Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 LUCENTL 22X55X10MM 12D PC

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270696812
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 22X55X10MM 12D PC

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270696812
Hospital Revenue Code	278
Min. Negotiated Rate	$3,180.00
Max. Negotiated Rate	$10,600.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,180.00
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

CAGE LUCENT L 22X55X8MM 6D PC

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270696391
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 22X55X8MM 6D PC

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270696391
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 LAT 12D 22X55X12MM

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270696636
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 LAT 12D 22X55X12MM

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270696636
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 LAT 18D 22X55X10MM

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270696638
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 LAT 18D 22X55X10MM

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270696638
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 LAT 18D 22X55X8MM

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270696637
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 LAT 18D 22X55X8MM

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270696637
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 PC 12D22X55X12MM

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270696634
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 PC 12D22X55X12MM

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270696634
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 PC 22X60X8MM 12D

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270698044
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 PC 22X60X8MM 12D

Facility

$21,200.00

Service Code	HCPCS C1889
Hospital Charge Code	270698044
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 PC 10X22X13MM 5D

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270694706
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 PC 10X22X13MM 5D

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270694706
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 PC 12X17X11MM 5D

Facility

$16,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693128
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 PC 12X17X11MM 5D

Facility

$16,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693128
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 PC 12X37X10MM 5D

Facility

$16,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697754
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 PC 12X37X10MM 5D

Facility

$16,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697754
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 PC 12X37X4MM 5D

Facility

$16,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697753
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 PC 12X37X4MM 5D

Facility

$16,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697753
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 PC 12X37X9MM 5D

Facility

$12,800.00

Service Code	HCPCS C1889
Hospital Charge Code	270697259
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 PC 12X37X9MM 5D

Facility

$12,800.00

Service Code	HCPCS C1889
Hospital Charge Code	270697259
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

Know your out-of-pocket cost for care.

All Charges