Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 T10 3.5 X 20MM

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270667256
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 T10 3.5 X 20MM

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	270667256
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 T10 3.5X24MM

Facility

$655.00

Service Code	HCPCS C1713
Hospital Charge Code	270670010
Hospital Revenue Code	278
Min. Negotiated Rate	$98.25
Max. Negotiated Rate	$327.50
Rate for Payer: Aetna Commercial	$196.50
Rate for Payer: Aetna Medicare Advantage	$196.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.03
Rate for Payer: Cigna Commercial	$327.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.51
Rate for Payer: Qualcare PPO/HMO/WC	$98.25

SCREW BONE T10 3.5X24MM

Facility

$655.00

Service Code	HCPCS C1713
Hospital Charge Code	270670010
Hospital Revenue Code	278
Min. Negotiated Rate	$98.25
Max. Negotiated Rate	$158.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.51
Rate for Payer: Qualcare PPO/HMO/WC	$98.25

SCREW BONE T10 3.5x30MM

Facility

$655.00

Service Code	HCPCS C1713
Hospital Charge Code	270673998
Hospital Revenue Code	278
Min. Negotiated Rate	$98.25
Max. Negotiated Rate	$327.50
Rate for Payer: Aetna Commercial	$196.50
Rate for Payer: Aetna Medicare Advantage	$196.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$167.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$167.03
Rate for Payer: Cigna Commercial	$327.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.51
Rate for Payer: Qualcare PPO/HMO/WC	$98.25

SCREW BONE T10 3.5x30MM

Facility

$655.00

Service Code	HCPCS C1713
Hospital Charge Code	270673998
Hospital Revenue Code	278
Min. Negotiated Rate	$98.25
Max. Negotiated Rate	$158.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.51
Rate for Payer: Qualcare PPO/HMO/WC	$98.25

SCREW BONE T10 FT 3.5X32MM

Facility

$711.55

Service Code	HCPCS C1713
Hospital Charge Code	270692173
Hospital Revenue Code	278
Min. Negotiated Rate	$106.73
Max. Negotiated Rate	$172.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.20
Rate for Payer: Qualcare PPO/HMO/WC	$106.73

SCREW BONE T10 FT 3.5X32MM

Facility

$711.55

Service Code	HCPCS C1713
Hospital Charge Code	270692173
Hospital Revenue Code	278
Min. Negotiated Rate	$106.73
Max. Negotiated Rate	$355.77
Rate for Payer: Aetna Commercial	$213.47
Rate for Payer: Aetna Medicare Advantage	$213.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.45
Rate for Payer: Cigna Commercial	$355.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.20
Rate for Payer: Qualcare PPO/HMO/WC	$106.73

SCREW BONE T10 FT 3.5X38MM

Facility

$711.55

Service Code	HCPCS C1713
Hospital Charge Code	270692174
Hospital Revenue Code	278
Min. Negotiated Rate	$106.73
Max. Negotiated Rate	$355.77
Rate for Payer: Aetna Commercial	$213.47
Rate for Payer: Aetna Medicare Advantage	$213.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.45
Rate for Payer: Cigna Commercial	$355.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.20
Rate for Payer: Qualcare PPO/HMO/WC	$106.73

SCREW BONE T10 FT 3.5X38MM

Facility

$711.55

Service Code	HCPCS C1713
Hospital Charge Code	270692174
Hospital Revenue Code	278
Min. Negotiated Rate	$106.73
Max. Negotiated Rate	$172.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.20
Rate for Payer: Qualcare PPO/HMO/WC	$106.73

SCREW BONE T10 FT 3.5X40MM

Facility

$711.55

Service Code	HCPCS C1713
Hospital Charge Code	270692175
Hospital Revenue Code	278
Min. Negotiated Rate	$106.73
Max. Negotiated Rate	$355.77
Rate for Payer: Aetna Commercial	$213.47
Rate for Payer: Aetna Medicare Advantage	$213.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.45
Rate for Payer: Cigna Commercial	$355.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.20
Rate for Payer: Qualcare PPO/HMO/WC	$106.73

SCREW BONE T10 FT 3.5X40MM

Facility

$711.55

Service Code	HCPCS C1713
Hospital Charge Code	270692175
Hospital Revenue Code	278
Min. Negotiated Rate	$106.73
Max. Negotiated Rate	$172.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.20
Rate for Payer: Qualcare PPO/HMO/WC	$106.73

SCREW BONE T10 FT 3.5X42MM

Facility

$711.55

Service Code	HCPCS C1713
Hospital Charge Code	270692176
Hospital Revenue Code	278
Min. Negotiated Rate	$106.73
Max. Negotiated Rate	$355.77
Rate for Payer: Aetna Commercial	$213.47
Rate for Payer: Aetna Medicare Advantage	$213.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.45
Rate for Payer: Cigna Commercial	$355.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.20
Rate for Payer: Qualcare PPO/HMO/WC	$106.73

SCREW BONE T10 FT 3.5X42MM

Facility

$711.55

Service Code	HCPCS C1713
Hospital Charge Code	270692176
Hospital Revenue Code	278
Min. Negotiated Rate	$106.73
Max. Negotiated Rate	$172.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.20
Rate for Payer: Qualcare PPO/HMO/WC	$106.73

SCREW BONE T8 2.7X14MM

Facility

$1,055.00

Service Code	HCPCS C1713
Hospital Charge Code	270699915
Hospital Revenue Code	278
Min. Negotiated Rate	$158.25
Max. Negotiated Rate	$255.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.31
Rate for Payer: Qualcare PPO/HMO/WC	$158.25

SCREW BONE T8 2.7X14MM

Facility

$1,055.00

Service Code	HCPCS C1713
Hospital Charge Code	270699915
Hospital Revenue Code	278
Min. Negotiated Rate	$158.25
Max. Negotiated Rate	$527.50
Rate for Payer: Aetna Commercial	$316.50
Rate for Payer: Aetna Medicare Advantage	$316.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.02
Rate for Payer: Cigna Commercial	$527.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.31
Rate for Payer: Qualcare PPO/HMO/WC	$158.25

SCREW BONE T8 FUL THD 2.7 28MM

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270703685
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 T8 FUL THD 2.7 28MM

Facility

$770.85

Service Code	HCPCS C1713
Hospital Charge Code	270703685
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 THD 3.5MM X L26MM

Facility

$752.45

Service Code	HCPCS C1713
Hospital Charge Code	270700877
Hospital Revenue Code	278
Min. Negotiated Rate	$112.87
Max. Negotiated Rate	$182.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.09
Rate for Payer: Qualcare PPO/HMO/WC	$112.87

SCREW BONE THD 3.5MM X L26MM

Facility

$752.45

Service Code	HCPCS C1713
Hospital Charge Code	270700877
Hospital Revenue Code	278
Min. Negotiated Rate	$112.87
Max. Negotiated Rate	$376.23
Rate for Payer: Aetna Commercial	$225.74
Rate for Payer: Aetna Medicare Advantage	$225.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.87
Rate for Payer: Cigna Commercial	$376.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.09
Rate for Payer: Qualcare PPO/HMO/WC	$112.87

SCREW BONE TI 1.7x12mm

Facility

$685.00

Hospital Charge Code	270669955
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 TI 1.7x12mm

Facility

$685.00

Hospital Charge Code	270669955
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 TI 2.3x16mm

Facility

$685.00

Hospital Charge Code	270669954
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 TI 2.3x16mm

Facility

$685.00

Hospital Charge Code	270669954
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

Know your out-of-pocket cost for care.

All Charges