270696274
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 LUMB SUPERION IDS 12MM

Facility

$13,375.00

Service Code	HCPCS C1889
Hospital Charge Code	270699506
Hospital Revenue Code	278
Min. Negotiated Rate	$2,006.25
Max. Negotiated Rate	$6,687.50
Rate for Payer: Aetna Commercial	$4,012.50
Rate for Payer: Aetna Medicare Advantage	$4,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,410.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,410.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,410.62
Rate for Payer: Cigna Commercial	$6,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,236.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,006.25

SPACER LUMB SUPERION IDS 12MM

Facility

$13,375.00

Service Code	HCPCS C1889
Hospital Charge Code	270699506
Hospital Revenue Code	278
Min. Negotiated Rate	$2,006.25
Max. Negotiated Rate	$3,236.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,236.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,006.25

SPACER MIS COALIT 12X14X7D7MM

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270693441
Hospital Revenue Code	278
Min. Negotiated Rate	$4,782.00
Max. Negotiated Rate	$15,940.00
Rate for Payer: Aetna Commercial	$9,564.00
Rate for Payer: Aetna Medicare Advantage	$9,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,129.40
Rate for Payer: Cigna Commercial	$15,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00

SPACER MIS COALIT 12X14X7D7MM

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270693441
Hospital Revenue Code	278
Min. Negotiated Rate	$4,782.00
Max. Negotiated Rate	$7,714.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00

SPACER MIS COALITION 14X16 7D

Facility

$27,720.00

Service Code	HCPCS C1889
Hospital Charge Code	270692223
Hospital Revenue Code	278
Min. Negotiated Rate	$4,158.00
Max. Negotiated Rate	$13,860.00
Rate for Payer: Aetna Commercial	$8,316.00
Rate for Payer: Aetna Medicare Advantage	$8,316.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,068.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,068.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,544.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,068.60
Rate for Payer: Cigna Commercial	$13,860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,708.24
Rate for Payer: Qualcare PPO/HMO/WC	$4,158.00

SPACER MIS COALITION 14X16 7D

Facility

$27,720.00

Service Code	HCPCS C1889
Hospital Charge Code	270692223
Hospital Revenue Code	278
Min. Negotiated Rate	$4,158.00
Max. Negotiated Rate	$6,708.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,544.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,708.24
Rate for Payer: Qualcare PPO/HMO/WC	$4,158.00

SPACER MIS COAL TI 12X14X7D6MM

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270693440
Hospital Revenue Code	278
Min. Negotiated Rate	$4,782.00
Max. Negotiated Rate	$15,940.00
Rate for Payer: Aetna Commercial	$9,564.00
Rate for Payer: Aetna Medicare Advantage	$9,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,129.40
Rate for Payer: Cigna Commercial	$15,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00

SPACER MIS COAL TI 12X14X7D6MM

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270693440
Hospital Revenue Code	278
Min. Negotiated Rate	$4,782.00
Max. Negotiated Rate	$7,714.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00

SPACER MIS TI 12X14X9MM 7D

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270697647
Hospital Revenue Code	278
Min. Negotiated Rate	$4,782.00
Max. Negotiated Rate	$7,714.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00

SPACER MIS TI 12X14X9MM 7D

Facility

$31,880.00

Service Code	HCPCS C1889
Hospital Charge Code	270697647
Hospital Revenue Code	278
Min. Negotiated Rate	$4,782.00
Max. Negotiated Rate	$15,940.00
Rate for Payer: Aetna Commercial	$9,564.00
Rate for Payer: Aetna Medicare Advantage	$9,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,129.40
Rate for Payer: Cigna Commercial	$15,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00

SPACER MIS TI 7D 6MM 14X16MM

Facility

$31,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270695460
Hospital Revenue Code	278
Min. Negotiated Rate	$4,782.00
Max. Negotiated Rate	$15,940.00
Rate for Payer: Aetna Commercial	$9,564.00
Rate for Payer: Aetna Medicare Advantage	$9,564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,129.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,129.40
Rate for Payer: Cigna Commercial	$15,940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00

SPACER MIS TI 7D 6MM 14X16MM

Facility

$31,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270695460
Hospital Revenue Code	278
Min. Negotiated Rate	$4,782.00
Max. Negotiated Rate	$7,714.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,714.96
Rate for Payer: Qualcare PPO/HMO/WC	$4,782.00

