Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN 4.0x20mm LONG THRD

Facility

$810.00

Hospital Charge Code	270657122
Hospital Revenue Code	278
Min. Negotiated Rate	$121.50
Max. Negotiated Rate	$196.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.02
Rate for Payer: Qualcare PPO/HMO/WC	$121.50

SCREW CANN 4.0X35MM ORTLOC SYS

Facility

$468.00

Service Code	HCPCS C1713
Hospital Charge Code	270704107
Hospital Revenue Code	278
Min. Negotiated Rate	$70.20
Max. Negotiated Rate	$113.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.26
Rate for Payer: Qualcare PPO/HMO/WC	$70.20

SCREW CANN 4.0X35MM ORTLOC SYS

Facility

$468.00

Service Code	HCPCS C1713
Hospital Charge Code	270704107
Hospital Revenue Code	278
Min. Negotiated Rate	$70.20
Max. Negotiated Rate	$234.00
Rate for Payer: Aetna Commercial	$140.40
Rate for Payer: Aetna Medicare Advantage	$140.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.34
Rate for Payer: Cigna Commercial	$234.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.26
Rate for Payer: Qualcare PPO/HMO/WC	$70.20

SCREW CANN 4.0X40MMHEADLSSCOMP

Facility

$2,132.00

Service Code	HCPCS C1713
Hospital Charge Code	270692647
Hospital Revenue Code	278
Min. Negotiated Rate	$319.80
Max. Negotiated Rate	$515.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.94
Rate for Payer: Qualcare PPO/HMO/WC	$319.80

SCREW CANN 4.0X40MMHEADLSSCOMP

Facility

$2,132.00

Service Code	HCPCS C1713
Hospital Charge Code	270692647
Hospital Revenue Code	278
Min. Negotiated Rate	$319.80
Max. Negotiated Rate	$1,066.00
Rate for Payer: Aetna Commercial	$639.60
Rate for Payer: Aetna Medicare Advantage	$639.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$543.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$543.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$543.66
Rate for Payer: Cigna Commercial	$1,066.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.94
Rate for Payer: Qualcare PPO/HMO/WC	$319.80

SCREW CANN 4.0X44MMHEADLSSCOMP

Facility

$2,132.00

Service Code	HCPCS C1713
Hospital Charge Code	270692648
Hospital Revenue Code	278
Min. Negotiated Rate	$319.80
Max. Negotiated Rate	$1,066.00
Rate for Payer: Aetna Commercial	$639.60
Rate for Payer: Aetna Medicare Advantage	$639.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$543.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$543.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$543.66
Rate for Payer: Cigna Commercial	$1,066.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.94
Rate for Payer: Qualcare PPO/HMO/WC	$319.80

SCREW CANN 4.0X44MMHEADLSSCOMP

Facility

$2,132.00

Service Code	HCPCS C1713
Hospital Charge Code	270692648
Hospital Revenue Code	278
Min. Negotiated Rate	$319.80
Max. Negotiated Rate	$515.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.94
Rate for Payer: Qualcare PPO/HMO/WC	$319.80

SCREW CANN 4.0x46mm SHORT THRD

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270644816
Hospital Revenue Code	278
Min. Negotiated Rate	$128.90
Max. Negotiated Rate	$429.68
Rate for Payer: Aetna Commercial	$257.81
Rate for Payer: Aetna Medicare Advantage	$257.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.13
Rate for Payer: Cigna Commercial	$429.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: Qualcare PPO/HMO/WC	$128.90

SCREW CANN 4.0x46mm SHORT THRD

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270644816
Hospital Revenue Code	278
Min. Negotiated Rate	$128.90
Max. Negotiated Rate	$207.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: Qualcare PPO/HMO/WC	$128.90

SCREW CANN 4.0x48mm LONG THRD

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270660820
Hospital Revenue Code	278
Min. Negotiated Rate	$128.90
Max. Negotiated Rate	$207.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: Qualcare PPO/HMO/WC	$128.90

SCREW CANN 4.0x48mm LONG THRD

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270660820
Hospital Revenue Code	278
Min. Negotiated Rate	$128.90
Max. Negotiated Rate	$429.68
Rate for Payer: Aetna Commercial	$257.81
Rate for Payer: Aetna Medicare Advantage	$257.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.13
Rate for Payer: Cigna Commercial	$429.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: Qualcare PPO/HMO/WC	$128.90

