Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW FACET FIXX FT 4.5X30MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693620
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

SCREW FACET FIXX FT 4.5X30MM

Facility

$4,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270693620
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 FEMORAL 14MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270676878
Hospital Revenue Code	278
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$42.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

SCREW FEMORAL 14MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	270676878
Hospital Revenue Code	278
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$52.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.35
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

SCREW FEMORAL AUG POST SZ1 5MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270680663
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$872.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG POST SZ1 5MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270680663
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,081.20
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ1 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270680664
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,081.20
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ1 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270680664
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$872.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ3 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270676963
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$872.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ3 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270676963
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,081.20
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ4 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270676558
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$872.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ4 10MM

Facility

$3,604.00

Service Code	HCPCS C1713
Hospital Charge Code	270676558
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,081.20
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ5 10MM

Facility

$3,604.00

Hospital Charge Code	270676681
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,081.20
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ5 10MM

Facility

$3,604.00

Hospital Charge Code	270676681
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$872.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ5 5MM

Facility

$3,604.00

Hospital Charge Code	270676680
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$872.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL AUG SZ5 5MM

Facility

$3,604.00

Hospital Charge Code	270676680
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,081.20
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL DISTAL SZ5 5MM

Facility

$3,604.00

Hospital Charge Code	270676745
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,081.20
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL DISTAL SZ5 5MM

Facility

$3,604.00

Hospital Charge Code	270676745
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$872.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

SCREW FEMORAL G2

Facility

$357.00

Service Code	HCPCS C1713
Hospital Charge Code	270681216
Hospital Revenue Code	278
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$86.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.39
Rate for Payer: Qualcare PPO/HMO/WC	$53.55

SCREW FEMORAL G2

Facility

$357.00

Service Code	HCPCS C1713
Hospital Charge Code	270681216
Hospital Revenue Code	278
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$178.50
Rate for Payer: Aetna Commercial	$107.10
Rate for Payer: Aetna Medicare Advantage	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.03
Rate for Payer: Cigna Commercial	$178.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.39
Rate for Payer: Qualcare PPO/HMO/WC	$53.55

SCREW FEMORAL LONG

Facility

$357.00

Service Code	HCPCS C1713
Hospital Charge Code	270684560
Hospital Revenue Code	278
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$86.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.39
Rate for Payer: Qualcare PPO/HMO/WC	$53.55

SCREW FEMORAL LONG

Facility

$357.00

Service Code	HCPCS C1713
Hospital Charge Code	270684560
Hospital Revenue Code	278
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$178.50
Rate for Payer: Aetna Commercial	$107.10
Rate for Payer: Aetna Medicare Advantage	$107.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.03
Rate for Payer: Cigna Commercial	$178.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.39
Rate for Payer: Qualcare PPO/HMO/WC	$53.55

SCREW FEMORAL POST SZ2 10MM

Facility

$3,604.30

Hospital Charge Code	270677338
Hospital Revenue Code	278
Min. Negotiated Rate	$540.64
Max. Negotiated Rate	$1,802.15
Rate for Payer: Aetna Commercial	$1,081.29
Rate for Payer: Aetna Medicare Advantage	$1,081.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.10
Rate for Payer: Cigna Commercial	$1,802.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.24
Rate for Payer: Qualcare PPO/HMO/WC	$540.64

SCREW FEMORAL POST SZ2 10MM

Facility

$3,604.30

Hospital Charge Code	270677338
Hospital Revenue Code	278
Min. Negotiated Rate	$540.64
Max. Negotiated Rate	$872.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.24
Rate for Payer: Qualcare PPO/HMO/WC	$540.64

SCREW FEMORAL POST SZ3 10MM

Facility

$3,604.00

Hospital Charge Code	270677099
Hospital Revenue Code	278
Min. Negotiated Rate	$540.60
Max. Negotiated Rate	$1,802.00
Rate for Payer: Aetna Commercial	$1,081.20
Rate for Payer: Aetna Medicare Advantage	$1,081.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$919.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$720.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$919.02
Rate for Payer: Cigna Commercial	$1,802.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$872.17
Rate for Payer: Qualcare PPO/HMO/WC	$540.60

Know your out-of-pocket cost for care.

All Charges