Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN COMP HDLS 4.5X75MM

Facility

$2,355.00

Service Code	HCPCS C1713
Hospital Charge Code	270698818
Hospital Revenue Code	278
Min. Negotiated Rate	$353.25
Max. Negotiated Rate	$569.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$471.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$569.91
Rate for Payer: Qualcare PPO/HMO/WC	$353.25

SCREW CANN COMP HDLS 4.5X75MM

Facility

$2,355.00

Service Code	HCPCS C1713
Hospital Charge Code	270698818
Hospital Revenue Code	278
Min. Negotiated Rate	$353.25
Max. Negotiated Rate	$1,177.50
Rate for Payer: Aetna Commercial	$706.50
Rate for Payer: Aetna Medicare Advantage	$706.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$600.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$600.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$471.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$600.52
Rate for Payer: Cigna Commercial	$1,177.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$569.91
Rate for Payer: Qualcare PPO/HMO/WC	$353.25

SCREW CANN COMP HL 4.5X38MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700248
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$2,687.50
Rate for Payer: Qualcare PPO/HMO/WC	$806.25
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

SCREW CANN COMP HL 4.5X38MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700248
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 CANN COMP HL 4.5X65MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700247
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 CANN COMP HL 4.5X65MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700247
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 CANN COMPR 3x26MM

Facility

$2,090.00

Service Code	HCPCS C1713
Hospital Charge Code	270675273
Hospital Revenue Code	278
Min. Negotiated Rate	$313.50
Max. Negotiated Rate	$505.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$418.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$505.78
Rate for Payer: Qualcare PPO/HMO/WC	$313.50

SCREW CANN COMPR 3x26MM

Facility

$2,090.00

Service Code	HCPCS C1713
Hospital Charge Code	270675273
Hospital Revenue Code	278
Min. Negotiated Rate	$313.50
Max. Negotiated Rate	$1,045.00
Rate for Payer: Aetna Commercial	$627.00
Rate for Payer: Aetna Medicare Advantage	$627.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$532.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$532.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$418.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$532.95
Rate for Payer: Cigna Commercial	$1,045.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$505.78
Rate for Payer: Qualcare PPO/HMO/WC	$313.50

SCREW CANN COMPR 3x40MM

Facility

$2,090.00

Service Code	HCPCS C1713
Hospital Charge Code	270675274
Hospital Revenue Code	278
Min. Negotiated Rate	$313.50
Max. Negotiated Rate	$505.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$418.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$505.78
Rate for Payer: Qualcare PPO/HMO/WC	$313.50

SCREW CANN COMPR 3x40MM

Facility

$2,090.00

Service Code	HCPCS C1713
Hospital Charge Code	270675274
Hospital Revenue Code	278
Min. Negotiated Rate	$313.50
Max. Negotiated Rate	$1,045.00
Rate for Payer: Aetna Commercial	$627.00
Rate for Payer: Aetna Medicare Advantage	$627.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$532.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$532.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$418.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$532.95
Rate for Payer: Cigna Commercial	$1,045.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$505.78
Rate for Payer: Qualcare PPO/HMO/WC	$313.50

SCREW CANN COMPRESS 3.5X50MM

Facility

$770.00

Service Code	HCPCS C1713
Hospital Charge Code	270698547
Hospital Revenue Code	278
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$385.00
Rate for Payer: Aetna Commercial	$231.00
Rate for Payer: Aetna Medicare Advantage	$231.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.35
Rate for Payer: Cigna Commercial	$385.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.34
Rate for Payer: Qualcare PPO/HMO/WC	$115.50

SCREW CANN COMPRESS 3.5X50MM

Facility

$770.00

Service Code	HCPCS C1713
Hospital Charge Code	270698547
Hospital Revenue Code	278
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$186.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.34
Rate for Payer: Qualcare PPO/HMO/WC	$115.50

SCREW CANN COMP SD 2.2X20MM

Facility

$2,796.40

Service Code	HCPCS C1713
Hospital Charge Code	270699923
Hospital Revenue Code	278
Min. Negotiated Rate	$419.46
Max. Negotiated Rate	$676.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.73
Rate for Payer: Qualcare PPO/HMO/WC	$419.46

