Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANNUALTED 2.4X12MM LONG

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270684720
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 CANNUALTED 2.4X12MM LONG

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270684720
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 CANNULATD 4.0 X 42MM

Facility

$1,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270663660
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$313.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

SCREW CANNULATD 4.0 X 42MM

Facility

$1,295.00

Service Code	HCPCS C1713
Hospital Charge Code	270663660
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$647.50
Rate for Payer: Aetna Commercial	$388.50
Rate for Payer: Aetna Medicare Advantage	$388.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.23
Rate for Payer: Cigna Commercial	$647.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.39
Rate for Payer: Qualcare PPO/HMO/WC	$194.25

SCREW CANNULATD 4.0 x 46mm

Facility

$1,448.00

Service Code	HCPCS C1713
Hospital Charge Code	270663659
Hospital Revenue Code	278
Min. Negotiated Rate	$217.20
Max. Negotiated Rate	$724.00
Rate for Payer: Aetna Commercial	$434.40
Rate for Payer: Aetna Medicare Advantage	$434.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.24
Rate for Payer: Cigna Commercial	$724.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.42
Rate for Payer: Qualcare PPO/HMO/WC	$217.20

SCREW CANNULATD 4.0 x 46mm

Facility

$1,448.00

Service Code	HCPCS C1713
Hospital Charge Code	270663659
Hospital Revenue Code	278
Min. Negotiated Rate	$217.20
Max. Negotiated Rate	$350.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.42
Rate for Payer: Qualcare PPO/HMO/WC	$217.20

SCREWCANNULATEASNIS6.5MMX80MM

Facility

$2,020.00

Hospital Charge Code	270661506
Hospital Revenue Code	278
Min. Negotiated Rate	$303.00
Max. Negotiated Rate	$1,010.00
Rate for Payer: Aetna Commercial	$606.00
Rate for Payer: Aetna Medicare Advantage	$606.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$515.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$515.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$404.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$515.10
Rate for Payer: Cigna Commercial	$1,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$488.84
Rate for Payer: Qualcare PPO/HMO/WC	$303.00

SCREWCANNULATEASNIS6.5MMX80MM

Facility

$2,020.00

Hospital Charge Code	270661506
Hospital Revenue Code	278
Min. Negotiated Rate	$303.00
Max. Negotiated Rate	$488.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$404.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$488.84
Rate for Payer: Qualcare PPO/HMO/WC	$303.00

SCREWCANNULATEASNIS6.5MMX85MM

Facility

$2,020.00

Hospital Charge Code	270664546
Hospital Revenue Code	278
Min. Negotiated Rate	$303.00
Max. Negotiated Rate	$488.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$404.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$488.84
Rate for Payer: Qualcare PPO/HMO/WC	$303.00

SCREWCANNULATEASNIS6.5MMX85MM

Facility

$2,020.00

Hospital Charge Code	270664546
Hospital Revenue Code	278
Min. Negotiated Rate	$303.00
Max. Negotiated Rate	$1,010.00
Rate for Payer: Aetna Commercial	$606.00
Rate for Payer: Aetna Medicare Advantage	$606.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$515.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$515.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$404.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$515.10
Rate for Payer: Cigna Commercial	$1,010.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$488.84
Rate for Payer: Qualcare PPO/HMO/WC	$303.00

SCREW CANNULATED 2.0MM X10 MM

Facility

$1,074.75

Service Code	HCPCS C1713
Hospital Charge Code	270681790
Hospital Revenue Code	278
Min. Negotiated Rate	$161.21
Max. Negotiated Rate	$537.38
Rate for Payer: Aetna Commercial	$322.43
Rate for Payer: Aetna Medicare Advantage	$322.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.06
Rate for Payer: Cigna Commercial	$537.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.09
Rate for Payer: Qualcare PPO/HMO/WC	$161.21

