Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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

CAGELORDOTCOROENT7X11X14MM5D

Facility

$5,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694723
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$1,650.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

CAGELORDOTCOROENT7X11X14MM5D

Facility

$5,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694723
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

CAGE LORDOTIC 18MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270681519
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 LORDOTIC 18MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270681519
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 LORDOTIC 9MMX11MMX27MM

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688239
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 LORDOTIC 9MMX11MMX27MM

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688239
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 LORDOTIC AIS 17X14X6MM

Facility

$22,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270697995
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 LORDOTIC AIS 17X14X6MM

Facility

$22,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270697995
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 LORDOTIC CERV D14217H06

Facility

$21,097.50

Service Code	HCPCS C1889
Hospital Charge Code	270698814
Hospital Revenue Code	278
Min. Negotiated Rate	$3,164.62
Max. Negotiated Rate	$5,105.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,219.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,105.60
Rate for Payer: Qualcare PPO/HMO/WC	$3,164.62

CAGE LORDOTIC CERV D14217H06

Facility

$21,097.50

Service Code	HCPCS C1889
Hospital Charge Code	270698814
Hospital Revenue Code	278
Min. Negotiated Rate	$3,164.62
Max. Negotiated Rate	$10,548.75
Rate for Payer: Aetna Commercial	$6,329.25
Rate for Payer: Aetna Medicare Advantage	$6,329.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,379.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,379.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,219.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,379.86
Rate for Payer: Cigna Commercial	$10,548.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,105.60
Rate for Payer: Qualcare PPO/HMO/WC	$3,164.62

CAGE LORDOTIC COALESCE 10X28X1

Facility

$24,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270691455
Hospital Revenue Code	278
Min. Negotiated Rate	$3,630.00
Max. Negotiated Rate	$5,856.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00

CAGE LORDOTIC COALESCE 10X28X1

Facility

$24,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270691455
Hospital Revenue Code	278
Min. Negotiated Rate	$3,630.00
Max. Negotiated Rate	$12,100.00
Rate for Payer: Aetna Commercial	$7,260.00
Rate for Payer: Aetna Medicare Advantage	$7,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,171.00
Rate for Payer: Cigna Commercial	$12,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,856.40
Rate for Payer: Qualcare PPO/HMO/WC	$3,630.00

CAGE LORDOTIC LG 14X17X7MM

Facility

$16,747.50

Service Code	HCPCS C1889
Hospital Charge Code	270698923
Hospital Revenue Code	278
Min. Negotiated Rate	$2,512.12
Max. Negotiated Rate	$4,052.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,349.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,052.89
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.12

CAGE LORDOTIC LG 14X17X7MM

Facility

$16,747.50

Service Code	HCPCS C1889
Hospital Charge Code	270698923
Hospital Revenue Code	278
Min. Negotiated Rate	$2,512.12
Max. Negotiated Rate	$8,373.75
Rate for Payer: Aetna Commercial	$5,024.25
Rate for Payer: Aetna Medicare Advantage	$5,024.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,270.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,270.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,349.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,270.61
Rate for Payer: Cigna Commercial	$8,373.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,052.89
Rate for Payer: Qualcare PPO/HMO/WC	$2,512.12

CAGE LORDOTIC TI H11 29MM

Facility

$19,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270695888
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 LORDOTIC TI H11 29MM

Facility

$19,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270695888
Hospital Revenue Code	278
Min. Negotiated Rate	$2,962.50
Max. Negotiated Rate	$9,875.00
Rate for Payer: Aetna Medicare Advantage	$5,925.00
Rate for Payer: Aetna Commercial	$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 LT 14x17.5x23mm 8941423

Facility

$17,816.40

Hospital Charge Code	270630619
Hospital Revenue Code	272
Min. Negotiated Rate	$2,672.46
Max. Negotiated Rate	$2,672.46
Rate for Payer: Qualcare PPO/HMO/WC	$2,672.46

CAGE LT 14x17.5x23mm 8941423

Facility

$17,816.40

Hospital Charge Code	270630619
Hospital Revenue Code	272
Min. Negotiated Rate	$2,316.13
Max. Negotiated Rate	$8,908.20
Rate for Payer: Aetna Commercial	$5,344.92
Rate for Payer: Aetna Medicare Advantage	$5,344.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,543.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,543.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,543.18
Rate for Payer: Cigna Commercial	$8,908.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,316.13
Rate for Payer: Oxford Commercial	$8,908.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,672.46
Rate for Payer: UnitedHealthcare Commercial	$8,908.20

CAGE LUCENT 10MMX27MMX10MM 5D

Facility

$8,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693044
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$2,400.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

CAGE LUCENT 10MMX27MMX10MM 5D

Facility

$8,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693044
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

CAGE LUCENT 10X22X13MM 5D

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270695589
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 LUCENT 10X22X13MM 5D

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270695589
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 LUCENT 10X22X8 5D

Facility

$8,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693988
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

CAGE LUCENT 10X22X8 5D

Facility

$8,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693988
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$2,400.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

Know your out-of-pocket cost for care.

All Charges