Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CORTICAL TI 5x58mm

Facility

$1,050.00

Hospital Charge Code	270665510
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW CORTICAL TI 5x65mm

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270643249
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW CORTICAL TI 5x65mm

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270643249
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$315.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW CORTICAL TI 5x75MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270643371
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW CORTICAL TI 5x75MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270643371
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$315.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW CORTICAL TI 5x80mm

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270645055
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$270.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

SCREW CORTICAL TI 5x80mm

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	270645055
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

SCREW CORTICAL TI 5x85mm

Facility

$905.00

Service Code	HCPCS C1713
Hospital Charge Code	270645059
Hospital Revenue Code	278
Min. Negotiated Rate	$135.75
Max. Negotiated Rate	$219.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.01
Rate for Payer: Qualcare PPO/HMO/WC	$135.75

SCREW CORTICAL TI 5x85mm

Facility

$905.00

Service Code	HCPCS C1713
Hospital Charge Code	270645059
Hospital Revenue Code	278
Min. Negotiated Rate	$135.75
Max. Negotiated Rate	$452.50
Rate for Payer: Aetna Commercial	$271.50
Rate for Payer: Aetna Medicare Advantage	$271.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.78
Rate for Payer: Cigna Commercial	$452.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$219.01
Rate for Payer: Qualcare PPO/HMO/WC	$135.75

SCREW CORTICAL TI 5x95mm

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270663669
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW CORTICAL TI 5x95mm

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270663669
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$315.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW CORTICAL TI-DOB LEAD

Facility

$2,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270705500
Hospital Revenue Code	278
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$810.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.40
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

SCREW CORTICAL TI-DOB LEAD

Facility

$2,700.00

Service Code	HCPCS C1713
Hospital Charge Code	270705500
Hospital Revenue Code	278
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$653.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$540.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$653.40
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

SCREW CORTICAL VHS 16-235130

Facility

$100.00

Hospital Charge Code	270637930
Hospital Revenue Code	278
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$24.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

SCREW CORTICAL VHS 16-235130

Facility

$100.00

Hospital Charge Code	270637930
Hospital Revenue Code	278
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$30.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

SCREW CORTICAL VHS 4.5x52mm

Facility

$120.00

Hospital Charge Code	270641335
Hospital Revenue Code	278
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.04
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

SCREW CORTICAL VHS 4.5x52mm

Facility

$120.00

Hospital Charge Code	270641335
Hospital Revenue Code	278
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$36.00
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.04
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

SCREW CORT LG 5.5x55 22535555

Facility

$570.45

Hospital Charge Code	270625981
Hospital Revenue Code	278
Min. Negotiated Rate	$85.57
Max. Negotiated Rate	$138.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.05
Rate for Payer: Qualcare PPO/HMO/WC	$85.57

SCREW CORT LG 5.5x55 22535555

Facility

$570.45

Hospital Charge Code	270625981
Hospital Revenue Code	278
Min. Negotiated Rate	$85.57
Max. Negotiated Rate	$285.23
Rate for Payer: Aetna Commercial	$171.13
Rate for Payer: Aetna Medicare Advantage	$171.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.46
Rate for Payer: Cigna Commercial	$285.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.05
Rate for Payer: Qualcare PPO/HMO/WC	$85.57

SCREW CORT LG 5.5x75 22537555

Facility

$611.25

Hospital Charge Code	270632354
Hospital Revenue Code	278
Min. Negotiated Rate	$91.69
Max. Negotiated Rate	$147.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.92
Rate for Payer: Qualcare PPO/HMO/WC	$91.69

SCREW CORT LG 5.5x75 22537555

Facility

$611.25

Hospital Charge Code	270632354
Hospital Revenue Code	278
Min. Negotiated Rate	$91.69
Max. Negotiated Rate	$305.62
Rate for Payer: Aetna Commercial	$183.38
Rate for Payer: Aetna Medicare Advantage	$183.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.87
Rate for Payer: Cigna Commercial	$305.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.92
Rate for Payer: Qualcare PPO/HMO/WC	$91.69

SCREW CORT LKG NS 3.5X36MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270697452
Hospital Revenue Code	278
Min. Negotiated Rate	$94.88
Max. Negotiated Rate	$316.25
Rate for Payer: Aetna Commercial	$189.75
Rate for Payer: Aetna Medicare Advantage	$189.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.29
Rate for Payer: Cigna Commercial	$316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: Qualcare PPO/HMO/WC	$94.88

SCREW CORT LKG NS 3.5X36MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270697452
Hospital Revenue Code	278
Min. Negotiated Rate	$94.88
Max. Negotiated Rate	$153.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: Qualcare PPO/HMO/WC	$94.88

SCREW CORT LKG NS 3.5X42MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270697453
Hospital Revenue Code	278
Min. Negotiated Rate	$94.88
Max. Negotiated Rate	$316.25
Rate for Payer: Aetna Commercial	$189.75
Rate for Payer: Aetna Medicare Advantage	$189.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.29
Rate for Payer: Cigna Commercial	$316.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: Qualcare PPO/HMO/WC	$94.88

SCREW CORT LKG NS 3.5X42MM

Facility

$632.50

Service Code	HCPCS C1713
Hospital Charge Code	270697453
Hospital Revenue Code	278
Min. Negotiated Rate	$94.88
Max. Negotiated Rate	$153.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.06
Rate for Payer: Qualcare PPO/HMO/WC	$94.88

Know your out-of-pocket cost for care.

All Charges