Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 44MM

Facility

$23,830.00

Hospital Charge Code	270676203
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 44MM

Facility

$23,830.00

Hospital Charge Code	270676203
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 STD 4MM 7DEG

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270667000
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 STD 4MM 7DEG

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270667000
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 STD 5MM 7DEG

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270663102
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 STD 5MM 7DEG

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270663102
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 STD 6MM 7DEG

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270665072
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 STD 6MM 7DEG

Facility

$6,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270665072
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 BLACKHAWK TI 16X16X6 6 H

Facility

$23,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270695158
Hospital Revenue Code	278
Min. Negotiated Rate	$3,562.50
Max. Negotiated Rate	$11,875.00
Rate for Payer: Aetna Commercial	$7,125.00
Rate for Payer: Aetna Medicare Advantage	$7,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,056.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,056.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,056.25
Rate for Payer: Cigna Commercial	$11,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,747.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,562.50

CAGE BLACKHAWK TI 16X16X6 6 H

Facility

$23,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270695158
Hospital Revenue Code	278
Min. Negotiated Rate	$3,562.50
Max. Negotiated Rate	$5,747.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,747.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,562.50

CAGE BNGEL 30MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270686288
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 BNGEL 30MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270686288
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 BNGEL 32MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270686289
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 BNGEL 32MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270686289
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 CALIX LORDOT 11X14X6MM 7D

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694502
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 CALIX LORDOT 11X14X6MM 7D

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694502
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 CERES-C 15X12X8MM 10D

Facility

$6,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270696388
Hospital Revenue Code	278
Min. Negotiated Rate	$930.00
Max. Negotiated Rate	$3,100.00
Rate for Payer: Aetna Commercial	$1,860.00
Rate for Payer: Aetna Medicare Advantage	$1,860.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,581.00
Rate for Payer: Cigna Commercial	$3,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: Qualcare PPO/HMO/WC	$930.00

CAGE CERES-C 15X12X8MM 10D

Facility

$6,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270696388
Hospital Revenue Code	278
Min. Negotiated Rate	$930.00
Max. Negotiated Rate	$1,500.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,500.40
Rate for Payer: Qualcare PPO/HMO/WC	$930.00

CAGE CERV 14.5X12MM 7D

Facility

$42,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270698160
Hospital Revenue Code	278
Min. Negotiated Rate	$6,375.00
Max. Negotiated Rate	$10,285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,285.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,375.00

CAGE CERV 14.5X12MM 7D

Facility

$42,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270698160
Hospital Revenue Code	278
Min. Negotiated Rate	$6,375.00
Max. Negotiated Rate	$21,250.00
Rate for Payer: Aetna Commercial	$12,750.00
Rate for Payer: Aetna Medicare Advantage	$12,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,837.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,837.50
Rate for Payer: Cigna Commercial	$21,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,285.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,375.00

CAGE CERV DISC PRESTIGE 7X18MM

Facility

$44,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694698
Hospital Revenue Code	278
Min. Negotiated Rate	$6,675.00
Max. Negotiated Rate	$22,250.00
Rate for Payer: Aetna Commercial	$13,350.00
Rate for Payer: Aetna Medicare Advantage	$13,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,347.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,347.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,347.50
Rate for Payer: Cigna Commercial	$22,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,769.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,675.00

CAGE CERV DISC PRESTIGE 7X18MM

Facility

$44,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694698
Hospital Revenue Code	278
Min. Negotiated Rate	$6,675.00
Max. Negotiated Rate	$10,769.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,769.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,675.00

CAGE CERV F3D 14.5X12X9MM 7D

Facility

$34,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696269
Hospital Revenue Code	278
Min. Negotiated Rate	$5,137.50
Max. Negotiated Rate	$8,288.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,288.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,137.50

CAGE CERV F3D 14.5X12X9MM 7D

Facility

$34,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696269
Hospital Revenue Code	278
Min. Negotiated Rate	$5,137.50
Max. Negotiated Rate	$17,125.00
Rate for Payer: Aetna Commercial	$10,275.00
Rate for Payer: Aetna Medicare Advantage	$10,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,733.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,733.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,733.75
Rate for Payer: Cigna Commercial	$17,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,288.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,137.50

Know your out-of-pocket cost for care.

All Charges