Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANC NON LOCK 4x50MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	270673653
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$82.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

SCREW CANC NON LOCK 4x50MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	270673653
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$102.00
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

SCREW CANC NON LOCK 4x55MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	270673654
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$102.00
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

SCREW CANC NON LOCK 4x55MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	270673654
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$82.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

SCREW CANC NO PROFLE 50 905406

Facility

$724.25

Hospital Charge Code	270633601
Hospital Revenue Code	278
Min. Negotiated Rate	$108.64
Max. Negotiated Rate	$362.12
Rate for Payer: Aetna Commercial	$217.28
Rate for Payer: Aetna Medicare Advantage	$217.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.68
Rate for Payer: Cigna Commercial	$362.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.27
Rate for Payer: Qualcare PPO/HMO/WC	$108.64

SCREW CANC NO PROFLE 50 905406

Facility

$724.25

Hospital Charge Code	270633601
Hospital Revenue Code	278
Min. Negotiated Rate	$108.64
Max. Negotiated Rate	$175.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.27
Rate for Payer: Qualcare PPO/HMO/WC	$108.64

SCREWCANCOMPHDLS6.5MMTIST110MM

Facility

$3,382.50

Service Code	HCPCS C1713
Hospital Charge Code	270694435
Hospital Revenue Code	278
Min. Negotiated Rate	$507.38
Max. Negotiated Rate	$1,691.25
Rate for Payer: Aetna Commercial	$1,014.75
Rate for Payer: Aetna Medicare Advantage	$1,014.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$862.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$862.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$676.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$862.54
Rate for Payer: Cigna Commercial	$1,691.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$818.57
Rate for Payer: Qualcare PPO/HMO/WC	$507.38

SCREWCANCOMPHDLS6.5MMTIST110MM

Facility

$3,382.50

Service Code	HCPCS C1713
Hospital Charge Code	270694435
Hospital Revenue Code	278
Min. Negotiated Rate	$507.38
Max. Negotiated Rate	$818.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$676.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$818.57
Rate for Payer: Qualcare PPO/HMO/WC	$507.38

SCREW CAN COMP HDLS 6.5TIX85MM

Facility

$1,066.00

Service Code	HCPCS C1713
Hospital Charge Code	270692295
Hospital Revenue Code	278
Min. Negotiated Rate	$159.90
Max. Negotiated Rate	$257.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.97
Rate for Payer: Qualcare PPO/HMO/WC	$159.90

SCREW CAN COMP HDLS 6.5TIX85MM

Facility

$1,066.00

Service Code	HCPCS C1713
Hospital Charge Code	270692295
Hospital Revenue Code	278
Min. Negotiated Rate	$159.90
Max. Negotiated Rate	$533.00
Rate for Payer: Aetna Commercial	$319.80
Rate for Payer: Aetna Medicare Advantage	$319.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.83
Rate for Payer: Cigna Commercial	$533.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.97
Rate for Payer: Qualcare PPO/HMO/WC	$159.90

SCREW CAN COMP HDLS 6.5TIX90MM

Facility

$1,066.00

Service Code	HCPCS C1713
Hospital Charge Code	270692296
Hospital Revenue Code	278
Min. Negotiated Rate	$159.90
Max. Negotiated Rate	$257.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.97
Rate for Payer: Qualcare PPO/HMO/WC	$159.90

SCREW CAN COMP HDLS 6.5TIX90MM

Facility

$1,066.00

Service Code	HCPCS C1713
Hospital Charge Code	270692296
Hospital Revenue Code	278
Min. Negotiated Rate	$159.90
Max. Negotiated Rate	$533.00
Rate for Payer: Aetna Commercial	$319.80
Rate for Payer: Aetna Medicare Advantage	$319.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.83
Rate for Payer: Cigna Commercial	$533.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.97
Rate for Payer: Qualcare PPO/HMO/WC	$159.90

