Heights University Hospital

All Charges

Charge

Type

Setting

Price

SPACER ZFUZE PLIF 22X10MM

Facility

$20,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270695435
Hospital Revenue Code	278
Min. Negotiated Rate	$3,075.00
Max. Negotiated Rate	$10,250.00
Rate for Payer: Aetna Commercial	$6,150.00
Rate for Payer: Aetna Medicare Advantage	$6,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,227.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,227.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,227.50
Rate for Payer: Cigna Commercial	$10,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,961.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,075.00

SPACER ZFUZE PLIF 22X10MM

Facility

$20,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270695435
Hospital Revenue Code	278
Min. Negotiated Rate	$3,075.00
Max. Negotiated Rate	$4,961.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,961.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,075.00

SPACR OSTBR IKA KNEE ARTH 40MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270678247
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$11,250.00
Rate for Payer: Aetna Commercial	$6,750.00
Rate for Payer: Aetna Medicare Advantage	$6,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,737.50
Rate for Payer: Cigna Commercial	$11,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SPACR OSTBR IKA KNEE ARTH 40MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270678247
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$5,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SPANAID BODY ALIGNER

Facility

$136.85

Hospital Charge Code	270303019
Hospital Revenue Code	270
Min. Negotiated Rate	$20.53
Max. Negotiated Rate	$20.53
Rate for Payer: Qualcare PPO/HMO/WC	$20.53

SPANAID BODY ALIGNER

Facility

$136.85

Hospital Charge Code	270303019
Hospital Revenue Code	270
Min. Negotiated Rate	$17.79
Max. Negotiated Rate	$68.42
Rate for Payer: Aetna Commercial	$41.05
Rate for Payer: Aetna Medicare Advantage	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.90
Rate for Payer: Cigna Commercial	$68.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.79
Rate for Payer: Oxford Commercial	$68.42
Rate for Payer: Qualcare PPO/HMO/WC	$20.53
Rate for Payer: UnitedHealthcare Commercial	$68.42

SPANAID BOOT CRADLE

Facility

$98.58

Hospital Charge Code	270302706
Hospital Revenue Code	270
Min. Negotiated Rate	$12.82
Max. Negotiated Rate	$49.29
Rate for Payer: Aetna Commercial	$29.57
Rate for Payer: Aetna Medicare Advantage	$29.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.14
Rate for Payer: Cigna Commercial	$49.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.82
Rate for Payer: Oxford Commercial	$49.29
Rate for Payer: Qualcare PPO/HMO/WC	$14.79
Rate for Payer: UnitedHealthcare Commercial	$49.29

SPANAID BOOT CRADLE

Facility

$98.58

Hospital Charge Code	270302706
Hospital Revenue Code	270
Min. Negotiated Rate	$14.79
Max. Negotiated Rate	$14.79
Rate for Payer: Qualcare PPO/HMO/WC	$14.79

SPANAID FOOT DROP STOP

Facility

$633.39

Hospital Charge Code	270303018
Hospital Revenue Code	270
Min. Negotiated Rate	$95.01
Max. Negotiated Rate	$95.01
Rate for Payer: Qualcare PPO/HMO/WC	$95.01

SPANAID FOOT DROP STOP

Facility

$633.39

Hospital Charge Code	270303018
Hospital Revenue Code	270
Min. Negotiated Rate	$82.34
Max. Negotiated Rate	$316.69
Rate for Payer: Aetna Commercial	$190.02
Rate for Payer: Aetna Medicare Advantage	$190.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.51
Rate for Payer: Cigna Commercial	$316.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.34
Rate for Payer: Oxford Commercial	$316.69
Rate for Payer: Qualcare PPO/HMO/WC	$95.01
Rate for Payer: UnitedHealthcare Commercial	$316.69

SPAN AID FT DRIP PR *********

Facility

$102.00

Hospital Charge Code	8001679
Hospital Revenue Code	279
Min. Negotiated Rate	$15.30
Max. Negotiated Rate	$15.30
Rate for Payer: Qualcare PPO/HMO/WC	$15.30

SPAN AID FT DRIP PR *********

Facility

$102.00

Hospital Charge Code	8001679
Hospital Revenue Code	279
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$51.00
Rate for Payer: Aetna Commercial	$30.60
Rate for Payer: Aetna Medicare Advantage	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.01
Rate for Payer: Cigna Commercial	$51.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.26
Rate for Payer: Oxford Commercial	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.30
Rate for Payer: UnitedHealthcare Commercial	$51.00

