Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN PART THD 2.4X14MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270682091
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW CANN PART THD 2.4X16MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270682092
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW CANN PART THD 2.4X16MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270682092
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW CANN PART THD 2.4X18MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270671791
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW CANN PART THD 2.4X18MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270671791
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW CANN PART THD 4x60MM

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270674954
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 PART THD 4x60MM

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270674954
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 PART THD 4x65MM

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270674955
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 PART THD 4x65MM

Facility

$931.20

Service Code	HCPCS C1713
Hospital Charge Code	270674955
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 PART THR 4.0MMx38MM

Facility

$542.00

Hospital Charge Code	270631982
Hospital Revenue Code	278
Min. Negotiated Rate	$81.30
Max. Negotiated Rate	$131.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.16
Rate for Payer: Qualcare PPO/HMO/WC	$81.30

SCREW CANN PART THR 4.0MMx38MM

Facility

$542.00

Hospital Charge Code	270631982
Hospital Revenue Code	278
Min. Negotiated Rate	$81.30
Max. Negotiated Rate	$271.00
Rate for Payer: Aetna Commercial	$162.60
Rate for Payer: Aetna Medicare Advantage	$162.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.21
Rate for Payer: Cigna Commercial	$271.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.16
Rate for Payer: Qualcare PPO/HMO/WC	$81.30

SCREW CANN PART THR 7.3MMX75MM

Facility

$1,002.00

Hospital Charge Code	270634789
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 CANN PART THR 7.3MMX75MM

Facility

$1,002.00

Hospital Charge Code	270634789
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 CANN PART THRD 3.0X36MM

Facility

$942.50

Service Code	HCPCS C1713
Hospital Charge Code	270694750
Hospital Revenue Code	278
Min. Negotiated Rate	$141.38
Max. Negotiated Rate	$228.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.09
Rate for Payer: Qualcare PPO/HMO/WC	$141.38

SCREW CANN PART THRD 3.0X36MM

Facility

$942.50

Service Code	HCPCS C1713
Hospital Charge Code	270694750
Hospital Revenue Code	278
Min. Negotiated Rate	$141.38
Max. Negotiated Rate	$471.25
Rate for Payer: Aetna Commercial	$282.75
Rate for Payer: Aetna Medicare Advantage	$282.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.34
Rate for Payer: Cigna Commercial	$471.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.09
Rate for Payer: Qualcare PPO/HMO/WC	$141.38

SCREW CANN. PART THRD 3.5X18MM

Facility

$780.00

Hospital Charge Code	270667997
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. PART THRD 3.5X18MM

Facility

$780.00

Hospital Charge Code	270667997
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 PART/THREAD 4.5/64

Facility

$881.65

Service Code	HCPCS C1713
Hospital Charge Code	270604898
Hospital Revenue Code	278
Min. Negotiated Rate	$132.25
Max. Negotiated Rate	$440.82
Rate for Payer: Aetna Commercial	$264.50
Rate for Payer: Aetna Medicare Advantage	$264.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.82
Rate for Payer: Cigna Commercial	$440.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.36
Rate for Payer: Qualcare PPO/HMO/WC	$132.25

SCREW CANN PART/THREAD 4.5/64

Facility

$881.65

Service Code	HCPCS C1713
Hospital Charge Code	270604898
Hospital Revenue Code	278
Min. Negotiated Rate	$132.25
Max. Negotiated Rate	$213.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.36
Rate for Payer: Qualcare PPO/HMO/WC	$132.25

SCREW CANN POLYAXIAL 2.5X30

Facility

$745.00

Service Code	HCPCS C1713
Hospital Charge Code	270664430
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$180.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

SCREW CANN POLYAXIAL 2.5X30

Facility

$745.00

Service Code	HCPCS C1713
Hospital Charge Code	270664430
Hospital Revenue Code	278
Min. Negotiated Rate	$111.75
Max. Negotiated Rate	$372.50
Rate for Payer: Aetna Commercial	$223.50
Rate for Payer: Aetna Medicare Advantage	$223.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.97
Rate for Payer: Cigna Commercial	$372.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$111.75

SCREW CANN PT 4.3X16MM

Facility

$3,125.00

Hospital Charge Code	270702505
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$937.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SCREW CANN PT 4.3X16MM

Facility

$3,125.00

Hospital Charge Code	270702505
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SCREW CANN P/THD 4.5X48MM

Facility

$881.65

Service Code	HCPCS C1713
Hospital Charge Code	270604892
Hospital Revenue Code	278
Min. Negotiated Rate	$132.25
Max. Negotiated Rate	$440.82
Rate for Payer: Aetna Commercial	$264.50
Rate for Payer: Aetna Medicare Advantage	$264.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.82
Rate for Payer: Cigna Commercial	$440.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.36
Rate for Payer: Qualcare PPO/HMO/WC	$132.25

SCREW CANN P/THD 4.5X48MM

Facility

$881.65

Service Code	HCPCS C1713
Hospital Charge Code	270604892
Hospital Revenue Code	278
Min. Negotiated Rate	$132.25
Max. Negotiated Rate	$213.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.36
Rate for Payer: Qualcare PPO/HMO/WC	$132.25

Know your out-of-pocket cost for care.

All Charges