Heights University Hospital

All Charges

Charge

Type

Setting

Price

SPINE FUSION EXTRA SEGMENT

Facility

$23,739.75

Service Code	HCPCS 22632
Hospital Charge Code	16000608
Hospital Revenue Code	360
Min. Negotiated Rate	$311.60
Max. Negotiated Rate	$7,121.93
Rate for Payer: Aetna Commercial	$7,121.93
Rate for Payer: Aetna Medicare Advantage	$7,121.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,053.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,053.64
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	$6,053.64
Rate for Payer: Cigna Commercial	$311.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,086.17
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,560.96
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SPINE FUSION EXTRA SEGMENT

Facility

$23,739.75

Service Code	HCPCS 22632
Hospital Charge Code	16000608
Hospital Revenue Code	360
Min. Negotiated Rate	$3,560.96
Max. Negotiated Rate	$3,560.96
Rate for Payer: Qualcare PPO/HMO/WC	$3,560.96

SPINE FUSION EXTRA SEGMENT

Facility

$20,716.40

Service Code	HCPCS 22634
Hospital Charge Code	16000609
Hospital Revenue Code	360
Min. Negotiated Rate	$3,107.46
Max. Negotiated Rate	$3,107.46
Rate for Payer: Qualcare PPO/HMO/WC	$3,107.46

SPINE FUSION EXTRA SEGMENT

Facility

$20,716.40

Service Code	HCPCS 22634
Hospital Charge Code	16000609
Hospital Revenue Code	360
Min. Negotiated Rate	$468.68
Max. Negotiated Rate	$6,214.92
Rate for Payer: Aetna Commercial	$6,214.92
Rate for Payer: Aetna Medicare Advantage	$6,214.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,282.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,282.68
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	$5,282.68
Rate for Payer: Cigna Commercial	$468.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,693.13
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,107.46
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SPINE JET QUICK CONNECTOR

Facility

$638.00

Hospital Charge Code	270335916
Hospital Revenue Code	272
Min. Negotiated Rate	$82.94
Max. Negotiated Rate	$319.00
Rate for Payer: Aetna Commercial	$191.40
Rate for Payer: Aetna Medicare Advantage	$191.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$162.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$162.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$162.69
Rate for Payer: Cigna Commercial	$319.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.94
Rate for Payer: Oxford Commercial	$319.00
Rate for Payer: Qualcare PPO/HMO/WC	$95.70
Rate for Payer: UnitedHealthcare Commercial	$319.00

SPINE JET QUICK CONNECTOR

Facility

$638.00

Hospital Charge Code	270335916
Hospital Revenue Code	272
Min. Negotiated Rate	$95.70
Max. Negotiated Rate	$95.70
Rate for Payer: Qualcare PPO/HMO/WC	$95.70

SPINL NEEDL 18G 3.5INCH TOUHEY

Facility

$447.00

Hospital Charge Code	270325403
Hospital Revenue Code	272
Min. Negotiated Rate	$58.11
Max. Negotiated Rate	$223.50
Rate for Payer: Aetna Commercial	$134.10
Rate for Payer: Aetna Medicare Advantage	$134.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.98
Rate for Payer: Cigna Commercial	$223.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.11
Rate for Payer: Oxford Commercial	$223.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.05
Rate for Payer: UnitedHealthcare Commercial	$223.50

SPINL NEEDL 18G 3.5INCH TOUHEY

Facility

$447.00

Hospital Charge Code	270325403
Hospital Revenue Code	272
Min. Negotiated Rate	$67.05
Max. Negotiated Rate	$67.05
Rate for Payer: Qualcare PPO/HMO/WC	$67.05

SPINT FINGER 3 11202

Facility

$48.65

Hospital Charge Code	270649341
Hospital Revenue Code	270
Min. Negotiated Rate	$6.32
Max. Negotiated Rate	$24.32
Rate for Payer: Aetna Commercial	$14.60
Rate for Payer: Aetna Medicare Advantage	$14.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.41
Rate for Payer: Cigna Commercial	$24.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.32
Rate for Payer: Oxford Commercial	$24.32
Rate for Payer: Qualcare PPO/HMO/WC	$7.30
Rate for Payer: UnitedHealthcare Commercial	$24.32

SPINT FINGER 3 11202

Facility

$48.65

Hospital Charge Code	270649341
Hospital Revenue Code	270
Min. Negotiated Rate	$7.30
Max. Negotiated Rate	$7.30
Rate for Payer: Qualcare PPO/HMO/WC	$7.30

