Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CAN 2.4 20 LONG 3 211820

Facility

$754.00

Service Code	HCPCS C1713
Hospital Charge Code	270634248
Hospital Revenue Code	278
Min. Negotiated Rate	$113.10
Max. Negotiated Rate	$182.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: Qualcare PPO/HMO/WC	$113.10

SCREW CAN 4X28 FORTE 248002841

Facility

$200.50

Hospital Charge Code	270638865
Hospital Revenue Code	278
Min. Negotiated Rate	$30.07
Max. Negotiated Rate	$100.25
Rate for Payer: Aetna Commercial	$60.15
Rate for Payer: Aetna Medicare Advantage	$60.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.13
Rate for Payer: Cigna Commercial	$100.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: Qualcare PPO/HMO/WC	$30.07

SCREW CAN 4X28 FORTE 248002841

Facility

$200.50

Hospital Charge Code	270638865
Hospital Revenue Code	278
Min. Negotiated Rate	$30.07
Max. Negotiated Rate	$48.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.52
Rate for Payer: Qualcare PPO/HMO/WC	$30.07

SCREW CAN 8.0MM X 80MM X 16MM

Facility

$2,509.10

Service Code	HCPCS C1713
Hospital Charge Code	270704915
Hospital Revenue Code	278
Min. Negotiated Rate	$376.37
Max. Negotiated Rate	$1,254.55
Rate for Payer: Aetna Commercial	$752.73
Rate for Payer: Aetna Medicare Advantage	$752.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$639.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$639.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$639.82
Rate for Payer: Cigna Commercial	$1,254.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$607.20
Rate for Payer: Qualcare PPO/HMO/WC	$376.37

SCREW CAN 8.0MM X 80MM X 16MM

Facility

$2,509.10

Service Code	HCPCS C1713
Hospital Charge Code	270704915
Hospital Revenue Code	278
Min. Negotiated Rate	$376.37
Max. Negotiated Rate	$607.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$501.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$607.20
Rate for Payer: Qualcare PPO/HMO/WC	$376.37

SCREW CANC 16MM THD 6.5X60MM

Facility

$335.00

Hospital Charge Code	270670997
Hospital Revenue Code	278
Min. Negotiated Rate	$50.25
Max. Negotiated Rate	$167.50
Rate for Payer: Aetna Commercial	$100.50
Rate for Payer: Aetna Medicare Advantage	$100.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.42
Rate for Payer: Cigna Commercial	$167.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.07
Rate for Payer: Qualcare PPO/HMO/WC	$50.25

SCREW CANC 16MM THD 6.5X60MM

Facility

$335.00

Hospital Charge Code	270670997
Hospital Revenue Code	278
Min. Negotiated Rate	$50.25
Max. Negotiated Rate	$81.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.07
Rate for Payer: Qualcare PPO/HMO/WC	$50.25

SCREW CANC 16MM THD 6.5X70MM

Facility

$335.00

Hospital Charge Code	270670998
Hospital Revenue Code	278
Min. Negotiated Rate	$50.25
Max. Negotiated Rate	$81.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.07
Rate for Payer: Qualcare PPO/HMO/WC	$50.25

SCREW CANC 16MM THD 6.5X70MM

Facility

$335.00

Hospital Charge Code	270670998
Hospital Revenue Code	278
Min. Negotiated Rate	$50.25
Max. Negotiated Rate	$167.50
Rate for Payer: Aetna Commercial	$100.50
Rate for Payer: Aetna Medicare Advantage	$100.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$67.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.42
Rate for Payer: Cigna Commercial	$167.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.07
Rate for Payer: Qualcare PPO/HMO/WC	$50.25

SCREW CANC 2.5 HEX 4x22MM

Facility

$205.00

Service Code	HCPCS C1713
Hospital Charge Code	270673717
Hospital Revenue Code	278
Min. Negotiated Rate	$30.75
Max. Negotiated Rate	$102.50
Rate for Payer: Aetna Commercial	$61.50
Rate for Payer: Aetna Medicare Advantage	$61.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.27
Rate for Payer: Cigna Commercial	$102.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.61
Rate for Payer: Qualcare PPO/HMO/WC	$30.75

SCREW CANC 2.5 HEX 4x22MM

Facility

$205.00

Service Code	HCPCS C1713
Hospital Charge Code	270673717
Hospital Revenue Code	278
Min. Negotiated Rate	$30.75
Max. Negotiated Rate	$49.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.61
Rate for Payer: Qualcare PPO/HMO/WC	$30.75

SCREW CANC 32MM THD 6.5x65MM

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270627314
Hospital Revenue Code	278
Min. Negotiated Rate	$20.86
Max. Negotiated Rate	$33.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: Qualcare PPO/HMO/WC	$20.86

