Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW INTERLOCK IM 4.5mmD 40mm

Facility

$611.10

Hospital Charge Code	270636662
Hospital Revenue Code	278
Min. Negotiated Rate	$91.67
Max. Negotiated Rate	$305.55
Rate for Payer: Aetna Commercial	$183.33
Rate for Payer: Aetna Medicare Advantage	$183.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.83
Rate for Payer: Cigna Commercial	$305.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.89
Rate for Payer: Qualcare PPO/HMO/WC	$91.67

SCREW INTLOCKG 4.5x45 22534545

Facility

$570.45

Hospital Charge Code	270632315
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 INTLOCKG 4.5x45 22534545

Facility

$570.45

Hospital Charge Code	270632315
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 INTLOCKG 4.5x60 22536045

Facility

$570.45

Hospital Charge Code	270632314
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 INTLOCKG 4.5x60 22536045

Facility

$570.45

Hospital Charge Code	270632314
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 INTRF 7x20MM DISP SHEATH

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270646569
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$172.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

SCREW INTRF 7x20MM DISP SHEATH

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270646569
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

SCREW INTRF 7x25MM DISP SHEATH

Facility

$825.00

Hospital Charge Code	270662450
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$247.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW INTRF 7x25MM DISP SHEATH

Facility

$825.00

Hospital Charge Code	270662450
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW INTRF 8x20MM DISP SHEATH

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270661235
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$247.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW INTRF 8x20MM DISP SHEATH

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270661235
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW INTRF 8x25MM DISP SHEATH

Facility

$825.00

Hospital Charge Code	270662451
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$247.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW INTRF 8x25MM DISP SHEATH

Facility

$825.00

Hospital Charge Code	270662451
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW INTRF 9x20MM DISP SHEATH

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270633507
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$139.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

SCREW INTRF 9x20MM DISP SHEATH

Facility

$575.00

Service Code	HCPCS C1713
Hospital Charge Code	270633507
Hospital Revenue Code	278
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$172.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.15
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

SCREW INTRF 9x25MM DISP SHEATH

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270633508
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW INTRF 9x25MM DISP SHEATH

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270633508
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$247.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW INTRFRNCE 9x30mm 231825

Facility

$1,725.00

Hospital Charge Code	270642504
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$517.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW INTRFRNCE 9x30mm 231825

Facility

$1,725.00

Hospital Charge Code	270642504
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW INV REV CANC 4.5X36MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270695300
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SCREW INV REV CANC 4.5X36MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270695300
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SCREW INV REV CANC 4.5X42MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270695310
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SCREW INV REV CANC 4.5X42MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270695310
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SCREW IRIX-C ST 3.5X14MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692358
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 IRIX-C ST 3.5X14MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692358
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

Know your out-of-pocket cost for care.

All Charges