Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW EXPED POLY SI 5.5X7X40MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270661528
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

SCREW EXP TI POLY 7.5x75MM

Facility

$5,500.00

Hospital Charge Code	270659850
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$1,650.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

SCREW EXP TI POLY 7.5x75MM

Facility

$5,500.00

Hospital Charge Code	270659850
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

SCREW EXTN KNEE REPLMT NEXGEN

Facility

$1,395.00

Hospital Charge Code	270660826
Hospital Revenue Code	278
Min. Negotiated Rate	$209.25
Max. Negotiated Rate	$337.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.59
Rate for Payer: Qualcare PPO/HMO/WC	$209.25

SCREW EXTN KNEE REPLMT NEXGEN

Facility

$1,395.00

Hospital Charge Code	270660826
Hospital Revenue Code	278
Min. Negotiated Rate	$209.25
Max. Negotiated Rate	$697.50
Rate for Payer: Aetna Commercial	$418.50
Rate for Payer: Aetna Medicare Advantage	$418.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$355.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$355.73
Rate for Payer: Cigna Commercial	$697.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.59
Rate for Payer: Qualcare PPO/HMO/WC	$209.25

SCREW EXT POLY DUAL 7.5X45MM

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270695761
Hospital Revenue Code	278
Min. Negotiated Rate	$630.00
Max. Negotiated Rate	$2,100.00
Rate for Payer: Aetna Commercial	$1,260.00
Rate for Payer: Aetna Medicare Advantage	$1,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,071.00
Rate for Payer: Cigna Commercial	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.40
Rate for Payer: Qualcare PPO/HMO/WC	$630.00

SCREW EXT POLY DUAL 7.5X45MM

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270695761
Hospital Revenue Code	278
Min. Negotiated Rate	$630.00
Max. Negotiated Rate	$1,016.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.40
Rate for Payer: Qualcare PPO/HMO/WC	$630.00

SCREW EXT POLY DUAL 7.5X50MM

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270695762
Hospital Revenue Code	278
Min. Negotiated Rate	$630.00
Max. Negotiated Rate	$1,016.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.40
Rate for Payer: Qualcare PPO/HMO/WC	$630.00

SCREW EXT POLY DUAL 7.5X50MM

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270695762
Hospital Revenue Code	278
Min. Negotiated Rate	$630.00
Max. Negotiated Rate	$2,100.00
Rate for Payer: Aetna Commercial	$1,260.00
Rate for Payer: Aetna Medicare Advantage	$1,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,071.00
Rate for Payer: Cigna Commercial	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.40
Rate for Payer: Qualcare PPO/HMO/WC	$630.00

SCREW EXTREMIFUSE 2MM

Facility

$6,750.00

Hospital Charge Code	270675633
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,025.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW EXTREMIFUSE 2MM

Facility

$6,750.00

Hospital Charge Code	270675633
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW EXTTAB CAN POLY 6.5X40MM

Facility

$7,562.50

Service Code	HCPCS C1713
Hospital Charge Code	270699534
Hospital Revenue Code	278
Min. Negotiated Rate	$1,134.38
Max. Negotiated Rate	$1,830.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,830.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,134.38

SCREW EXTTAB CAN POLY 6.5X40MM

Facility

$7,562.50

Service Code	HCPCS C1713
Hospital Charge Code	270699534
Hospital Revenue Code	278
Min. Negotiated Rate	$1,134.38
Max. Negotiated Rate	$3,781.25
Rate for Payer: Aetna Commercial	$2,268.75
Rate for Payer: Aetna Medicare Advantage	$2,268.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,928.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,928.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,928.44
Rate for Payer: Cigna Commercial	$3,781.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,830.12
Rate for Payer: Qualcare PPO/HMO/WC	$1,134.38

SCREW EXT TAB T20 7.5X40MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270698046
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,092.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

SCREW EXT TAB T20 7.5X40MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270698046
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

SCREW EXT TAB T20 7.5X45MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270698047
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

SCREW EXT TAB T20 7.5X45MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270698047
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,092.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

SCREW FA 4.0 MM X L16MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688699
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW FA 4.0 MM X L16MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688699
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW FACET 6.0X10MM

Facility

$44,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270696784
Hospital Revenue Code	278
Min. Negotiated Rate	$6,727.50
Max. Negotiated Rate	$22,425.00
Rate for Payer: Aetna Commercial	$13,455.00
Rate for Payer: Aetna Medicare Advantage	$13,455.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,436.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,436.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,970.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,436.75
Rate for Payer: Cigna Commercial	$22,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,853.70
Rate for Payer: Qualcare PPO/HMO/WC	$6,727.50

SCREW FACET 6.0X10MM

Facility

$44,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270696784
Hospital Revenue Code	278
Min. Negotiated Rate	$6,727.50
Max. Negotiated Rate	$10,853.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,853.70
Rate for Payer: Qualcare PPO/HMO/WC	$6,727.50

SCREW FACET CANN 5X30MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703619
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

SCREW FACET CANN 5X30MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270703619
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

SCREW FACET FIXX FT 4.5X25MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693619
Hospital Revenue Code	278
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,492.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

SCREW FACET FIXX FT 4.5X25MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693619
Hospital Revenue Code	278
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$1,203.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,203.95
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

Know your out-of-pocket cost for care.

All Charges