Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN LCKG 5.0x85MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270630779
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$250.29
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LNG THD 3x24MM

Facility

$819.00

Service Code	HCPCS C1713
Hospital Charge Code	270675473
Hospital Revenue Code	278
Min. Negotiated Rate	$122.85
Max. Negotiated Rate	$409.50
Rate for Payer: Aetna Commercial	$245.70
Rate for Payer: Aetna Medicare Advantage	$245.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.84
Rate for Payer: Cigna Commercial	$409.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.20
Rate for Payer: Qualcare PPO/HMO/WC	$122.85

SCREW CANN LNG THD 3x24MM

Facility

$819.00

Service Code	HCPCS C1713
Hospital Charge Code	270675473
Hospital Revenue Code	278
Min. Negotiated Rate	$122.85
Max. Negotiated Rate	$198.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.20
Rate for Payer: Qualcare PPO/HMO/WC	$122.85

SCREW CANN LNG THD 3x34MM

Facility

$819.00

Service Code	HCPCS C1713
Hospital Charge Code	270675472
Hospital Revenue Code	278
Min. Negotiated Rate	$122.85
Max. Negotiated Rate	$409.50
Rate for Payer: Aetna Commercial	$245.70
Rate for Payer: Aetna Medicare Advantage	$245.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.84
Rate for Payer: Cigna Commercial	$409.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.20
Rate for Payer: Qualcare PPO/HMO/WC	$122.85

SCREW CANN LNG THD 3x34MM

Facility

$819.00

Service Code	HCPCS C1713
Hospital Charge Code	270675472
Hospital Revenue Code	278
Min. Negotiated Rate	$122.85
Max. Negotiated Rate	$198.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.20
Rate for Payer: Qualcare PPO/HMO/WC	$122.85

SCREW CANN LNG THD 4.0X16MM

Facility

$810.00

Hospital Charge Code	270670834
Hospital Revenue Code	278
Min. Negotiated Rate	$121.50
Max. Negotiated Rate	$405.00
Rate for Payer: Aetna Commercial	$243.00
Rate for Payer: Aetna Medicare Advantage	$243.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.55
Rate for Payer: Cigna Commercial	$405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.02
Rate for Payer: Qualcare PPO/HMO/WC	$121.50

SCREW CANN LNG THD 4.0X16MM

Facility

$810.00

Hospital Charge Code	270670834
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 LNG THD 4.0x22MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652255
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LNG THD 4.0x22MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652255
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$250.29
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LNG THD 4.0x24MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652289
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$250.29
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LNG THD 4.0x24MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652289
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LNG THD 4.0X28MM

Facility

$810.00

Service Code	HCPCS C1713
Hospital Charge Code	270670835
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 LNG THD 4.0X28MM

Facility

$810.00

Service Code	HCPCS C1713
Hospital Charge Code	270670835
Hospital Revenue Code	278
Min. Negotiated Rate	$121.50
Max. Negotiated Rate	$405.00
Rate for Payer: Aetna Commercial	$243.00
Rate for Payer: Aetna Medicare Advantage	$243.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.55
Rate for Payer: Cigna Commercial	$405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.02
Rate for Payer: Qualcare PPO/HMO/WC	$121.50

SCREW CANN LNG THD 4.0x30MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652267
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LNG THD 4.0x30MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652267
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$250.29
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LNG THD 4.0x32MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270642841
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LNG THD 4.0x32MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270642841
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$250.29
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LNG THD 4.0x34MM

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270676400
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 LNG THD 4.0x34MM

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270676400
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 LNG THD 4.0x36MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270642557
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LNG THD 4.0x36MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270642557
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$250.29
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LNG THD 4.0x38MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270648508
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$417.15
Rate for Payer: Aetna Commercial	$250.29
Rate for Payer: Aetna Medicare Advantage	$250.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.75
Rate for Payer: Cigna Commercial	$417.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LNG THD 4.0x38MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270648508
Hospital Revenue Code	278
Min. Negotiated Rate	$125.14
Max. Negotiated Rate	$201.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.90
Rate for Payer: Qualcare PPO/HMO/WC	$125.14

SCREW CANN LNG THD 4.0x40MM

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270648484
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 LNG THD 4.0x40MM

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270648484
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

Know your out-of-pocket cost for care.

All Charges