Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE CANN F/THD 4x12MM

Facility

$72.00

Service Code	HCPCS C1713
Hospital Charge Code	270604233
Hospital Revenue Code	278
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$36.00
Rate for Payer: Aetna Commercial	$21.60
Rate for Payer: Aetna Medicare Advantage	$21.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.36
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.42
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

SCREW BONE CANN F/THD 4x12MM

Facility

$72.00

Service Code	HCPCS C1713
Hospital Charge Code	270604233
Hospital Revenue Code	278
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.42
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

SCREW BONE CANN F/THD 4x14MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604234
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$38.17
Rate for Payer: Aetna Commercial	$22.91
Rate for Payer: Aetna Medicare Advantage	$22.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.47
Rate for Payer: Cigna Commercial	$38.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$11.45

SCREW BONE CANN F/THD 4x14MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604234
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$18.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$11.45

SCREW BONE CANN F/THD 4x16MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604235
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$38.17
Rate for Payer: Aetna Commercial	$22.91
Rate for Payer: Aetna Medicare Advantage	$22.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.47
Rate for Payer: Cigna Commercial	$38.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$11.45

SCREW BONE CANN F/THD 4x16MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604235
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$18.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$11.45

SCREW BONE CANN F/THD 4x20MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604237
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$17.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x20MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604237
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$37.08
Rate for Payer: Aetna Commercial	$22.25
Rate for Payer: Aetna Medicare Advantage	$22.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$37.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x22MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604238
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$17.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x22MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604238
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$37.08
Rate for Payer: Aetna Commercial	$22.25
Rate for Payer: Aetna Medicare Advantage	$22.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$37.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x24MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604239
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$37.08
Rate for Payer: Aetna Commercial	$22.25
Rate for Payer: Aetna Medicare Advantage	$22.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$37.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x24MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604239
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$17.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x26MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604240
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$37.08
Rate for Payer: Aetna Commercial	$22.25
Rate for Payer: Aetna Medicare Advantage	$22.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$37.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x26MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604240
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$17.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x28MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604241
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$17.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x28MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604241
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$37.08
Rate for Payer: Aetna Commercial	$22.25
Rate for Payer: Aetna Medicare Advantage	$22.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$37.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x30MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604242
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$38.17
Rate for Payer: Aetna Commercial	$22.91
Rate for Payer: Aetna Medicare Advantage	$22.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.47
Rate for Payer: Cigna Commercial	$38.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$11.45

SCREW BONE CANN F/THD 4x30MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604242
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$18.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$11.45

SCREW BONE CANN F/THD 4x35MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270603210
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$37.08
Rate for Payer: Aetna Commercial	$22.25
Rate for Payer: Aetna Medicare Advantage	$22.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$37.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x35MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270603210
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$17.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x40MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604246
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$18.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$11.45

SCREW BONE CANN F/THD 4x40MM

Facility

$76.35

Service Code	HCPCS C1713
Hospital Charge Code	270604246
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$38.17
Rate for Payer: Aetna Commercial	$22.91
Rate for Payer: Aetna Medicare Advantage	$22.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.47
Rate for Payer: Cigna Commercial	$38.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.48
Rate for Payer: Qualcare PPO/HMO/WC	$11.45

SCREW BONE CANN F/THD 4x45MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604247
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$37.08
Rate for Payer: Aetna Commercial	$22.25
Rate for Payer: Aetna Medicare Advantage	$22.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$37.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x45MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604247
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$17.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x50MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604248
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$37.08
Rate for Payer: Aetna Commercial	$22.25
Rate for Payer: Aetna Medicare Advantage	$22.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$37.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

Know your out-of-pocket cost for care.

All Charges