Heights University Hospital

All Charges

Charge

Type

Setting

Price

CAGE LUCENT12MMX27MMX10MM 5DEG

Facility

$16,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270692995
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$8,000.00
Rate for Payer: Aetna Commercial	$4,800.00
Rate for Payer: Aetna Medicare Advantage	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,080.00
Rate for Payer: Cigna Commercial	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

CAGE LUCENT12MMX27MMX10MM 5DEG

Facility

$16,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270692995
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$3,872.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

CAGE LUCENT 12MMX27MMX11MM 5D

Facility

$16,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693037
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$8,000.00
Rate for Payer: Aetna Commercial	$4,800.00
Rate for Payer: Aetna Medicare Advantage	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,080.00
Rate for Payer: Cigna Commercial	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

CAGE LUCENT 12MMX27MMX11MM 5D

Facility

$16,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693037
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$3,872.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

CAGELUCENT12MMX27MMX12MM 5D PC

Facility

$8,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693035
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

CAGELUCENT12MMX27MMX12MM 5D PC

Facility

$8,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693035
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 12X27X12MM 5DEG

Facility

$16,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693007
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$3,872.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

CAGE LUCENT 12X27X12MM 5DEG

Facility

$16,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693007
Hospital Revenue Code	278
Min. Negotiated Rate	$2,400.00
Max. Negotiated Rate	$8,000.00
Rate for Payer: Aetna Commercial	$4,800.00
Rate for Payer: Aetna Medicare Advantage	$4,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,080.00
Rate for Payer: Cigna Commercial	$8,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,872.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,400.00

CAGE LUCENT 12X27X9MM 5D PC

Facility

$12,800.00

Service Code	HCPCS C1889
Hospital Charge Code	270697141
Hospital Revenue Code	278
Min. Negotiated Rate	$1,920.00
Max. Negotiated Rate	$3,097.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,097.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,920.00

CAGE LUCENT 12X27X9MM 5D PC

Facility

$12,800.00

Service Code	HCPCS C1889
Hospital Charge Code	270697141
Hospital Revenue Code	278
Min. Negotiated Rate	$1,920.00
Max. Negotiated Rate	$6,400.00
Rate for Payer: Aetna Commercial	$3,840.00
Rate for Payer: Aetna Medicare Advantage	$3,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,264.00
Rate for Payer: Cigna Commercial	$6,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,097.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,920.00

CAGE LUCENT 12X37X11MM 5D PC

Facility

$17,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270696832
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 LUCENT 12X37X11MM 5D PC

Facility

$17,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270696832
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

CAGE LUCENT 12X37X13MM 5D

Facility

$12,800.00

Service Code	HCPCS C1889
Hospital Charge Code	270697980
Hospital Revenue Code	278
Min. Negotiated Rate	$1,920.00
Max. Negotiated Rate	$3,097.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,097.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,920.00

CAGE LUCENT 12X37X13MM 5D

Facility

$12,800.00

Service Code	HCPCS C1889
Hospital Charge Code	270697980
Hospital Revenue Code	278
Min. Negotiated Rate	$1,920.00
Max. Negotiated Rate	$6,400.00
Rate for Payer: Aetna Commercial	$3,840.00
Rate for Payer: Aetna Medicare Advantage	$3,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,264.00
Rate for Payer: Cigna Commercial	$6,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,097.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,920.00

CAGE LUCENT 22X60X10MM 12D LAT

Facility

$26,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694362
Hospital Revenue Code	278
Min. Negotiated Rate	$3,975.00
Max. Negotiated Rate	$6,413.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,413.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,975.00

CAGE LUCENT 22X60X10MM 12D LAT

Facility

$26,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694362
Hospital Revenue Code	278
Min. Negotiated Rate	$3,975.00
Max. Negotiated Rate	$13,250.00
Rate for Payer: Aetna Commercial	$7,950.00
Rate for Payer: Aetna Medicare Advantage	$7,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,757.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,757.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,757.50
Rate for Payer: Cigna Commercial	$13,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,413.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,975.00

CAGE LUCENT 22X60X12MM 12D LAT

Facility

$26,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694363
Hospital Revenue Code	278
Min. Negotiated Rate	$3,975.00
Max. Negotiated Rate	$13,250.00
Rate for Payer: Aetna Commercial	$7,950.00
Rate for Payer: Aetna Medicare Advantage	$7,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,757.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,757.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,757.50
Rate for Payer: Cigna Commercial	$13,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,413.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,975.00

CAGE LUCENT 22X60X12MM 12D LAT

Facility

$26,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270694363
Hospital Revenue Code	278
Min. Negotiated Rate	$3,975.00
Max. Negotiated Rate	$6,413.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,413.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,975.00

CAGE LUCENT BULLET 12X27X10 5D

Facility

$12,800.00

Service Code	HCPCS C1889
Hospital Charge Code	270696325
Hospital Revenue Code	278
Min. Negotiated Rate	$1,920.00
Max. Negotiated Rate	$3,097.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,097.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,920.00

CAGE LUCENT BULLET 12X27X10 5D

Facility

$12,800.00

Service Code	HCPCS C1889
Hospital Charge Code	270696325
Hospital Revenue Code	278
Min. Negotiated Rate	$1,920.00
Max. Negotiated Rate	$6,400.00
Rate for Payer: Aetna Commercial	$3,840.00
Rate for Payer: Aetna Medicare Advantage	$3,840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,264.00
Rate for Payer: Cigna Commercial	$6,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,097.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,920.00

CAGE LUCENT L 18X55X10MM

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270694703
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 LUCENT L 18X55X10MM

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270694703
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 LUCENT L 18X55X10MM 6D

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270697482
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 LUCENT L 18X55X10MM 6D

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270697482
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 LUCENTL 18X60X10MM 12D PC

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270696811
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

Know your out-of-pocket cost for care.

All Charges