Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 HP 6 DEG 12 X 5 MM

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270689732
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 HP 6 DEG 12 X 5 MM

Facility

$16,475.00

Service Code	HCPCS C1889
Hospital Charge Code	270689732
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 IBD PLAN 8X18X14 6D

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693712
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$2,662.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

CAGE IBD PLAN 8X18X14 6D

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693712
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$5,500.00
Rate for Payer: Aetna Commercial	$3,300.00
Rate for Payer: Aetna Medicare Advantage	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,805.00
Rate for Payer: Cigna Commercial	$5,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

CAGE INC LORD14MMX12MMX24MM10D

Facility

$19,250.00

Service Code	HCPCS L8699
Hospital Charge Code	270693003
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.50
Max. Negotiated Rate	$9,625.00
Rate for Payer: Aetna Commercial	$5,775.00
Rate for Payer: Aetna Medicare Advantage	$5,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,908.75
Rate for Payer: Cigna Commercial	$9,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50

CAGE INC LORD14MMX12MMX24MM10D

Facility

$19,250.00

Service Code	HCPCS L8699
Hospital Charge Code	270693003
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.50
Max. Negotiated Rate	$4,658.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50

CAGE INST KIT

Facility

$2,500.00

Hospital Charge Code	270701866
Hospital Revenue Code	272
Min. Negotiated Rate	$325.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.00
Rate for Payer: Oxford Commercial	$1,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$1,250.00

CAGE INST KIT

Facility

$2,500.00

Hospital Charge Code	270701866
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

CAGE INTBDY ALIF 37X27X16MM18D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698450
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 INTBDY ALIF 37X27X16MM18D

Facility

$20,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270698450
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 INTERBODY 10X22X14MM5D PC

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270698193
Hospital Revenue Code	278
Min. Negotiated Rate	$960.00
Max. Negotiated Rate	$1,548.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,548.80
Rate for Payer: Qualcare PPO/HMO/WC	$960.00

CAGE INTERBODY 10X22X14MM5D PC

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270698193
Hospital Revenue Code	278
Min. Negotiated Rate	$960.00
Max. Negotiated Rate	$3,200.00
Rate for Payer: Aetna Commercial	$1,920.00
Rate for Payer: Aetna Medicare Advantage	$1,920.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,632.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,632.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,632.00
Rate for Payer: Cigna Commercial	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,548.80
Rate for Payer: Qualcare PPO/HMO/WC	$960.00

CAGE INTERBODY 10X27X9MM 5

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270698164
Hospital Revenue Code	278
Min. Negotiated Rate	$960.00
Max. Negotiated Rate	$3,200.00
Rate for Payer: Aetna Commercial	$1,920.00
Rate for Payer: Aetna Medicare Advantage	$1,920.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,632.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,632.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,632.00
Rate for Payer: Cigna Commercial	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,548.80
Rate for Payer: Qualcare PPO/HMO/WC	$960.00

CAGE INTERBODY 10X27X9MM 5

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270698164
Hospital Revenue Code	278
Min. Negotiated Rate	$960.00
Max. Negotiated Rate	$1,548.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,548.80
Rate for Payer: Qualcare PPO/HMO/WC	$960.00

CAGE INTERBODY 16X13X6MM 0D

Facility

$5,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270695313
Hospital Revenue Code	278
Min. Negotiated Rate	$840.00
Max. Negotiated Rate	$2,800.00
Rate for Payer: Aetna Commercial	$1,680.00
Rate for Payer: Aetna Medicare Advantage	$1,680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,428.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,428.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,428.00
Rate for Payer: Cigna Commercial	$2,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,355.20
Rate for Payer: Qualcare PPO/HMO/WC	$840.00

CAGE INTERBODY 16X13X6MM 0D

Facility

$5,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270695313
Hospital Revenue Code	278
Min. Negotiated Rate	$840.00
Max. Negotiated Rate	$1,355.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,355.20
Rate for Payer: Qualcare PPO/HMO/WC	$840.00

CAGE INTERBODY 16X14X6MM 7D RT

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694364
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 INTERBODY 16X14X6MM 7D RT

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694364
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 INTERBODY 16X14X8MM 7D RT

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270693405
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 INTERBODY 16X14X8MM 7D RT

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270693405
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 INTERBODY 7D 16X14X6MM

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694352
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 INTERBODY 7D 16X14X6MM

Facility

$24,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694352
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 INTERBODY 7D 16X14X8MM

Facility

$19,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694353
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.50
Max. Negotiated Rate	$4,658.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50

CAGE INTERBODY 7D 16X14X8MM

Facility

$19,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270694353
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.50
Max. Negotiated Rate	$9,625.00
Rate for Payer: Aetna Commercial	$5,775.00
Rate for Payer: Aetna Medicare Advantage	$5,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,908.75
Rate for Payer: Cigna Commercial	$9,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50

Know your out-of-pocket cost for care.

All Charges