Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SYN CORT 3.5 100 204100

Facility

$100.85

Hospital Charge Code	270604229
Hospital Revenue Code	278
Min. Negotiated Rate	$15.13
Max. Negotiated Rate	$24.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.41
Rate for Payer: Qualcare PPO/HMO/WC	$15.13

SCREW SYN CORT 3.5 105M 204105

Facility

$100.85

Hospital Charge Code	270604230
Hospital Revenue Code	278
Min. Negotiated Rate	$15.13
Max. Negotiated Rate	$50.42
Rate for Payer: Aetna Commercial	$30.25
Rate for Payer: Aetna Medicare Advantage	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.72
Rate for Payer: Cigna Commercial	$50.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.41
Rate for Payer: Qualcare PPO/HMO/WC	$15.13

SCREW SYN CORT 3.5 105M 204105

Facility

$100.85

Hospital Charge Code	270604230
Hospital Revenue Code	278
Min. Negotiated Rate	$15.13
Max. Negotiated Rate	$24.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.41
Rate for Payer: Qualcare PPO/HMO/WC	$15.13

SCREW SYN CORT 3.5 110M 204110

Facility

$100.85

Hospital Charge Code	270604231
Hospital Revenue Code	278
Min. Negotiated Rate	$15.13
Max. Negotiated Rate	$50.42
Rate for Payer: Aetna Commercial	$30.25
Rate for Payer: Aetna Medicare Advantage	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.72
Rate for Payer: Cigna Commercial	$50.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.41
Rate for Payer: Qualcare PPO/HMO/WC	$15.13

SCREW SYN CORT 3.5 110M 204110

Facility

$100.85

Hospital Charge Code	270604231
Hospital Revenue Code	278
Min. Negotiated Rate	$15.13
Max. Negotiated Rate	$24.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.41
Rate for Payer: Qualcare PPO/HMO/WC	$15.13

SCREW SYN CORT 3.5/18MM***

Facility

$35.60

Hospital Charge Code	270601832
Hospital Revenue Code	279
Min. Negotiated Rate	$5.34
Max. Negotiated Rate	$5.34
Rate for Payer: Qualcare PPO/HMO/WC	$5.34

SCREW SYN CORT 3.5/18MM***

Facility

$35.60

Hospital Charge Code	270601832
Hospital Revenue Code	279
Min. Negotiated Rate	$4.63
Max. Negotiated Rate	$17.80
Rate for Payer: Aetna Commercial	$10.68
Rate for Payer: Aetna Medicare Advantage	$10.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.08
Rate for Payer: Cigna Commercial	$17.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.63
Rate for Payer: Oxford Commercial	$17.80
Rate for Payer: Qualcare PPO/HMO/WC	$5.34
Rate for Payer: UnitedHealthcare Commercial	$17.80

SCREW SYN CORT 3.5 22MM 204.22

Facility

$67.25

Hospital Charge Code	270604208
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$16.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW SYN CORT 3.5 22MM 204.22

Facility

$67.25

Hospital Charge Code	270604208
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$33.62
Rate for Payer: Aetna Commercial	$20.18
Rate for Payer: Aetna Medicare Advantage	$20.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$33.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW SYN CORT 3.5 26MM 204.26

Facility

$67.25

Hospital Charge Code	270604210
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$33.62
Rate for Payer: Aetna Commercial	$20.18
Rate for Payer: Aetna Medicare Advantage	$20.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$33.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW SYN CORT 3.5 26MM 204.26

Facility

$67.25

Hospital Charge Code	270604210
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$16.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW SYN CORT 3.5 28MM 204.28

Facility

$67.25

Hospital Charge Code	270604211
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$33.62
Rate for Payer: Aetna Commercial	$20.18
Rate for Payer: Aetna Medicare Advantage	$20.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$33.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW SYN CORT 3.5 28MM 204.28

Facility

$67.25

Hospital Charge Code	270604211
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$16.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW SYN CORT 3.5 30MM 204.30

Facility

$67.25

Service Code	HCPCS C1713
Hospital Charge Code	270604212
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$16.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW SYN CORT 3.5 30MM 204.30

Facility

$67.25

Service Code	HCPCS C1713
Hospital Charge Code	270604212
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$33.62
Rate for Payer: Aetna Commercial	$20.18
Rate for Payer: Aetna Medicare Advantage	$20.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$33.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW SYN CORT 3.5 32MM 204.32

Facility

$71.25

Hospital Charge Code	270604213
Hospital Revenue Code	278
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$17.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.24
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

SCREW SYN CORT 3.5 32MM 204.32

Facility

$71.25

Hospital Charge Code	270604213
Hospital Revenue Code	278
Min. Negotiated Rate	$10.69
Max. Negotiated Rate	$35.62
Rate for Payer: Aetna Commercial	$21.38
Rate for Payer: Aetna Medicare Advantage	$21.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.17
Rate for Payer: Cigna Commercial	$35.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.24
Rate for Payer: Qualcare PPO/HMO/WC	$10.69

SCREW SYN CORT 3.5 34MM 204.34

Facility

$67.25

Hospital Charge Code	270604214
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$16.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW SYN CORT 3.5 34MM 204.34

Facility

$67.25

Hospital Charge Code	270604214
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$33.62
Rate for Payer: Aetna Commercial	$20.18
Rate for Payer: Aetna Medicare Advantage	$20.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$33.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW SYN CORT 3.5 38MM 204.38

Facility

$67.25

Hospital Charge Code	270604216
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$16.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW SYN CORT 3.5 38MM 204.38

Facility

$67.25

Hospital Charge Code	270604216
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$33.62
Rate for Payer: Aetna Commercial	$20.18
Rate for Payer: Aetna Medicare Advantage	$20.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$33.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW SYN CORT 3.5 40MM 204.40

Facility

$44.00

Hospital Charge Code	207604217
Hospital Revenue Code	278
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$10.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

SCREW SYN CORT 3.5 40MM 204.40

Facility

$44.00

Hospital Charge Code	207604217
Hospital Revenue Code	278
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$13.20
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

SCREW SYN CORT 3.5 40MM 204.40

Facility

$67.25

Service Code	HCPCS C1713
Hospital Charge Code	270604217
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$33.62
Rate for Payer: Aetna Commercial	$20.18
Rate for Payer: Aetna Medicare Advantage	$20.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$33.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW SYN CORT 3.5 40MM 204.40

Facility

$67.25

Service Code	HCPCS C1713
Hospital Charge Code	270604217
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$16.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

Know your out-of-pocket cost for care.

All Charges