Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LKG HEXALOBE 3.5X40MM

Facility

$1,080.00

Service Code	HCPCS C1713
Hospital Charge Code	270697232
Hospital Revenue Code	278
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$261.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$216.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$261.36
Rate for Payer: Qualcare PPO/HMO/WC	$162.00

SCREW LKG IM NL 5 80 XL25

Facility

$1,259.50

Service Code	HCPCS C1713
Hospital Charge Code	270698103
Hospital Revenue Code	278
Min. Negotiated Rate	$188.93
Max. Negotiated Rate	$629.75
Rate for Payer: Aetna Commercial	$377.85
Rate for Payer: Aetna Medicare Advantage	$377.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$321.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$321.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$321.17
Rate for Payer: Cigna Commercial	$629.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.80
Rate for Payer: Qualcare PPO/HMO/WC	$188.93

SCREW LKG IM NL 5 80 XL25

Facility

$1,259.50

Service Code	HCPCS C1713
Hospital Charge Code	270698103
Hospital Revenue Code	278
Min. Negotiated Rate	$188.93
Max. Negotiated Rate	$304.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.80
Rate for Payer: Qualcare PPO/HMO/WC	$188.93

SCREW LKG IM NL 5X38MM XL25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692606
Hospital Revenue Code	278
Min. Negotiated Rate	$133.25
Max. Negotiated Rate	$444.15
Rate for Payer: Aetna Commercial	$266.49
Rate for Payer: Aetna Medicare Advantage	$266.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.52
Rate for Payer: Cigna Commercial	$444.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.97
Rate for Payer: Qualcare PPO/HMO/WC	$133.25

SCREW LKG IM NL 5X38MM XL25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692606
Hospital Revenue Code	278
Min. Negotiated Rate	$133.25
Max. Negotiated Rate	$214.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.97
Rate for Payer: Qualcare PPO/HMO/WC	$133.25

SCREW LKG IM NL 5X58MM XL25

Facility

$1,259.50

Service Code	HCPCS C1713
Hospital Charge Code	270698100
Hospital Revenue Code	278
Min. Negotiated Rate	$188.93
Max. Negotiated Rate	$304.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.80
Rate for Payer: Qualcare PPO/HMO/WC	$188.93

SCREW LKG IM NL 5X58MM XL25

Facility

$1,259.50

Service Code	HCPCS C1713
Hospital Charge Code	270698100
Hospital Revenue Code	278
Min. Negotiated Rate	$188.93
Max. Negotiated Rate	$629.75
Rate for Payer: Aetna Commercial	$377.85
Rate for Payer: Aetna Medicare Advantage	$377.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$321.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$321.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$321.17
Rate for Payer: Cigna Commercial	$629.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.80
Rate for Payer: Qualcare PPO/HMO/WC	$188.93

SCREW LKG ORTHOLOC3DI 3.5X28MM

Facility

$1,050.60

Service Code	HCPCS C1713
Hospital Charge Code	270700374
Hospital Revenue Code	278
Min. Negotiated Rate	$157.59
Max. Negotiated Rate	$525.30
Rate for Payer: Aetna Commercial	$315.18
Rate for Payer: Aetna Medicare Advantage	$315.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.90
Rate for Payer: Cigna Commercial	$525.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.25
Rate for Payer: Qualcare PPO/HMO/WC	$157.59

SCREW LKG ORTHOLOC3DI 3.5X28MM

Facility

$1,050.60

Service Code	HCPCS C1713
Hospital Charge Code	270700374
Hospital Revenue Code	278
Min. Negotiated Rate	$157.59
Max. Negotiated Rate	$254.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.25
Rate for Payer: Qualcare PPO/HMO/WC	$157.59

SCREW LKG PERIPH 5.5X16MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270699155
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW LKG PERIPH 5.5X16MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270699155
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$180.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW LKG PERIPH 5.5X20MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270699156
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW LKG PERIPH 5.5X20MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270699156
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$180.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW LKG PERIPH 5.5X40MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270699157
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$180.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW LKG PERIPH 5.5X40MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270699157
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW LKG PT T2 SHAFT 5X35MM

