Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE CANN P/THD 4x40MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604275
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$17.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

SCREW BONE CANN P/THD 4x40MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604275
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$35.15
Rate for Payer: Aetna Commercial	$21.09
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.93
Rate for Payer: Cigna Commercial	$35.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

SCREW BONE CANN P/THD 4x45MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604276
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$17.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

SCREW BONE CANN P/THD 4x45MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604276
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$35.15
Rate for Payer: Aetna Commercial	$21.09
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.93
Rate for Payer: Cigna Commercial	$35.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

SCREW BONE CANN P/THD 4x50MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604277
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$35.15
Rate for Payer: Aetna Commercial	$21.09
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.93
Rate for Payer: Cigna Commercial	$35.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

SCREW BONE CANN P/THD 4x50MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604277
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$17.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

SCREW BONE CANN P/THD 4x55MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604278
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$17.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

SCREW BONE CANN P/THD 4x55MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604278
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$35.15
Rate for Payer: Aetna Commercial	$21.09
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.93
Rate for Payer: Cigna Commercial	$35.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

SCREW BONE CANN P/THD 4x60MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604279
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$17.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

SCREW BONE CANN P/THD 4x60MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270604279
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$35.15
Rate for Payer: Aetna Commercial	$21.09
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.93
Rate for Payer: Cigna Commercial	$35.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

SCREW BONE CORTICAL 4.5X26MM

Facility

$220.00

Service Code	HCPCS C1713
Hospital Charge Code	270694690
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$66.00
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

SCREW BONE CORTICAL 4.5X26MM

Facility

$220.00

Service Code	HCPCS C1713
Hospital Charge Code	270694690
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$53.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

SCREW BONE CORTICAL 4.5X28MM

Facility

$220.00

Service Code	HCPCS C1713
Hospital Charge Code	270694692
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$53.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

SCREW BONE CORTICAL 4.5X28MM

Facility

$220.00

Service Code	HCPCS C1713
Hospital Charge Code	270694692
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$66.00
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.24
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

SCREW BONE CORTICAL 5.0MMX38

Facility

$1,320.00

Service Code	HCPCS C1713
Hospital Charge Code	270702721
Hospital Revenue Code	278
Min. Negotiated Rate	$198.00
Max. Negotiated Rate	$319.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: Qualcare PPO/HMO/WC	$198.00

SCREW BONE CORTICAL 5.0MMX38

Facility

$1,320.00

Service Code	HCPCS C1713
Hospital Charge Code	270702721
Hospital Revenue Code	278
Min. Negotiated Rate	$198.00
Max. Negotiated Rate	$660.00
Rate for Payer: Aetna Commercial	$396.00
Rate for Payer: Aetna Medicare Advantage	$396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$336.60
Rate for Payer: Cigna Commercial	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: Qualcare PPO/HMO/WC	$198.00

SCREW BONE FUL THD 2.4 X 26MM

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270705671
Hospital Revenue Code	278
Min. Negotiated Rate	$115.63
Max. Negotiated Rate	$385.43
Rate for Payer: Aetna Commercial	$231.25
Rate for Payer: Aetna Medicare Advantage	$231.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$196.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$196.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$196.57
Rate for Payer: Cigna Commercial	$385.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.55
Rate for Payer: Qualcare PPO/HMO/WC	$115.63

SCREW BONE FUL THD 2.4 X 26MM

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270705671
Hospital Revenue Code	278
Min. Negotiated Rate	$115.63
Max. Negotiated Rate	$186.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$154.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.55
Rate for Payer: Qualcare PPO/HMO/WC	$115.63

SCREW BONE INBONE

Facility

$680.00

Service Code	HCPCS C1713
Hospital Charge Code	270670899
Hospital Revenue Code	278
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$340.00
Rate for Payer: Aetna Commercial	$204.00
Rate for Payer: Aetna Medicare Advantage	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.40
Rate for Payer: Cigna Commercial	$340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.56
Rate for Payer: Qualcare PPO/HMO/WC	$102.00

SCREW BONE INBONE

Facility

$680.00

Service Code	HCPCS C1713
Hospital Charge Code	270670899
Hospital Revenue Code	278
Min. Negotiated Rate	$102.00
Max. Negotiated Rate	$164.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$136.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$164.56
Rate for Payer: Qualcare PPO/HMO/WC	$102.00

SCREW BONE LOCKING 1.7X 10MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270655375
Hospital Revenue Code	278
Min. Negotiated Rate	$105.75
Max. Negotiated Rate	$352.50
Rate for Payer: Aetna Commercial	$211.50
Rate for Payer: Aetna Medicare Advantage	$211.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.78
Rate for Payer: Cigna Commercial	$352.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: Qualcare PPO/HMO/WC	$105.75

SCREW BONE LOCKING 1.7X 10MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270655375
Hospital Revenue Code	278
Min. Negotiated Rate	$105.75
Max. Negotiated Rate	$170.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: Qualcare PPO/HMO/WC	$105.75

SCREW BONE LOCKING 1.7X7MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270656394
Hospital Revenue Code	278
Min. Negotiated Rate	$105.75
Max. Negotiated Rate	$352.50
Rate for Payer: Aetna Commercial	$211.50
Rate for Payer: Aetna Medicare Advantage	$211.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.78
Rate for Payer: Cigna Commercial	$352.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: Qualcare PPO/HMO/WC	$105.75

SCREW BONE LOCKING 1.7X7MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270656394
Hospital Revenue Code	278
Min. Negotiated Rate	$105.75
Max. Negotiated Rate	$170.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: Qualcare PPO/HMO/WC	$105.75

SCREW BONE LOCKING 1.7X8MM

Facility

$705.00

Service Code	HCPCS C1713
Hospital Charge Code	270656396
Hospital Revenue Code	278
Min. Negotiated Rate	$105.75
Max. Negotiated Rate	$170.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$141.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$170.61
Rate for Payer: Qualcare PPO/HMO/WC	$105.75

Know your out-of-pocket cost for care.

All Charges