Heights University Hospital

All Charges

Charge

Type

Setting

Price

CAGE ELSA 20X60MM 5-20D

Facility

$53,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270694590
Hospital Revenue Code	278
Min. Negotiated Rate	$8,062.50
Max. Negotiated Rate	$26,875.00
Rate for Payer: Aetna Commercial	$16,125.00
Rate for Payer: Aetna Medicare Advantage	$16,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,706.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,706.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,706.25
Rate for Payer: Cigna Commercial	$26,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,007.50
Rate for Payer: Qualcare PPO/HMO/WC	$8,062.50

CAGE ELSA 20X60MM 5-20D

Facility

$53,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270694590
Hospital Revenue Code	278
Min. Negotiated Rate	$8,062.50
Max. Negotiated Rate	$13,007.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,007.50
Rate for Payer: Qualcare PPO/HMO/WC	$8,062.50

CAGE EXPAND 11X23X10 MM

Facility

$80,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697758
Hospital Revenue Code	278
Min. Negotiated Rate	$12,000.00
Max. Negotiated Rate	$40,000.00
Rate for Payer: Aetna Commercial	$24,000.00
Rate for Payer: Aetna Medicare Advantage	$24,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20,400.00
Rate for Payer: Cigna Commercial	$40,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19,360.00
Rate for Payer: Qualcare PPO/HMO/WC	$12,000.00

CAGE EXPAND 11X23X10 MM

Facility

$80,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697758
Hospital Revenue Code	278
Min. Negotiated Rate	$12,000.00
Max. Negotiated Rate	$19,360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19,360.00
Rate for Payer: Qualcare PPO/HMO/WC	$12,000.00

CAGEEXPANDLUCE10X27X10MM10-15D

Facility

$17,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270698872
Hospital Revenue Code	278
Min. Negotiated Rate	$2,640.00
Max. Negotiated Rate	$4,259.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,520.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,259.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,640.00

CAGEEXPANDLUCE10X27X10MM10-15D

Facility

$17,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270698872
Hospital Revenue Code	278
Min. Negotiated Rate	$2,640.00
Max. Negotiated Rate	$8,800.00
Rate for Payer: Aetna Commercial	$5,280.00
Rate for Payer: Aetna Medicare Advantage	$5,280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,520.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,488.00
Rate for Payer: Cigna Commercial	$8,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,259.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,640.00

CAGE FLREHWK SHELL LORDOT 29MM

Facility

$19,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270693872
Hospital Revenue Code	278
Min. Negotiated Rate	$2,962.50
Max. Negotiated Rate	$4,779.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50

CAGE FLREHWK SHELL LORDOT 29MM

Facility

$19,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270693872
Hospital Revenue Code	278
Min. Negotiated Rate	$2,962.50
Max. Negotiated Rate	$9,875.00
Rate for Payer: Aetna Commercial	$5,925.00
Rate for Payer: Aetna Medicare Advantage	$5,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,036.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,036.25
Rate for Payer: Cigna Commercial	$9,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,779.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,962.50

CAGE FLREHWK SHIM 14MMX29MM

Facility

$18,925.00

Service Code	HCPCS C1889
Hospital Charge Code	270693873
Hospital Revenue Code	278
Min. Negotiated Rate	$2,838.75
Max. Negotiated Rate	$9,462.50
Rate for Payer: Aetna Commercial	$5,677.50
Rate for Payer: Aetna Medicare Advantage	$5,677.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,825.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,825.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,825.88
Rate for Payer: Cigna Commercial	$9,462.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,579.85
Rate for Payer: Qualcare PPO/HMO/WC	$2,838.75

CAGE FLREHWK SHIM 14MMX29MM

Facility

$18,925.00

Service Code	HCPCS C1889
Hospital Charge Code	270693873
Hospital Revenue Code	278
Min. Negotiated Rate	$2,838.75
Max. Negotiated Rate	$4,579.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,785.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,579.85
Rate for Payer: Qualcare PPO/HMO/WC	$2,838.75

