Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW ZIM CANN 16 7 70 114670

Facility

$981.65

Service Code	HCPCS C1713
Hospital Charge Code	270605975
Hospital Revenue Code	278
Min. Negotiated Rate	$147.25
Max. Negotiated Rate	$490.82
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$294.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.32
Rate for Payer: Cigna Commercial	$490.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.56
Rate for Payer: Qualcare PPO/HMO/WC	$147.25

SCREW ZIM CANN 16 7 75 114675

Facility

$820.00

Hospital Charge Code	270605976
Hospital Revenue Code	278
Min. Negotiated Rate	$123.00
Max. Negotiated Rate	$198.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$164.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.44
Rate for Payer: Qualcare PPO/HMO/WC	$123.00

SCREW ZIM CANN 16 7 75 114675

Facility

$820.00

Hospital Charge Code	270605976
Hospital Revenue Code	278
Min. Negotiated Rate	$123.00
Max. Negotiated Rate	$410.00
Rate for Payer: Aetna Commercial	$246.00
Rate for Payer: Aetna Medicare Advantage	$246.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$209.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$164.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$209.10
Rate for Payer: Cigna Commercial	$410.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$198.44
Rate for Payer: Qualcare PPO/HMO/WC	$123.00

SCREW ZIM CANN 32 7 110 114611

Facility

$752.00

Hospital Charge Code	270619388
Hospital Revenue Code	278
Min. Negotiated Rate	$112.80
Max. Negotiated Rate	$376.00
Rate for Payer: Aetna Commercial	$225.60
Rate for Payer: Aetna Medicare Advantage	$225.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.76
Rate for Payer: Cigna Commercial	$376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.98
Rate for Payer: Qualcare PPO/HMO/WC	$112.80

SCREW ZIM CANN 32 7 110 114611

Facility

$752.00

Hospital Charge Code	270619388
Hospital Revenue Code	278
Min. Negotiated Rate	$112.80
Max. Negotiated Rate	$181.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.98
Rate for Payer: Qualcare PPO/HMO/WC	$112.80

SCREW ZIM CANN 32 7 55 114655

Facility

$756.00

Hospital Charge Code	270620799
Hospital Revenue Code	278
Min. Negotiated Rate	$113.40
Max. Negotiated Rate	$378.00
Rate for Payer: Aetna Commercial	$226.80
Rate for Payer: Aetna Medicare Advantage	$226.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$151.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.78
Rate for Payer: Cigna Commercial	$378.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.95
Rate for Payer: Qualcare PPO/HMO/WC	$113.40

SCREW ZIM CANN 32 7 55 114655

Facility

$756.00

Hospital Charge Code	270620799
Hospital Revenue Code	278
Min. Negotiated Rate	$113.40
Max. Negotiated Rate	$182.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$151.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.95
Rate for Payer: Qualcare PPO/HMO/WC	$113.40

SCREW ZIM CANN 32 7 60 114660

Facility

$756.00

Hospital Charge Code	270620823
Hospital Revenue Code	278
Min. Negotiated Rate	$113.40
Max. Negotiated Rate	$182.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$151.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.95
Rate for Payer: Qualcare PPO/HMO/WC	$113.40

SCREW ZIM CANN 32 7 60 114660

Facility

$756.00

Hospital Charge Code	270620823
Hospital Revenue Code	278
Min. Negotiated Rate	$113.40
Max. Negotiated Rate	$378.00
Rate for Payer: Aetna Commercial	$226.80
Rate for Payer: Aetna Medicare Advantage	$226.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$151.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.78
Rate for Payer: Cigna Commercial	$378.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.95
Rate for Payer: Qualcare PPO/HMO/WC	$113.40

SCREW ZIM CANN 32 7 70 114670

Facility

$756.00

Hospital Charge Code	270620800
Hospital Revenue Code	278
Min. Negotiated Rate	$113.40
Max. Negotiated Rate	$182.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$151.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.95
Rate for Payer: Qualcare PPO/HMO/WC	$113.40

SCREW ZIM CANN 32 7 70 114670

Facility

$756.00

Hospital Charge Code	270620800
Hospital Revenue Code	278
Min. Negotiated Rate	$113.40
Max. Negotiated Rate	$378.00
Rate for Payer: Aetna Commercial	$226.80
Rate for Payer: Aetna Medicare Advantage	$226.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$151.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.78
Rate for Payer: Cigna Commercial	$378.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.95
Rate for Payer: Qualcare PPO/HMO/WC	$113.40

SCREW ZIM CANN 32 7 75 114675

Facility

$751.95

Hospital Charge Code	270606467
Hospital Revenue Code	278
Min. Negotiated Rate	$112.79
Max. Negotiated Rate	$181.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.79