Facility

$2,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270699231
Hospital Revenue Code	278
Min. Negotiated Rate	$372.00
Max. Negotiated Rate	$600.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: Qualcare PPO/HMO/WC	$372.00

SCREW LKG PT T2 SHAFT 5X35MM

Facility

$2,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270699231
Hospital Revenue Code	278
Min. Negotiated Rate	$372.00
Max. Negotiated Rate	$1,240.00
Rate for Payer: Aetna Commercial	$744.00
Rate for Payer: Aetna Medicare Advantage	$744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$632.40
Rate for Payer: Cigna Commercial	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: Qualcare PPO/HMO/WC	$372.00

SCREW LKG R3CON 3.5X12MM

Facility

$841.50

Service Code	HCPCS C1713
Hospital Charge Code	270700176
Hospital Revenue Code	278
Min. Negotiated Rate	$126.22
Max. Negotiated Rate	$420.75
Rate for Payer: Aetna Commercial	$252.45
Rate for Payer: Aetna Medicare Advantage	$252.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.58
Rate for Payer: Cigna Commercial	$420.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.64
Rate for Payer: Qualcare PPO/HMO/WC	$126.22

SCREW LKG R3CON 3.5X12MM

Facility

$841.50

Service Code	HCPCS C1713
Hospital Charge Code	270700176
Hospital Revenue Code	278
Min. Negotiated Rate	$126.22
Max. Negotiated Rate	$203.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$168.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.64
Rate for Payer: Qualcare PPO/HMO/WC	$126.22

SCREW LKG ST 2.7x14MM

Facility

$1,760.00

Service Code	HCPCS C1713
Hospital Charge Code	270648481
Hospital Revenue Code	278
Min. Negotiated Rate	$264.00
Max. Negotiated Rate	$880.00
Rate for Payer: Aetna Commercial	$528.00
Rate for Payer: Aetna Medicare Advantage	$528.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$352.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.80
Rate for Payer: Cigna Commercial	$880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.92
Rate for Payer: Qualcare PPO/HMO/WC	$264.00

SCREW LKG ST 2.7x14MM

Facility

$1,760.00

Service Code	HCPCS C1713
Hospital Charge Code	270648481
Hospital Revenue Code	278
Min. Negotiated Rate	$264.00
Max. Negotiated Rate	$425.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$352.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.92
Rate for Payer: Qualcare PPO/HMO/WC	$264.00

SCREW LKG T2 ALPHA 5.0X47.5MM

Facility

$1,570.55

Service Code	HCPCS C1713
Hospital Charge Code	270697351
Hospital Revenue Code	278
Min. Negotiated Rate	$235.58
Max. Negotiated Rate	$380.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.07
Rate for Payer: Qualcare PPO/HMO/WC	$235.58

SCREW LKG T2 ALPHA 5.0X47.5MM

Facility

$1,570.55

Service Code	HCPCS C1713
Hospital Charge Code	270697351
Hospital Revenue Code	278
Min. Negotiated Rate	$235.58
Max. Negotiated Rate	$785.27
Rate for Payer: Aetna Commercial	$471.17
Rate for Payer: Aetna Medicare Advantage	$471.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$400.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$400.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$314.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$400.49
Rate for Payer: Cigna Commercial	$785.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$380.07
Rate for Payer: Qualcare PPO/HMO/WC	$235.58

SCREW LKG T2 ALPHA 5X27.5MM

Facility

$2,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270699234
Hospital Revenue Code	278
Min. Negotiated Rate	$372.00
Max. Negotiated Rate	$1,240.00
Rate for Payer: Aetna Commercial	$744.00
Rate for Payer: Aetna Medicare Advantage	$744.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$632.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$632.40
Rate for Payer: Cigna Commercial	$1,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: Qualcare PPO/HMO/WC	$372.00

SCREW LKG T2 ALPHA 5X27.5MM

Facility

$2,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270699234
Hospital Revenue Code	278
Min. Negotiated Rate	$372.00
Max. Negotiated Rate	$600.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: Qualcare PPO/HMO/WC	$372.00

Know your out-of-pocket cost for care.

All Charges