Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANC F/THRD 3.5x50MM

Facility

$825.05

Service Code	HCPCS C1713
Hospital Charge Code	270655904
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 6.5x60MM

Facility

$135.00

Hospital Charge Code	270676303
Hospital Revenue Code	278
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$67.50
Rate for Payer: Aetna Commercial	$40.50
Rate for Payer: Aetna Medicare Advantage	$40.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.42
Rate for Payer: Cigna Commercial	$67.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

SCREW CANC F/THRD 6.5x60MM

Facility

$135.00

Hospital Charge Code	270676303
Hospital Revenue Code	278
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$32.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: Qualcare PPO/HMO/WC	$20.25

SCREW CANC INV REVER 4.5X36MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270696095
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SCREW CANC INV REVER 4.5X36MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270696095
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SCREW CANCL 6.5 16x50 16235250

Facility

$238.15

Hospital Charge Code	270633935
Hospital Revenue Code	278
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$119.08
Rate for Payer: Aetna Commercial	$71.44
Rate for Payer: Aetna Medicare Advantage	$71.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.73
Rate for Payer: Cigna Commercial	$119.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.63
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

SCREW CANCL 6.5 16x50 16235250

Facility

$238.15

Hospital Charge Code	270633935
Hospital Revenue Code	278
Min. Negotiated Rate	$35.72
Max. Negotiated Rate	$57.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.63
Rate for Payer: Qualcare PPO/HMO/WC	$35.72

SCREW CANC LAG 5.5x90mm

Facility

$405.00

Service Code	HCPCS C1713
Hospital Charge Code	270671595
Hospital Revenue Code	278
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$202.50
Rate for Payer: Cigna Commercial	$202.50
Rate for Payer: Aetna Commercial	$121.50
Rate for Payer: Aetna Medicare Advantage	$121.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

SCREW CANC LAG 5.5x90mm

Facility

$405.00

Service Code	HCPCS C1713
Hospital Charge Code	270671595
Hospital Revenue Code	278
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$98.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

SCREW CANC LOCK 4.2x36 3742236

Facility

$945.00

Hospital Charge Code	270643577
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$283.50
Rate for Payer: Aetna Medicare Advantage	$283.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.97
Rate for Payer: Cigna Commercial	$472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW CANC LOCK 4.2x36 3742236

Facility

$945.00

Hospital Charge Code	270643577
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$228.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW CANC LOCK 4.2x40 3742240

Facility

$945.00

Hospital Charge Code	270643576
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$283.50
Rate for Payer: Aetna Medicare Advantage	$283.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.97
Rate for Payer: Cigna Commercial	$472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW CANC LOCK 4.2x40 3742240

Facility

$945.00

Hospital Charge Code	270643576
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$228.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW CANC LOCK 4.2x50 3742250

Facility

$945.00

Hospital Charge Code	270643575
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$283.50
Rate for Payer: Aetna Medicare Advantage	$283.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.97
Rate for Payer: Cigna Commercial	$472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW CANC LOCK 4.2x50 3742250

Facility

$945.00

Hospital Charge Code	270643575
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$228.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW CANC LOCK 44MM

Facility

$1,155.00

Hospital Charge Code	270702010
Hospital Revenue Code	278
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$279.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$231.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.51
Rate for Payer: Qualcare PPO/HMO/WC	$173.25

SCREW CANC LOCK 44MM

Facility

$1,155.00

Hospital Charge Code	270702010
Hospital Revenue Code	278
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$577.50
Rate for Payer: Aetna Commercial	$346.50
Rate for Payer: Aetna Medicare Advantage	$346.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$294.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$294.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$231.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$294.52
Rate for Payer: Cigna Commercial	$577.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.51
Rate for Payer: Qualcare PPO/HMO/WC	$173.25

SCREW CANC LOCK 48MM

Facility

$1,155.00

Service Code	HCPCS C1713
Hospital Charge Code	270702011
Hospital Revenue Code	278
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$577.50
Rate for Payer: Aetna Commercial	$346.50
Rate for Payer: Aetna Medicare Advantage	$346.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$294.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$294.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$231.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$294.52
Rate for Payer: Cigna Commercial	$577.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.51
Rate for Payer: Qualcare PPO/HMO/WC	$173.25

SCREW CANC LOCK 48MM

Facility

$1,155.00

Service Code	HCPCS C1713
Hospital Charge Code	270702011
Hospital Revenue Code	278
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$279.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$231.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.51
Rate for Payer: Qualcare PPO/HMO/WC	$173.25

SCREW CANC LOCK 55MM

Facility

$1,155.00

Service Code	HCPCS C1713
Hospital Charge Code	270702012
Hospital Revenue Code	278
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$577.50
Rate for Payer: Aetna Commercial	$346.50
Rate for Payer: Aetna Medicare Advantage	$346.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$294.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$294.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$231.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$294.52
Rate for Payer: Cigna Commercial	$577.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.51
Rate for Payer: Qualcare PPO/HMO/WC	$173.25

SCREW CANC LOCK 55MM

Facility

$1,155.00

Service Code	HCPCS C1713
Hospital Charge Code	270702012
Hospital Revenue Code	278
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$279.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$231.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.51
Rate for Payer: Qualcare PPO/HMO/WC	$173.25

SCREW CANC LOCK 60MM

Facility

$1,155.00

Service Code	HCPCS C1713
Hospital Charge Code	270702013
Hospital Revenue Code	278
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$279.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$231.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.51
Rate for Payer: Qualcare PPO/HMO/WC	$173.25

SCREW CANC LOCK 60MM

Facility

$1,155.00

Service Code	HCPCS C1713
Hospital Charge Code	270702013
Hospital Revenue Code	278
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$577.50
Rate for Payer: Aetna Commercial	$346.50
Rate for Payer: Aetna Medicare Advantage	$346.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$294.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$294.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$231.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$294.52
Rate for Payer: Cigna Commercial	$577.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.51
Rate for Payer: Qualcare PPO/HMO/WC	$173.25

SCREW CANCL Ti 6.5X60 AR13260T

Facility

$496.00

Hospital Charge Code	270636946
Hospital Revenue Code	278
Min. Negotiated Rate	$74.40
Max. Negotiated Rate	$248.00
Rate for Payer: Aetna Commercial	$148.80
Rate for Payer: Aetna Medicare Advantage	$148.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.48
Rate for Payer: Cigna Commercial	$248.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.03
Rate for Payer: Qualcare PPO/HMO/WC	$74.40

SCREW CANCL Ti 6.5X60 AR13260T

Facility

$496.00

Hospital Charge Code	270636946
Hospital Revenue Code	278
Min. Negotiated Rate	$74.40
Max. Negotiated Rate	$120.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.03
Rate for Payer: Qualcare PPO/HMO/WC	$74.40

Know your out-of-pocket cost for care.

All Charges