Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN P/THREADED 4x30MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270667259
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 P/THREADED 4x30MM

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	270667259
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 SH THD 4.0X16MM

Facility

$810.00

Service Code	HCPCS C1713
Hospital Charge Code	270670833
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 SH THD 4.0X16MM

Facility

$810.00

Service Code	HCPCS C1713
Hospital Charge Code	270670833
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 SH/THRD 4.0x10MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270648924
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 SH/THRD 4.0x10MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270648924
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 SH/THRD 4.0x12MM

Facility

$833.40

Service Code	HCPCS C1713
Hospital Charge Code	270652249
Hospital Revenue Code	278
Min. Negotiated Rate	$125.01
Max. Negotiated Rate	$416.70
Rate for Payer: Aetna Commercial	$250.02
Rate for Payer: Aetna Medicare Advantage	$250.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.52
Rate for Payer: Cigna Commercial	$416.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.68
Rate for Payer: Qualcare PPO/HMO/WC	$125.01

SCREW CANN SH/THRD 4.0x12MM

Facility

$833.40

Service Code	HCPCS C1713
Hospital Charge Code	270652249
Hospital Revenue Code	278
Min. Negotiated Rate	$125.01
Max. Negotiated Rate	$201.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$166.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.68
Rate for Payer: Qualcare PPO/HMO/WC	$125.01

SCREW CANN SH/THRD 4.0x14MM

Facility

$810.00

Hospital Charge Code	270676296
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 SH/THRD 4.0x14MM

Facility

$810.00

Hospital Charge Code	270676296
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 SH/THRD 4.0x18MM

Facility

$810.00

Hospital Charge Code	270676298
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 SH/THRD 4.0x18MM

Facility

$810.00

Hospital Charge Code	270676298
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 SH/THRD 4.0x20mm

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652251
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 SH/THRD 4.0x20mm

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652251
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 SH/THRD 4.0x22mm

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270652253
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 SH/THRD 4.0x22mm

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270652253
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 SH/THRD 4.0x24mm

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270652257
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 SH/THRD 4.0x24mm

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270652257
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 SH/THRD 4.0x26mm

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270652262
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 SH/THRD 4.0x26mm

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270652262
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 SH/THRD 4.0x28MM

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270652264
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 SH/THRD 4.0x28MM

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270652264
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 SH/THRD 4.0x30MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652266
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 SH/THRD 4.0x30MM

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270652266
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 SH/THRD 4.0x32MM

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270657141
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