Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LCK CAP KIT 4.5X26MM ORG

Facility

$601.60

Service Code	HCPCS C1713
Hospital Charge Code	270668551
Hospital Revenue Code	278
Min. Negotiated Rate	$90.24
Max. Negotiated Rate	$300.80
Rate for Payer: Aetna Commercial	$180.48
Rate for Payer: Aetna Medicare Advantage	$180.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.41
Rate for Payer: Cigna Commercial	$300.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.59
Rate for Payer: Qualcare PPO/HMO/WC	$90.24

SCREW LCK CAP KIT 4.5X30MM BLU

Facility

$601.60

Service Code	HCPCS C1713
Hospital Charge Code	270668554
Hospital Revenue Code	278
Min. Negotiated Rate	$90.24
Max. Negotiated Rate	$300.80
Rate for Payer: Aetna Commercial	$180.48
Rate for Payer: Aetna Medicare Advantage	$180.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.41
Rate for Payer: Cigna Commercial	$300.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.59
Rate for Payer: Qualcare PPO/HMO/WC	$90.24

SCREW LCK CAP KIT 4.5X30MM BLU

Facility

$601.60

Service Code	HCPCS C1713
Hospital Charge Code	270668554
Hospital Revenue Code	278
Min. Negotiated Rate	$90.24
Max. Negotiated Rate	$145.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.59
Rate for Payer: Qualcare PPO/HMO/WC	$90.24

SCREW LCKG 2.0 X 12

Facility

$512.20

Service Code	HCPCS C1713
Hospital Charge Code	270688181
Hospital Revenue Code	278
Min. Negotiated Rate	$76.83
Max. Negotiated Rate	$256.10
Rate for Payer: Aetna Commercial	$153.66
Rate for Payer: Aetna Medicare Advantage	$153.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.61
Rate for Payer: Cigna Commercial	$256.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.95
Rate for Payer: Qualcare PPO/HMO/WC	$76.83

SCREW LCKG 2.0 X 12

Facility

$512.20

Service Code	HCPCS C1713
Hospital Charge Code	270688181
Hospital Revenue Code	278
Min. Negotiated Rate	$76.83
Max. Negotiated Rate	$123.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.95
Rate for Payer: Qualcare PPO/HMO/WC	$76.83

SCREW LCKG 2.0 X 14

Facility

$512.20

Service Code	HCPCS C1713
Hospital Charge Code	270688182
Hospital Revenue Code	278
Min. Negotiated Rate	$76.83
Max. Negotiated Rate	$256.10
Rate for Payer: Aetna Commercial	$153.66
Rate for Payer: Aetna Medicare Advantage	$153.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$130.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$130.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$130.61
Rate for Payer: Cigna Commercial	$256.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.95
Rate for Payer: Qualcare PPO/HMO/WC	$76.83

SCREW LCKG 2.0 X 14

Facility

$512.20

Service Code	HCPCS C1713
Hospital Charge Code	270688182
Hospital Revenue Code	278
Min. Negotiated Rate	$76.83
Max. Negotiated Rate	$123.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$102.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.95
Rate for Payer: Qualcare PPO/HMO/WC	$76.83

SCREW LCKG 525 STR DRV 5x40MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270660156
Hospital Revenue Code	278
Min. Negotiated Rate	$147.04
Max. Negotiated Rate	$237.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04

SCREW LCKG 525 STR DRV 5x40MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270660156
Hospital Revenue Code	278
Min. Negotiated Rate	$147.04
Max. Negotiated Rate	$490.12
Rate for Payer: Aetna Commercial	$294.07
Rate for Payer: Aetna Medicare Advantage	$294.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.96
Rate for Payer: Cigna Commercial	$490.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04

SCREW LCKG SLF-TAP T4 1.3x16M

Facility

$472.75

Service Code	HCPCS C1713
Hospital Charge Code	270683578
Hospital Revenue Code	278
Min. Negotiated Rate	$70.91
Max. Negotiated Rate	$236.38
Rate for Payer: Aetna Commercial	$141.82
Rate for Payer: Aetna Medicare Advantage	$141.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.55
Rate for Payer: Cigna Commercial	$236.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.41
Rate for Payer: Qualcare PPO/HMO/WC	$70.91

SCREW LCKG SLF-TAP T4 1.3x16M

Facility

$472.75

Service Code	HCPCS C1713
Hospital Charge Code	270683578
Hospital Revenue Code	278
Min. Negotiated Rate	$70.91
Max. Negotiated Rate	$114.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.41
Rate for Payer: Qualcare PPO/HMO/WC	$70.91

SCREW LCKG SLF-TAP T4 1.3x18

Facility

$472.75

Service Code	HCPCS C1713
Hospital Charge Code	270683579
Hospital Revenue Code	278
Min. Negotiated Rate	$70.91
Max. Negotiated Rate	$236.38
Rate for Payer: Aetna Commercial	$141.82
Rate for Payer: Aetna Medicare Advantage	$141.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.55
Rate for Payer: Cigna Commercial	$236.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.41
Rate for Payer: Qualcare PPO/HMO/WC	$70.91

