Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LCKG T25 STR DRV 5x36MM

Facility

$3,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270646672
Hospital Revenue Code	278
Min. Negotiated Rate	$498.75
Max. Negotiated Rate	$804.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$665.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$804.65
Rate for Payer: Qualcare PPO/HMO/WC	$498.75

SCREW LCKG T25 STR DRV 5x38MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270660153
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 T25 STR DRV 5x38MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270660153
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 5x42MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270645685
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 T25 STR DRV 5x42MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270645685
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 5X48MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270676404
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 T25 STR DRV 5X48MM

Facility

$980.25

Service Code	HCPCS C1713
Hospital Charge Code	270676404
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 5x58MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270671811
Hospital Revenue Code	278
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$223.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.60

SCREW LCKG T25 STR DRV 5x58MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270671811
Hospital Revenue Code	278
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$462.00
Rate for Payer: Aetna Commercial	$277.20
Rate for Payer: Aetna Medicare Advantage	$277.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.62
Rate for Payer: Cigna Commercial	$462.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.60

SCREW LCKG T25 STR DRV 5x62MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270675113
Hospital Revenue Code	278
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$462.00
Rate for Payer: Aetna Commercial	$277.20
Rate for Payer: Aetna Medicare Advantage	$277.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.62
Rate for Payer: Cigna Commercial	$462.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.60

SCREW LCKG T25 STR DRV 5x62MM

Facility

$924.00

Service Code	HCPCS C1713
Hospital Charge Code	270675113
Hospital Revenue Code	278
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$223.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.60

SCREW LCKG T25 STR DRV 5x66MM

Facility

$965.85

Service Code	HCPCS C1713
Hospital Charge Code	270688214
Hospital Revenue Code	278
Min. Negotiated Rate	$144.88
Max. Negotiated Rate	$233.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.74
Rate for Payer: Qualcare PPO/HMO/WC	$144.88

SCREW LCKG T25 STR DRV 5x66MM

Facility

$965.85

Service Code	HCPCS C1713
Hospital Charge Code	270688214
Hospital Revenue Code	278
Min. Negotiated Rate	$144.88
Max. Negotiated Rate	$482.93
Rate for Payer: Aetna Commercial	$289.75
Rate for Payer: Aetna Medicare Advantage	$289.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$246.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$246.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$193.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$246.29
Rate for Payer: Cigna Commercial	$482.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.74
Rate for Payer: Qualcare PPO/HMO/WC	$144.88

SCREW LCKG T25 STR DRV 5x72MM

Facility

$924.00

Hospital Charge Code	270677440
Hospital Revenue Code	278
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$462.00
Rate for Payer: Aetna Commercial	$277.20
Rate for Payer: Aetna Medicare Advantage	$277.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.62
Rate for Payer: Cigna Commercial	$462.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.60

SCREW LCKG T25 STR DRV 5x72MM

Facility

$924.00

Hospital Charge Code	270677440
Hospital Revenue Code	278
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$223.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.60

SCREW LCKG T25 STR DRV 5x85MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270680078
Hospital Revenue Code	278
Min. Negotiated Rate	$142.75
Max. Negotiated Rate	$230.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: Qualcare PPO/HMO/WC	$142.75

SCREW LCKG T25 STR DRV 5x85MM

Facility

$951.70

Service Code	HCPCS C1713
Hospital Charge Code	270680078
Hospital Revenue Code	278
Min. Negotiated Rate	$142.75
Max. Negotiated Rate	$475.85
Rate for Payer: Aetna Commercial	$285.51
Rate for Payer: Aetna Medicare Advantage	$285.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$242.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$190.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$242.68
Rate for Payer: Cigna Commercial	$475.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$230.31
Rate for Payer: Qualcare PPO/HMO/WC	$142.75

SCREW LCKING 4.0MM TI ANGULAR

Facility

$1,340.00

Hospital Charge Code	270662824
Hospital Revenue Code	278
Min. Negotiated Rate	$201.00
Max. Negotiated Rate	$670.00
Rate for Payer: Aetna Commercial	$402.00
Rate for Payer: Aetna Medicare Advantage	$402.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$341.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$341.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$341.70
Rate for Payer: Cigna Commercial	$670.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.28
Rate for Payer: Qualcare PPO/HMO/WC	$201.00

SCREW LCKING 4.0MM TI ANGULAR

Facility

$1,340.00

Hospital Charge Code	270662824
Hospital Revenue Code	278
Min. Negotiated Rate	$201.00
Max. Negotiated Rate	$324.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$268.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.28
Rate for Payer: Qualcare PPO/HMO/WC	$201.00

SCREW LCKNG CAP KIT 4.5x46MM P

Facility

$547.85

Service Code	HCPCS C1713
Hospital Charge Code	270684300
Hospital Revenue Code	278
Min. Negotiated Rate	$82.18
Max. Negotiated Rate	$132.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.58
Rate for Payer: Qualcare PPO/HMO/WC	$82.18

SCREW LCKNG CAP KIT 4.5x46MM P

Facility

$547.85

Service Code	HCPCS C1713
Hospital Charge Code	270684300
Hospital Revenue Code	278
Min. Negotiated Rate	$82.18
Max. Negotiated Rate	$273.93
Rate for Payer: Aetna Commercial	$164.35
Rate for Payer: Aetna Medicare Advantage	$164.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.70
Rate for Payer: Cigna Commercial	$273.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.58
Rate for Payer: Qualcare PPO/HMO/WC	$82.18

SCREW LCKNG SLF TAP 2.7x10MM

Facility

$623.80

Service Code	HCPCS C1713
Hospital Charge Code	270648480
Hospital Revenue Code	278
Min. Negotiated Rate	$93.57
Max. Negotiated Rate	$311.90
Rate for Payer: Aetna Commercial	$187.14
Rate for Payer: Aetna Medicare Advantage	$187.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.07
Rate for Payer: Cigna Commercial	$311.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.96
Rate for Payer: Qualcare PPO/HMO/WC	$93.57

SCREW LCKNG SLF TAP 2.7x10MM

Facility

$623.80

Service Code	HCPCS C1713
Hospital Charge Code	270648480
Hospital Revenue Code	278
Min. Negotiated Rate	$93.57
Max. Negotiated Rate	$150.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$124.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.96
Rate for Payer: Qualcare PPO/HMO/WC	$93.57

SCREW LCKNG SLF TAP 2.7x8MM

Facility

$605.65

Service Code	HCPCS C1713
Hospital Charge Code	270664150
Hospital Revenue Code	278
Min. Negotiated Rate	$90.85
Max. Negotiated Rate	$146.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.57
Rate for Payer: Qualcare PPO/HMO/WC	$90.85

SCREW LCKNG SLF TAP 2.7x8MM

Facility

$605.65

Service Code	HCPCS C1713
Hospital Charge Code	270664150
Hospital Revenue Code	278
Min. Negotiated Rate	$90.85
Max. Negotiated Rate	$302.82
Rate for Payer: Aetna Commercial	$181.69
Rate for Payer: Aetna Medicare Advantage	$181.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$121.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.44
Rate for Payer: Cigna Commercial	$302.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$146.57
Rate for Payer: Qualcare PPO/HMO/WC	$90.85

Know your out-of-pocket cost for care.

All Charges