Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW FRLOK STD LAG 55-140MM**

Facility

$733.00

Hospital Charge Code	1605708
Hospital Revenue Code	274
Min. Negotiated Rate	$109.95
Max. Negotiated Rate	$177.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.39
Rate for Payer: Qualcare PPO/HMO/WC	$109.95

SCREW FSD 4.0X10MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695488
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 FSD 4.0X10MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270695488
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 FT COMP 4.0X42MM

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270698524
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$949.00
Rate for Payer: Aetna Commercial	$569.40
Rate for Payer: Aetna Medicare Advantage	$569.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.99
Rate for Payer: Cigna Commercial	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW FT COMP 4.0X42MM

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270698524
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$459.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW FT PANTA2 5.0X26MM

Facility

$3,260.00

Service Code	HCPCS C1713
Hospital Charge Code	270699959
Hospital Revenue Code	278
Min. Negotiated Rate	$489.00
Max. Negotiated Rate	$1,630.00
Rate for Payer: Aetna Commercial	$978.00
Rate for Payer: Aetna Medicare Advantage	$978.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$831.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$831.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$652.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$831.30
Rate for Payer: Cigna Commercial	$1,630.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$788.92
Rate for Payer: Qualcare PPO/HMO/WC	$489.00

SCREW FT PANTA2 5.0X26MM

Facility

$3,260.00

Service Code	HCPCS C1713
Hospital Charge Code	270699959
Hospital Revenue Code	278
Min. Negotiated Rate	$489.00
Max. Negotiated Rate	$788.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$652.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$788.92
Rate for Payer: Qualcare PPO/HMO/WC	$489.00

SCREWFT SACROILIAC 9.5X50MM

Facility

$18,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270699022
Hospital Revenue Code	278
Min. Negotiated Rate	$2,737.50
Max. Negotiated Rate	$9,125.00
Rate for Payer: Aetna Commercial	$5,475.00
Rate for Payer: Aetna Medicare Advantage	$5,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,653.75
Rate for Payer: Cigna Commercial	$9,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50

SCREWFT SACROILIAC 9.5X50MM

Facility

$18,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270699022
Hospital Revenue Code	278
Min. Negotiated Rate	$2,737.50
Max. Negotiated Rate	$4,416.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50

SCREW FT T8 2.4X14MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270700504
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW FT T8 2.4X14MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270700504
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW FT T8 2.4X18MM

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270700505
Hospital Revenue Code	278
Min. Negotiated Rate	$109.08
Max. Negotiated Rate	$175.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08

SCREW FT T8 2.4X18MM

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270700505
Hospital Revenue Code	278
Min. Negotiated Rate	$109.08
Max. Negotiated Rate	$363.60
Rate for Payer: Aetna Commercial	$218.16
Rate for Payer: Aetna Medicare Advantage	$218.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.44
Rate for Payer: Cigna Commercial	$363.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08

SCREW FULL CAN 2 X 12 MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701235
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW FULL CAN 2 X 12 MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701235
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$288.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW FULL CORTICAL 3.5 X 14 M

Facility

$535.00

Service Code	HCPCS C1713
Hospital Charge Code	270701109
Hospital Revenue Code	278
Min. Negotiated Rate	$80.25
Max. Negotiated Rate	$129.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.47
Rate for Payer: Qualcare PPO/HMO/WC	$80.25

SCREW FULL CORTICAL 3.5 X 14 M

Facility

$535.00

Service Code	HCPCS C1713
Hospital Charge Code	270701109
Hospital Revenue Code	278
Min. Negotiated Rate	$80.25
Max. Negotiated Rate	$267.50
Rate for Payer: Aetna Commercial	$160.50
Rate for Payer: Aetna Medicare Advantage	$160.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.43
Rate for Payer: Cigna Commercial	$267.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.47
Rate for Payer: Qualcare PPO/HMO/WC	$80.25

SCREW FULL THREAD 3.5X10MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270695347
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

SCREW FULL THREAD 3.5X10MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270695347
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$307.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

SCREW FULL THREAD 3.5X12MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270695343
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

SCREW FULL THREAD 3.5X12MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270695343
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$307.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

SCREW FULL THREAD 3.5X14MM

Facility

$1,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270695345
Hospital Revenue Code	278
Min. Negotiated Rate	$282.00
Max. Negotiated Rate	$454.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$454.96
Rate for Payer: Qualcare PPO/HMO/WC	$282.00

SCREW FULL THREAD 3.5X14MM

Facility

$1,880.00

Service Code	HCPCS C1713
Hospital Charge Code	270695345
Hospital Revenue Code	278
Min. Negotiated Rate	$282.00
Max. Negotiated Rate	$940.00
Rate for Payer: Aetna Commercial	$564.00
Rate for Payer: Aetna Medicare Advantage	$564.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$479.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$479.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$376.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$479.40
Rate for Payer: Cigna Commercial	$940.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$454.96
Rate for Payer: Qualcare PPO/HMO/WC	$282.00

SCREW FULL THREAD 3.5X22MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270695346
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$248.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

SCREW FULL THREAD 3.5X22MM

Facility

$1,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270695346
Hospital Revenue Code	278
Min. Negotiated Rate	$153.75
Max. Negotiated Rate	$512.50
Rate for Payer: Aetna Commercial	$307.50
Rate for Payer: Aetna Medicare Advantage	$307.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$261.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$205.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$261.38
Rate for Payer: Cigna Commercial	$512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$248.05
Rate for Payer: Qualcare PPO/HMO/WC	$153.75

Know your out-of-pocket cost for care.

All Charges