Heights University Hospital

All Charges

Charge

Type

Setting

Price

CAGE INTERBODY ALIGN 18X55X10

Facility

$40,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270696684
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 INTERBODY ALIGN 18X55X10

Facility

$40,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270696684
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 INTERBODY ALIGN 18X60X10

Facility

$40,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270696683
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 INTERBODY ALIGN 18X60X10

Facility

$40,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270696683
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 IO EXPAND LORDOT 10X19MM

Facility

$18,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270699277
Hospital Revenue Code	278
Min. Negotiated Rate	$2,812.50
Max. Negotiated Rate	$9,375.00
Rate for Payer: Aetna Commercial	$5,625.00
Rate for Payer: Aetna Medicare Advantage	$5,625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,781.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,781.25
Rate for Payer: Cigna Commercial	$9,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50

CAGE IO EXPAND LORDOT 10X19MM

Facility

$18,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270699277
Hospital Revenue Code	278
Min. Negotiated Rate	$2,812.50
Max. Negotiated Rate	$4,537.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,537.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,812.50

CAGE IRIX-C 13X16X6MM 7D

Facility

$31,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270693471
Hospital Revenue Code	278
Min. Negotiated Rate	$4,687.50
Max. Negotiated Rate	$15,625.00
Rate for Payer: Aetna Commercial	$9,375.00
Rate for Payer: Aetna Medicare Advantage	$9,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,968.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,968.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,968.75
Rate for Payer: Cigna Commercial	$15,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,562.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,687.50

CAGE IRIX-C 13X16X6MM 7D

Facility

$31,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270693471
Hospital Revenue Code	278
Min. Negotiated Rate	$4,687.50
Max. Negotiated Rate	$7,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,562.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,687.50

CAGE IRIX-C 16X13 X

Facility

$31,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270693292
Hospital Revenue Code	278
Min. Negotiated Rate	$4,687.50
Max. Negotiated Rate	$7,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,562.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,687.50

CAGE IRIX-C 16X13 X

Facility

$31,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270693292
Hospital Revenue Code	278
Min. Negotiated Rate	$4,687.50
Max. Negotiated Rate	$15,625.00
Rate for Payer: Aetna Commercial	$9,375.00
Rate for Payer: Aetna Medicare Advantage	$9,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,968.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,968.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,968.75
Rate for Payer: Cigna Commercial	$15,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,562.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,687.50

CAGE IRIX-C 18X14X7MM 7D

Facility

$31,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696486
Hospital Revenue Code	278
Min. Negotiated Rate	$4,687.50
Max. Negotiated Rate	$15,625.00
Rate for Payer: Aetna Commercial	$9,375.00
Rate for Payer: Aetna Medicare Advantage	$9,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,968.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,968.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,968.75
Rate for Payer: Cigna Commercial	$15,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,562.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,687.50

CAGE IRIX-C 18X14X7MM 7D

Facility

$31,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270696486
Hospital Revenue Code	278
Min. Negotiated Rate	$4,687.50
Max. Negotiated Rate	$7,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,562.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,687.50

CAGE IRIX-C CERV 13X16X6MM 7D

Facility

$31,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270695413
Hospital Revenue Code	278
Min. Negotiated Rate	$4,710.00
Max. Negotiated Rate	$7,598.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,598.80
Rate for Payer: Qualcare PPO/HMO/WC	$4,710.00

CAGE IRIX-C CERV 13X16X6MM 7D

Facility

$31,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270695413
Hospital Revenue Code	278
Min. Negotiated Rate	$4,710.00
Max. Negotiated Rate	$15,700.00
Rate for Payer: Aetna Commercial	$9,420.00
Rate for Payer: Aetna Medicare Advantage	$9,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,007.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,007.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,007.00
Rate for Payer: Cigna Commercial	$15,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,598.80
Rate for Payer: Qualcare PPO/HMO/WC	$4,710.00

CAGE JULIET TI PO 24X8X8MM 6D

Facility

$31,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270699471
Hospital Revenue Code	278
Min. Negotiated Rate	$4,687.50
Max. Negotiated Rate	$7,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,562.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,687.50

CAGE JULIET TI PO 24X8X8MM 6D

Facility

$31,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270699471
Hospital Revenue Code	278
Min. Negotiated Rate	$4,687.50
Max. Negotiated Rate	$15,625.00
Rate for Payer: Aetna Commercial	$9,375.00
Rate for Payer: Aetna Medicare Advantage	$9,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,968.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,968.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,968.75
Rate for Payer: Cigna Commercial	$15,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,562.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,687.50

CAGE LARGE Z CORE

Facility

$7,125.00

Hospital Charge Code	270701787
Hospital Revenue Code	278
Min. Negotiated Rate	$1,068.75
Max. Negotiated Rate	$3,562.50
Rate for Payer: Aetna Commercial	$2,137.50
Rate for Payer: Aetna Medicare Advantage	$2,137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,816.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,816.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,816.88
Rate for Payer: Cigna Commercial	$3,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,724.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,068.75

CAGE LARGE Z CORE

Facility

$7,125.00

Hospital Charge Code	270701787
Hospital Revenue Code	278
Min. Negotiated Rate	$1,068.75
Max. Negotiated Rate	$1,724.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,724.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,068.75

CAGE LATERAL 18WX50LX12H 8D

Facility

$29,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270693622
Hospital Revenue Code	278
Min. Negotiated Rate	$4,462.50
Max. Negotiated Rate	$14,875.00
Rate for Payer: Aetna Commercial	$8,925.00
Rate for Payer: Aetna Medicare Advantage	$8,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,586.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,586.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,586.25
Rate for Payer: Cigna Commercial	$14,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,199.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,462.50

CAGE LATERAL 18WX50LX12H 8D

Facility

$29,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270693622
Hospital Revenue Code	278
Min. Negotiated Rate	$4,462.50
Max. Negotiated Rate	$7,199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,199.50
Rate for Payer: Qualcare PPO/HMO/WC	$4,462.50

CAGE LATERAL 22X55X12MM 18D PC

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270695823
Hospital Revenue Code	278
Min. Negotiated Rate	$3,180.00
Max. Negotiated Rate	$10,600.00
Rate for Payer: Aetna Commercial	$6,360.00
Rate for Payer: Aetna Medicare Advantage	$6,360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,406.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,406.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,406.00
Rate for Payer: Cigna Commercial	$10,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,130.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,180.00

CAGE LATERAL 22X55X12MM 18D PC

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270695823
Hospital Revenue Code	278
Min. Negotiated Rate	$3,180.00
Max. Negotiated Rate	$5,130.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,130.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,180.00

CAGE LAT PC 18X55X8MM 12D

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270698013
Hospital Revenue Code	278
Min. Negotiated Rate	$3,180.00
Max. Negotiated Rate	$10,600.00
Rate for Payer: Aetna Commercial	$6,360.00
Rate for Payer: Aetna Medicare Advantage	$6,360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,406.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,406.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,406.00
Rate for Payer: Cigna Commercial	$10,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,130.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,180.00

CAGE LAT PC 18X55X8MM 12D

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270698013
Hospital Revenue Code	278
Min. Negotiated Rate	$3,180.00
Max. Negotiated Rate	$5,130.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,130.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,180.00

CAGE LLIF 3DR 10X50144MM

Facility

$21,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270698896
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

Know your out-of-pocket cost for care.

All Charges