CAGE FORTILINK 11MMX22MM

Facility

$21,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270692283
Hospital Revenue Code	278
Min. Negotiated Rate	$3,225.00
Max. Negotiated Rate	$10,750.00
Rate for Payer: Aetna Commercial	$6,450.00
Rate for Payer: Aetna Medicare Advantage	$6,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,482.50
Rate for Payer: Cigna Commercial	$10,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00

CAGE FORTILINK 11MMX22MM

Facility

$21,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270692283
Hospital Revenue Code	278
Min. Negotiated Rate	$3,225.00
Max. Negotiated Rate	$5,203.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00

CAGE FORTILINK 12MM 8MM

Facility

$22,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270690755
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 FORTILINK 12MM 8MM

Facility

$22,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270690755
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 FORTILINK 14.5X17X8MM

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270690022
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$3,986.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

CAGE FORTILINK 14.5X17X8MM

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270690022
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$8,237.50
Rate for Payer: Aetna Commercial	$4,942.50
Rate for Payer: Aetna Medicare Advantage	$4,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,201.12
Rate for Payer: Cigna Commercial	$8,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

CAGE FORTILINK 18X13X55MM 6D

Facility

$37,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270697267
Hospital Revenue Code	278
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$9,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,075.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

CAGE FORTILINK 18X13X55MM 6D

Facility

$37,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270697267
Hospital Revenue Code	278
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$18,750.00
Rate for Payer: Aetna Commercial	$11,250.00
Rate for Payer: Aetna Medicare Advantage	$11,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,562.50
Rate for Payer: Cigna Commercial	$18,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,075.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

CAGEFORTILINKIBFSYS15X22MM6D

Facility

$21,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694318
Hospital Revenue Code	278
Min. Negotiated Rate	$3,225.00
Max. Negotiated Rate	$5,203.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00

CAGEFORTILINKIBFSYS15X22MM6D

Facility

$21,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694318
Hospital Revenue Code	278
Min. Negotiated Rate	$3,225.00
Max. Negotiated Rate	$10,750.00
Rate for Payer: Aetna Commercial	$6,450.00
Rate for Payer: Aetna Medicare Advantage	$6,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,482.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,482.50
Rate for Payer: Cigna Commercial	$10,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,203.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,225.00

CAGE FORTLINK TET 12X14X7MM 6D

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270694860
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$3,986.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

CAGE FORTLINK TET 12X14X7MM 6D

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270694860
Hospital Revenue Code	278
Min. Negotiated Rate	$2,471.25
Max. Negotiated Rate	$8,237.50
Rate for Payer: Aetna Commercial	$4,942.50
Rate for Payer: Aetna Medicare Advantage	$4,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,201.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,201.12
Rate for Payer: Cigna Commercial	$8,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,986.95
Rate for Payer: Qualcare PPO/HMO/WC	$2,471.25

CAGE GLENOID CEMENTED MED

Facility

$7,405.00

Service Code	HCPCS C1776
Hospital Charge Code	270682811
Hospital Revenue Code	278
Min. Negotiated Rate	$1,110.75
Max. Negotiated Rate	$1,792.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,481.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,792.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,110.75

CAGE GLENOID CEMENTED MED

Facility

$7,405.00

Service Code	HCPCS C1776
Hospital Charge Code	270682811
Hospital Revenue Code	278
Min. Negotiated Rate	$1,110.75
Max. Negotiated Rate	$3,702.50
Rate for Payer: Aetna Commercial	$2,221.50
Rate for Payer: Aetna Medicare Advantage	$2,221.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,888.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,888.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,481.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,888.28
Rate for Payer: Cigna Commercial	$3,702.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,792.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,110.75

CAGE GLENOID CEMENTED SM

Facility

$7,405.00

Service Code	HCPCS C1713
Hospital Charge Code	270681775
Hospital Revenue Code	278
Min. Negotiated Rate	$1,110.75
Max. Negotiated Rate	$3,702.50
Rate for Payer: Aetna Commercial	$2,221.50
Rate for Payer: Aetna Medicare Advantage	$2,221.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,888.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,888.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,481.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,888.28
Rate for Payer: Cigna Commercial	$3,702.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,792.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,110.75

Know your out-of-pocket cost for care.

All Charges