Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE SELF TAP 2.7x24MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270672958
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$205.50
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

SCREW BONE SELF TAP 2.7x24MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270672958
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

SCREW BONE SELF TAP 3.5x12mm

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270662025
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$172.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

SCREW BONE SELF TAP 3.5x12mm

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270662025
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

SCREW BONE SELF TAP 3.5x14mm

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270669708
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

SCREW BONE SELF TAP 3.5x14mm

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270669708
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$205.50
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

SCREW BONE SELF TAP 3.5x16mm

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270648602
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

SCREW BONE SELF TAP 3.5x16mm

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270648602
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$205.50
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

SCREW BONE SELF TAP 3.5x18mm

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270648603
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$205.50
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

SCREW BONE SELF TAP 3.5x18mm

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270648603
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

SCREW BONE SELFTAP 6.5x25mm

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270663510
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

SCREW BONE SELFTAP 6.5x25mm

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270663510
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

SCREW BONE SELFTAP 6.5x35mm

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270626109
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

SCREW BONE SELFTAP 6.5x35mm

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270626109
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

SCREW BONE SELFTAP 6.5x40mm

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270677528
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

SCREW BONE SELFTAP 6.5x40mm

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270677528
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

SCREW BONE SELFTAP 6.5 x 50mm

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270686594
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

SCREW BONE SELFTAP 6.5 x 50mm

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270686594
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

SCREW BONE SELF-TAP 7.5X55MM

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270693733
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,500.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SCREW BONE SELF-TAP 7.5X55MM

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270693733
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SCREW BONE SLF TAP 3.5X10MM

Facility

$685.00

Hospital Charge Code	270670988
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$205.50
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

SCREW BONE SLF TAP 3.5X10MM

Facility

$685.00

Hospital Charge Code	270670988
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

SCREW BONE S/TAPPING 6.5x20mm

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270616307
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$120.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

SCREW BONE S/TAPPING 6.5x20mm

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270616307
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

SCREW BONE S/TAPPING 6.5x35mm

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	270612165
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

Know your out-of-pocket cost for care.

All Charges