Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 56 X 12 MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270687499
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 5CT

Facility

$2,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270665095
Hospital Revenue Code	278
Min. Negotiated Rate	$435.00
Max. Negotiated Rate	$1,450.00
Rate for Payer: Aetna Commercial	$870.00
Rate for Payer: Aetna Medicare Advantage	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$739.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$739.50
Rate for Payer: Cigna Commercial	$1,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00

SCREW 5CT

Facility

$2,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270665095
Hospital Revenue Code	278
Min. Negotiated Rate	$435.00
Max. Negotiated Rate	$701.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$580.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$701.80
Rate for Payer: Qualcare PPO/HMO/WC	$435.00

SCREW 5L30

Facility

$1,250.00

Hospital Charge Code	270703488
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 5L30

Facility

$1,250.00

Hospital Charge Code	270703488
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 5MM LOCKING 75MM

Facility

$14,942.05

Service Code	HCPCS C1713
Hospital Charge Code	270693022
Hospital Revenue Code	278
Min. Negotiated Rate	$2,241.31
Max. Negotiated Rate	$7,471.02
Rate for Payer: Aetna Commercial	$4,482.61
Rate for Payer: Aetna Medicare Advantage	$4,482.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,810.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,810.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,988.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,810.22
Rate for Payer: Cigna Commercial	$7,471.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,615.98
Rate for Payer: Qualcare PPO/HMO/WC	$2,241.31

SCREW 5MM LOCKING 75MM

Facility

$14,942.05

Service Code	HCPCS C1713
Hospital Charge Code	270693022
Hospital Revenue Code	278
Min. Negotiated Rate	$2,241.31
Max. Negotiated Rate	$3,615.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,988.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,615.98
Rate for Payer: Qualcare PPO/HMO/WC	$2,241.31

SCREW 5MM LOCKING 80MM

Facility

$1,245.45

Service Code	HCPCS C1713
Hospital Charge Code	270693023
Hospital Revenue Code	278
Min. Negotiated Rate	$186.82
Max. Negotiated Rate	$622.73
Rate for Payer: Aetna Commercial	$373.63
Rate for Payer: Aetna Medicare Advantage	$373.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.59
Rate for Payer: Cigna Commercial	$622.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.40
Rate for Payer: Qualcare PPO/HMO/WC	$186.82

SCREW 5MM LOCKING 80MM

Facility

$1,245.45

Service Code	HCPCS C1713
Hospital Charge Code	270693023
Hospital Revenue Code	278
Min. Negotiated Rate	$186.82
Max. Negotiated Rate	$301.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$249.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.40
Rate for Payer: Qualcare PPO/HMO/WC	$186.82

SCREW 5mm MTRX 04.503.225.01

Facility

$383.25

Hospital Charge Code	270640447
Hospital Revenue Code	278
Min. Negotiated Rate	$57.49
Max. Negotiated Rate	$191.62
Rate for Payer: Aetna Commercial	$114.97
Rate for Payer: Aetna Medicare Advantage	$114.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.73
Rate for Payer: Cigna Commercial	$191.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.75
Rate for Payer: Qualcare PPO/HMO/WC	$57.49

SCREW 5mm MTRX 04.503.225.01

Facility

$383.25

Hospital Charge Code	270640447
Hospital Revenue Code	278
Min. Negotiated Rate	$57.49
Max. Negotiated Rate	$92.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.75
Rate for Payer: Qualcare PPO/HMO/WC	$57.49

SCREW 5mm X 40mm 14-405040

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270640292
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW 5mm X 40mm 14-405040

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270640292
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$315.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW 5X17.5MM

Facility

$1,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270704777
Hospital Revenue Code	278
Min. Negotiated Rate	$236.25
Max. Negotiated Rate	$787.50
Rate for Payer: Aetna Commercial	$472.50
Rate for Payer: Aetna Medicare Advantage	$472.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$401.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$401.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$401.62
Rate for Payer: Cigna Commercial	$787.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.15
Rate for Payer: Qualcare PPO/HMO/WC	$236.25

SCREW 5X17.5MM

Facility

$1,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270704777
Hospital Revenue Code	278
Min. Negotiated Rate	$236.25
Max. Negotiated Rate	$381.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.15
Rate for Payer: Qualcare PPO/HMO/WC	$236.25

SCREW 5X20MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704663
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW 5X20MM

Facility

$2,500.00

Hospital Charge Code	270701766
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

SCREW 5X20MM

Facility

$2,500.00

Hospital Charge Code	270701766
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$750.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

SCREW 5X20MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704663
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW 5X25MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704098
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

SCREW 5X25MM

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270701767
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$605.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

SCREW 5X25MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705786
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW 5X25MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270704098
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$450.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

SCREW 5X25MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704863
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW 5X25MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270705786
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

Know your out-of-pocket cost for care.

All Charges