Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$246.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$204.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$246.84
Rate for Payer: Qualcare PPO/HMO/WC	$153.00

SCREW CANN VA LCKG 5.0x75MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270649686
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 5.0x75MM

Facility

$1,082.10

Service Code	HCPCS C1713
Hospital Charge Code	270649686
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 VAL OPTILINK 5X30MM

Facility

$3,215.00

Service Code	HCPCS C1713
Hospital Charge Code	270699689
Hospital Revenue Code	278
Min. Negotiated Rate	$482.25
Max. Negotiated Rate	$778.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.03
Rate for Payer: Qualcare PPO/HMO/WC	$482.25

SCREW CANN VAL OPTILINK 5X30MM

Facility

$3,215.00

Service Code	HCPCS C1713
Hospital Charge Code	270699689
Hospital Revenue Code	278
Min. Negotiated Rate	$482.25
Max. Negotiated Rate	$1,607.50
Rate for Payer: Aetna Commercial	$964.50
Rate for Payer: Aetna Medicare Advantage	$964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$819.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$819.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$819.83
Rate for Payer: Cigna Commercial	$1,607.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.03
Rate for Payer: Qualcare PPO/HMO/WC	$482.25

SCREW CANN VAL OPTILINK 5X70MM

Facility

$3,215.00

Service Code	HCPCS C1713
Hospital Charge Code	270699690
Hospital Revenue Code	278
Min. Negotiated Rate	$482.25
Max. Negotiated Rate	$1,607.50
Rate for Payer: Cigna Commercial	$1,607.50
Rate for Payer: Aetna Commercial	$964.50
Rate for Payer: Aetna Medicare Advantage	$964.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$819.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$819.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$819.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.03
Rate for Payer: Qualcare PPO/HMO/WC	$482.25

SCREW CANN VAL OPTILINK 5X70MM

Facility

$3,215.00

Service Code	HCPCS C1713
Hospital Charge Code	270699690
Hospital Revenue Code	278
Min. Negotiated Rate	$482.25
Max. Negotiated Rate	$778.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$643.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$778.03
Rate for Payer: Qualcare PPO/HMO/WC	$482.25

SCREW CANN VAL OPTLNK 5.0X55MM

Facility

$3,060.00

Service Code	HCPCS C1713
Hospital Charge Code	270699467
Hospital Revenue Code	278
Min. Negotiated Rate	$459.00
Max. Negotiated Rate	$740.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$612.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.52
Rate for Payer: Qualcare PPO/HMO/WC	$459.00

SCREW CANN VAL OPTLNK 5.0X55MM

Facility

$3,060.00

Service Code	HCPCS C1713
Hospital Charge Code	270699467
Hospital Revenue Code	278
Min. Negotiated Rate	$459.00
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$918.00
Rate for Payer: Aetna Medicare Advantage	$918.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$780.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$780.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$780.30
Rate for Payer: Cigna Commercial	$1,530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.52
Rate for Payer: Qualcare PPO/HMO/WC	$459.00

SCREW CANN VAL OPTLNK 5.0X65MM

Facility

$3,060.00

Service Code	HCPCS C1713
Hospital Charge Code	270699466
Hospital Revenue Code	278
Min. Negotiated Rate	$459.00
Max. Negotiated Rate	$740.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$612.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.52
Rate for Payer: Qualcare PPO/HMO/WC	$459.00

SCREW CANN VAL OPTLNK 5.0X65MM

Facility

$3,060.00

Service Code	HCPCS C1713
Hospital Charge Code	270699466
Hospital Revenue Code	278
Min. Negotiated Rate	$459.00
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$918.00
Rate for Payer: Aetna Medicare Advantage	$918.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$780.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$780.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$780.30
Rate for Payer: Cigna Commercial	$1,530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.52
Rate for Payer: Qualcare PPO/HMO/WC	$459.00

SCREW CANN VAL OPTLNK 5.0X75MM

Facility

$3,060.00

Service Code	HCPCS C1713
Hospital Charge Code	270699465
Hospital Revenue Code	278
Min. Negotiated Rate	$459.00
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$918.00
Rate for Payer: Aetna Medicare Advantage	$918.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$780.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$780.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$780.30
Rate for Payer: Cigna Commercial	$1,530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.52
Rate for Payer: Qualcare PPO/HMO/WC	$459.00

