Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREWTICANCOMPHDLSST2.5X28MM

Facility

$4,780.00

Service Code	HCPCS C1713
Hospital Charge Code	270700201
Hospital Revenue Code	278
Min. Negotiated Rate	$717.00
Max. Negotiated Rate	$1,156.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$956.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,156.76
Rate for Payer: Qualcare PPO/HMO/WC	$717.00

SCREW Ti CANN 7.0X110mm 345736

Facility

$818.45

Hospital Charge Code	270632037
Hospital Revenue Code	278
Min. Negotiated Rate	$122.77
Max. Negotiated Rate	$409.23
Rate for Payer: Aetna Commercial	$245.53
Rate for Payer: Aetna Medicare Advantage	$245.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.70
Rate for Payer: Cigna Commercial	$409.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.06
Rate for Payer: Qualcare PPO/HMO/WC	$122.77

SCREW Ti CANN 7.0X110mm 345736

Facility

$818.45

Hospital Charge Code	270632037
Hospital Revenue Code	278
Min. Negotiated Rate	$122.77
Max. Negotiated Rate	$198.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.06
Rate for Payer: Qualcare PPO/HMO/WC	$122.77

SCREW TI CANN COMP FT 3.5X30MM

Facility

$2,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270700348
Hospital Revenue Code	278
Min. Negotiated Rate	$338.25
Max. Negotiated Rate	$545.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: Qualcare PPO/HMO/WC	$338.25

SCREW TI CANN COMP FT 3.5X30MM

Facility

$2,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270700348
Hospital Revenue Code	278
Min. Negotiated Rate	$338.25
Max. Negotiated Rate	$1,127.50
Rate for Payer: Aetna Commercial	$676.50
Rate for Payer: Aetna Medicare Advantage	$676.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$575.02
Rate for Payer: Cigna Commercial	$1,127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: Qualcare PPO/HMO/WC	$338.25

SCREW TI CANN COMP FT 3.5X40MM

Facility

$2,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270700350
Hospital Revenue Code	278
Min. Negotiated Rate	$338.25
Max. Negotiated Rate	$1,127.50
Rate for Payer: Aetna Commercial	$676.50
Rate for Payer: Aetna Medicare Advantage	$676.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$575.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$575.02
Rate for Payer: Cigna Commercial	$1,127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: Qualcare PPO/HMO/WC	$338.25

SCREW TI CANN COMP FT 3.5X40MM

Facility

$2,255.00

Service Code	HCPCS C1713
Hospital Charge Code	270700350
Hospital Revenue Code	278
Min. Negotiated Rate	$338.25
Max. Negotiated Rate	$545.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.71
Rate for Payer: Qualcare PPO/HMO/WC	$338.25

SCREW TI CANN COMP HL 6.5X75MM

Facility

$8,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270700124
Hospital Revenue Code	278
Min. Negotiated Rate	$1,329.00
Max. Negotiated Rate	$4,430.00
Rate for Payer: Aetna Commercial	$2,658.00
Rate for Payer: Aetna Medicare Advantage	$2,658.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,259.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,259.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,772.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,259.30
Rate for Payer: Cigna Commercial	$4,430.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,144.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,329.00

SCREW TI CANN COMP HL 6.5X75MM

Facility

$8,860.00

Service Code	HCPCS C1713
Hospital Charge Code	270700124
Hospital Revenue Code	278
Min. Negotiated Rate	$1,329.00
Max. Negotiated Rate	$2,144.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,772.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,144.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,329.00

SCREW TI CANN FT 4.0X18MM

Facility

$259.40

Service Code	HCPCS C1713
Hospital Charge Code	270696913
Hospital Revenue Code	278
Min. Negotiated Rate	$38.91
Max. Negotiated Rate	$62.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.77
Rate for Payer: Qualcare PPO/HMO/WC	$38.91

SCREW TI CANN FT 4.0X18MM

Facility

$259.40

Service Code	HCPCS C1713
Hospital Charge Code	270696913
Hospital Revenue Code	278
Min. Negotiated Rate	$38.91
Max. Negotiated Rate	$129.70
Rate for Payer: Aetna Commercial	$77.82
Rate for Payer: Aetna Medicare Advantage	$77.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.15
Rate for Payer: Cigna Commercial	$129.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.77
Rate for Payer: Qualcare PPO/HMO/WC	$38.91

SCREW TI CANN SHORT 6.5X60MM

Facility

$1,809.50

Service Code	HCPCS C1713
Hospital Charge Code	270697391
Hospital Revenue Code	278
Min. Negotiated Rate	$271.43
Max. Negotiated Rate	$437.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.90
Rate for Payer: Qualcare PPO/HMO/WC	$271.43