SCREW CANN 4.0x50mm SHORT THRD

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270646924
Hospital Revenue Code	278
Min. Negotiated Rate	$128.90
Max. Negotiated Rate	$207.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: Qualcare PPO/HMO/WC	$128.90

SCREW CANN 4.0x50mm SHORT THRD

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270646924
Hospital Revenue Code	278
Min. Negotiated Rate	$128.90
Max. Negotiated Rate	$429.68
Rate for Payer: Aetna Commercial	$257.81
Rate for Payer: Aetna Medicare Advantage	$257.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.13
Rate for Payer: Cigna Commercial	$429.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: Qualcare PPO/HMO/WC	$128.90

SCREW CANN 4.0x50mm SHORT THRD

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270645153
Hospital Revenue Code	278
Min. Negotiated Rate	$128.90
Max. Negotiated Rate	$207.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: Qualcare PPO/HMO/WC	$128.90

SCREW CANN 4.0x50mm SHORT THRD

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270645153
Hospital Revenue Code	278
Min. Negotiated Rate	$128.90
Max. Negotiated Rate	$429.68
Rate for Payer: Aetna Commercial	$257.81
Rate for Payer: Aetna Medicare Advantage	$257.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.13
Rate for Payer: Cigna Commercial	$429.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: Qualcare PPO/HMO/WC	$128.90

SCREW CANN 4.0X52MMHEADLSSCOMP

Facility

$2,132.00

Service Code	HCPCS C1713
Hospital Charge Code	270692649
Hospital Revenue Code	278
Min. Negotiated Rate	$319.80
Max. Negotiated Rate	$515.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.94
Rate for Payer: Qualcare PPO/HMO/WC	$319.80

SCREW CANN 4.0X52MMHEADLSSCOMP

Facility

$2,132.00

Service Code	HCPCS C1713
Hospital Charge Code	270692649
Hospital Revenue Code	278
Min. Negotiated Rate	$319.80
Max. Negotiated Rate	$1,066.00
Rate for Payer: Aetna Commercial	$639.60
Rate for Payer: Aetna Medicare Advantage	$639.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$543.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$543.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$543.66
Rate for Payer: Cigna Commercial	$1,066.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.94
Rate for Payer: Qualcare PPO/HMO/WC	$319.80

SCREW CANN 4.0X60MMHEADLSSCOMP

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270692642
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$949.00
Rate for Payer: Aetna Commercial	$569.40
Rate for Payer: Aetna Medicare Advantage	$569.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.99
Rate for Payer: Cigna Commercial	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW CANN 4.0X60MMHEADLSSCOMP

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270692642
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$459.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW CANN 4X38MM STERILE

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270670036
Hospital Revenue Code	278
Min. Negotiated Rate	$139.68
Max. Negotiated Rate	$225.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.35
Rate for Payer: Qualcare PPO/HMO/WC	$139.68

SCREW CANN 4X38MM STERILE

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270670036
Hospital Revenue Code	278
Min. Negotiated Rate	$139.68
Max. Negotiated Rate	$465.60
Rate for Payer: Aetna Commercial	$279.36
Rate for Payer: Aetna Medicare Advantage	$279.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.46
Rate for Payer: Cigna Commercial	$465.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.35
Rate for Payer: Qualcare PPO/HMO/WC	$139.68

SCREW CANN 4X38MM THD 13MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270670012
Hospital Revenue Code	278
Min. Negotiated Rate	$204.00
Max. Negotiated Rate	$329.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.12
Rate for Payer: Qualcare PPO/HMO/WC	$204.00

SCREW CANN 4X38MM THD 13MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270670012
Hospital Revenue Code	278
Min. Negotiated Rate	$204.00
Max. Negotiated Rate	$680.00
Rate for Payer: Aetna Commercial	$408.00
Rate for Payer: Aetna Medicare Advantage	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$346.80
Rate for Payer: Cigna Commercial	$680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.12
Rate for Payer: Qualcare PPO/HMO/WC	$204.00

SCREW CANN 4x40MM TL 16 SH THD

Facility

$790.00

Hospital Charge Code	270667927
Hospital Revenue Code	278
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$191.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

SCREW CANN 4x40MM TL 16 SH THD

Facility

$790.00

Hospital Charge Code	270667927
Hospital Revenue Code	278
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$395.00
Rate for Payer: Aetna Commercial	$237.00
Rate for Payer: Aetna Medicare Advantage	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$158.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.45
Rate for Payer: Cigna Commercial	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$191.18
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

Know your out-of-pocket cost for care.

All Charges