SCREW CAN COMP HDLS 6.5TIX95MM

Facility

$1,066.00

Service Code	HCPCS C1713
Hospital Charge Code	270692297
Hospital Revenue Code	278
Min. Negotiated Rate	$159.90
Max. Negotiated Rate	$533.00
Rate for Payer: Aetna Commercial	$319.80
Rate for Payer: Aetna Medicare Advantage	$319.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.83
Rate for Payer: Cigna Commercial	$533.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.97
Rate for Payer: Qualcare PPO/HMO/WC	$159.90

SCREW CAN COMP HDLS 6.5TIX95MM

Facility

$1,066.00

Service Code	HCPCS C1713
Hospital Charge Code	270692297
Hospital Revenue Code	278
Min. Negotiated Rate	$159.90
Max. Negotiated Rate	$257.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.97
Rate for Payer: Qualcare PPO/HMO/WC	$159.90

SCREWCANCOMPHDLS7.5MMTIST120MM

Facility

$3,382.50

Service Code	HCPCS C1713
Hospital Charge Code	270694436
Hospital Revenue Code	278
Min. Negotiated Rate	$507.38
Max. Negotiated Rate	$818.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$676.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$818.57
Rate for Payer: Qualcare PPO/HMO/WC	$507.38

SCREWCANCOMPHDLS7.5MMTIST120MM

Facility

$3,382.50

Service Code	HCPCS C1713
Hospital Charge Code	270694436
Hospital Revenue Code	278
Min. Negotiated Rate	$507.38
Max. Negotiated Rate	$1,691.25
Rate for Payer: Aetna Commercial	$1,014.75
Rate for Payer: Aetna Medicare Advantage	$1,014.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$862.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$862.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$676.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$862.54
Rate for Payer: Cigna Commercial	$1,691.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$818.57
Rate for Payer: Qualcare PPO/HMO/WC	$507.38

SCREW CAN COMP HDLS TI4.5 40MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700658
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW CAN COMP HDLS TI4.5 40MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700658
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$1,612.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW CAN COMP HDLS TI4.5 44MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700657
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW CAN COMP HDLS TI4.5 44MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700657
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$1,612.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW CAN CONICL 5.0x55 222557

Facility

$664.70

Hospital Charge Code	270634362
Hospital Revenue Code	278
Min. Negotiated Rate	$99.70
Max. Negotiated Rate	$332.35
Rate for Payer: Aetna Commercial	$199.41
Rate for Payer: Aetna Medicare Advantage	$199.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.50
Rate for Payer: Cigna Commercial	$332.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.86
Rate for Payer: Qualcare PPO/HMO/WC	$99.70

SCREW CAN CONICL 5.0x55 222557

Facility

$664.70

Hospital Charge Code	270634362
Hospital Revenue Code	278
Min. Negotiated Rate	$99.70
Max. Negotiated Rate	$160.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.86
Rate for Payer: Qualcare PPO/HMO/WC	$99.70

SCREW CAN CONICL 7.3x80 222607

Facility

$1,002.00

Hospital Charge Code	270634364
Hospital Revenue Code	278
Min. Negotiated Rate	$150.30
Max. Negotiated Rate	$242.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.48
Rate for Payer: Qualcare PPO/HMO/WC	$150.30

SCREW CAN CONICL 7.3x80 222607

Facility

$1,002.00

Hospital Charge Code	270634364
Hospital Revenue Code	278
Min. Negotiated Rate	$150.30
Max. Negotiated Rate	$501.00
Rate for Payer: Aetna Commercial	$300.60
Rate for Payer: Aetna Medicare Advantage	$300.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.51
Rate for Payer: Cigna Commercial	$501.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.48
Rate for Payer: Qualcare PPO/HMO/WC	$150.30

SCREW CANC P/THRD 3.5x10MM

Facility

$803.40

Service Code	HCPCS C1713
Hospital Charge Code	270648934
Hospital Revenue Code	278
Min. Negotiated Rate	$120.51
Max. Negotiated Rate	$401.70
Rate for Payer: Aetna Commercial	$241.02
Rate for Payer: Aetna Medicare Advantage	$241.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.87
Rate for Payer: Cigna Commercial	$401.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.42
Rate for Payer: Qualcare PPO/HMO/WC	$120.51

Know your out-of-pocket cost for care.

All Charges