Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 40X12M

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270685320
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW 40X12M

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270685320
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW 4.0 X 12MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270657250
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 4.0 X 12MM

Facility

$2,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270657250
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 4.0X 12MM

Facility

$11,735.00

Service Code	HCPCS C1713
Hospital Charge Code	270694870
Hospital Revenue Code	278
Min. Negotiated Rate	$1,760.25
Max. Negotiated Rate	$2,839.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,347.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,839.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,760.25

SCREW 4.0X 12MM

Facility

$11,735.00

Service Code	HCPCS C1713
Hospital Charge Code	270694870
Hospital Revenue Code	278
Min. Negotiated Rate	$1,760.25
Max. Negotiated Rate	$5,867.50
Rate for Payer: Aetna Commercial	$3,520.50
Rate for Payer: Aetna Medicare Advantage	$3,520.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,992.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,992.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,347.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,992.43
Rate for Payer: Cigna Commercial	$5,867.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,839.87
Rate for Payer: Qualcare PPO/HMO/WC	$1,760.25

SCREW 4.0 X 12MM SELF TAPPING

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686428
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW 4.0 X 12MM SELF TAPPING

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686428
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 40 X 14 MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687500
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW 40 X 14 MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687500
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW 4.0X14MM CERES-C SELFTAP

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692584
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW 4.0X14MM CERES-C SELFTAP

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692584
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 4.0 X 14MM SELF TAPPING

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686429
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW 4.0 X 14MM SELF TAPPING

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270686429
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 4.0X15mm 876.815

Facility

$1,428.50

Hospital Charge Code	270631183
Hospital Revenue Code	278
Min. Negotiated Rate	$214.28
Max. Negotiated Rate	$345.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$345.70
Rate for Payer: Qualcare PPO/HMO/WC	$214.28

SCREW 4.0X15mm 876.815

Facility

$1,428.50

Hospital Charge Code	270631183
Hospital Revenue Code	278
Min. Negotiated Rate	$214.28
Max. Negotiated Rate	$714.25
Rate for Payer: Aetna Commercial	$428.55
Rate for Payer: Aetna Medicare Advantage	$428.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$364.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$364.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$285.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$364.27
Rate for Payer: Cigna Commercial	$714.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$345.70
Rate for Payer: Qualcare PPO/HMO/WC	$214.28

SCREW 4.0X16MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694164
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 4.0X16MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694164
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW 4.0X16MM CERES-C SELF TA

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692578
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW 4.0X16MM CERES-C SELF TA

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692578
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 4.0 X 16MM VARIABLE

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688414
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW 4.0 X 16MM VARIABLE

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688414
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW 4.0x20mm CANCELLOUS

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270678509
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW 4.0x20mm CANCELLOUS

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270678509
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW 4.0X20.MM POLY

Facility

$8,755.00

Hospital Charge Code	270657225
Hospital Revenue Code	278
Min. Negotiated Rate	$1,313.25
Max. Negotiated Rate	$2,118.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,751.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,118.71
Rate for Payer: Qualcare PPO/HMO/WC	$1,313.25

Know your out-of-pocket cost for care.

All Charges