Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW OTPD CANN 2.2/22MM

Facility

$382.45

Hospital Charge Code	270606270
Hospital Revenue Code	278
Min. Negotiated Rate	$57.37
Max. Negotiated Rate	$92.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.55
Rate for Payer: Qualcare PPO/HMO/WC	$57.37

SCREW OTPD CANN 2.2/22MM

Facility

$420.00

Hospital Charge Code	270606262
Hospital Revenue Code	278
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$210.00
Rate for Payer: Aetna Commercial	$126.00
Rate for Payer: Aetna Medicare Advantage	$126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.10
Rate for Payer: Cigna Commercial	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

SCREW OTPD CANN 2.2/22MM

Facility

$382.45

Hospital Charge Code	270606270
Hospital Revenue Code	278
Min. Negotiated Rate	$57.37
Max. Negotiated Rate	$191.22
Rate for Payer: Aetna Commercial	$114.73
Rate for Payer: Aetna Medicare Advantage	$114.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.52
Rate for Payer: Cigna Commercial	$191.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.55
Rate for Payer: Qualcare PPO/HMO/WC	$57.37

SCREW OTPD CANN 2.2/24MM

Facility

$420.00

Hospital Charge Code	270606263
Hospital Revenue Code	278
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$210.00
Rate for Payer: Aetna Commercial	$126.00
Rate for Payer: Aetna Medicare Advantage	$126.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.10
Rate for Payer: Cigna Commercial	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

SCREW OTPD CANN 2.2/24MM

Facility

$382.45

Hospital Charge Code	270606272
Hospital Revenue Code	278
Min. Negotiated Rate	$57.37
Max. Negotiated Rate	$191.22
Rate for Payer: Aetna Commercial	$114.73
Rate for Payer: Aetna Medicare Advantage	$114.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.52
Rate for Payer: Cigna Commercial	$191.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.55
Rate for Payer: Qualcare PPO/HMO/WC	$57.37

SCREW OTPD CANN 2.2/24MM

Facility

$382.45

Hospital Charge Code	270606272
Hospital Revenue Code	278
Min. Negotiated Rate	$57.37
Max. Negotiated Rate	$92.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.55
Rate for Payer: Qualcare PPO/HMO/WC	$57.37

SCREW OTPD CANN 2.2/24MM

Facility

$420.00

Hospital Charge Code	270606263
Hospital Revenue Code	278
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$101.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.64
Rate for Payer: Qualcare PPO/HMO/WC	$63.00

SCREW OTPD CANN 2.2/26MM

Facility

$436.85

Hospital Charge Code	270606274
Hospital Revenue Code	278
Min. Negotiated Rate	$65.53
Max. Negotiated Rate	$105.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.72
Rate for Payer: Qualcare PPO/HMO/WC	$65.53

SCREW OTPD CANN 2.2/26MM

Facility

$436.85

Hospital Charge Code	270606274
Hospital Revenue Code	278
Min. Negotiated Rate	$65.53
Max. Negotiated Rate	$218.43
Rate for Payer: Aetna Commercial	$131.06
Rate for Payer: Aetna Medicare Advantage	$131.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.40
Rate for Payer: Cigna Commercial	$218.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.72
Rate for Payer: Qualcare PPO/HMO/WC	$65.53

SCREW OTPD CANN 2.7/28MM

Facility

$436.85

Hospital Charge Code	270606275
Hospital Revenue Code	278
Min. Negotiated Rate	$65.53
Max. Negotiated Rate	$105.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.72
Rate for Payer: Qualcare PPO/HMO/WC	$65.53

SCREW OTPD CANN 2.7/28MM

Facility

$436.85

Hospital Charge Code	270606275
Hospital Revenue Code	278
Min. Negotiated Rate	$65.53
Max. Negotiated Rate	$218.43
Rate for Payer: Aetna Commercial	$131.06
Rate for Payer: Aetna Medicare Advantage	$131.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.40
Rate for Payer: Cigna Commercial	$218.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.72
Rate for Payer: Qualcare PPO/HMO/WC	$65.53

SCREW OUT RESTORE REVISION SM

Facility

$2,130.00

Hospital Charge Code	270637163
Hospital Revenue Code	278
Min. Negotiated Rate	$319.50
Max. Negotiated Rate	$1,065.00
Rate for Payer: Aetna Commercial	$639.00
Rate for Payer: Aetna Medicare Advantage	$639.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$543.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$543.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$543.15
Rate for Payer: Cigna Commercial	$1,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.46
Rate for Payer: Qualcare PPO/HMO/WC	$319.50

SCREW OUT RESTORE REVISION SM

Facility

$2,130.00

Hospital Charge Code	270637163
Hospital Revenue Code	278
Min. Negotiated Rate	$319.50
Max. Negotiated Rate	$515.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.46
Rate for Payer: Qualcare PPO/HMO/WC	$319.50

SCREW OUT REST REV LG 219382

Facility

$2,130.00

Hospital Charge Code	270637164
Hospital Revenue Code	278
Min. Negotiated Rate	$319.50
Max. Negotiated Rate	$515.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.46
Rate for Payer: Qualcare PPO/HMO/WC	$319.50

SCREW OUT REST REV LG 219382

Facility

$2,130.00

Hospital Charge Code	270637164
Hospital Revenue Code	278
Min. Negotiated Rate	$319.50
Max. Negotiated Rate	$1,065.00
Rate for Payer: Aetna Commercial	$639.00
Rate for Payer: Aetna Medicare Advantage	$639.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$543.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$543.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$426.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$543.15
Rate for Payer: Cigna Commercial	$1,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.46
Rate for Payer: Qualcare PPO/HMO/WC	$319.50

SCREW OVERWATCH 7.5MMX50 MM

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692997
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,575.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

SCREW OVERWATCH 7.5MMX50 MM

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692997
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

SCREW OVERWATCH 7.5X45MM

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692996
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,575.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

SCREW OVERWATCH 7.5X45MM

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692996
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

SCREWOVERWATCHEXTENTAB6.5X45MM

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270694705
Hospital Revenue Code	278
Min. Negotiated Rate	$630.00
Max. Negotiated Rate	$1,016.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.40
Rate for Payer: Qualcare PPO/HMO/WC	$630.00

SCREWOVERWATCHEXTENTAB6.5X45MM

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270694705
Hospital Revenue Code	278
Min. Negotiated Rate	$630.00
Max. Negotiated Rate	$2,100.00
Rate for Payer: Aetna Commercial	$1,260.00
Rate for Payer: Aetna Medicare Advantage	$1,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,071.00
Rate for Payer: Cigna Commercial	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.40
Rate for Payer: Qualcare PPO/HMO/WC	$630.00

SCREW OVERWATCH EXT TAB 50MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270694707
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$168.00
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

SCREW OVERWATCH EXT TAB 50MM

Facility

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	270694707
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$135.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

SCREWOVERWATCHMISEXTAB8.5X40MM

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270695184
Hospital Revenue Code	278
Min. Negotiated Rate	$630.00
Max. Negotiated Rate	$2,100.00
Rate for Payer: Aetna Commercial	$1,260.00
Rate for Payer: Aetna Medicare Advantage	$1,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,071.00
Rate for Payer: Cigna Commercial	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.40
Rate for Payer: Qualcare PPO/HMO/WC	$630.00

SCREWOVERWATCHMISEXTAB8.5X40MM

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270695184
Hospital Revenue Code	278
Min. Negotiated Rate	$630.00
Max. Negotiated Rate	$1,016.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.40
Rate for Payer: Qualcare PPO/HMO/WC	$630.00

Know your out-of-pocket cost for care.

All Charges