Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW ASNIS CANN 3.0 6.0X28MM

Facility

$2,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270697325
Hospital Revenue Code	278
Min. Negotiated Rate	$354.00
Max. Negotiated Rate	$571.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$472.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$571.12
Rate for Payer: Qualcare PPO/HMO/WC	$354.00

SCREW ASNIS CANULATED 4.0X70MM

Facility

$1,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270668344
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

SCREW ASNIS CANULATED 4.0X70MM

Facility

$1,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270668344
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

SCREW ASNIS MICRO 6X26MM

Facility

$1,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270699182
Hospital Revenue Code	278
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$290.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$180.00

SCREW ASNIS MICRO 6X26MM

Facility

$1,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270699182
Hospital Revenue Code	278
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$360.00
Rate for Payer: Aetna Medicare Advantage	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.00
Rate for Payer: Cigna Commercial	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$180.00

SCREW ASNIS PART THD 4X50MM

Facility

$1,360.00

Hospital Charge Code	270669927
Hospital Revenue Code	278
Min. Negotiated Rate	$204.00
Max. Negotiated Rate	$680.00
Rate for Payer: Aetna Commercial	$408.00
Rate for Payer: Aetna Medicare Advantage	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$346.80
Rate for Payer: Cigna Commercial	$680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.12
Rate for Payer: Qualcare PPO/HMO/WC	$204.00

SCREW ASNIS PART THD 4X50MM

Facility

$1,360.00

Hospital Charge Code	270669927
Hospital Revenue Code	278
Min. Negotiated Rate	$204.00
Max. Negotiated Rate	$329.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.12
Rate for Payer: Qualcare PPO/HMO/WC	$204.00

SCREW ASNIS PART THD 4X55MM

Facility

$1,360.00

Hospital Charge Code	270669926
Hospital Revenue Code	278
Min. Negotiated Rate	$204.00
Max. Negotiated Rate	$680.00
Rate for Payer: Aetna Commercial	$408.00
Rate for Payer: Aetna Medicare Advantage	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$346.80
Rate for Payer: Cigna Commercial	$680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.12
Rate for Payer: Qualcare PPO/HMO/WC	$204.00

SCREW ASNIS PART THD 4X55MM

Facility

$1,360.00

Hospital Charge Code	270669926
Hospital Revenue Code	278
Min. Negotiated Rate	$204.00
Max. Negotiated Rate	$329.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.12
Rate for Payer: Qualcare PPO/HMO/WC	$204.00

SCREW ASNIS TI 3X32MM

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	270661035
Hospital Revenue Code	278
Min. Negotiated Rate	$207.75
Max. Negotiated Rate	$335.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.17
Rate for Payer: Qualcare PPO/HMO/WC	$207.75

SCREW ASNIS TI 3X32MM

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	270661035
Hospital Revenue Code	278
Min. Negotiated Rate	$207.75
Max. Negotiated Rate	$692.50
Rate for Payer: Aetna Commercial	$415.50
Rate for Payer: Aetna Medicare Advantage	$415.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$353.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$353.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$353.18
Rate for Payer: Cigna Commercial	$692.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$335.17
Rate for Payer: Qualcare PPO/HMO/WC	$207.75

SCREW ATHX BIO 10 23 AR1400B

Facility

$1,153.65

Hospital Charge Code	270621865
Hospital Revenue Code	278
Min. Negotiated Rate	$173.05
Max. Negotiated Rate	$576.83
Rate for Payer: Aetna Commercial	$346.10
Rate for Payer: Aetna Medicare Advantage	$346.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$294.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$294.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$294.18
Rate for Payer: Cigna Commercial	$576.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.18
Rate for Payer: Qualcare PPO/HMO/WC	$173.05

SCREW ATHX BIO 10 23 AR1400B

Facility

$1,153.65

Hospital Charge Code	270621865
Hospital Revenue Code	278
Min. Negotiated Rate	$173.05
Max. Negotiated Rate	$279.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.18
Rate for Payer: Qualcare PPO/HMO/WC	$173.05

SCREW ATHX BIO 10 28 AR1400TB

Facility

$1,035.25

Hospital Charge Code	270610588
Hospital Revenue Code	278
Min. Negotiated Rate	$155.29
Max. Negotiated Rate	$250.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$207.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.53
Rate for Payer: Qualcare PPO/HMO/WC	$155.29

