Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW AXSOS LKG 5.0X36MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697355
Hospital Revenue Code	278
Min. Negotiated Rate	$190.89
Max. Negotiated Rate	$636.30
Rate for Payer: Aetna Commercial	$381.78
Rate for Payer: Aetna Medicare Advantage	$381.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$324.51
Rate for Payer: Cigna Commercial	$636.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89

SCREW AXSOS LKG 5.0X36MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697355
Hospital Revenue Code	278
Min. Negotiated Rate	$190.89
Max. Negotiated Rate	$307.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89

SCREW AXSOS LKG 5.0X50MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697356
Hospital Revenue Code	278
Min. Negotiated Rate	$190.89
Max. Negotiated Rate	$307.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89

SCREW AXSOS LKG 5.0X50MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697356
Hospital Revenue Code	278
Min. Negotiated Rate	$190.89
Max. Negotiated Rate	$636.30
Rate for Payer: Aetna Commercial	$381.78
Rate for Payer: Aetna Medicare Advantage	$381.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$324.51
Rate for Payer: Cigna Commercial	$636.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89

SCREW AXSOS LKG TI ST 5X34MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697354
Hospital Revenue Code	278
Min. Negotiated Rate	$190.89
Max. Negotiated Rate	$307.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89

SCREW AXSOS LKG TI ST 5X34MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697354
Hospital Revenue Code	278
Min. Negotiated Rate	$190.89
Max. Negotiated Rate	$636.30
Rate for Payer: Aetna Commercial	$381.78
Rate for Payer: Aetna Medicare Advantage	$381.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$324.51
Rate for Payer: Cigna Commercial	$636.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89

SCREW AXSOS LKG TI ST 5X40MM

Facility

$984.20

Service Code	HCPCS C1713
Hospital Charge Code	270673770
Hospital Revenue Code	278
Min. Negotiated Rate	$147.63
Max. Negotiated Rate	$492.10
Rate for Payer: Aetna Commercial	$295.26
Rate for Payer: Aetna Medicare Advantage	$295.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.97
Rate for Payer: Cigna Commercial	$492.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.18
Rate for Payer: Qualcare PPO/HMO/WC	$147.63

SCREW AXSOS LKG TI ST 5X40MM

Facility

$984.20

Service Code	HCPCS C1713
Hospital Charge Code	270673770
Hospital Revenue Code	278
Min. Negotiated Rate	$147.63
Max. Negotiated Rate	$238.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.18
Rate for Payer: Qualcare PPO/HMO/WC	$147.63

SCREW AXSOS LKG TI ST 5X60MM

Facility

$984.20

Service Code	HCPCS C1713
Hospital Charge Code	270673769
Hospital Revenue Code	278
Min. Negotiated Rate	$147.63
Max. Negotiated Rate	$238.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.18
Rate for Payer: Qualcare PPO/HMO/WC	$147.63

SCREW AXSOS LKG TI ST 5X60MM

Facility

$984.20

Service Code	HCPCS C1713
Hospital Charge Code	270673769
Hospital Revenue Code	278
Min. Negotiated Rate	$147.63
Max. Negotiated Rate	$492.10
Rate for Payer: Aetna Commercial	$295.26
Rate for Payer: Aetna Medicare Advantage	$295.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.97
Rate for Payer: Cigna Commercial	$492.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.18
Rate for Payer: Qualcare PPO/HMO/WC	$147.63

SCREW AXSOS LKG TI ST 5X65MM

Facility

$984.20

Service Code	HCPCS C1713
Hospital Charge Code	270673766
Hospital Revenue Code	278
Min. Negotiated Rate	$147.63
Max. Negotiated Rate	$238.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.18
Rate for Payer: Qualcare PPO/HMO/WC	$147.63

SCREW AXSOS LKG TI ST 5X65MM

Facility

$984.20

Service Code	HCPCS C1713
Hospital Charge Code	270673766
Hospital Revenue Code	278
Min. Negotiated Rate	$147.63
Max. Negotiated Rate	$492.10
Rate for Payer: Aetna Commercial	$295.26
Rate for Payer: Aetna Medicare Advantage	$295.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.97
Rate for Payer: Cigna Commercial	$492.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.18
Rate for Payer: Qualcare PPO/HMO/WC	$147.63

SCREW AXSOS LOCKING 4X16MM

Facility

$1,206.95

Service Code	HCPCS C1713
Hospital Charge Code	270699638
Hospital Revenue Code	278
Min. Negotiated Rate	$181.04
Max. Negotiated Rate	$603.48
Rate for Payer: Aetna Commercial	$362.08
Rate for Payer: Aetna Medicare Advantage	$362.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.77
Rate for Payer: Cigna Commercial	$603.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.08
Rate for Payer: Qualcare PPO/HMO/WC	$181.04

SCREW AXSOS LOCKING 4X16MM

Facility

$1,206.95

Service Code	HCPCS C1713
Hospital Charge Code	270699638
Hospital Revenue Code	278
Min. Negotiated Rate	$181.04
Max. Negotiated Rate	$292.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.08
Rate for Payer: Qualcare PPO/HMO/WC	$181.04

SCREW AXSOS LOCKING 4X20MM

Facility

$1,206.95

Service Code	HCPCS C1713
Hospital Charge Code	270699639
Hospital Revenue Code	278
Min. Negotiated Rate	$181.04
Max. Negotiated Rate	$603.48
Rate for Payer: Aetna Commercial	$362.08
Rate for Payer: Aetna Medicare Advantage	$362.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.77
Rate for Payer: Cigna Commercial	$603.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.08
Rate for Payer: Qualcare PPO/HMO/WC	$181.04

SCREW AXSOS LOCKING 4X20MM

Facility

$1,206.95

Service Code	HCPCS C1713
Hospital Charge Code	270699639
Hospital Revenue Code	278
Min. Negotiated Rate	$181.04
Max. Negotiated Rate	$292.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.08
Rate for Payer: Qualcare PPO/HMO/WC	$181.04

SCREW AXSOS LOCKING 4X30MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270696727
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW AXSOS LOCKING 4X30MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270696727
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$517.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW AXSOS LOCKING 4X32MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270696728
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW AXSOS LOCKING 4X32MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270696728
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$517.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW AXSOS LOCKING 4X75MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270696746
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW AXSOS LOCKING 4X75MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270696746
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$517.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW AXSOS LOCKING 5.0X50MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697988
Hospital Revenue Code	278
Min. Negotiated Rate	$190.89
Max. Negotiated Rate	$636.30
Rate for Payer: Aetna Commercial	$381.78
Rate for Payer: Aetna Medicare Advantage	$381.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$324.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$324.51
Rate for Payer: Cigna Commercial	$636.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89

SCREW AXSOS LOCKING 5.0X50MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697988
Hospital Revenue Code	278
Min. Negotiated Rate	$190.89
Max. Negotiated Rate	$307.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89

SCREW AXSOS LOCKING 5.0X85MM

Facility

$1,272.60

Service Code	HCPCS C1713
Hospital Charge Code	270697987
Hospital Revenue Code	278
Min. Negotiated Rate	$190.89
Max. Negotiated Rate	$307.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$254.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.97
Rate for Payer: Qualcare PPO/HMO/WC	$190.89

Know your out-of-pocket cost for care.

All Charges