Heights University Hospital

All Charges

Charge

Type

Setting

Price

CAGE TLX20 9X11X26MM 20 DEG

Facility

$31,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270691369
Hospital Revenue Code	278
Min. Negotiated Rate	$4,650.00
Max. Negotiated Rate	$7,502.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,502.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,650.00

CAGE TRANQUIL-C IBD 7X18X14 6D

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$2,662.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

CAGE TRANQUIL-C IBD 7X18X14 6D

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270693713
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$5,500.00
Rate for Payer: Aetna Commercial	$3,300.00
Rate for Payer: Aetna Medicare Advantage	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,805.00
Rate for Payer: Cigna Commercial	$5,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

CAGE TRANQUIL-C IBD 8X16X3MM

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270696676
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$5,500.00
Rate for Payer: Aetna Commercial	$3,300.00
Rate for Payer: Aetna Medicare Advantage	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,805.00
Rate for Payer: Cigna Commercial	$5,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

CAGE TRANQUIL-C IBD 8X16X3MM

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270696676
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$2,662.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

CAGE VARILIFT LX IBFD 28X10MM

Facility

$25,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693006
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$6,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

CAGE VARILIFT LX IBFD 28X10MM

Facility

$25,000.00

Service Code	HCPCS L8699
Hospital Charge Code	270693006
Hospital Revenue Code	278
Min. Negotiated Rate	$3,750.00
Max. Negotiated Rate	$12,500.00
Rate for Payer: Aetna Commercial	$7,500.00
Rate for Payer: Aetna Medicare Advantage	$7,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,375.00
Rate for Payer: Cigna Commercial	$12,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,050.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,750.00

CAGE VBR INCORP 14X12X20MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696994
Hospital Revenue Code	278
Min. Negotiated Rate	$2,310.00
Max. Negotiated Rate	$3,726.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00

CAGE VBR INCORP 14X12X20MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696994
Hospital Revenue Code	278
Min. Negotiated Rate	$2,310.00
Max. Negotiated Rate	$7,700.00
Rate for Payer: Aetna Commercial	$4,620.00
Rate for Payer: Aetna Medicare Advantage	$4,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,927.00
Rate for Payer: Cigna Commercial	$7,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00

CAGE VBR INCORP 14X12X26MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696845
Hospital Revenue Code	278
Min. Negotiated Rate	$2,310.00
Max. Negotiated Rate	$7,700.00
Rate for Payer: Aetna Commercial	$4,620.00
Rate for Payer: Aetna Medicare Advantage	$4,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,927.00
Rate for Payer: Cigna Commercial	$7,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00

CAGE VBR INCORP 14X12X26MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696845
Hospital Revenue Code	278
Min. Negotiated Rate	$2,310.00
Max. Negotiated Rate	$3,726.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00

CAGE VBR INCORP 14X12X26MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696945
Hospital Revenue Code	278
Min. Negotiated Rate	$2,310.00
Max. Negotiated Rate	$7,700.00
Rate for Payer: Aetna Commercial	$4,620.00
Rate for Payer: Aetna Medicare Advantage	$4,620.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,927.00
Rate for Payer: Cigna Commercial	$7,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00

CAGE VBR INCORP 14X12X26MM 10D

Facility

$15,400.00

Service Code	HCPCS C1889
Hospital Charge Code	270696945
Hospital Revenue Code	278
Min. Negotiated Rate	$2,310.00
Max. Negotiated Rate	$3,726.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,726.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,310.00

CAGE VEO LATERAL 6D 17X11X55MM

Facility

$36,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270695256
Hospital Revenue Code	278
Min. Negotiated Rate	$5,437.50
Max. Negotiated Rate	$8,772.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,772.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,437.50

CAGE VEO LATERAL 6D 17X11X55MM

Facility

$36,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270695256
Hospital Revenue Code	278
Min. Negotiated Rate	$5,437.50
Max. Negotiated Rate	$18,125.00
Rate for Payer: Aetna Commercial	$10,875.00
Rate for Payer: Aetna Medicare Advantage	$10,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,243.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,243.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9,243.75
Rate for Payer: Cigna Commercial	$18,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,772.50
Rate for Payer: Qualcare PPO/HMO/WC	$5,437.50

CAGE WIDE 7MM

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270690708
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

CAGE WIDE 7MM

Facility

$0.01

Service Code	HCPCS C1889
Hospital Charge Code	270690708
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

CAGE ZERO PVA 7 MM LORD

Facility

$16,267.25

Service Code	HCPCS C1889
Hospital Charge Code	270692398
Hospital Revenue Code	278
Min. Negotiated Rate	$2,440.09
Max. Negotiated Rate	$8,133.62
Rate for Payer: Aetna Commercial	$4,880.18
Rate for Payer: Aetna Medicare Advantage	$4,880.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,148.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,148.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,253.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,148.15
Rate for Payer: Cigna Commercial	$8,133.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,936.67
Rate for Payer: Qualcare PPO/HMO/WC	$2,440.09

CAGE ZERO PVA 7 MM LORD

Facility

$16,267.25

Service Code	HCPCS C1889
Hospital Charge Code	270692398
Hospital Revenue Code	278
Min. Negotiated Rate	$2,440.09
Max. Negotiated Rate	$3,936.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,253.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,936.67
Rate for Payer: Qualcare PPO/HMO/WC	$2,440.09

CAGE ZEUS LORDOTIC 16X22X40

Facility

$27,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270692243
Hospital Revenue Code	278
Min. Negotiated Rate	$4,125.00
Max. Negotiated Rate	$6,655.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,655.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,125.00

CAGE ZEUS LORDOTIC 16X22X40

Facility

$27,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270692243
Hospital Revenue Code	278
Min. Negotiated Rate	$4,125.00
Max. Negotiated Rate	$13,750.00
Rate for Payer: Aetna Commercial	$8,250.00
Rate for Payer: Aetna Medicare Advantage	$8,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,012.50
Rate for Payer: Cigna Commercial	$13,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,655.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,125.00

CAID MD EVAL

Facility

$800.80

Hospital Charge Code	84509058
Hospital Revenue Code	918
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

CAID MD EVAL

Facility

$800.80

Hospital Charge Code	84509058
Hospital Revenue Code	918
Min. Negotiated Rate	$104.10
Max. Negotiated Rate	$1,994.00
Rate for Payer: Aetna Commercial	$240.24
Rate for Payer: Aetna Medicare Advantage	$240.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.20
Rate for Payer: Cigna Commercial	$400.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.10
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.12
Rate for Payer: UnitedHealthcare Commercial	$1,994.00

CAID MEDICATION MONITORNG ONLY

Facility

$800.80

Service Code	HCPCS H0035
Hospital Charge Code	84509059
Hospital Revenue Code	919
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$120.12
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

CAID MEDICATION MONITORNG ONLY

Facility

$800.80

Service Code	HCPCS H0035
Hospital Charge Code	84509059
Hospital Revenue Code	919
Min. Negotiated Rate	$104.10
Max. Negotiated Rate	$400.40
Rate for Payer: Aetna Commercial	$240.24
Rate for Payer: Aetna Medicare Advantage	$240.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.20
Rate for Payer: Cigna Commercial	$400.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.10
Rate for Payer: Qualcare PPO/HMO/WC	$120.12

Know your out-of-pocket cost for care.

All Charges