SCREW CANNULATED 2.0MM X10 MM

Facility

$1,074.75

Service Code	HCPCS C1713
Hospital Charge Code	270681790
Hospital Revenue Code	278
Min. Negotiated Rate	$161.21
Max. Negotiated Rate	$260.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$214.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.09
Rate for Payer: Qualcare PPO/HMO/WC	$161.21

SCREW CANNULATED 2.0 X 16MM

Facility

$860.00

Service Code	HCPCS C1713
Hospital Charge Code	270662156
Hospital Revenue Code	278
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$430.00
Rate for Payer: Aetna Commercial	$258.00
Rate for Payer: Aetna Medicare Advantage	$258.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.30
Rate for Payer: Cigna Commercial	$430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

SCREW CANNULATED 2.0 X 16MM

Facility

$860.00

Service Code	HCPCS C1713
Hospital Charge Code	270662156
Hospital Revenue Code	278
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$208.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

SCREW CANNULATED 2.0 X 18MM

Facility

$860.00

Hospital Charge Code	27062155
Hospital Revenue Code	278
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$430.00
Rate for Payer: Aetna Commercial	$258.00
Rate for Payer: Aetna Medicare Advantage	$258.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.30
Rate for Payer: Cigna Commercial	$430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

SCREW CANNULATED 2.0 X 18MM

Facility

$860.00

Hospital Charge Code	27062155
Hospital Revenue Code	278
Min. Negotiated Rate	$129.00
Max. Negotiated Rate	$208.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.12
Rate for Payer: Qualcare PPO/HMO/WC	$129.00

SCREW CANNULATED 2.4 X 12MM

Facility

$895.00

Hospital Charge Code	270662157
Hospital Revenue Code	278
Min. Negotiated Rate	$134.25
Max. Negotiated Rate	$216.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.59
Rate for Payer: Qualcare PPO/HMO/WC	$134.25

SCREW CANNULATED 2.4 X 12MM

Facility

$895.00

Hospital Charge Code	270662157
Hospital Revenue Code	278
Min. Negotiated Rate	$134.25
Max. Negotiated Rate	$447.50
Rate for Payer: Aetna Commercial	$268.50
Rate for Payer: Aetna Medicare Advantage	$268.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$228.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$228.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$228.22
Rate for Payer: Cigna Commercial	$447.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.59
Rate for Payer: Qualcare PPO/HMO/WC	$134.25

SCREW CANNULATED 2.4x12MM

Facility

$950.00

Hospital Charge Code	270674378
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$475.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$285.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.25
Rate for Payer: Cigna Commercial	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

SCREW CANNULATED 2.4x12MM

Facility

$950.00

Hospital Charge Code	270674378
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$229.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$229.90
Rate for Payer: Qualcare PPO/HMO/WC	$142.50

SCREW CANNULATED 2.5MM X 18MM

Facility

$2,935.00

Service Code	HCPCS C1713
Hospital Charge Code	270678563
Hospital Revenue Code	278
Min. Negotiated Rate	$440.25
Max. Negotiated Rate	$1,467.50
Rate for Payer: Aetna Commercial	$880.50
Rate for Payer: Aetna Medicare Advantage	$880.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$748.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$748.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$587.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$748.42
Rate for Payer: Cigna Commercial	$1,467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$710.27
Rate for Payer: Qualcare PPO/HMO/WC	$440.25

SCREW CANNULATED 2.5MM X 18MM

Facility

$2,935.00

Service Code	HCPCS C1713
Hospital Charge Code	270678563
Hospital Revenue Code	278
Min. Negotiated Rate	$440.25
Max. Negotiated Rate	$710.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$587.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$710.27
Rate for Payer: Qualcare PPO/HMO/WC	$440.25

SCREW CANNULATED 2.5 X 14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688590
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW CANNULATED 2.5 X 14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688590
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW CANNULATED 2.5 X 20MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701485
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$288.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

Know your out-of-pocket cost for care.

All Charges