SCREW TI CANN SHORT 6.5X60MM

Facility

$1,809.50

Service Code	HCPCS C1713
Hospital Charge Code	270697391
Hospital Revenue Code	278
Min. Negotiated Rate	$271.43
Max. Negotiated Rate	$904.75
Rate for Payer: Aetna Commercial	$542.85
Rate for Payer: Aetna Medicare Advantage	$542.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.42
Rate for Payer: Cigna Commercial	$904.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.90
Rate for Payer: Qualcare PPO/HMO/WC	$271.43

SCREW TI CANN ST 5X80MM

Facility

$1,809.50

Service Code	HCPCS C1713
Hospital Charge Code	270698492
Hospital Revenue Code	278
Min. Negotiated Rate	$271.43
Max. Negotiated Rate	$437.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.90
Rate for Payer: Qualcare PPO/HMO/WC	$271.43

SCREW TI CANN ST 5X80MM

Facility

$1,809.50

Service Code	HCPCS C1713
Hospital Charge Code	270698492
Hospital Revenue Code	278
Min. Negotiated Rate	$271.43
Max. Negotiated Rate	$904.75
Rate for Payer: Cigna Commercial	$904.75
Rate for Payer: Aetna Commercial	$542.85
Rate for Payer: Aetna Medicare Advantage	$542.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.90
Rate for Payer: Qualcare PPO/HMO/WC	$271.43

SCREW TI CANN ST 5X85MM

Facility

$1,809.50

Service Code	HCPCS C1713
Hospital Charge Code	270698491
Hospital Revenue Code	278
Min. Negotiated Rate	$271.43
Max. Negotiated Rate	$437.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.90
Rate for Payer: Qualcare PPO/HMO/WC	$271.43

SCREW TI CANN ST 5X85MM

Facility

$1,809.50

Service Code	HCPCS C1713
Hospital Charge Code	270698491
Hospital Revenue Code	278
Min. Negotiated Rate	$271.43
Max. Negotiated Rate	$904.75
Rate for Payer: Aetna Commercial	$542.85
Rate for Payer: Aetna Medicare Advantage	$542.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$461.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$461.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$461.42
Rate for Payer: Cigna Commercial	$904.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.90
Rate for Payer: Qualcare PPO/HMO/WC	$271.43

SCREW Ti CANNUL 70X115m 345738

Facility

$818.45

Hospital Charge Code	270630432
Hospital Revenue Code	278
Min. Negotiated Rate	$122.77
Max. Negotiated Rate	$409.23
Rate for Payer: Aetna Commercial	$245.53
Rate for Payer: Aetna Medicare Advantage	$245.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.70
Rate for Payer: Cigna Commercial	$409.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.06
Rate for Payer: Qualcare PPO/HMO/WC	$122.77

SCREW Ti CANNUL 70X115m 345738

Facility

$818.45

Hospital Charge Code	270630432
Hospital Revenue Code	278
Min. Negotiated Rate	$122.77
Max. Negotiated Rate	$198.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$163.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.06
Rate for Payer: Qualcare PPO/HMO/WC	$122.77

SCREW TI CORTEX 1.5MM

Facility

$155.10

Service Code	HCPCS C1713
Hospital Charge Code	270689211
Hospital Revenue Code	278
Min. Negotiated Rate	$23.27
Max. Negotiated Rate	$37.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.53
Rate for Payer: Qualcare PPO/HMO/WC	$23.27

SCREW TI CORTEX 1.5MM

Facility

$155.10

Service Code	HCPCS C1713
Hospital Charge Code	270689211
Hospital Revenue Code	278
Min. Negotiated Rate	$23.27
Max. Negotiated Rate	$77.55
Rate for Payer: Aetna Commercial	$46.53
Rate for Payer: Aetna Medicare Advantage	$46.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.55
Rate for Payer: Cigna Commercial	$77.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.53
Rate for Payer: Qualcare PPO/HMO/WC	$23.27

SCREW TI F ACDF 3.5X14MM 6D

Facility

$6,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270697117
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$1,875.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

SCREW TI F ACDF 3.5X14MM 6D

Facility

$6,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270697117
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

SCREW TIGER HEADLESS 3MMX34

Facility

$1,375.00

Hospital Charge Code	270666766
Hospital Revenue Code	278
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$412.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

SCREW TIGER HEADLESS 3MMX34

Facility

$1,375.00

Hospital Charge Code	270666766
Hospital Revenue Code	278
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$332.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

Know your out-of-pocket cost for care.

All Charges