Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 2.5x16MM PEG PRT TP16000

Facility

$540.00

Service Code	HCPCS C1713
Hospital Charge Code	270648149
Hospital Revenue Code	278
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$130.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: Qualcare PPO/HMO/WC	$81.00

SCREW 2.5x18MM PEG PRT TP18000

Facility

$540.00

Hospital Charge Code	270648151
Hospital Revenue Code	278
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$162.00
Rate for Payer: Aetna Medicare Advantage	$162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.70
Rate for Payer: Cigna Commercial	$270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: Qualcare PPO/HMO/WC	$81.00

SCREW 2.5x18MM PEG PRT TP18000

Facility

$540.00

Hospital Charge Code	270648151
Hospital Revenue Code	278
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$130.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: Qualcare PPO/HMO/WC	$81.00

SCREW 2.5 X 19 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270701810
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW 2.5 X 19 MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270701810
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$375.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW 2.5x24MM PEG PRT TP24000

Facility

$540.00

Hospital Charge Code	270648154
Hospital Revenue Code	278
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$162.00
Rate for Payer: Aetna Medicare Advantage	$162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.70
Rate for Payer: Cigna Commercial	$270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: Qualcare PPO/HMO/WC	$81.00

SCREW 2.5x24MM PEG PRT TP24000

Facility

$540.00

Hospital Charge Code	270648154
Hospital Revenue Code	278
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$130.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: Qualcare PPO/HMO/WC	$81.00

SCREW 2.5 X 8 MM HEADLESS

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270690629
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW 2.5 X 8 MM HEADLESS

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270690629
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656724
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656721
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656725
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$67.88
Rate for Payer: Aetna Commercial	$40.73
Rate for Payer: Aetna Medicare Advantage	$40.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.62
Rate for Payer: Cigna Commercial	$67.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656723
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656724
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$67.88
Rate for Payer: Aetna Commercial	$40.73
Rate for Payer: Aetna Medicare Advantage	$40.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.62
Rate for Payer: Cigna Commercial	$67.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270657221
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270657221
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$67.88
Rate for Payer: Aetna Commercial	$40.73
Rate for Payer: Aetna Medicare Advantage	$40.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.62
Rate for Payer: Cigna Commercial	$67.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656722
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656722
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$67.88
Rate for Payer: Aetna Commercial	$40.73
Rate for Payer: Aetna Medicare Advantage	$40.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.62
Rate for Payer: Cigna Commercial	$67.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656719
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656721
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$67.88
Rate for Payer: Aetna Commercial	$40.73
Rate for Payer: Aetna Medicare Advantage	$40.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.62
Rate for Payer: Cigna Commercial	$67.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656725
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656723
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$67.88
Rate for Payer: Aetna Commercial	$40.73
Rate for Payer: Aetna Medicare Advantage	$40.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.62
Rate for Payer: Cigna Commercial	$67.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SELF TAPPING

Facility

$135.75

Hospital Charge Code	270656719
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$67.88
Rate for Payer: Aetna Commercial	$40.73
Rate for Payer: Aetna Medicare Advantage	$40.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.62
Rate for Payer: Cigna Commercial	$67.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SLEF TAPPING

Facility

$135.75

Hospital Charge Code	270656718
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$67.88
Rate for Payer: Aetna Commercial	$40.73
Rate for Payer: Aetna Medicare Advantage	$40.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.62
Rate for Payer: Cigna Commercial	$67.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

SCREW 2.7 CORTEX SLEF TAPPING

Facility

$135.75

Hospital Charge Code	270656718
Hospital Revenue Code	278
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.85
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

Know your out-of-pocket cost for care.

All Charges