Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANCELLOUS 4X16MM

Facility

$468.00

Service Code	HCPCS C1713
Hospital Charge Code	270705087
Hospital Revenue Code	278
Min. Negotiated Rate	$70.20
Max. Negotiated Rate	$113.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.26
Rate for Payer: Qualcare PPO/HMO/WC	$70.20

SCREW CANCELLOUS 5.5mm x 45mm

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270678709
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

SCREW CANCELLOUS 5.5mm x 45mm

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270678709
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$112.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

SCREW CANCELLOUS 5x34 RD156934

Facility

$1,056.50

Hospital Charge Code	270632871
Hospital Revenue Code	278
Min. Negotiated Rate	$158.47
Max. Negotiated Rate	$255.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.67
Rate for Payer: Qualcare PPO/HMO/WC	$158.47

SCREW CANCELLOUS 5x34 RD156934

Facility

$1,056.50

Hospital Charge Code	270632871
Hospital Revenue Code	278
Min. Negotiated Rate	$158.47
Max. Negotiated Rate	$528.25
Rate for Payer: Aetna Commercial	$316.95
Rate for Payer: Aetna Medicare Advantage	$316.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.41
Rate for Payer: Cigna Commercial	$528.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.67
Rate for Payer: Qualcare PPO/HMO/WC	$158.47

SCREW CANCELLOUS 5X37.5MM

Facility

$995.00

Hospital Charge Code	270671058
Hospital Revenue Code	278
Min. Negotiated Rate	$149.25
Max. Negotiated Rate	$240.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.25

SCREW CANCELLOUS 5X37.5MM

Facility

$995.00

Hospital Charge Code	270671058
Hospital Revenue Code	278
Min. Negotiated Rate	$149.25
Max. Negotiated Rate	$497.50
Rate for Payer: Aetna Commercial	$298.50
Rate for Payer: Aetna Medicare Advantage	$298.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.72
Rate for Payer: Cigna Commercial	$497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.25

SCREW CANCELLOUS 5X40MM

Facility

$995.00

Hospital Charge Code	270671059
Hospital Revenue Code	278
Min. Negotiated Rate	$149.25
Max. Negotiated Rate	$240.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.25

SCREW CANCELLOUS 5X40MM

Facility

$995.00

Hospital Charge Code	270671059
Hospital Revenue Code	278
Min. Negotiated Rate	$149.25
Max. Negotiated Rate	$497.50
Rate for Payer: Aetna Commercial	$298.50
Rate for Payer: Aetna Medicare Advantage	$298.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$199.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.72
Rate for Payer: Cigna Commercial	$497.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.79
Rate for Payer: Qualcare PPO/HMO/WC	$149.25

screw cancellous 6.5x30

Facility

$143.20

Service Code	HCPCS C1713
Hospital Charge Code	270684679
Hospital Revenue Code	278
Min. Negotiated Rate	$21.48
Max. Negotiated Rate	$34.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.65
Rate for Payer: Qualcare PPO/HMO/WC	$21.48

screw cancellous 6.5x30

Facility

$143.20

Service Code	HCPCS C1713
Hospital Charge Code	270684679
Hospital Revenue Code	278
Min. Negotiated Rate	$21.48
Max. Negotiated Rate	$71.60
Rate for Payer: Aetna Commercial	$42.96
Rate for Payer: Aetna Medicare Advantage	$42.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.52
Rate for Payer: Cigna Commercial	$71.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.65
Rate for Payer: Qualcare PPO/HMO/WC	$21.48

SCREW CANCELLOUS 6.5 X 35MM

Facility

$320.00

Hospital Charge Code	270668343
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$160.00
Rate for Payer: Aetna Commercial	$96.00
Rate for Payer: Aetna Medicare Advantage	$96.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.60
Rate for Payer: Cigna Commercial	$160.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

SCREW CANCELLOUS 6.5 X 35MM

Facility

$320.00

Hospital Charge Code	270668343
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$77.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.44
Rate for Payer: Qualcare PPO/HMO/WC	$48.00

screw cancellous 6.5x80

Facility

$143.20

Service Code	HCPCS C1713
Hospital Charge Code	270384680
Hospital Revenue Code	278
Min. Negotiated Rate	$21.48
Max. Negotiated Rate	$71.60
Rate for Payer: Aetna Commercial	$42.96
Rate for Payer: Aetna Medicare Advantage	$42.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.52
Rate for Payer: Cigna Commercial	$71.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.65
Rate for Payer: Qualcare PPO/HMO/WC	$21.48

screw cancellous 6.5x80

Facility

$143.20

Service Code	HCPCS C1713
Hospital Charge Code	270384680
Hospital Revenue Code	278
Min. Negotiated Rate	$21.48
Max. Negotiated Rate	$34.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.65
Rate for Payer: Qualcare PPO/HMO/WC	$21.48

SCREW CANCELLOUS BONE 6.5 MM 2

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270688632
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 CANCELLOUS BONE 6.5 MM 2

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270688632
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 CANCELLOUS BONE 6.5 MMX

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270688142
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 CANCELLOUS BONE 6.5 MMX

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270688142
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 CANCELLOUS BONE 6.5X20MM

Facility

$676.00

Service Code	HCPCS C1713
Hospital Charge Code	270680638
Hospital Revenue Code	278
Min. Negotiated Rate	$101.40
Max. Negotiated Rate	$163.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.59
Rate for Payer: Qualcare PPO/HMO/WC	$101.40

SCREW CANCELLOUS BONE 6.5X20MM

Facility

$676.00

Service Code	HCPCS C1713
Hospital Charge Code	270680638
Hospital Revenue Code	278
Min. Negotiated Rate	$101.40
Max. Negotiated Rate	$338.00
Rate for Payer: Aetna Commercial	$202.80
Rate for Payer: Aetna Medicare Advantage	$202.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.38
Rate for Payer: Cigna Commercial	$338.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.59
Rate for Payer: Qualcare PPO/HMO/WC	$101.40

SCREW CANCELLOUS BONE 6.5X35MM

Facility

$733.50

Service Code	HCPCS C1713
Hospital Charge Code	270671316
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 CANCELLOUS BONE 6.5X35MM

Facility

$733.50

Service Code	HCPCS C1713
Hospital Charge Code	270671316
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 CANCELLOUS BONE 6.5X35MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697694
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW CANCELLOUS BONE 6.5X35MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697694
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

Know your out-of-pocket cost for care.

All Charges