SCREW CANN VAL OPTLNK 5.0X75MM

Facility

$3,060.00

Service Code	HCPCS C1713
Hospital Charge Code	270699465
Hospital Revenue Code	278
Min. Negotiated Rate	$459.00
Max. Negotiated Rate	$740.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$612.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.52
Rate for Payer: Qualcare PPO/HMO/WC	$459.00

SCREW CANN VAL OPTLNK 5.0X80MM

Facility

$3,060.00

Service Code	HCPCS C1713
Hospital Charge Code	270699464
Hospital Revenue Code	278
Min. Negotiated Rate	$459.00
Max. Negotiated Rate	$740.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$612.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.52
Rate for Payer: Qualcare PPO/HMO/WC	$459.00

SCREW CANN VAL OPTLNK 5.0X80MM

Facility

$3,060.00

Service Code	HCPCS C1713
Hospital Charge Code	270699464
Hospital Revenue Code	278
Min. Negotiated Rate	$459.00
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$918.00
Rate for Payer: Aetna Medicare Advantage	$918.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$780.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$780.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$612.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$780.30
Rate for Payer: Cigna Commercial	$1,530.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$740.52
Rate for Payer: Qualcare PPO/HMO/WC	$459.00

SCREW CAN PART 4.0x30 11424130

Facility

$505.65

Hospital Charge Code	270629616
Hospital Revenue Code	278
Min. Negotiated Rate	$75.85
Max. Negotiated Rate	$252.82
Rate for Payer: Aetna Commercial	$151.69
Rate for Payer: Aetna Medicare Advantage	$151.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.94
Rate for Payer: Cigna Commercial	$252.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.37
Rate for Payer: Qualcare PPO/HMO/WC	$75.85

SCREW CAN PART 4.0x30 11424130

Facility

$505.65

Hospital Charge Code	270629616
Hospital Revenue Code	278
Min. Negotiated Rate	$75.85
Max. Negotiated Rate	$122.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.37
Rate for Payer: Qualcare PPO/HMO/WC	$75.85

SCREW CAN PART 5.0x40 11425140

Facility

$568.60

Hospital Charge Code	270629705
Hospital Revenue Code	278
Min. Negotiated Rate	$85.29
Max. Negotiated Rate	$137.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.60
Rate for Payer: Qualcare PPO/HMO/WC	$85.29

SCREW CAN PART 5.0x40 11425140

Facility

$568.60

Hospital Charge Code	270629705
Hospital Revenue Code	278
Min. Negotiated Rate	$85.29
Max. Negotiated Rate	$284.30
Rate for Payer: Aetna Commercial	$170.58
Rate for Payer: Aetna Medicare Advantage	$170.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.99
Rate for Payer: Cigna Commercial	$284.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.60
Rate for Payer: Qualcare PPO/HMO/WC	$85.29

SCREW CAN PART 5.0x42 11425142

Facility

$568.60

Hospital Charge Code	270632041
Hospital Revenue Code	278
Min. Negotiated Rate	$85.29
Max. Negotiated Rate	$284.30
Rate for Payer: Aetna Commercial	$170.58
Rate for Payer: Aetna Medicare Advantage	$170.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.99
Rate for Payer: Cigna Commercial	$284.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.60
Rate for Payer: Qualcare PPO/HMO/WC	$85.29

SCREW CAN PART 5.0x42 11425142

Facility

$568.60

Hospital Charge Code	270632041
Hospital Revenue Code	278
Min. Negotiated Rate	$85.29
Max. Negotiated Rate	$137.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.60
Rate for Payer: Qualcare PPO/HMO/WC	$85.29

SCREW CAN PTHD 5.0x38 11425138

Facility

$568.60

Hospital Charge Code	270634537
Hospital Revenue Code	278
Min. Negotiated Rate	$85.29
Max. Negotiated Rate	$284.30
Rate for Payer: Aetna Commercial	$170.58
Rate for Payer: Aetna Medicare Advantage	$170.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.99
Rate for Payer: Cigna Commercial	$284.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.60
Rate for Payer: Qualcare PPO/HMO/WC	$85.29

SCREW CAN PTHD 5.0x38 11425138

Facility

$568.60

Hospital Charge Code	270634537
Hospital Revenue Code	278
Min. Negotiated Rate	$85.29
Max. Negotiated Rate	$137.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.60
Rate for Payer: Qualcare PPO/HMO/WC	$85.29

SCREW CAN SHT THD 30 X32

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270702704
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

SCREW CAN SHT THD 30 X32

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270702704
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
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