SCREW ZIM CANN 32 7 75 114675

Facility

$751.95

Hospital Charge Code	270606467
Hospital Revenue Code	278
Min. Negotiated Rate	$112.79
Max. Negotiated Rate	$375.98
Rate for Payer: Aetna Commercial	$225.59
Rate for Payer: Aetna Medicare Advantage	$225.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.75
Rate for Payer: Cigna Commercial	$375.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.79

SCREW ZIM CANN 32 7 80 114680

Facility

$751.95

Hospital Charge Code	270606469
Hospital Revenue Code	278
Min. Negotiated Rate	$112.79
Max. Negotiated Rate	$181.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.79

SCREW ZIM CANN 32 7 80 114680

Facility

$751.95

Hospital Charge Code	270606469
Hospital Revenue Code	278
Min. Negotiated Rate	$112.79
Max. Negotiated Rate	$375.98
Rate for Payer: Aetna Commercial	$225.59
Rate for Payer: Aetna Medicare Advantage	$225.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.75
Rate for Payer: Cigna Commercial	$375.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.79

SCREW ZIM CANN 32 7 85 114685

Facility

$751.95

Hospital Charge Code	270606470
Hospital Revenue Code	278
Min. Negotiated Rate	$112.79
Max. Negotiated Rate	$375.98
Rate for Payer: Aetna Commercial	$225.59
Rate for Payer: Aetna Medicare Advantage	$225.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.75
Rate for Payer: Cigna Commercial	$375.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.79

SCREW ZIM CANN 32 7 85 114685

Facility

$751.95

Hospital Charge Code	270606470
Hospital Revenue Code	278
Min. Negotiated Rate	$112.79
Max. Negotiated Rate	$181.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.79

SCREW ZIM CANN 32 7 90 114690

Facility

$813.65

Hospital Charge Code	270606851
Hospital Revenue Code	278
Min. Negotiated Rate	$122.05
Max. Negotiated Rate	$196.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.90
Rate for Payer: Qualcare PPO/HMO/WC	$122.05

SCREW ZIM CANN 32 7 90 114690

Facility

$813.65

Hospital Charge Code	270606851
Hospital Revenue Code	278
Min. Negotiated Rate	$122.05
Max. Negotiated Rate	$406.82
Rate for Payer: Aetna Commercial	$244.09
Rate for Payer: Aetna Medicare Advantage	$244.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.48
Rate for Payer: Cigna Commercial	$406.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.90
Rate for Payer: Qualcare PPO/HMO/WC	$122.05

SCREW ZIM CANN 32 7 95 114695

Facility

$751.95

Hospital Charge Code	270606471
Hospital Revenue Code	278
Min. Negotiated Rate	$112.79
Max. Negotiated Rate	$181.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.79

SCREW ZIM CANN 32 7 95 114695

Facility

$751.95

Hospital Charge Code	270606471
Hospital Revenue Code	278
Min. Negotiated Rate	$112.79
Max. Negotiated Rate	$375.98
Rate for Payer: Aetna Commercial	$225.59
Rate for Payer: Aetna Medicare Advantage	$225.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.75
Rate for Payer: Cigna Commercial	$375.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.79

SCREW ZIM CANN 4 28 11424028

Facility

$568.15

Hospital Charge Code	270614918
Hospital Revenue Code	278
Min. Negotiated Rate	$85.22
Max. Negotiated Rate	$137.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.49
Rate for Payer: Qualcare PPO/HMO/WC	$85.22

SCREW ZIM CANN 4 28 11424028

Facility

$568.15

Hospital Charge Code	270614918
Hospital Revenue Code	278
Min. Negotiated Rate	$85.22
Max. Negotiated Rate	$284.07
Rate for Payer: Aetna Commercial	$170.44
Rate for Payer: Aetna Medicare Advantage	$170.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.88
Rate for Payer: Cigna Commercial	$284.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.49
Rate for Payer: Qualcare PPO/HMO/WC	$85.22

SCREW ZIM CANN 4 34 11424134

Facility

$542.00

Hospital Charge Code	270627006
Hospital Revenue Code	278
Min. Negotiated Rate	$81.30
Max. Negotiated Rate	$271.00
Rate for Payer: Aetna Commercial	$162.60
Rate for Payer: Aetna Medicare Advantage	$162.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.21
Rate for Payer: Cigna Commercial	$271.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.16
Rate for Payer: Qualcare PPO/HMO/WC	$81.30

SCREW ZIM CANN 4 34 11424134

Facility

$542.00

Hospital Charge Code	270627006
Hospital Revenue Code	278
Min. Negotiated Rate	$81.30
Max. Negotiated Rate	$131.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.16
Rate for Payer: Qualcare PPO/HMO/WC	$81.30

Know your out-of-pocket cost for care.

All Charges