SPIRAL ELECTRODE

Facility

$51.00

Hospital Charge Code	270331667
Hospital Revenue Code	272
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$7.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.65

SPIRAL ELECTRODE

Facility

$51.00

Hospital Charge Code	270331667
Hospital Revenue Code	272
Min. Negotiated Rate	$6.63
Max. Negotiated Rate	$25.50
Rate for Payer: Aetna Commercial	$15.30
Rate for Payer: Aetna Medicare Advantage	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.01
Rate for Payer: Cigna Commercial	$25.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.63
Rate for Payer: Oxford Commercial	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$7.65
Rate for Payer: UnitedHealthcare Commercial	$25.50

SPIRALOK 5.0MM O-C V&B

Facility

$1,850.00

Hospital Charge Code	270658636
Hospital Revenue Code	278
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$555.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.70
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

SPIRALOK 5.0MM O-C V&B

Facility

$1,850.00

Hospital Charge Code	270658636
Hospital Revenue Code	278
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$447.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.70
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

SPIRA V 19MM

Facility

$27,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704959
Hospital Revenue Code	278
Min. Negotiated Rate	$4,125.00
Max. Negotiated Rate	$6,655.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,655.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,125.00

SPIRA V 19MM

Facility

$27,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704959
Hospital Revenue Code	278
Min. Negotiated Rate	$4,125.00
Max. Negotiated Rate	$13,750.00
Rate for Payer: Aetna Commercial	$8,250.00
Rate for Payer: Aetna Medicare Advantage	$8,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,012.50
Rate for Payer: Cigna Commercial	$13,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,655.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,125.00

SPIRO 12 X 16 1 1/4 IN

Facility

$285.00

Hospital Charge Code	270682982
Hospital Revenue Code	272
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$142.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$85.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.67
Rate for Payer: Cigna Commercial	$142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.05
Rate for Payer: Oxford Commercial	$142.50
Rate for Payer: Qualcare PPO/HMO/WC	$42.75
Rate for Payer: UnitedHealthcare Commercial	$142.50

SPIRO 12 X 16 1 1/4 IN

Facility

$285.00

Hospital Charge Code	270682982
Hospital Revenue Code	272
Min. Negotiated Rate	$42.75
Max. Negotiated Rate	$42.75
Rate for Payer: Qualcare PPO/HMO/WC	$42.75

SPIROMETER BELL DRY SEA

Facility

$2,681.65

Hospital Charge Code	270606088
Hospital Revenue Code	272
Min. Negotiated Rate	$348.61
Max. Negotiated Rate	$1,340.83
Rate for Payer: Aetna Commercial	$804.50
Rate for Payer: Aetna Medicare Advantage	$804.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$683.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$683.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$683.82
Rate for Payer: Cigna Commercial	$1,340.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$348.61
Rate for Payer: Oxford Commercial	$1,340.83
Rate for Payer: Qualcare PPO/HMO/WC	$402.25
Rate for Payer: UnitedHealthcare Commercial	$1,340.83

SPIROMETER BELL DRY SEA

Facility

$2,681.65

Hospital Charge Code	270606088
Hospital Revenue Code	272
Min. Negotiated Rate	$402.25
Max. Negotiated Rate	$402.25
Rate for Payer: Qualcare PPO/HMO/WC	$402.25

SPIROMETER INCENTIVE

Facility

$37.65

Hospital Charge Code	270607014
Hospital Revenue Code	270
Min. Negotiated Rate	$4.89
Max. Negotiated Rate	$18.82
Rate for Payer: Aetna Commercial	$11.29
Rate for Payer: Aetna Medicare Advantage	$11.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.60
Rate for Payer: Cigna Commercial	$18.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.89
Rate for Payer: Oxford Commercial	$18.82
Rate for Payer: Qualcare PPO/HMO/WC	$5.65
Rate for Payer: UnitedHealthcare Commercial	$18.82

SPIROMETER INCENTIVE

Facility

$37.65

Hospital Charge Code	270607014
Hospital Revenue Code	270
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$5.65
Rate for Payer: Qualcare PPO/HMO/WC	$5.65

SPIROMETER INCENTIVE DEVICE

Facility

$32.00

Hospital Charge Code	270603159
Hospital Revenue Code	272
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

SPIROMETER INCENTIVE DEVICE

Facility

$32.00

Hospital Charge Code	270603159
Hospital Revenue Code	272
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$9.60
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$16.00

SPIROMETER INCENTIVE DEVICE***

Facility

$25.00

Hospital Charge Code	9501024
Hospital Revenue Code	279
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

Know your out-of-pocket cost for care.

All Charges