Heights University Hospital

All Charges

Charge

Type

Setting

Price

CAGE MONET XWIDE 8MM

Facility

$9,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270697688
Hospital Revenue Code	278
Min. Negotiated Rate	$1,417.50
Max. Negotiated Rate	$4,725.00
Rate for Payer: Aetna Commercial	$2,835.00
Rate for Payer: Aetna Medicare Advantage	$2,835.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,409.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,409.75
Rate for Payer: Cigna Commercial	$4,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50

CAGE MONET XWIDE 8MM

Facility

$9,450.00

Service Code	HCPCS C1889
Hospital Charge Code	270697688
Hospital Revenue Code	278
Min. Negotiated Rate	$1,417.50
Max. Negotiated Rate	$2,286.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,286.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,417.50

CAGE MONTECEY 14X28X36 MM

Facility

$44,975.00

Service Code	HCPCS C1716
Hospital Charge Code	270701765
Hospital Revenue Code	278
Min. Negotiated Rate	$1,197.08
Max. Negotiated Rate	$13,492.50
Rate for Payer: Aetna Commercial	$13,492.50
Rate for Payer: Aetna Medicare Advantage	$13,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,468.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,468.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,468.62
Rate for Payer: Cigna Commercial	$1,197.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,883.95
Rate for Payer: Qualcare PPO/HMO/WC	$6,746.25

CAGE MONTECEY 14X28X36 MM

Facility

$44,975.00

Service Code	HCPCS C1716
Hospital Charge Code	270701765
Hospital Revenue Code	278
Min. Negotiated Rate	$6,746.25
Max. Negotiated Rate	$10,883.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,883.95
Rate for Payer: Qualcare PPO/HMO/WC	$6,746.25

CAGE PARALLEL 9X11X27 MM

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688237
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 PARALLEL 9X11X27 MM

Facility

$24,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688237
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 PC 10X22X10MM 5D

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270697668
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 PC 10X22X10MM 5D

Facility

$6,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270697668
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 PC T1 BOND 14X11X6MM 7D

Facility

$5,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270696324
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 PC T1 BOND 14X11X6MM 7D

Facility

$5,600.00

Service Code	HCPCS C1889
Hospital Charge Code	270696324
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 PEEK 12MM X 10MM

Facility

$29,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270691714
Hospital Revenue Code	278
Min. Negotiated Rate	$4,425.00
Max. Negotiated Rate	$14,750.00
Rate for Payer: Aetna Commercial	$8,850.00
Rate for Payer: Aetna Medicare Advantage	$8,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,522.50
Rate for Payer: Cigna Commercial	$14,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,139.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,425.00

CAGE PEEK 12MM X 10MM

Facility

$29,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270691714
Hospital Revenue Code	278
Min. Negotiated Rate	$4,425.00
Max. Negotiated Rate	$7,139.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,139.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,425.00

CAGE PEEK 20 X 16MM

Facility

$16,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688411
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 PEEK 20 X 16MM

Facility

$16,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688411
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 PEEK 2C TPLIF 10X29MM

Facility

$36,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270695961
Hospital Revenue Code	278
Min. Negotiated Rate	$5,400.00
Max. Negotiated Rate	$8,712.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,712.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,400.00

CAGE PEEK 2C TPLIF 10X29MM

Facility

$36,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270695961
Hospital Revenue Code	278
Min. Negotiated Rate	$5,400.00
Max. Negotiated Rate	$18,000.00
Rate for Payer: Aetna Commercial	$10,800.00
Rate for Payer: Aetna Medicare Advantage	$10,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,180.00
Rate for Payer: Cigna Commercial	$18,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,712.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,400.00

CAGE PEEK 2C TPLIF 11X29MM

Facility

$36,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697531
Hospital Revenue Code	278
Min. Negotiated Rate	$5,400.00
Max. Negotiated Rate	$18,000.00
Rate for Payer: Aetna Commercial	$10,800.00
Rate for Payer: Aetna Medicare Advantage	$10,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,180.00
Rate for Payer: Cigna Commercial	$18,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,712.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,400.00

CAGE PEEK 2C TPLIF 11X29MM

Facility

$36,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270697531
Hospital Revenue Code	278
Min. Negotiated Rate	$5,400.00
Max. Negotiated Rate	$8,712.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,712.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,400.00

CAGE PEEK 2C TPLIF 13X29MM

Facility

$40,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270697309
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 PEEK 2C TPLIF 13X29MM

Facility

$40,750.00

Service Code	HCPCS C1889
Hospital Charge Code	270697309
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 PEEK 2C TPLIF 7X29MM

Facility

$22,100.00

Service Code	HCPCS C1889
Hospital Charge Code	270695864
Hospital Revenue Code	278
Min. Negotiated Rate	$3,315.00
Max. Negotiated Rate	$5,348.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,348.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,315.00

CAGE PEEK 2C TPLIF 7X29MM

Facility

$22,100.00

Service Code	HCPCS C1889
Hospital Charge Code	270695864
Hospital Revenue Code	278
Min. Negotiated Rate	$3,315.00
Max. Negotiated Rate	$11,050.00
Rate for Payer: Aetna Commercial	$6,630.00
Rate for Payer: Aetna Medicare Advantage	$6,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,635.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,635.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,635.50
Rate for Payer: Cigna Commercial	$11,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,348.20
Rate for Payer: Qualcare PPO/HMO/WC	$3,315.00

CAGE PEEK 42MM

Facility

$29,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270691140
Hospital Revenue Code	278
Min. Negotiated Rate	$4,425.00
Max. Negotiated Rate	$14,750.00
Rate for Payer: Aetna Commercial	$8,850.00
Rate for Payer: Aetna Medicare Advantage	$8,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,522.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,522.50
Rate for Payer: Cigna Commercial	$14,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,139.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,425.00

CAGE PEEK 42MM

Facility

$29,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270691140
Hospital Revenue Code	278
Min. Negotiated Rate	$4,425.00
Max. Negotiated Rate	$7,139.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,139.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,425.00

CAGE PEEK 6 MM LARDATH

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270690707
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Know your out-of-pocket cost for care.

All Charges