Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW HEADLESS COMP 4.3 X 24

Facility

$1,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270688171
Hospital Revenue Code	278
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$555.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.70
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

SCREW HEADLESS COMP 4.3 X 24

Facility

$1,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270688170
Hospital Revenue Code	278
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$555.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.70
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

SCREW HEADLESS COMP 4.3 X 24

Facility

$1,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270688170
Hospital Revenue Code	278
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$447.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.70
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

SCREW HEADLESS COMP 4.5/6.5

Facility

$462.00

Service Code	HCPCS C1713
Hospital Charge Code	270685925
Hospital Revenue Code	278
Min. Negotiated Rate	$69.30
Max. Negotiated Rate	$111.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.80
Rate for Payer: Qualcare PPO/HMO/WC	$69.30

SCREW HEADLESS COMP 4.5/6.5

Facility

$462.00

Service Code	HCPCS C1713
Hospital Charge Code	270685925
Hospital Revenue Code	278
Min. Negotiated Rate	$69.30
Max. Negotiated Rate	$231.00
Rate for Payer: Aetna Commercial	$138.60
Rate for Payer: Aetna Medicare Advantage	$138.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.81
Rate for Payer: Cigna Commercial	$231.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.80
Rate for Payer: Qualcare PPO/HMO/WC	$69.30

SCREW HEADLESS COMPRESSION 2.4

Facility

$1,410.00

Hospital Charge Code	270660883
Hospital Revenue Code	278
Min. Negotiated Rate	$211.50
Max. Negotiated Rate	$705.00
Rate for Payer: Aetna Commercial	$423.00
Rate for Payer: Aetna Medicare Advantage	$423.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$359.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$359.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$359.55
Rate for Payer: Cigna Commercial	$705.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.22
Rate for Payer: Qualcare PPO/HMO/WC	$211.50

SCREW HEADLESS COMPRESSION 2.4

Facility

$1,410.00

Hospital Charge Code	270660883
Hospital Revenue Code	278
Min. Negotiated Rate	$211.50
Max. Negotiated Rate	$341.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$282.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$341.22
Rate for Payer: Qualcare PPO/HMO/WC	$211.50

SCREW HEADLESSCOMP ST 6.5X40MM

Facility

$2,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270694533
Hospital Revenue Code	278
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$695.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

SCREW HEADLESSCOMP ST 6.5X40MM

Facility

$2,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270694533
Hospital Revenue Code	278
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$862.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

SCREW HEADLESS MNI 4.0 X 40 MM

Facility

$0.01

Service Code	HCPCS C1713
Hospital Charge Code	270690345
Hospital Revenue Code	278
Max. Negotiated Rate	$0.01
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SCREW HEADLESS MNI 4.0 X 40 MM

Facility

$0.01

Service Code	HCPCS C1713
Hospital Charge Code	270690345
Hospital Revenue Code	278
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$0.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SCREW HEADLESSS 2.5X14 TI

Facility

$2,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270688012
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$719.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

SCREW HEADLESSS 2.5X14 TI

Facility

$2,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270688012
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$892.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

SCREW HEADLESSS 2.5 X 16TI

Facility

$2,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270688014
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$1,487.50
Rate for Payer: Aetna Commercial	$892.50
Rate for Payer: Aetna Medicare Advantage	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$758.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$758.62
Rate for Payer: Cigna Commercial	$1,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

SCREW HEADLESSS 2.5 X 16TI

Facility

$2,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270688014
Hospital Revenue Code	278
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$719.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$719.95
Rate for Payer: Qualcare PPO/HMO/WC	$446.25

SCREW HEADLESS SHORT 2.5X20MM

Facility

$1,058.25

Service Code	HCPCS C1713
Hospital Charge Code	270706186
Hospital Revenue Code	278
Min. Negotiated Rate	$158.74
Max. Negotiated Rate	$529.12
Rate for Payer: Aetna Commercial	$317.48
Rate for Payer: Aetna Medicare Advantage	$317.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.85
Rate for Payer: Cigna Commercial	$529.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.10
Rate for Payer: Qualcare PPO/HMO/WC	$158.74

SCREW HEADLESS SHORT 2.5X20MM

Facility

$1,058.25

Service Code	HCPCS C1713
Hospital Charge Code	270706186
Hospital Revenue Code	278
Min. Negotiated Rate	$158.74
Max. Negotiated Rate	$256.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.10
Rate for Payer: Qualcare PPO/HMO/WC	$158.74

SCREW HEAD PEDICLE EXT POLY G2

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270694930
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$1,612.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW HEAD PEDICLE EXT POLY G2

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270694930
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW HED COMP 3.5 X35 MM

Facility

$1,055.00

Service Code	HCPCS C1713
Hospital Charge Code	270701112
Hospital Revenue Code	278
Min. Negotiated Rate	$158.25
Max. Negotiated Rate	$527.50
Rate for Payer: Aetna Commercial	$316.50
Rate for Payer: Aetna Medicare Advantage	$316.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.02
Rate for Payer: Cigna Commercial	$527.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.31
Rate for Payer: Qualcare PPO/HMO/WC	$158.25

SCREW HED COMP 3.5 X35 MM

Facility

$1,055.00

Service Code	HCPCS C1713
Hospital Charge Code	270701112
Hospital Revenue Code	278
Min. Negotiated Rate	$158.25
Max. Negotiated Rate	$255.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.31
Rate for Payer: Qualcare PPO/HMO/WC	$158.25

SCREW HEDLESS 2.5 X 14 COMP

Facility

$1,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270703236
Hospital Revenue Code	278
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$570.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.70
Rate for Payer: Cigna Commercial	$570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.88
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

SCREW HEDLESS 2.5 X 14 COMP

Facility

$1,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270703236
Hospital Revenue Code	278
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$275.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.88
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

SCREW HEDLESS 2.5 X 16 COMP

Facility

$1,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270703237
Hospital Revenue Code	278
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$275.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.88
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

SCREW HEDLESS 2.5 X 16 COMP

Facility

$1,140.00

Service Code	HCPCS C1713
Hospital Charge Code	270703237
Hospital Revenue Code	278
Min. Negotiated Rate	$171.00
Max. Negotiated Rate	$570.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$342.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$290.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$290.70
Rate for Payer: Cigna Commercial	$570.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$275.88
Rate for Payer: Qualcare PPO/HMO/WC	$171.00

Know your out-of-pocket cost for care.

All Charges