Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANNULATED MIS 6.5X45

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694770
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW CANNULATED MIS 6.5X45

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694770
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$3,225.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW CANNULATED PT/THD 3x32MM

Facility

$860.00

Hospital Charge Code	270672899
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 PT/THD 3x32MM

Facility

$860.00

Hospital Charge Code	270672899
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 PT/THD 3x36MM

Facility

$860.00

Hospital Charge Code	270672898
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 PT/THD 3x36MM

Facility

$860.00

Hospital Charge Code	270672898
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 STAINLESS

Facility

$2,020.00

Hospital Charge Code	270663875
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

SCREW CANNULATED STAINLESS

Facility

$2,020.00

Hospital Charge Code	270663875
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 TI 4.0X36MM

Facility

$1,490.00

Service Code	HCPCS C1713
Hospital Charge Code	270696026
Hospital Revenue Code	278
Min. Negotiated Rate	$223.50
Max. Negotiated Rate	$360.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.58
Rate for Payer: Qualcare PPO/HMO/WC	$223.50

SCREW CANNULATED TI 4.0X36MM

Facility

$1,490.00

Service Code	HCPCS C1713
Hospital Charge Code	270696026
Hospital Revenue Code	278
Min. Negotiated Rate	$223.50
Max. Negotiated Rate	$745.00
Rate for Payer: Aetna Commercial	$447.00
Rate for Payer: Aetna Medicare Advantage	$447.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$379.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$379.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$298.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$379.95
Rate for Payer: Cigna Commercial	$745.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.58
Rate for Payer: Qualcare PPO/HMO/WC	$223.50

SCREW CANNUL MARINER 6.50X45MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694848
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$3,225.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW CANNUL MARINER 6.50X45MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694848
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW CANNUL MARINER 7.50X40MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694849
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW CANNUL MARINER 7.50X40MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694849
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$3,225.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW CANNUL PED EXT 7.5X30MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694888
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$3,225.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW CANNUL PED EXT 7.5X30MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694888
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW CANN VA LCKG 5.0x30MM

Facility

$1,050.60

Hospital Charge Code	270678077
Hospital Revenue Code	278
Min. Negotiated Rate	$157.59
Max. Negotiated Rate	$525.30
Rate for Payer: Aetna Commercial	$315.18
Rate for Payer: Aetna Medicare Advantage	$315.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.90
Rate for Payer: Cigna Commercial	$525.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.25
Rate for Payer: Qualcare PPO/HMO/WC	$157.59

SCREW CANN VA LCKG 5.0x30MM

Facility

$1,050.60

Hospital Charge Code	270678077
Hospital Revenue Code	278
Min. Negotiated Rate	$157.59
Max. Negotiated Rate	$254.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.25
Rate for Payer: Qualcare PPO/HMO/WC	$157.59

SCREW CANN VA LCKG 5.0x35MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270649685
Hospital Revenue Code	278
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$261.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31

SCREW CANN VA LCKG 5.0x35MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270649685
Hospital Revenue Code	278
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$541.05
Rate for Payer: Aetna Commercial	$324.63
Rate for Payer: Aetna Medicare Advantage	$324.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.94
Rate for Payer: Cigna Commercial	$541.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31

SCREW CANN VA LCKG 5.0x50MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270677480
Hospital Revenue Code	278
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$541.05
Rate for Payer: Aetna Commercial	$324.63
Rate for Payer: Aetna Medicare Advantage	$324.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.94
Rate for Payer: Cigna Commercial	$541.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31

SCREW CANN VA LCKG 5.0x50MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270677480
Hospital Revenue Code	278
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$261.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31

SCREW CANN VA LCKG 5.0x55MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270677481
Hospital Revenue Code	278
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$541.05
Rate for Payer: Aetna Commercial	$324.63
Rate for Payer: Aetna Medicare Advantage	$324.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.94
Rate for Payer: Cigna Commercial	$541.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31

SCREW CANN VA LCKG 5.0x55MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270677481
Hospital Revenue Code	278
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$261.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.87
Rate for Payer: Qualcare PPO/HMO/WC	$162.31

SCREW CANN VA LCKG 5.0x65MM

Facility

$1,020.00

Service Code	HCPCS C1713
Hospital Charge Code	270677138
Hospital Revenue Code	278
Min. Negotiated Rate	$153.00
Max. Negotiated Rate	$510.00
Rate for Payer: Aetna Commercial	$306.00
Rate for Payer: Aetna Medicare Advantage	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$260.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$260.10
Rate for Payer: Cigna Commercial	$510.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: Qualcare PPO/HMO/WC	$153.00

Know your out-of-pocket cost for care.

All Charges