SCREW LCKG SLF-TAP T4 1.3x18

Facility

$472.75

Service Code	HCPCS C1713
Hospital Charge Code	270683579
Hospital Revenue Code	278
Min. Negotiated Rate	$70.91
Max. Negotiated Rate	$114.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.41
Rate for Payer: Qualcare PPO/HMO/WC	$70.91

SCREW LCKG SLF TPNG

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	270660646
Hospital Revenue Code	278
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$125.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: Qualcare PPO/HMO/WC	$77.85

SCREW LCKG SLF TPNG

Facility

$519.00

Service Code	HCPCS C1713
Hospital Charge Code	270660646
Hospital Revenue Code	278
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$259.50
Rate for Payer: Aetna Commercial	$155.70
Rate for Payer: Aetna Medicare Advantage	$155.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$103.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.34
Rate for Payer: Cigna Commercial	$259.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.60
Rate for Payer: Qualcare PPO/HMO/WC	$77.85

SCREW LCKG S/TPNG 4.0x22MM

Facility

$611.80

Service Code	HCPCS C1713
Hospital Charge Code	270646169
Hospital Revenue Code	278
Min. Negotiated Rate	$91.77
Max. Negotiated Rate	$148.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.06
Rate for Payer: Qualcare PPO/HMO/WC	$91.77

SCREW LCKG S/TPNG 4.0x22MM

Facility

$611.80

Service Code	HCPCS C1713
Hospital Charge Code	270646169
Hospital Revenue Code	278
Min. Negotiated Rate	$91.77
Max. Negotiated Rate	$305.90
Rate for Payer: Aetna Commercial	$183.54
Rate for Payer: Aetna Medicare Advantage	$183.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.01
Rate for Payer: Cigna Commercial	$305.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.06
Rate for Payer: Qualcare PPO/HMO/WC	$91.77

SCREW LCKG S/TPPNG 5.0x10MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648922
Hospital Revenue Code	278
Min. Negotiated Rate	$135.34
Max. Negotiated Rate	$218.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: Qualcare PPO/HMO/WC	$135.34

SCREW LCKG S/TPPNG 5.0x10MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648922
Hospital Revenue Code	278
Min. Negotiated Rate	$135.34
Max. Negotiated Rate	$451.15
Rate for Payer: Aetna Commercial	$270.69
Rate for Payer: Aetna Medicare Advantage	$270.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.09
Rate for Payer: Cigna Commercial	$451.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: Qualcare PPO/HMO/WC	$135.34

SCREW LCKG S/TPPNG 5.0x12MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648923
Hospital Revenue Code	278
Min. Negotiated Rate	$135.34
Max. Negotiated Rate	$218.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: Qualcare PPO/HMO/WC	$135.34

SCREW LCKG S/TPPNG 5.0x12MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648923
Hospital Revenue Code	278
Min. Negotiated Rate	$135.34
Max. Negotiated Rate	$451.15
Rate for Payer: Aetna Commercial	$270.69
Rate for Payer: Aetna Medicare Advantage	$270.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.09
Rate for Payer: Cigna Commercial	$451.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: Qualcare PPO/HMO/WC	$135.34

SCREW LCKG S/TPPNG 5.0x8MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648921
Hospital Revenue Code	278
Min. Negotiated Rate	$135.34
Max. Negotiated Rate	$451.15
Rate for Payer: Aetna Commercial	$270.69
Rate for Payer: Aetna Medicare Advantage	$270.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$230.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$230.09
Rate for Payer: Cigna Commercial	$451.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: Qualcare PPO/HMO/WC	$135.34

SCREW LCKG S/TPPNG 5.0x8MM

Facility

$902.30

Service Code	HCPCS C1713
Hospital Charge Code	270648921
Hospital Revenue Code	278
Min. Negotiated Rate	$135.34
Max. Negotiated Rate	$218.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.36
Rate for Payer: Qualcare PPO/HMO/WC	$135.34

SCREW LCKG T25 STR DRV 4x24MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270637803
Hospital Revenue Code	278
Min. Negotiated Rate	$147.04
Max. Negotiated Rate	$490.12
Rate for Payer: Aetna Commercial	$294.07
Rate for Payer: Aetna Medicare Advantage	$294.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.96
Rate for Payer: Cigna Commercial	$490.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04

SCREW LCKG T25 STR DRV 4x24MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270637803
Hospital Revenue Code	278
Min. Negotiated Rate	$147.04
Max. Negotiated Rate	$237.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.22
Rate for Payer: Qualcare PPO/HMO/WC	$147.04

Know your out-of-pocket cost for care.

All Charges