Heights University Hospital

All Charges

Charge

Type

Setting

Price

CAGE ALIF 13MM 8DEG

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705781
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 ALIF 13MM 8DEG

Facility

$25,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270705781
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 ALIF PC MAG 30X25X14MM12D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697372
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

CAGE ALIF PC MAG 30X25X14MM12D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697372
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

CAGE ALIGN LAT 18X60X11MM 12D

Facility

$40,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270696336
Hospital Revenue Code	278
Min. Negotiated Rate	$6,112.50
Max. Negotiated Rate	$9,861.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,861.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,112.50

CAGE ALIGN LAT 18X60X11MM 12D

Facility

$40,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270696336
Hospital Revenue Code	278
Min. Negotiated Rate	$6,112.50
Max. Negotiated Rate	$20,375.00
Rate for Payer: Aetna Commercial	$12,225.00
Rate for Payer: Aetna Medicare Advantage	$12,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,391.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,391.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,391.25
Rate for Payer: Cigna Commercial	$20,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,861.50
Rate for Payer: Qualcare PPO/HMO/WC	$6,112.50

CAGE ANT LUMBAR MONTEREY

Facility

$44,975.00

Hospital Charge Code	270702924
Hospital Revenue Code	278
Min. Negotiated Rate	$6,746.25
Max. Negotiated Rate	$10,883.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,883.95
Rate for Payer: Qualcare PPO/HMO/WC	$6,746.25

CAGE ANT LUMBAR MONTEREY

Facility

$44,975.00

Hospital Charge Code	270702924
Hospital Revenue Code	278
Min. Negotiated Rate	$6,746.25
Max. Negotiated Rate	$22,487.50
Rate for Payer: Aetna Commercial	$13,492.50
Rate for Payer: Aetna Medicare Advantage	$13,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,468.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,468.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,468.62
Rate for Payer: Cigna Commercial	$22,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,883.95
Rate for Payer: Qualcare PPO/HMO/WC	$6,746.25

CAGE BANGAL 28MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270686282
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

CAGE BANGAL 28MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270686282
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

CAGE BENGAL 20MM

Facility

$20,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270689202
Hospital Revenue Code	278
Min. Negotiated Rate	$3,021.00
Max. Negotiated Rate	$4,873.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00

CAGE BENGAL 20MM

Facility

$20,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270689202
Hospital Revenue Code	278
Min. Negotiated Rate	$3,021.00
Max. Negotiated Rate	$10,070.00
Rate for Payer: Aetna Commercial	$6,042.00
Rate for Payer: Aetna Medicare Advantage	$6,042.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,135.70
Rate for Payer: Cigna Commercial	$10,070.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00

CAGE BENGAL 26MM

Facility

$20,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270689201
Hospital Revenue Code	278
Min. Negotiated Rate	$3,021.00
Max. Negotiated Rate	$4,873.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00

CAGE BENGAL 26MM

Facility

$20,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270689201
Hospital Revenue Code	278
Min. Negotiated Rate	$3,021.00
Max. Negotiated Rate	$10,070.00
Rate for Payer: Aetna Commercial	$6,042.00
Rate for Payer: Aetna Medicare Advantage	$6,042.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,135.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,028.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,135.70
Rate for Payer: Cigna Commercial	$10,070.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,873.88
Rate for Payer: Qualcare PPO/HMO/WC	$3,021.00

CAGE BENGAL 5MM

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270663294
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CAGE BENGAL 5MM

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270663294
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$1,950.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CAGE BENGAL7MM

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270680083
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$1,950.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CAGE BENGAL7MM

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270680083
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CAGE BENGAL CAGE 5MM

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270683533
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$3,250.00
Rate for Payer: Aetna Commercial	$1,950.00
Rate for Payer: Aetna Medicare Advantage	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,657.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,657.50
Rate for Payer: Cigna Commercial	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CAGE BENGAL CAGE 5MM

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270683533
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$1,573.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,573.00
Rate for Payer: Qualcare PPO/HMO/WC	$975.00

CAGE BENGAL STACK STD LOR 32MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270674899
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

CAGE BENGAL STACK STD LOR 32MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270674899
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

CAGE BENGAL STACK STD LOR 38MM

Facility

$23,830.00

Hospital Charge Code	270666239
Hospital Revenue Code	278
Min. Negotiated Rate	$3,574.50
Max. Negotiated Rate	$11,915.00
Rate for Payer: Aetna Commercial	$7,149.00
Rate for Payer: Aetna Medicare Advantage	$7,149.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,076.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,076.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,766.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,076.65
Rate for Payer: Cigna Commercial	$11,915.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,766.86
Rate for Payer: Qualcare PPO/HMO/WC	$3,574.50

CAGE BENGAL STACK STD LOR 38MM

Facility

$23,830.00

Hospital Charge Code	270666239
Hospital Revenue Code	278
Min. Negotiated Rate	$3,574.50
Max. Negotiated Rate	$5,766.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,766.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,766.86
Rate for Payer: Qualcare PPO/HMO/WC	$3,574.50

CAGE BENGAL STACK STD LOR 40MM

Facility

$23,830.00

Service Code	HCPCS C1713
Hospital Charge Code	270665834
Hospital Revenue Code	278
Min. Negotiated Rate	$3,574.50
Max. Negotiated Rate	$11,915.00
Rate for Payer: Aetna Commercial	$7,149.00
Rate for Payer: Aetna Medicare Advantage	$7,149.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,076.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,076.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,766.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,076.65
Rate for Payer: Cigna Commercial	$11,915.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,766.86
Rate for Payer: Qualcare PPO/HMO/WC	$3,574.50

Know your out-of-pocket cost for care.

All Charges