SCREW CANC 32MM THD 6.5x65MM

Facility

$139.05

Service Code	HCPCS C1713
Hospital Charge Code	270627314
Hospital Revenue Code	278
Min. Negotiated Rate	$20.86
Max. Negotiated Rate	$69.53
Rate for Payer: Aetna Commercial	$41.72
Rate for Payer: Aetna Medicare Advantage	$41.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.46
Rate for Payer: Cigna Commercial	$69.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.65
Rate for Payer: Qualcare PPO/HMO/WC	$20.86

SCREW CANC 4.0MM, SM HEX, 4

Facility

$110.00

Hospital Charge Code	270667690
Hospital Revenue Code	278
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$26.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

SCREW CANC 4.0MM, SM HEX, 4

Facility

$110.00

Hospital Charge Code	270667690
Hospital Revenue Code	278
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$33.00
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

SCREW CANC 4.0mmX24mm 24802441

Facility

$191.35

Hospital Charge Code	270634824
Hospital Revenue Code	278
Min. Negotiated Rate	$28.70
Max. Negotiated Rate	$95.67
Rate for Payer: Aetna Commercial	$57.41
Rate for Payer: Aetna Medicare Advantage	$57.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.79
Rate for Payer: Cigna Commercial	$95.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.31
Rate for Payer: Qualcare PPO/HMO/WC	$28.70

SCREW CANC 4.0mmX24mm 24802441

Facility

$191.35

Hospital Charge Code	270634824
Hospital Revenue Code	278
Min. Negotiated Rate	$28.70
Max. Negotiated Rate	$46.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.31
Rate for Payer: Qualcare PPO/HMO/WC	$28.70

SCREW CANC 4.0mmX30mm 24803041

Facility

$191.35

Hospital Charge Code	270634825
Hospital Revenue Code	278
Min. Negotiated Rate	$28.70
Max. Negotiated Rate	$46.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.31
Rate for Payer: Qualcare PPO/HMO/WC	$28.70

SCREW CANC 4.0mmX30mm 24803041

Facility

$191.35

Hospital Charge Code	270634825
Hospital Revenue Code	278
Min. Negotiated Rate	$28.70
Max. Negotiated Rate	$95.67
Rate for Payer: Aetna Commercial	$57.41
Rate for Payer: Aetna Medicare Advantage	$57.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.79
Rate for Payer: Cigna Commercial	$95.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.31
Rate for Payer: Qualcare PPO/HMO/WC	$28.70

SCREW CANC 4.0mmX32mm 28403241

Facility

$191.35

Hospital Charge Code	270634826
Hospital Revenue Code	278
Min. Negotiated Rate	$28.70
Max. Negotiated Rate	$46.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.31
Rate for Payer: Qualcare PPO/HMO/WC	$28.70

SCREW CANC 4.0mmX32mm 28403241

Facility

$191.35

Hospital Charge Code	270634826
Hospital Revenue Code	278
Min. Negotiated Rate	$28.70
Max. Negotiated Rate	$95.67
Rate for Payer: Aetna Commercial	$57.41
Rate for Payer: Aetna Medicare Advantage	$57.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.79
Rate for Payer: Cigna Commercial	$95.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.31
Rate for Payer: Qualcare PPO/HMO/WC	$28.70

SCREW CANC 4.0mmX34mm 24803441

Facility

$191.35

Hospital Charge Code	270634827
Hospital Revenue Code	278
Min. Negotiated Rate	$28.70
Max. Negotiated Rate	$95.67
Rate for Payer: Aetna Commercial	$57.41
Rate for Payer: Aetna Medicare Advantage	$57.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.79
Rate for Payer: Cigna Commercial	$95.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.31
Rate for Payer: Qualcare PPO/HMO/WC	$28.70

SCREW CANC 4.0mmX34mm 24803441

Facility

$191.35

Hospital Charge Code	270634827
Hospital Revenue Code	278
Min. Negotiated Rate	$28.70
Max. Negotiated Rate	$46.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.31
Rate for Payer: Qualcare PPO/HMO/WC	$28.70

SCREW CANC 4.0mmX40mm 24804041

Facility

$191.35

Service Code	HCPCS C1713
Hospital Charge Code	270634828
Hospital Revenue Code	278
Min. Negotiated Rate	$28.70
Max. Negotiated Rate	$46.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.31
Rate for Payer: Qualcare PPO/HMO/WC	$28.70

SCREW CANC 4.0mmX40mm 24804041

Facility

$191.35

Service Code	HCPCS C1713
Hospital Charge Code	270634828
Hospital Revenue Code	278
Min. Negotiated Rate	$28.70
Max. Negotiated Rate	$95.67
Rate for Payer: Aetna Commercial	$57.41
Rate for Payer: Aetna Medicare Advantage	$57.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.79
Rate for Payer: Cigna Commercial	$95.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.31
Rate for Payer: Qualcare PPO/HMO/WC	$28.70

Know your out-of-pocket cost for care.

All Charges