SPAN AID WEDGE **********

Facility

$214.00

Hospital Charge Code	8001661
Hospital Revenue Code	279
Min. Negotiated Rate	$27.82
Max. Negotiated Rate	$107.00
Rate for Payer: Aetna Commercial	$64.20
Rate for Payer: Aetna Medicare Advantage	$64.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.57
Rate for Payer: Cigna Commercial	$107.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.82
Rate for Payer: Oxford Commercial	$107.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.10
Rate for Payer: UnitedHealthcare Commercial	$107.00

SPAN AID WEDGE **********

Facility

$214.00

Hospital Charge Code	8001661
Hospital Revenue Code	279
Min. Negotiated Rate	$32.10
Max. Negotiated Rate	$32.10
Rate for Payer: Qualcare PPO/HMO/WC	$32.10

SPANDAGE LEG MEDIUM 24 MT3X24

Facility

$6.80

Hospital Charge Code	270639041
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.02

SPANDAGE LEG MEDIUM 24 MT3X24

Facility

$6.80

Hospital Charge Code	270639041
Hospital Revenue Code	272
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$3.40
Rate for Payer: Aetna Commercial	$2.04
Rate for Payer: Aetna Medicare Advantage	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.73
Rate for Payer: Cigna Commercial	$3.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.88
Rate for Payer: Oxford Commercial	$3.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.02
Rate for Payer: UnitedHealthcare Commercial	$3.40

SPANDAGE SZ 8 MT8X24

Facility

$5.53

Hospital Charge Code	270640000W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$0.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.83

SPANDAGE SZ 8 MT8X24

Facility

$5.53

Hospital Charge Code	270640000W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$2.77
Rate for Payer: Aetna Commercial	$1.66
Rate for Payer: Aetna Medicare Advantage	$1.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.41
Rate for Payer: Cigna Commercial	$2.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.72
Rate for Payer: Oxford Commercial	$2.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.83
Rate for Payer: UnitedHealthcare Commercial	$2.77

SPANDAGE TOE 24 MT1X24

Facility

$10.00

Hospital Charge Code	270639040
Hospital Revenue Code	272
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

SPANDAGE TOE 24 MT1X24

Facility

$10.00

Hospital Charge Code	270639040
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$3.00
Rate for Payer: Aetna Medicare Advantage	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.55
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$5.00

SPATULA DISP 14-9300

Facility

$300.85

Hospital Charge Code	270609014
Hospital Revenue Code	272
Min. Negotiated Rate	$39.11
Max. Negotiated Rate	$150.43
Rate for Payer: Aetna Commercial	$90.25
Rate for Payer: Aetna Medicare Advantage	$90.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.72
Rate for Payer: Cigna Commercial	$150.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.11
Rate for Payer: Oxford Commercial	$150.43
Rate for Payer: Qualcare PPO/HMO/WC	$45.13
Rate for Payer: UnitedHealthcare Commercial	$150.43

SPATULA DISP 14-9300

Facility

$300.85

Hospital Charge Code	270609014
Hospital Revenue Code	272
Min. Negotiated Rate	$45.13
Max. Negotiated Rate	$45.13
Rate for Payer: Qualcare PPO/HMO/WC	$45.13

SPATULA ELECTRODE DISP *****

Facility

$78.00

Hospital Charge Code	1606300
Hospital Revenue Code	272
Min. Negotiated Rate	$10.14
Max. Negotiated Rate	$39.00
Rate for Payer: Aetna Commercial	$23.40
Rate for Payer: Aetna Medicare Advantage	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.89
Rate for Payer: Cigna Commercial	$39.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.14
Rate for Payer: Oxford Commercial	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.70
Rate for Payer: UnitedHealthcare Commercial	$39.00

SPATULA ELECTRODE DISP *****

Facility

$78.00

Hospital Charge Code	1606300
Hospital Revenue Code	272
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$11.70
Rate for Payer: Qualcare PPO/HMO/WC	$11.70

SP BONE AGRFT MORSEL ADD-ON

Facility

$6,322.68

Service Code	HCPCS 20937
Hospital Charge Code	16000603
Hospital Revenue Code	360
Min. Negotiated Rate	$159.63
Max. Negotiated Rate	$6,873.00
Rate for Payer: Aetna Commercial	$1,896.80
Rate for Payer: Aetna Medicare Advantage	$1,896.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,612.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,612.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,612.28
Rate for Payer: Cigna Commercial	$159.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$821.95
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$948.40
Rate for Payer: UnitedHealthcare Commercial	$6,873.00

Know your out-of-pocket cost for care.

All Charges