Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN F/THRD 4.5x48MM

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604916
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$213.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THRD 4.5x50mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604917
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x50mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604917
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$151.50
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x52mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604918
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x52mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604918
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$151.50
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x60mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604921
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$151.50
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x60mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604921
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x64mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604922
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x64mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604922
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$151.50
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x68mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604924
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$151.50
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x68mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604924
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN FULL 4.0X30 MM

Facility

$468.00

Service Code	HCPCS C1713
Hospital Charge Code	270704104
Hospital Revenue Code	278
Min. Negotiated Rate	$70.20
Max. Negotiated Rate	$234.00
Rate for Payer: Aetna Commercial	$140.40
Rate for Payer: Aetna Medicare Advantage	$140.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.34
Rate for Payer: Cigna Commercial	$234.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.26
Rate for Payer: Qualcare PPO/HMO/WC	$70.20

SCREW CANN FULL 4.0X30 MM

Facility

$468.00

Service Code	HCPCS C1713
Hospital Charge Code	270704104
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 CANN FULL THD 5.0mmX40mm

Facility

$546.45

Hospital Charge Code	270633503
Hospital Revenue Code	278
Min. Negotiated Rate	$81.97
Max. Negotiated Rate	$132.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.24
Rate for Payer: Qualcare PPO/HMO/WC	$81.97

SCREW CANN FULL THD 5.0mmX40mm

Facility

$546.45

Hospital Charge Code	270633503
Hospital Revenue Code	278
Min. Negotiated Rate	$81.97
Max. Negotiated Rate	$273.23
Rate for Payer: Aetna Commercial	$163.94
Rate for Payer: Aetna Medicare Advantage	$163.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.34
Rate for Payer: Cigna Commercial	$273.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.24
Rate for Payer: Qualcare PPO/HMO/WC	$81.97

SCREW CANN FULL THREAD 9x20MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270674089
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SCREW CANN FULL THREAD 9x20MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270674089
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SCREW CANN FULLY THD 4.5x26MM

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270672275
Hospital Revenue Code	278
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$322.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

SCREW CANN FULLY THD 4.5x26MM

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270672275
Hospital Revenue Code	278
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

SCREW CANN FULLY THD 4.5x36MM

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270672276
Hospital Revenue Code	278
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

SCREW CANN FULLY THD 4.5x36MM

Facility

$1,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270672276
Hospital Revenue Code	278
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$322.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$260.15
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

SCREW CANN FUL THD 30MM 4.0

Facility

$918.00

Service Code	HCPCS C1713
Hospital Charge Code	270704266
Hospital Revenue Code	278
Min. Negotiated Rate	$137.70
Max. Negotiated Rate	$222.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$183.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.16
Rate for Payer: Qualcare PPO/HMO/WC	$137.70

SCREW CANN FUL THD 30MM 4.0

Facility

$918.00

Service Code	HCPCS C1713
Hospital Charge Code	270704266
Hospital Revenue Code	278
Min. Negotiated Rate	$137.70
Max. Negotiated Rate	$459.00
Rate for Payer: Aetna Commercial	$275.40
Rate for Payer: Aetna Medicare Advantage	$275.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.09
Rate for Payer: Cigna Commercial	$459.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$222.16
Rate for Payer: Qualcare PPO/HMO/WC	$137.70

SCREW CANN. HD 2.7x24MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270680848
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$560.00
Rate for Payer: Aetna Commercial	$336.00
Rate for Payer: Aetna Medicare Advantage	$336.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$285.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$285.60
Rate for Payer: Cigna Commercial	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

SCREW CANN. HD 2.7x24MM

Facility

$1,120.00

Service Code	HCPCS C1713
Hospital Charge Code	270680848
Hospital Revenue Code	278
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$271.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$271.04
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

Know your out-of-pocket cost for care.

All Charges