Heights University Hospital

All Charges

Charge

Type

Setting

Price

CAGE 7 X 12 X 14 CM

Facility

$18,839.95

Service Code	HCPCS C1889
Hospital Charge Code	270690117
Hospital Revenue Code	278
Min. Negotiated Rate	$2,825.99
Max. Negotiated Rate	$4,559.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,767.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,559.27
Rate for Payer: Qualcare PPO/HMO/WC	$2,825.99

CAGE 7 X 12 X 14 CM

Facility

$18,839.95

Service Code	HCPCS C1889
Hospital Charge Code	270690117
Hospital Revenue Code	278
Min. Negotiated Rate	$2,825.99
Max. Negotiated Rate	$9,419.98
Rate for Payer: Aetna Commercial	$5,651.98
Rate for Payer: Aetna Medicare Advantage	$5,651.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,804.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,804.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,767.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,804.19
Rate for Payer: Cigna Commercial	$9,419.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,559.27
Rate for Payer: Qualcare PPO/HMO/WC	$2,825.99

CAGE 7X14X12MM

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	27070454
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

CAGE 7X14X12MM

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	27070454
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

CAGE 7X14X12MM

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704540
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

CAGE 7X14X12MM

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270704540
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

CAGE 8MM PEEK MONET

Facility

$9,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270693271
Hospital Revenue Code	278
Min. Negotiated Rate	$1,417.50
Max. Negotiated Rate	$4,725.00
Rate for Payer: Aetna Commercial	$2,835.00
Rate for Payer: Aetna Medicare Advantage	$2,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,409.75
Rate for Payer: Cigna Commercial	$4,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50

CAGE 8MM PEEK MONET

Facility

$9,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270693271
Hospital Revenue Code	278
Min. Negotiated Rate	$1,417.50
Max. Negotiated Rate	$2,286.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50

CAGE 8 MM ZERO PAV

Facility

$1,627.25

Service Code	HCPCS C1889
Hospital Charge Code	270692349
Hospital Revenue Code	278
Min. Negotiated Rate	$244.09
Max. Negotiated Rate	$813.62
Rate for Payer: Aetna Commercial	$488.18
Rate for Payer: Aetna Medicare Advantage	$488.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.95
Rate for Payer: Cigna Commercial	$813.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.79
Rate for Payer: Qualcare PPO/HMO/WC	$244.09

CAGE 8 MM ZERO PAV

Facility

$1,627.25

Service Code	HCPCS C1889
Hospital Charge Code	270692349
Hospital Revenue Code	278
Min. Negotiated Rate	$244.09
Max. Negotiated Rate	$393.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.79
Rate for Payer: Qualcare PPO/HMO/WC	$244.09

CAGE 8X16X14MM 10DEGREE

Facility

$8,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704432
Hospital Revenue Code	279
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$1,275.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

CAGE 8X16X14MM 10DEGREE

Facility

$8,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704432
Hospital Revenue Code	279
Min. Negotiated Rate	$1,105.00
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$2,550.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,105.00
Rate for Payer: Oxford Commercial	$4,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00
Rate for Payer: UnitedHealthcare Commercial	$4,250.00

CAGE 8 X 9 X 23MM

Facility

$26,660.00

Hospital Charge Code	270667336
Hospital Revenue Code	278
Min. Negotiated Rate	$3,999.00
Max. Negotiated Rate	$13,330.00
Rate for Payer: Aetna Commercial	$7,998.00
Rate for Payer: Aetna Medicare Advantage	$7,998.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,798.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,798.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,332.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,798.30
Rate for Payer: Cigna Commercial	$13,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,451.72
Rate for Payer: Qualcare PPO/HMO/WC	$3,999.00

CAGE 8 X 9 X 23MM

Facility

$26,660.00

Hospital Charge Code	270667336
Hospital Revenue Code	278
Min. Negotiated Rate	$3,999.00
Max. Negotiated Rate	$6,451.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,332.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,451.72
Rate for Payer: Qualcare PPO/HMO/WC	$3,999.00

CAGE 9MM, ODEG.

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705909
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$7,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

CAGE 9MM, ODEG.

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705909
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

CAGE 9MM X 11 MM X 23 MM

Facility

$20,270.00

Service Code	HCPCS C1889
Hospital Charge Code	270689800
Hospital Revenue Code	278
Min. Negotiated Rate	$3,040.50
Max. Negotiated Rate	$10,135.00
Rate for Payer: Aetna Commercial	$6,081.00
Rate for Payer: Aetna Medicare Advantage	$6,081.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,168.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,168.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,054.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,168.85
Rate for Payer: Cigna Commercial	$10,135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,905.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,040.50

CAGE 9MM X 11 MM X 23 MM

Facility

$20,270.00

Service Code	HCPCS C1889
Hospital Charge Code	270689800
Hospital Revenue Code	278
Min. Negotiated Rate	$3,040.50
Max. Negotiated Rate	$4,905.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,054.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,905.34
Rate for Payer: Qualcare PPO/HMO/WC	$3,040.50

CAGE 9MM X 11MM X 23 MM

Facility

$24,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688260
Hospital Revenue Code	278
Min. Negotiated Rate	$3,600.00
Max. Negotiated Rate	$5,808.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,808.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,600.00

CAGE 9MM X 11MM X 23 MM

Facility

$24,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688260
Hospital Revenue Code	278
Min. Negotiated Rate	$3,600.00
Max. Negotiated Rate	$12,000.00
Rate for Payer: Aetna Commercial	$7,200.00
Rate for Payer: Aetna Medicare Advantage	$7,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,120.00
Rate for Payer: Cigna Commercial	$12,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,808.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,600.00

CAGE 9MM X11 MM X 23 MM

Facility

$24,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270683546
Hospital Revenue Code	278
Min. Negotiated Rate	$3,600.00
Max. Negotiated Rate	$5,808.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,808.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,600.00

CAGE 9MM X11 MM X 23 MM

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270688471
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

CAGE 9MM X11 MM X 23 MM

Facility

$24,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270683546
Hospital Revenue Code	278
Min. Negotiated Rate	$3,600.00
Max. Negotiated Rate	$12,000.00
Rate for Payer: Aetna Commercial	$7,200.00
Rate for Payer: Aetna Medicare Advantage	$7,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,120.00
Rate for Payer: Cigna Commercial	$12,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,808.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,600.00

CAGE 9MM X11 MM X 23 MM

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270688471
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

CAGE 9MM X-WIDE TI

Facility

$9,175.00

Hospital Charge Code	270703142
Hospital Revenue Code	278
Min. Negotiated Rate	$1,376.25
Max. Negotiated Rate	$4,587.50
Rate for Payer: Aetna Commercial	$2,752.50
Rate for Payer: Aetna Medicare Advantage	$2,752.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,339.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,339.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,339.62
Rate for Payer: Cigna Commercial	$4,587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,220.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,376.25

Know your out-of-pocket cost for care.

All Charges