SCREW CANN COMP SD 2.2X20MM

Facility

$2,796.40

Service Code	HCPCS C1713
Hospital Charge Code	270699923
Hospital Revenue Code	278
Min. Negotiated Rate	$419.46
Max. Negotiated Rate	$1,398.20
Rate for Payer: Aetna Commercial	$838.92
Rate for Payer: Aetna Medicare Advantage	$838.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$713.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$713.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$559.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$713.08
Rate for Payer: Cigna Commercial	$1,398.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$676.73
Rate for Payer: Qualcare PPO/HMO/WC	$419.46

SCREW CANN CONICAL 5.0X70MM

Facility

$3,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270699951
Hospital Revenue Code	278
Min. Negotiated Rate	$457.50
Max. Negotiated Rate	$1,525.00
Rate for Payer: Aetna Commercial	$915.00
Rate for Payer: Aetna Medicare Advantage	$915.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$777.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$777.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$777.75
Rate for Payer: Cigna Commercial	$1,525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$738.10
Rate for Payer: Qualcare PPO/HMO/WC	$457.50

SCREW CANN CONICAL 5.0X70MM

Facility

$3,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270699951
Hospital Revenue Code	278
Min. Negotiated Rate	$457.50
Max. Negotiated Rate	$738.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$610.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$738.10
Rate for Payer: Qualcare PPO/HMO/WC	$457.50

SCREW CANN CONICAL 5.0 X 80mm

Facility

$664.70

Hospital Charge Code	270636084
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 CANN CONICAL 5.0 X 80mm

Facility

$664.70

Hospital Charge Code	270636084
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 CANN CONICAL 5X70MM

Facility

$890.00

Hospital Charge Code	270638844
Hospital Revenue Code	278
Min. Negotiated Rate	$133.50
Max. Negotiated Rate	$445.00
Rate for Payer: Aetna Commercial	$267.00
Rate for Payer: Aetna Medicare Advantage	$267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.95
Rate for Payer: Cigna Commercial	$445.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.38
Rate for Payer: Qualcare PPO/HMO/WC	$133.50

SCREW CANN CONICAL 5X70MM

Facility

$890.00

Hospital Charge Code	270638844
Hospital Revenue Code	278
Min. Negotiated Rate	$133.50
Max. Negotiated Rate	$215.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.38
Rate for Payer: Qualcare PPO/HMO/WC	$133.50

SCREW CANN CONICAL 5X85MM

Facility

$780.00

Hospital Charge Code	270638841
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$188.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW CANN CONICAL 5X85MM

Facility

$780.00

Hospital Charge Code	270638841
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$234.00
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW CANN CONI P/THD 7.3x50MM

Facility

$1,074.00

Hospital Charge Code	270657174
Hospital Revenue Code	278
Min. Negotiated Rate	$161.10
Max. Negotiated Rate	$259.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.91
Rate for Payer: Qualcare PPO/HMO/WC	$161.10

SCREW CANN CONI P/THD 7.3x50MM

Facility

$1,074.00

Hospital Charge Code	270657174
Hospital Revenue Code	278
Min. Negotiated Rate	$161.10
Max. Negotiated Rate	$537.00
Rate for Payer: Aetna Commercial	$322.20
Rate for Payer: Aetna Medicare Advantage	$322.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.87
Rate for Payer: Cigna Commercial	$537.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.91
Rate for Payer: Qualcare PPO/HMO/WC	$161.10

SCREW CANN CONI P/THD 7.3x55MM

Facility

$1,074.00

Hospital Charge Code	270657184
Hospital Revenue Code	278
Min. Negotiated Rate	$161.10
Max. Negotiated Rate	$537.00
Rate for Payer: Aetna Commercial	$322.20
Rate for Payer: Aetna Medicare Advantage	$322.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$273.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$273.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$273.87
Rate for Payer: Cigna Commercial	$537.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.91
Rate for Payer: Qualcare PPO/HMO/WC	$161.10

Know your out-of-pocket cost for care.

All Charges