Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN SH/THRD 4.0x64mm

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270648503
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 4.0x64mm

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270648503
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 4.0x68mm

Facility

$562.33

Service Code	HCPCS C1713
Hospital Charge Code	270648505
Hospital Revenue Code	278
Min. Negotiated Rate	$84.35
Max. Negotiated Rate	$281.17
Rate for Payer: Aetna Commercial	$168.70
Rate for Payer: Aetna Medicare Advantage	$168.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.39
Rate for Payer: Cigna Commercial	$281.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.08
Rate for Payer: Qualcare PPO/HMO/WC	$84.35

SCREW CANN SH/THRD 4.0x68mm

Facility

$562.33

Service Code	HCPCS C1713
Hospital Charge Code	270648505
Hospital Revenue Code	278
Min. Negotiated Rate	$84.35
Max. Negotiated Rate	$136.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.08
Rate for Payer: Qualcare PPO/HMO/WC	$84.35

SCREW CANN SH/THRD 4.0x72mm

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270648936
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 4.0x72mm

Facility

$834.30

Service Code	HCPCS C1713
Hospital Charge Code	270648936
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 ST 4.0X38MM

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270700112
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

SCREW CANN ST 4.0X38MM

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270700112
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

SCREW CANN THD 16 7.3X45MM

Facility

$1,065.00

Hospital Charge Code	270670827
Hospital Revenue Code	278
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$257.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: Qualcare PPO/HMO/WC	$159.75

SCREW CANN THD 16 7.3X45MM

Facility

$1,065.00

Hospital Charge Code	270670827
Hospital Revenue Code	278
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$532.50
Rate for Payer: Aetna Commercial	$319.50
Rate for Payer: Aetna Medicare Advantage	$319.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.57
Rate for Payer: Cigna Commercial	$532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: Qualcare PPO/HMO/WC	$159.75

SCREW CANN THD 7Dx40mm

Facility

$689.65

Hospital Charge Code	270633504
Hospital Revenue Code	278
Min. Negotiated Rate	$103.45
Max. Negotiated Rate	$166.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.90
Rate for Payer: Qualcare PPO/HMO/WC	$103.45

SCREW CANN THD 7Dx40mm

Facility

$689.65

Hospital Charge Code	270633504
Hospital Revenue Code	278
Min. Negotiated Rate	$103.45
Max. Negotiated Rate	$344.82
Rate for Payer: Aetna Commercial	$206.90
Rate for Payer: Aetna Medicare Advantage	$206.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.86
Rate for Payer: Cigna Commercial	$344.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.90
Rate for Payer: Qualcare PPO/HMO/WC	$103.45

SCREW CANN THD 7Dx45mm

Facility

$689.65

Hospital Charge Code	270633505
Hospital Revenue Code	278
Min. Negotiated Rate	$103.45
Max. Negotiated Rate	$166.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.90
Rate for Payer: Qualcare PPO/HMO/WC	$103.45

SCREW CANN THD 7Dx45mm

Facility

$689.65

Hospital Charge Code	270633505
Hospital Revenue Code	278
Min. Negotiated Rate	$103.45
Max. Negotiated Rate	$344.82
Rate for Payer: Aetna Commercial	$206.90
Rate for Payer: Aetna Medicare Advantage	$206.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.86
Rate for Payer: Cigna Commercial	$344.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.90
Rate for Payer: Qualcare PPO/HMO/WC	$103.45

SCREW CANN THR 4.0x32 11424132

Facility

$521.15

Hospital Charge Code	270633219
Hospital Revenue Code	278
Min. Negotiated Rate	$78.17
Max. Negotiated Rate	$260.57
Rate for Payer: Aetna Commercial	$156.34
Rate for Payer: Aetna Medicare Advantage	$156.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.89
Rate for Payer: Cigna Commercial	$260.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.12
Rate for Payer: Qualcare PPO/HMO/WC	$78.17

SCREW CANN THR 4.0x32 11424132

Facility

$521.15

Hospital Charge Code	270633219
Hospital Revenue Code	278
Min. Negotiated Rate	$78.17
Max. Negotiated Rate	$126.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.12
Rate for Payer: Qualcare PPO/HMO/WC	$78.17

SCREW CANN TI 4.0X44MM LT

Facility

$3,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700093
Hospital Revenue Code	278
Min. Negotiated Rate	$470.25
Max. Negotiated Rate	$1,567.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$940.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.42
Rate for Payer: Cigna Commercial	$1,567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.67
Rate for Payer: Qualcare PPO/HMO/WC	$470.25

SCREW CANN TI 4.0X44MM LT

Facility

$3,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700093
Hospital Revenue Code	278
Min. Negotiated Rate	$470.25
Max. Negotiated Rate	$758.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.67
Rate for Payer: Qualcare PPO/HMO/WC	$470.25

SCREW CANN TI 4.0X46MM LT

Facility

$3,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700094
Hospital Revenue Code	278
Min. Negotiated Rate	$470.25
Max. Negotiated Rate	$1,567.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$940.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.42
Rate for Payer: Cigna Commercial	$1,567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.67
Rate for Payer: Qualcare PPO/HMO/WC	$470.25

SCREW CANN TI 4.0X46MM LT

Facility

$3,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700094
Hospital Revenue Code	278
Min. Negotiated Rate	$470.25
Max. Negotiated Rate	$758.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.67
Rate for Payer: Qualcare PPO/HMO/WC	$470.25

SCREW CANN TI 4.0X50MM LT

Facility

$3,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700092
Hospital Revenue Code	278
Min. Negotiated Rate	$470.25
Max. Negotiated Rate	$758.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.67
Rate for Payer: Qualcare PPO/HMO/WC	$470.25

SCREW CANN TI 4.0X50MM LT

Facility

$3,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270700092
Hospital Revenue Code	278
Min. Negotiated Rate	$470.25
Max. Negotiated Rate	$1,567.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$940.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.42
Rate for Payer: Cigna Commercial	$1,567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$758.67
Rate for Payer: Qualcare PPO/HMO/WC	$470.25

SCREW CANN TI 4.0X70MM

Facility

$1,363.50

Service Code	HCPCS C1713
Hospital Charge Code	270699448
Hospital Revenue Code	278
Min. Negotiated Rate	$204.53
Max. Negotiated Rate	$329.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.97
Rate for Payer: Qualcare PPO/HMO/WC	$204.53

SCREW CANN TI 4.0X70MM

Facility

$1,363.50

Service Code	HCPCS C1713
Hospital Charge Code	270699448
Hospital Revenue Code	278
Min. Negotiated Rate	$204.53
Max. Negotiated Rate	$681.75
Rate for Payer: Aetna Commercial	$409.05
Rate for Payer: Aetna Medicare Advantage	$409.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$347.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$347.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$272.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$347.69
Rate for Payer: Cigna Commercial	$681.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.97
Rate for Payer: Qualcare PPO/HMO/WC	$204.53

SCREW CANN TI FT 4X60MM

Facility

$272.70

Service Code	HCPCS C1713
Hospital Charge Code	270699117
Hospital Revenue Code	278
Min. Negotiated Rate	$40.91
Max. Negotiated Rate	$65.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.99
Rate for Payer: Qualcare PPO/HMO/WC	$40.91

Know your out-of-pocket cost for care.

All Charges