Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANCELLOUS TI 4X70MM

Facility

$258.40

Service Code	HCPCS C1713
Hospital Charge Code	270692170
Hospital Revenue Code	278
Min. Negotiated Rate	$38.76
Max. Negotiated Rate	$62.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.53
Rate for Payer: Qualcare PPO/HMO/WC	$38.76

SCREW CANCELLS 110X40 B6011040

Facility

$540.70

Hospital Charge Code	270634732
Hospital Revenue Code	278
Min. Negotiated Rate	$81.11
Max. Negotiated Rate	$270.35
Rate for Payer: Aetna Commercial	$162.21
Rate for Payer: Aetna Medicare Advantage	$162.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.88
Rate for Payer: Cigna Commercial	$270.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.85
Rate for Payer: Qualcare PPO/HMO/WC	$81.11

SCREW CANCELLS 110X40 B6011040

Facility

$540.70

Hospital Charge Code	270634732
Hospital Revenue Code	278
Min. Negotiated Rate	$81.11
Max. Negotiated Rate	$130.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.85
Rate for Payer: Qualcare PPO/HMO/WC	$81.11

SCREW CANCELLS 110X50 B6011050

Facility

$540.70

Hospital Charge Code	270634731
Hospital Revenue Code	278
Min. Negotiated Rate	$81.11
Max. Negotiated Rate	$270.35
Rate for Payer: Aetna Commercial	$162.21
Rate for Payer: Aetna Medicare Advantage	$162.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.88
Rate for Payer: Cigna Commercial	$270.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.85
Rate for Payer: Qualcare PPO/HMO/WC	$81.11

SCREW CANCELLS 110X50 B6011050

Facility

$540.70

Hospital Charge Code	270634731
Hospital Revenue Code	278
Min. Negotiated Rate	$81.11
Max. Negotiated Rate	$130.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.85
Rate for Payer: Qualcare PPO/HMO/WC	$81.11

SCREW CANCELLUS 5x364 RD156936

Facility

$1,056.50

Hospital Charge Code	270632872
Hospital Revenue Code	278
Min. Negotiated Rate	$158.47
Max. Negotiated Rate	$255.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.67
Rate for Payer: Qualcare PPO/HMO/WC	$158.47

SCREW CANCELLUS 5x364 RD156936

Facility

$1,056.50

Hospital Charge Code	270632872
Hospital Revenue Code	278
Min. Negotiated Rate	$158.47
Max. Negotiated Rate	$528.25
Rate for Payer: Aetna Commercial	$316.95
Rate for Payer: Aetna Medicare Advantage	$316.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.41
Rate for Payer: Cigna Commercial	$528.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.67
Rate for Payer: Qualcare PPO/HMO/WC	$158.47

SCREW CANCELOUS 16X40 16235240

Facility

$203.25

Hospital Charge Code	270629706
Hospital Revenue Code	278
Min. Negotiated Rate	$30.49
Max. Negotiated Rate	$49.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.19
Rate for Payer: Qualcare PPO/HMO/WC	$30.49

SCREW CANCELOUS 16X40 16235240

Facility

$203.25

Hospital Charge Code	270629706
Hospital Revenue Code	278
Min. Negotiated Rate	$30.49
Max. Negotiated Rate	$101.62
Rate for Payer: Aetna Commercial	$60.98
Rate for Payer: Aetna Medicare Advantage	$60.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.83
Rate for Payer: Cigna Commercial	$101.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.19
Rate for Payer: Qualcare PPO/HMO/WC	$30.49

SCREW CANC FT 12 NN 4 MM

Facility

$247.50

Service Code	HCPCS C1713
Hospital Charge Code	270684093
Hospital Revenue Code	278
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$59.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

SCREW CANC FT 12 NN 4 MM

Facility

$247.50

Service Code	HCPCS C1713
Hospital Charge Code	270684093
Hospital Revenue Code	278
Min. Negotiated Rate	$37.12
Max. Negotiated Rate	$123.75
Rate for Payer: Aetna Commercial	$74.25
Rate for Payer: Aetna Medicare Advantage	$74.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$49.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.11
Rate for Payer: Cigna Commercial	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.90
Rate for Payer: Qualcare PPO/HMO/WC	$37.12

SCREW CANC F/THRD 3.5x10MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655871
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$199.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x10MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655871
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$412.52
Rate for Payer: Aetna Commercial	$247.51
Rate for Payer: Aetna Medicare Advantage	$247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.39
Rate for Payer: Cigna Commercial	$412.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x12MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655873
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$199.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x12MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655873
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$412.52
Rate for Payer: Aetna Commercial	$247.51
Rate for Payer: Aetna Medicare Advantage	$247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.39
Rate for Payer: Cigna Commercial	$412.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x14MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655875
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$199.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x14MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655875
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$412.52
Rate for Payer: Aetna Commercial	$247.51
Rate for Payer: Aetna Medicare Advantage	$247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.39
Rate for Payer: Cigna Commercial	$412.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x16MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655876
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$412.52
Rate for Payer: Aetna Commercial	$247.51
Rate for Payer: Aetna Medicare Advantage	$247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.39
Rate for Payer: Cigna Commercial	$412.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x16MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655876
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$199.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x18MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655880
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$199.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x18MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655880
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$412.52
Rate for Payer: Aetna Commercial	$247.51
Rate for Payer: Aetna Medicare Advantage	$247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.39
Rate for Payer: Cigna Commercial	$412.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x20MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270652239
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$199.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x20MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270652239
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$412.52
Rate for Payer: Aetna Commercial	$247.51
Rate for Payer: Aetna Medicare Advantage	$247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.39
Rate for Payer: Cigna Commercial	$412.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x22MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655882
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$199.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

SCREW CANC F/THRD 3.5x22MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655882
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$412.52
Rate for Payer: Aetna Commercial	$247.51
Rate for Payer: Aetna Medicare Advantage	$247.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.39
Rate for Payer: Cigna Commercial	$412.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.66
Rate for Payer: Qualcare PPO/HMO/WC	$123.76

Know your out-of-pocket cost for care.

All Charges