Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW ST FA RESCUE 4.5X18MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270700538
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$375.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW STK RSB FT 7 20 905600

Facility

$1,127.25

Hospital Charge Code	270616378
Hospital Revenue Code	278
Min. Negotiated Rate	$169.09
Max. Negotiated Rate	$563.62
Rate for Payer: Aetna Commercial	$338.18
Rate for Payer: Aetna Medicare Advantage	$338.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$287.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$287.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$287.45
Rate for Payer: Cigna Commercial	$563.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.79
Rate for Payer: Qualcare PPO/HMO/WC	$169.09

SCREW STK RSB FT 7 20 905600

Facility

$1,127.25

Hospital Charge Code	270616378
Hospital Revenue Code	278
Min. Negotiated Rate	$169.09
Max. Negotiated Rate	$272.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.79
Rate for Payer: Qualcare PPO/HMO/WC	$169.09

SCREW STK RSB FT 7 25 905601

Facility

$1,127.25

Hospital Charge Code	270616376
Hospital Revenue Code	278
Min. Negotiated Rate	$169.09
Max. Negotiated Rate	$563.62
Rate for Payer: Aetna Commercial	$338.18
Rate for Payer: Aetna Medicare Advantage	$338.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$287.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$287.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$287.45
Rate for Payer: Cigna Commercial	$563.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.79
Rate for Payer: Qualcare PPO/HMO/WC	$169.09

SCREW STK RSB FT 7 25 905601

Facility

$1,127.25

Hospital Charge Code	270616376
Hospital Revenue Code	278
Min. Negotiated Rate	$169.09
Max. Negotiated Rate	$272.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.79
Rate for Payer: Qualcare PPO/HMO/WC	$169.09

SCREW STK RSB FT 8 30 905605

Facility

$1,127.25

Hospital Charge Code	270616375
Hospital Revenue Code	278
Min. Negotiated Rate	$169.09
Max. Negotiated Rate	$563.62
Rate for Payer: Aetna Commercial	$338.18
Rate for Payer: Aetna Medicare Advantage	$338.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$287.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$287.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$287.45
Rate for Payer: Cigna Commercial	$563.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.79
Rate for Payer: Qualcare PPO/HMO/WC	$169.09

SCREW STK RSB FT 8 30 905605

Facility

$1,127.25

Hospital Charge Code	270616375
Hospital Revenue Code	278
Min. Negotiated Rate	$169.09
Max. Negotiated Rate	$272.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.79
Rate for Payer: Qualcare PPO/HMO/WC	$169.09

SCREW STK RSB FT 9 25 905607

Facility

$1,127.25

Hospital Charge Code	270616377
Hospital Revenue Code	278
Min. Negotiated Rate	$169.09
Max. Negotiated Rate	$563.62
Rate for Payer: Aetna Commercial	$338.18
Rate for Payer: Aetna Medicare Advantage	$338.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$287.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$287.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$287.45
Rate for Payer: Cigna Commercial	$563.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.79
Rate for Payer: Qualcare PPO/HMO/WC	$169.09

SCREW STK RSB FT 9 25 905607

Facility

$1,127.25

Hospital Charge Code	270616377
Hospital Revenue Code	278
Min. Negotiated Rate	$169.09
Max. Negotiated Rate	$272.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$272.79
Rate for Payer: Qualcare PPO/HMO/WC	$169.09

SCREW STRM LOCKING 2.7X12MM ST

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270693325
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$188.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW STRM LOCKING 2.7X12MM ST

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270693325
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$234.00
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW STRM LOCKING 2.7X14MM ST

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270693509
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$188.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW STRM LOCKING 2.7X14MM ST

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270693509
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$234.00
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW STRM LOCKING 2.7X16MM ST

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270693508
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$234.00
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW STRM LOCKING 2.7X16MM ST

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270693508
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$188.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW STRM NL 2.4 X 12MM RS ST

Facility

$920.00

Service Code	HCPCS C1713
Hospital Charge Code	270692252
Hospital Revenue Code	278
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$276.00
Rate for Payer: Aetna Medicare Advantage	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.60
Rate for Payer: Cigna Commercial	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.64
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

SCREW STRM NL 2.4 X 12MM RS ST

Facility

$920.00

Service Code	HCPCS C1713
Hospital Charge Code	270692252
Hospital Revenue Code	278
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$222.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.64
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

SCREW STRM NL LP 2.7X14MM ST

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270693506
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$234.00
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW STRM NL LP 2.7X14MM ST

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270693506
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$188.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW STRY BIOS 10 28 2004-06

Facility

$1,262.45

Hospital Charge Code	270626964
Hospital Revenue Code	278
Min. Negotiated Rate	$189.37
Max. Negotiated Rate	$305.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$252.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$305.51
Rate for Payer: Qualcare PPO/HMO/WC	$189.37

SCREW STRY BIOS 10 28 2004-06

Facility

$1,262.45

Hospital Charge Code	270626964
Hospital Revenue Code	278
Min. Negotiated Rate	$189.37
Max. Negotiated Rate	$631.23
Rate for Payer: Aetna Commercial	$378.74
Rate for Payer: Aetna Medicare Advantage	$378.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$321.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$321.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$252.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$321.92
Rate for Payer: Cigna Commercial	$631.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$305.51
Rate for Payer: Qualcare PPO/HMO/WC	$189.37

SCREW ST T25STDR TI LOCK 5MM

Facility

$895.05

Service Code	HCPCS C1713
Hospital Charge Code	270693694
Hospital Revenue Code	278
Min. Negotiated Rate	$134.26
Max. Negotiated Rate	$447.52
Rate for Payer: Aetna Commercial	$268.51
Rate for Payer: Aetna Medicare Advantage	$268.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$228.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$228.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$228.24
Rate for Payer: Cigna Commercial	$447.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.60
Rate for Payer: Qualcare PPO/HMO/WC	$134.26

SCREW ST T25STDR TI LOCK 5MM

Facility

$895.05

Service Code	HCPCS C1713
Hospital Charge Code	270693694
Hospital Revenue Code	278
Min. Negotiated Rate	$134.26
Max. Negotiated Rate	$216.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$179.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$216.60
Rate for Payer: Qualcare PPO/HMO/WC	$134.26

SCREW ST VAR 4.5X12MM

Facility

$4,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270695653
Hospital Revenue Code	278
Min. Negotiated Rate	$720.00
Max. Negotiated Rate	$1,161.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$720.00

SCREW ST VAR 4.5X12MM

Facility

$4,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270695653
Hospital Revenue Code	278
Min. Negotiated Rate	$720.00
Max. Negotiated Rate	$2,400.00
Rate for Payer: Aetna Commercial	$1,440.00
Rate for Payer: Aetna Medicare Advantage	$1,440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,224.00
Rate for Payer: Cigna Commercial	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,161.60
Rate for Payer: Qualcare PPO/HMO/WC	$720.00

Know your out-of-pocket cost for care.

All Charges