SCREW ATHX BIO 10 28 AR1400TB

Facility

$1,035.25

Hospital Charge Code	270610588
Hospital Revenue Code	278
Min. Negotiated Rate	$155.29
Max. Negotiated Rate	$517.62
Rate for Payer: Aetna Commercial	$310.57
Rate for Payer: Aetna Medicare Advantage	$310.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$263.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$263.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$207.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$263.99
Rate for Payer: Cigna Commercial	$517.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.53
Rate for Payer: Qualcare PPO/HMO/WC	$155.29

SCREW ATHX BIO 11 28 AR1403TB

Facility

$1,153.65

Hospital Charge Code	270623145
Hospital Revenue Code	278
Min. Negotiated Rate	$173.05
Max. Negotiated Rate	$576.83
Rate for Payer: Aetna Commercial	$346.10
Rate for Payer: Aetna Medicare Advantage	$346.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$294.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$294.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$294.18
Rate for Payer: Cigna Commercial	$576.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.18
Rate for Payer: Qualcare PPO/HMO/WC	$173.05

SCREW ATHX BIO 11 28 AR1403TB

Facility

$1,153.65

Hospital Charge Code	270623145
Hospital Revenue Code	278
Min. Negotiated Rate	$173.05
Max. Negotiated Rate	$279.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.18
Rate for Payer: Qualcare PPO/HMO/WC	$173.05

SCREW ATHX BIO 8 23 AR1380B

Facility

$1,242.45

Hospital Charge Code	270614431
Hospital Revenue Code	278
Min. Negotiated Rate	$186.37
Max. Negotiated Rate	$300.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.67
Rate for Payer: Qualcare PPO/HMO/WC	$186.37

SCREW ATHX BIO 8 23 AR1380B

Facility

$1,242.45

Hospital Charge Code	270614431
Hospital Revenue Code	278
Min. Negotiated Rate	$186.37
Max. Negotiated Rate	$621.23
Rate for Payer: Aetna Commercial	$372.74
Rate for Payer: Aetna Medicare Advantage	$372.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.82
Rate for Payer: Cigna Commercial	$621.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.67
Rate for Payer: Qualcare PPO/HMO/WC	$186.37

SCREW ATHX BIO 9 28 AR1390TB

Facility

$1,685.65

Hospital Charge Code	270621137
Hospital Revenue Code	278
Min. Negotiated Rate	$252.85
Max. Negotiated Rate	$842.83
Rate for Payer: Aetna Commercial	$505.69
Rate for Payer: Aetna Medicare Advantage	$505.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$429.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$429.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$337.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$429.84
Rate for Payer: Cigna Commercial	$842.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$407.93
Rate for Payer: Qualcare PPO/HMO/WC	$252.85

SCREW ATHX BIO 9 28 AR1390TB

Facility

$1,685.65

Hospital Charge Code	270621137
Hospital Revenue Code	278
Min. Negotiated Rate	$252.85
Max. Negotiated Rate	$407.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$337.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$407.93
Rate for Payer: Qualcare PPO/HMO/WC	$252.85

SCREW ATHX CAN 9 25 AR1391E

Facility

$1,058.45

Hospital Charge Code	270601993
Hospital Revenue Code	278
Min. Negotiated Rate	$158.77
Max. Negotiated Rate	$529.23
Rate for Payer: Aetna Commercial	$317.54
Rate for Payer: Aetna Medicare Advantage	$317.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.90
Rate for Payer: Cigna Commercial	$529.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.14
Rate for Payer: Qualcare PPO/HMO/WC	$158.77

SCREW ATHX CAN 9 25 AR1391E

Facility

$1,058.45

Hospital Charge Code	270601993
Hospital Revenue Code	278
Min. Negotiated Rate	$158.77
Max. Negotiated Rate	$256.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.14
Rate for Payer: Qualcare PPO/HMO/WC	$158.77

SCREW ATHX CANC 6.5 35 AR1357

Facility

$1,012.85

Hospital Charge Code	270614427
Hospital Revenue Code	278
Min. Negotiated Rate	$151.93
Max. Negotiated Rate	$506.43
Rate for Payer: Aetna Commercial	$303.86
Rate for Payer: Aetna Medicare Advantage	$303.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$258.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$258.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$202.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$258.28
Rate for Payer: Cigna Commercial	$506.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.11
Rate for Payer: Qualcare PPO/HMO/WC	$151.93

SCREW ATHX CANC 6.5 35 AR1357

Facility

$1,012.85

Hospital Charge Code	270614427
Hospital Revenue Code	278
Min. Negotiated Rate	$151.93
Max. Negotiated Rate	$245.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$202.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.11
Rate for Payer: Qualcare PPO/HMO/WC	$151.93

Know your out-of-pocket cost for care.

All Charges