Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE ACET 36MM

Facility

$7,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270692216
Hospital Revenue Code	278
Min. Negotiated Rate	$1,181.25
Max. Negotiated Rate	$1,905.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,905.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,181.25

SCREW BONE ACET 6.5X30MM

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270692219
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$262.50
Rate for Payer: Aetna Commercial	$157.50
Rate for Payer: Aetna Medicare Advantage	$157.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.88
Rate for Payer: Cigna Commercial	$262.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

SCREW BONE ACET 6.5X30MM

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270692219
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$127.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$78.75

SCREW BONE CAN 6.5MMX30MM

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270646341
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

SCREW BONE CAN 6.5MMX30MM

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270646341
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$195.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

SCREW BONE CAN 6.5MMX40MM

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270679972
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$195.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

SCREW BONE CAN 6.5MMX40MM

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270679972
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

SCREW BONE CAN 6.5MMX50MM

Facility

$733.50

Service Code	HCPCS C1713
Hospital Charge Code	270646340
Hospital Revenue Code	278
Min. Negotiated Rate	$110.03
Max. Negotiated Rate	$366.75
Rate for Payer: Aetna Commercial	$220.05
Rate for Payer: Aetna Medicare Advantage	$220.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$187.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$187.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$187.04
Rate for Payer: Cigna Commercial	$366.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.51
Rate for Payer: Qualcare PPO/HMO/WC	$110.03

SCREW BONE CAN 6.5MMX50MM

Facility

$733.50

Service Code	HCPCS C1713
Hospital Charge Code	270646340
Hospital Revenue Code	278
Min. Negotiated Rate	$110.03
Max. Negotiated Rate	$177.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.51
Rate for Payer: Qualcare PPO/HMO/WC	$110.03

SCREW BONE CANC 6.5x25MM

Facility

$296.65

Service Code	HCPCS C1713
Hospital Charge Code	270676581
Hospital Revenue Code	278
Min. Negotiated Rate	$44.50
Max. Negotiated Rate	$148.32
Rate for Payer: Aetna Commercial	$89.00
Rate for Payer: Aetna Medicare Advantage	$89.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.65
Rate for Payer: Cigna Commercial	$148.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.79
Rate for Payer: Qualcare PPO/HMO/WC	$44.50

SCREW BONE CANC 6.5x25MM

Facility

$296.65

Service Code	HCPCS C1713
Hospital Charge Code	270676581
Hospital Revenue Code	278
Min. Negotiated Rate	$44.50
Max. Negotiated Rate	$71.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.79
Rate for Payer: Qualcare PPO/HMO/WC	$44.50

SCREW BONE CANCELLOUS 6.5x15MM

Facility

$500.00

Hospital Charge Code	270672543
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW BONE CANCELLOUS 6.5x15MM

Facility

$500.00

Hospital Charge Code	270672543
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW BONE CANCELLOUS 6.5x16MM

Facility

$432.00

Service Code	HCPCS C1713
Hospital Charge Code	270676686
Hospital Revenue Code	278
Min. Negotiated Rate	$64.80
Max. Negotiated Rate	$104.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.54
Rate for Payer: Qualcare PPO/HMO/WC	$64.80

SCREW BONE CANCELLOUS 6.5x16MM

Facility

$432.00

Service Code	HCPCS C1713
Hospital Charge Code	270676686
Hospital Revenue Code	278
Min. Negotiated Rate	$64.80
Max. Negotiated Rate	$216.00
Rate for Payer: Aetna Commercial	$129.60
Rate for Payer: Aetna Medicare Advantage	$129.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.16
Rate for Payer: Cigna Commercial	$216.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.54
Rate for Payer: Qualcare PPO/HMO/WC	$64.80

SCREW BONE CANCELLOUS 6.5x25MM

Facility

$500.00

Hospital Charge Code	270672544
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW BONE CANCELLOUS 6.5x25MM

Facility

$500.00

Hospital Charge Code	270672544
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW BONE CANCELLOUS 6.5x35MM

Facility

$500.00

Hospital Charge Code	270672545
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW BONE CANCELLOUS 6.5x35MM

Facility

$500.00

Hospital Charge Code	270672545
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW BONE CANCELLOUS 6.5x45MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270672546
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW BONE CANCELLOUS 6.5x45MM

Facility

$733.50

Service Code	HCPCS C1713
Hospital Charge Code	270671853
Hospital Revenue Code	278
Min. Negotiated Rate	$110.03
Max. Negotiated Rate	$177.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.51
Rate for Payer: Qualcare PPO/HMO/WC	$110.03

SCREW BONE CANCELLOUS 6.5x45MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270672546
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW BONE CANCELLOUS 6.5x45MM

Facility

$733.50

Service Code	HCPCS C1713
Hospital Charge Code	270671853
Hospital Revenue Code	278
Min. Negotiated Rate	$110.03
Max. Negotiated Rate	$366.75
Rate for Payer: Aetna Commercial	$220.05
Rate for Payer: Aetna Medicare Advantage	$220.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$187.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$187.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$187.04
Rate for Payer: Cigna Commercial	$366.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.51
Rate for Payer: Qualcare PPO/HMO/WC	$110.03

SCREW BONE CANN F/THD 4x10MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604232
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$17.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

SCREW BONE CANN F/THD 4x10MM

Facility

$74.15

Service Code	HCPCS C1713
Hospital Charge Code	270604232
Hospital Revenue Code	278
Min. Negotiated Rate	$11.12
Max. Negotiated Rate	$37.08
Rate for Payer: Aetna Commercial	$22.25
Rate for Payer: Aetna Medicare Advantage	$22.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$37.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.12

Know your out-of-pocket cost for care.

All Charges