Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SELF TAP VARIAB 3.5X14MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694462
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW SELF VARIABLE 4.5MMX14MM

Facility

$875.00

Hospital Charge Code	270703045
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW SELF VARIABLE 4.5MMX14MM

Facility

$875.00

Hospital Charge Code	270703045
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW SET

Facility

$2,900.00

Hospital Charge Code	270656144
Hospital Revenue Code	278
Min. Negotiated Rate	$435.00
Max. Negotiated Rate	$701.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00

SCREW SET

Facility

$785.00

Service Code	HCPCS C1713
Hospital Charge Code	270688707
Hospital Revenue Code	278
Min. Negotiated Rate	$117.75
Max. Negotiated Rate	$392.50
Rate for Payer: Aetna Commercial	$235.50
Rate for Payer: Aetna Medicare Advantage	$235.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.18
Rate for Payer: Cigna Commercial	$392.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.97
Rate for Payer: Qualcare PPO/HMO/WC	$117.75

SCREW SET

Facility

$1,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270685220
Hospital Revenue Code	278
Min. Negotiated Rate	$246.00
Max. Negotiated Rate	$820.00
Rate for Payer: Aetna Commercial	$492.00
Rate for Payer: Aetna Medicare Advantage	$492.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$418.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$418.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$418.20
Rate for Payer: Cigna Commercial	$820.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.88
Rate for Payer: Qualcare PPO/HMO/WC	$246.00

SCREW SET

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688420
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$598.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

SCREW SET

Facility

$2,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270688522
Hospital Revenue Code	278
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$1,187.50
Rate for Payer: Aetna Commercial	$712.50
Rate for Payer: Aetna Medicare Advantage	$712.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$605.62
Rate for Payer: Cigna Commercial	$1,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.75
Rate for Payer: Qualcare PPO/HMO/WC	$356.25

SCREW SET

Facility

$785.00

Service Code	HCPCS C1713
Hospital Charge Code	270688707
Hospital Revenue Code	278
Min. Negotiated Rate	$117.75
Max. Negotiated Rate	$189.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$189.97
Rate for Payer: Qualcare PPO/HMO/WC	$117.75

SCREW SET

Facility

$2,900.00

Hospital Charge Code	270656144
Hospital Revenue Code	278
Min. Negotiated Rate	$435.00
Max. Negotiated Rate	$1,450.00
Rate for Payer: Aetna Commercial	$870.00
Rate for Payer: Aetna Medicare Advantage	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$739.50
Rate for Payer: Cigna Commercial	$1,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00

SCREW SET

Facility

$725.00

Hospital Charge Code	270694028
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW SET

Facility

$1,640.00

Service Code	HCPCS C1713
Hospital Charge Code	270685220
Hospital Revenue Code	278
Min. Negotiated Rate	$246.00
Max. Negotiated Rate	$396.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$328.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$396.88
Rate for Payer: Qualcare PPO/HMO/WC	$246.00

SCREW SET

Facility

$725.00

Hospital Charge Code	270694028
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW SET

Facility

$2,900.00

Hospital Charge Code	270661266
Hospital Revenue Code	278
Min. Negotiated Rate	$435.00
Max. Negotiated Rate	$701.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00

SCREW SET

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688420
Hospital Revenue Code	278
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$742.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$598.95
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

SCREW SET

Facility

$2,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270688522
Hospital Revenue Code	278
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$574.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.75
Rate for Payer: Qualcare PPO/HMO/WC	$356.25

SCREW SET

Facility

$2,900.00

Hospital Charge Code	270661266
Hospital Revenue Code	278
Min. Negotiated Rate	$435.00
Max. Negotiated Rate	$1,450.00
Rate for Payer: Aetna Commercial	$870.00
Rate for Payer: Aetna Medicare Advantage	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$739.50
Rate for Payer: Cigna Commercial	$1,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00

SCREW SET 15100

Facility

$618.75

Service Code	HCPCS C1713
Hospital Charge Code	270698056
Hospital Revenue Code	278
Min. Negotiated Rate	$92.81
Max. Negotiated Rate	$149.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.74
Rate for Payer: Qualcare PPO/HMO/WC	$92.81

SCREW SET 15100

Facility

$618.75

Service Code	HCPCS C1713
Hospital Charge Code	270698056
Hospital Revenue Code	278
Min. Negotiated Rate	$92.81
Max. Negotiated Rate	$309.38
Rate for Payer: Aetna Commercial	$185.62
Rate for Payer: Aetna Medicare Advantage	$185.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$157.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$157.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$157.78
Rate for Payer: Cigna Commercial	$309.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.74
Rate for Payer: Qualcare PPO/HMO/WC	$92.81

SCREW SET AR

Facility

$1,065.00

Hospital Charge Code	270657229
Hospital Revenue Code	278
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$532.50
Rate for Payer: Aetna Commercial	$319.50
Rate for Payer: Aetna Medicare Advantage	$319.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.57
Rate for Payer: Cigna Commercial	$532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: Qualcare PPO/HMO/WC	$159.75

SCREW SET AR

Facility

$1,065.00

Hospital Charge Code	270657229
Hospital Revenue Code	278
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$257.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: Qualcare PPO/HMO/WC	$159.75

SCREW SET FIREBIRD

Facility

$495.00

Service Code	HCPCS C1713
Hospital Charge Code	270692300
Hospital Revenue Code	278
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$148.50
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

SCREW SET FIREBIRD

Facility

$495.00

Service Code	HCPCS C1713
Hospital Charge Code	270692300
Hospital Revenue Code	278
Min. Negotiated Rate	$74.25
Max. Negotiated Rate	$119.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: Qualcare PPO/HMO/WC	$74.25

SCREW SET M10 9690855

Facility

$669.65

Hospital Charge Code	270630338
Hospital Revenue Code	278
Min. Negotiated Rate	$100.45
Max. Negotiated Rate	$162.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.06
Rate for Payer: Qualcare PPO/HMO/WC	$100.45

SCREW SET M10 9690855

Facility

$669.65

Hospital Charge Code	270630338
Hospital Revenue Code	278
Min. Negotiated Rate	$100.45
Max. Negotiated Rate	$334.82
Rate for Payer: Aetna Commercial	$200.90
Rate for Payer: Aetna Medicare Advantage	$200.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.76
Rate for Payer: Cigna Commercial	$334.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.06
Rate for Payer: Qualcare PPO/HMO/WC	$100.45

Know your out-of-pocket cost for care.

All Charges