Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LAG CANN 5.5mx55m 27455

Facility

$720.00

Hospital Charge Code	270639625
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$360.00
Rate for Payer: Aetna Commercial	$216.00
Rate for Payer: Aetna Medicare Advantage	$216.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.60
Rate for Payer: Cigna Commercial	$360.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

SCREW LAG CANN 5.5mx55m 27455

Facility

$720.00

Hospital Charge Code	270639625
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$174.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.24
Rate for Payer: Qualcare PPO/HMO/WC	$108.00

SCREW LAG CANN 5.5x35mm

Facility

$910.00

Service Code	HCPCS C1713
Hospital Charge Code	270673604
Hospital Revenue Code	278
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$220.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

SCREW LAG CANN 5.5x35mm

Facility

$910.00

Service Code	HCPCS C1713
Hospital Charge Code	270673604
Hospital Revenue Code	278
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$455.00
Rate for Payer: Aetna Commercial	$273.00
Rate for Payer: Aetna Medicare Advantage	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.05
Rate for Payer: Cigna Commercial	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

SCREW LAG CANN 5.5x50 27450

Facility

$825.00

Hospital Charge Code	270639199
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$247.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW LAG CANN 5.5x50 27450

Facility

$825.00

Hospital Charge Code	270639199
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW LAG CANN 5.5x65 27465

Facility

$825.00

Hospital Charge Code	270639198
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW LAG CANN 5.5x65 27465

Facility

$825.00

Hospital Charge Code	270639198
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$247.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW LAG CANN 5.5x70mm

Facility

$405.00

Service Code	HCPCS C1713
Hospital Charge Code	270673603
Hospital Revenue Code	278
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$202.50
Rate for Payer: Aetna Commercial	$121.50
Rate for Payer: Aetna Medicare Advantage	$121.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.28
Rate for Payer: Cigna Commercial	$202.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

SCREW LAG CANN 5.5x70mm

Facility

$405.00

Service Code	HCPCS C1713
Hospital Charge Code	270673603
Hospital Revenue Code	278
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$98.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

SCREW LAG CANN 5.5x75mm

Facility

$910.00

Service Code	HCPCS C1713
Hospital Charge Code	270639196
Hospital Revenue Code	278
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$220.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

SCREW LAG CANN 5.5x75mm

Facility

$910.00

Service Code	HCPCS C1713
Hospital Charge Code	270639196
Hospital Revenue Code	278
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$455.00
Rate for Payer: Aetna Commercial	$273.00
Rate for Payer: Aetna Medicare Advantage	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.05
Rate for Payer: Cigna Commercial	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

SCREW LAG DHS 12.7mm 100mm

Facility

$1,410.00

Hospital Charge Code	270603767
Hospital Revenue Code	278
Min. Negotiated Rate	$211.50
Max. Negotiated Rate	$341.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.22
Rate for Payer: Qualcare PPO/HMO/WC	$211.50

SCREW LAG DHS 12.7mm 100mm

Facility

$1,410.00

Hospital Charge Code	270603767
Hospital Revenue Code	278
Min. Negotiated Rate	$211.50
Max. Negotiated Rate	$705.00
Rate for Payer: Aetna Commercial	$423.00
Rate for Payer: Aetna Medicare Advantage	$423.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$359.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$359.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$359.55
Rate for Payer: Cigna Commercial	$705.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.22
Rate for Payer: Qualcare PPO/HMO/WC	$211.50

SCREW LAG FIXED 80mm DC29255

Facility

$1,920.00

Hospital Charge Code	270645074
Hospital Revenue Code	278
Min. Negotiated Rate	$288.00
Max. Negotiated Rate	$464.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$384.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.64
Rate for Payer: Qualcare PPO/HMO/WC	$288.00

SCREW LAG FIXED 80mm DC29255

Facility

$1,920.00

Hospital Charge Code	270645074
Hospital Revenue Code	278
Min. Negotiated Rate	$288.00
Max. Negotiated Rate	$960.00
Rate for Payer: Aetna Commercial	$576.00
Rate for Payer: Aetna Medicare Advantage	$576.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$489.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$489.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$384.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$489.60
Rate for Payer: Cigna Commercial	$960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.64
Rate for Payer: Qualcare PPO/HMO/WC	$288.00

SCREW LAG FRACTURE NAIL 10.5MM

Facility

$4,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270656703
Hospital Revenue Code	278
Min. Negotiated Rate	$607.50
Max. Negotiated Rate	$980.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$810.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$980.10
Rate for Payer: Qualcare PPO/HMO/WC	$607.50

SCREW LAG FRACTURE NAIL 10.5MM

Facility

$4,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270656703
Hospital Revenue Code	278
Min. Negotiated Rate	$607.50
Max. Negotiated Rate	$2,025.00
Rate for Payer: Aetna Commercial	$1,215.00
Rate for Payer: Aetna Medicare Advantage	$1,215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,032.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,032.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,032.75
Rate for Payer: Cigna Commercial	$2,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$980.10
Rate for Payer: Qualcare PPO/HMO/WC	$607.50

SCREW LAG FX NAIL 10.5X105MM

Facility

$2,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270673671
Hospital Revenue Code	278
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$635.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

SCREW LAG FX NAIL 10.5X105MM

Facility

$2,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270673671
Hospital Revenue Code	278
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$1,312.50
Rate for Payer: Aetna Commercial	$787.50
Rate for Payer: Aetna Medicare Advantage	$787.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$669.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$669.38
Rate for Payer: Cigna Commercial	$1,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$635.25
Rate for Payer: Qualcare PPO/HMO/WC	$393.75

SCREW LAG GAMMA 10.5X75MM

Facility

$4,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270700389
Hospital Revenue Code	278
Min. Negotiated Rate	$633.75
Max. Negotiated Rate	$1,022.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$845.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,022.45
Rate for Payer: Qualcare PPO/HMO/WC	$633.75

SCREW LAG GAMMA 10.5X75MM

Facility

$4,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270700389
Hospital Revenue Code	278
Min. Negotiated Rate	$633.75
Max. Negotiated Rate	$2,112.50
Rate for Payer: Aetna Commercial	$1,267.50
Rate for Payer: Aetna Medicare Advantage	$1,267.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,077.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,077.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,077.38
Rate for Payer: Cigna Commercial	$2,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,022.45
Rate for Payer: Qualcare PPO/HMO/WC	$633.75

SCREW LAG HIP FRACT 0.5x95mm

Facility

$2,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270650495
Hospital Revenue Code	278
Min. Negotiated Rate	$396.00
Max. Negotiated Rate	$1,320.00
Rate for Payer: Aetna Commercial	$792.00
Rate for Payer: Aetna Medicare Advantage	$792.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$673.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$673.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$528.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$673.20
Rate for Payer: Cigna Commercial	$1,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$638.88
Rate for Payer: Qualcare PPO/HMO/WC	$396.00

SCREW LAG HIP FRACT 0.5x95mm

Facility

$2,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270650495
Hospital Revenue Code	278
Min. Negotiated Rate	$396.00
Max. Negotiated Rate	$638.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$528.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$638.88
Rate for Payer: Qualcare PPO/HMO/WC	$396.00

SCREW LAG ONE-PIECE 11mm 105mm

Facility

$1,045.00

Hospital Charge Code	270637268
Hospital Revenue Code	278
Min. Negotiated Rate	$156.75
Max. Negotiated Rate	$252.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$209.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.89
Rate for Payer: Qualcare PPO/HMO/WC	$156.75

Know your out-of-pocket cost for care.

All Charges