SPACER MOD TLIF-O 8D 8X10X25MM

Facility

$32,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270693670
Hospital Revenue Code	278
Min. Negotiated Rate	$4,875.00
Max. Negotiated Rate	$16,250.00
Rate for Payer: Aetna Commercial	$9,750.00
Rate for Payer: Aetna Medicare Advantage	$9,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,287.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,287.50
Rate for Payer: Cigna Commercial	$16,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00

SPACER MOD TLIF-O 8D 8X10X25MM

Facility

$32,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270693670
Hospital Revenue Code	278
Min. Negotiated Rate	$4,875.00
Max. Negotiated Rate	$7,865.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,865.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,875.00

SPACER NANO 6D SM 6MM

Facility

$38,653.75

Service Code	HCPCS C1889
Hospital Charge Code	270697819
Hospital Revenue Code	278
Min. Negotiated Rate	$5,798.06
Max. Negotiated Rate	$19,326.88
Rate for Payer: Aetna Commercial	$11,596.12
Rate for Payer: Aetna Medicare Advantage	$11,596.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,856.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,856.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,730.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,856.71
Rate for Payer: Cigna Commercial	$19,326.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,354.21
Rate for Payer: Qualcare PPO/HMO/WC	$5,798.06

SPACER NANO 6D SM 6MM

Facility

$38,653.75

Service Code	HCPCS C1889
Hospital Charge Code	270697819
Hospital Revenue Code	278
Min. Negotiated Rate	$5,798.06
Max. Negotiated Rate	$9,354.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,730.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,354.21
Rate for Payer: Qualcare PPO/HMO/WC	$5,798.06

SPACER NANO TC 6D SM 7MM

Facility

$38,653.75

Service Code	HCPCS C1889
Hospital Charge Code	270697822
Hospital Revenue Code	278
Min. Negotiated Rate	$5,798.06
Max. Negotiated Rate	$9,354.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,730.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,354.21
Rate for Payer: Qualcare PPO/HMO/WC	$5,798.06

SPACER NANO TC 6D SM 7MM

Facility

$38,653.75

Service Code	HCPCS C1889
Hospital Charge Code	270697822
Hospital Revenue Code	278
Min. Negotiated Rate	$5,798.06
Max. Negotiated Rate	$19,326.88
Rate for Payer: Aetna Commercial	$11,596.12
Rate for Payer: Aetna Medicare Advantage	$11,596.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,856.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,856.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,730.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,856.71
Rate for Payer: Cigna Commercial	$19,326.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,354.21
Rate for Payer: Qualcare PPO/HMO/WC	$5,798.06

SPACER NANO TI 7D 21X32X12MM

Facility

$105,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270696607
Hospital Revenue Code	278
Min. Negotiated Rate	$15,821.25
Max. Negotiated Rate	$52,737.50
Rate for Payer: Aetna Commercial	$31,642.50
Rate for Payer: Aetna Medicare Advantage	$31,642.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,896.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,896.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21,095.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26,896.12
Rate for Payer: Cigna Commercial	$52,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25,524.95
Rate for Payer: Qualcare PPO/HMO/WC	$15,821.25

SPACER NANO TI 7D 21X32X12MM

Facility

$105,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270696607
Hospital Revenue Code	278
Min. Negotiated Rate	$15,821.25
Max. Negotiated Rate	$25,524.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21,095.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25,524.95
Rate for Payer: Qualcare PPO/HMO/WC	$15,821.25

SPACER PEEK 12x15x7 6DEG

Facility

$9,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270677681
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$4,500.00
Rate for Payer: Aetna Commercial	$2,700.00
Rate for Payer: Aetna Medicare Advantage	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,295.00
Rate for Payer: Cigna Commercial	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

SPACER PEEK 12x15x7 6DEG

Facility

$9,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270677681
Hospital Revenue Code	278
Min. Negotiated Rate	$1,350.00
Max. Negotiated Rate	$2,178.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,178.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,350.00

SPACER PEEK 7D 16X14X6MM

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694921
Hospital Revenue Code	278
Min. Negotiated Rate	$3,637.50
Max. Negotiated Rate	$12,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,637.50
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

SPACER PEEK 7D 16X14X6MM

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694921
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

Know your out-of-pocket cost for care.

All Charges