Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN F/THRD 4.5x20mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604900
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x20mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604900
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$151.50
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x22mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604902
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$151.50
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x22mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604902
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x24mm

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604903
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$213.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THRD 4.5x24mm

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604903
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$440.32
Rate for Payer: Aetna Commercial	$264.19
Rate for Payer: Aetna Medicare Advantage	$264.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.57
Rate for Payer: Cigna Commercial	$440.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THRD 4.5x26mm

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270652283
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$440.32
Rate for Payer: Aetna Commercial	$264.19
Rate for Payer: Aetna Medicare Advantage	$264.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.57
Rate for Payer: Cigna Commercial	$440.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THRD 4.5x26mm

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270652283
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$213.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THRD 4.5x28mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604905
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$151.50
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x28mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604905
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x30mm

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604906
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$213.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THRD 4.5x30mm

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604906
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$440.32
Rate for Payer: Aetna Commercial	$264.19
Rate for Payer: Aetna Medicare Advantage	$264.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.57
Rate for Payer: Cigna Commercial	$440.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THRD 4.5x32mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604907
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$151.50
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x32mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604907
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x34MM

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604908
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$213.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THRD 4.5x34MM

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604908
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$440.32
Rate for Payer: Aetna Commercial	$264.19
Rate for Payer: Aetna Medicare Advantage	$264.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.57
Rate for Payer: Cigna Commercial	$440.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THRD 4.5x40mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604911
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x40mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604911
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$151.50
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x42mm

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604913
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$440.32
Rate for Payer: Aetna Commercial	$264.19
Rate for Payer: Aetna Medicare Advantage	$264.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.57
Rate for Payer: Cigna Commercial	$440.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THRD 4.5x42mm

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604913
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$213.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THRD 4.5x44mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604914
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$151.50
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x44mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604914
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x46mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604915
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x46mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604915
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$151.50
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x48MM

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604916
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$440.32
Rate for Payer: Aetna Commercial	$264.19
Rate for Payer: Aetna Medicare Advantage	$264.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.57
Rate for Payer: Cigna Commercial	$440.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

Know your out-of-pocket cost for care.

All Charges