Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW PERI 3.5X50 2348-050-35

Facility

$134.60

Hospital Charge Code	270638713
Hospital Revenue Code	278
Min. Negotiated Rate	$20.19
Max. Negotiated Rate	$32.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.57
Rate for Payer: Qualcare PPO/HMO/WC	$20.19

SCREW PERIA LOCK/CANN 4.5X28MM

Facility

$610.00

Hospital Charge Code	270639623
Hospital Revenue Code	278
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$147.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

SCREW PERIA LOCK/CANN 4.5X28MM

Facility

$610.00

Hospital Charge Code	270639623
Hospital Revenue Code	278
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$183.00
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

SCREW PERIA LOCK/CANN 4.5X32MM

Facility

$940.00

Service Code	HCPCS C1713
Hospital Charge Code	270639624
Hospital Revenue Code	278
Min. Negotiated Rate	$141.00
Max. Negotiated Rate	$227.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.48
Rate for Payer: Qualcare PPO/HMO/WC	$141.00

SCREW PERIA LOCK/CANN 4.5X32MM

Facility

$940.00

Service Code	HCPCS C1713
Hospital Charge Code	270639624
Hospital Revenue Code	278
Min. Negotiated Rate	$141.00
Max. Negotiated Rate	$470.00
Rate for Payer: Aetna Commercial	$282.00
Rate for Payer: Aetna Medicare Advantage	$282.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$239.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$239.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$188.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$239.70
Rate for Payer: Cigna Commercial	$470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.48
Rate for Payer: Qualcare PPO/HMO/WC	$141.00

SCREW PERIA LOCK/CANN 4.5X40MM

Facility

$610.00

Service Code	HCPCS C1713
Hospital Charge Code	270639201
Hospital Revenue Code	278
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$147.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

SCREW PERIA LOCK/CANN 4.5X40MM

Facility

$610.00

Service Code	HCPCS C1713
Hospital Charge Code	270639201
Hospital Revenue Code	278
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$183.00
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

SCREW PERIA LOCK/CANN 5.5X25MM

Facility

$910.00

Hospital Charge Code	270670427
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 PERIA LOCK/CANN 5.5X25MM

Facility

$910.00

Hospital Charge Code	270670427
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 PERIA LOCK/CANN 5.5X45MM

Facility

$910.00

Hospital Charge Code	270648674
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 PERIA LOCK/CANN 5.5X45MM

Facility

$910.00

Hospital Charge Code	270648674
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 PERIA LOCK/CANN 5.5X60MM

Facility

$910.00

Hospital Charge Code	270639678
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 PERIA LOCK/CANN 5.5X60MM

Facility

$910.00

Hospital Charge Code	270639678
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 PERIA LOCK/CANN 5.5X70MM

Facility

$910.00

Hospital Charge Code	270639197
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 PERIA LOCK/CANN 5.5X70MM

Facility

$910.00

Hospital Charge Code	270639197
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 PERIA LOCK/CANN 5.5X80MM

Facility

$910.00

Hospital Charge Code	270639677
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 PERIA LOCK/CANN 5.5X80MM

Facility

$910.00

Hospital Charge Code	270639677
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 PERIART 3 5 16 234702016

Facility

$107.10

Hospital Charge Code	270637141
Hospital Revenue Code	278
Min. Negotiated Rate	$16.07
Max. Negotiated Rate	$53.55
Rate for Payer: Aetna Commercial	$32.13
Rate for Payer: Aetna Medicare Advantage	$32.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.31
Rate for Payer: Cigna Commercial	$53.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.92
Rate for Payer: Qualcare PPO/HMO/WC	$16.07

SCREW PERIART 3 5 16 234702016

Facility

$107.10

Hospital Charge Code	270637141
Hospital Revenue Code	278
Min. Negotiated Rate	$16.07
Max. Negotiated Rate	$25.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.92
Rate for Payer: Qualcare PPO/HMO/WC	$16.07

SCREW PERIART 3.5 24 234802436

Facility

$128.15

Hospital Charge Code	270638864
Hospital Revenue Code	278
Min. Negotiated Rate	$19.22
Max. Negotiated Rate	$31.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.01
Rate for Payer: Qualcare PPO/HMO/WC	$19.22

SCREW PERIART 3.5 24 234802436

Facility

$128.15

Hospital Charge Code	270638864
Hospital Revenue Code	278
Min. Negotiated Rate	$19.22
Max. Negotiated Rate	$64.08
Rate for Payer: Aetna Commercial	$38.45
Rate for Payer: Aetna Medicare Advantage	$38.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.68
Rate for Payer: Cigna Commercial	$64.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.01
Rate for Payer: Qualcare PPO/HMO/WC	$19.22

SCREW PERIARTICULAR 2347-26-55

Facility

$117.00

Hospital Charge Code	270636212
Hospital Revenue Code	278
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$58.50
Rate for Payer: Aetna Commercial	$35.10
Rate for Payer: Aetna Medicare Advantage	$35.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.84
Rate for Payer: Cigna Commercial	$58.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.31
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

SCREW PERIARTICULAR 2347-26-55

Facility

$117.00

Hospital Charge Code	270636212
Hospital Revenue Code	278
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$28.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.31
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

SCREW PERIARTICULAR 3.5mm 34mm

Facility

$99.25

Hospital Charge Code	270632096
Hospital Revenue Code	278
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$49.62
Rate for Payer: Aetna Commercial	$29.77
Rate for Payer: Aetna Medicare Advantage	$29.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.31
Rate for Payer: Cigna Commercial	$49.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.02
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

SCREW PERIARTICULAR 3.5mm 34mm

Facility

$99.25

Hospital Charge Code	270632096
Hospital Revenue Code	278
Min. Negotiated Rate	$14.89
Max. Negotiated Rate	$24.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.02
Rate for Payer: Qualcare PPO/HMO/WC	$14.89

Know your out-of-pocket cost for care.

All Charges