Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCK 3.5X12MM

Facility

$1,615.00

Service Code	HCPCS C1713
Hospital Charge Code	270703646
Hospital Revenue Code	278
Min. Negotiated Rate	$242.25
Max. Negotiated Rate	$807.50
Rate for Payer: Aetna Commercial	$484.50
Rate for Payer: Aetna Medicare Advantage	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$411.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$411.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$323.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$411.82
Rate for Payer: Cigna Commercial	$807.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.83
Rate for Payer: Qualcare PPO/HMO/WC	$242.25

SCREW LOCK 3.5 X 14MM 40-35614

Facility

$799.01

Service Code	HCPCS C1713
Hospital Charge Code	270660369
Hospital Revenue Code	278
Min. Negotiated Rate	$119.85
Max. Negotiated Rate	$399.50
Rate for Payer: Aetna Commercial	$239.70
Rate for Payer: Aetna Medicare Advantage	$239.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.75
Rate for Payer: Cigna Commercial	$399.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.36
Rate for Payer: Qualcare PPO/HMO/WC	$119.85

SCREW LOCK 3.5 X 14MM 40-35614

Facility

$799.01

Service Code	HCPCS C1713
Hospital Charge Code	270660369
Hospital Revenue Code	278
Min. Negotiated Rate	$119.85
Max. Negotiated Rate	$193.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.36
Rate for Payer: Qualcare PPO/HMO/WC	$119.85

SCREW LOCK 3.5 X 16MM 40-35616

Facility

$1,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270660372
Hospital Revenue Code	278
Min. Negotiated Rate	$177.00
Max. Negotiated Rate	$285.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.56
Rate for Payer: Qualcare PPO/HMO/WC	$177.00

SCREW LOCK 3.5 X 16MM 40-35616

Facility

$1,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270660372
Hospital Revenue Code	278
Min. Negotiated Rate	$177.00
Max. Negotiated Rate	$590.00
Rate for Payer: Aetna Commercial	$354.00
Rate for Payer: Aetna Medicare Advantage	$354.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$300.90
Rate for Payer: Cigna Commercial	$590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.56
Rate for Payer: Qualcare PPO/HMO/WC	$177.00

SCREW LOCK 3.5 X 18MM 40-35618

Facility

$1,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270660371
Hospital Revenue Code	278
Min. Negotiated Rate	$177.00
Max. Negotiated Rate	$285.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.56
Rate for Payer: Qualcare PPO/HMO/WC	$177.00

SCREW LOCK 3.5 X 18MM 40-35618

Facility

$1,180.00

Service Code	HCPCS C1713
Hospital Charge Code	270660371
Hospital Revenue Code	278
Min. Negotiated Rate	$177.00
Max. Negotiated Rate	$590.00
Rate for Payer: Aetna Commercial	$354.00
Rate for Payer: Aetna Medicare Advantage	$354.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$300.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$236.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$300.90
Rate for Payer: Cigna Commercial	$590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.56
Rate for Payer: Qualcare PPO/HMO/WC	$177.00

SCREW LOCK 3.5X26MM SELF TAP

Facility

$1,370.00

Hospital Charge Code	270669707
Hospital Revenue Code	278
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$331.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.54
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

SCREW LOCK 3.5X26MM SELF TAP

Facility

$1,370.00

Hospital Charge Code	270669707
Hospital Revenue Code	278
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$685.00
Rate for Payer: Aetna Commercial	$411.00
Rate for Payer: Aetna Medicare Advantage	$411.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.35
Rate for Payer: Cigna Commercial	$685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.54
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

SCREW LOCK 3.5X50MM SELF TAP

Facility

$1,370.00

Hospital Charge Code	270669706
Hospital Revenue Code	278
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$331.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.54
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

SCREW LOCK 3.5X50MM SELF TAP

Facility

$1,370.00

Hospital Charge Code	270669706
Hospital Revenue Code	278
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$685.00
Rate for Payer: Aetna Commercial	$411.00
Rate for Payer: Aetna Medicare Advantage	$411.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.35
Rate for Payer: Cigna Commercial	$685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.54
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

SCREW LOCK 3.5X70MM SELF TAP

Facility

$1,370.00

Hospital Charge Code	270669705
Hospital Revenue Code	278
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$685.00
Rate for Payer: Aetna Commercial	$411.00
Rate for Payer: Aetna Medicare Advantage	$411.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.35
Rate for Payer: Cigna Commercial	$685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.54
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

SCREW LOCK 3.5X70MM SELF TAP

Facility

$1,370.00

Hospital Charge Code	270669705
Hospital Revenue Code	278
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$331.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$274.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.54
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

SCREW LOCK 4.0 x 26mm 370526

Facility

$560.00

Hospital Charge Code	270638777
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$135.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

SCREW LOCK 4.0 x 26mm 370526

Facility

$560.00

Hospital Charge Code	270638777
Hospital Revenue Code	278
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$168.00
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

SCREW LOCK 4.5x14mm 27814

Facility

$610.00

Service Code	HCPCS C1713
Hospital Charge Code	270648676
Hospital Revenue Code	278
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$147.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

SCREW LOCK 4.5x14mm 27814

Facility

$610.00

Service Code	HCPCS C1713
Hospital Charge Code	270648676
Hospital Revenue Code	278
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$183.00
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

SCREW LOCK 5.5MM OPEN TULIP

Facility

$385.00

Service Code	HCPCS C1713
Hospital Charge Code	270691604
Hospital Revenue Code	278
Min. Negotiated Rate	$57.75
Max. Negotiated Rate	$192.50
Rate for Payer: Aetna Commercial	$115.50
Rate for Payer: Aetna Medicare Advantage	$115.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.17
Rate for Payer: Cigna Commercial	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.17
Rate for Payer: Qualcare PPO/HMO/WC	$57.75

SCREW LOCK 5.5MM OPEN TULIP

Facility

$385.00

Service Code	HCPCS C1713
Hospital Charge Code	270691604
Hospital Revenue Code	278
Min. Negotiated Rate	$57.75
Max. Negotiated Rate	$93.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$77.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.17
Rate for Payer: Qualcare PPO/HMO/WC	$57.75

SCREW LOCK CANC 3.0X20 3730220

Facility

$695.00

Hospital Charge Code	270643379
Hospital Revenue Code	278
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$168.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

SCREW LOCK CANC 3.0X20 3730220

Facility

$695.00

Hospital Charge Code	270643379
Hospital Revenue Code	278
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$208.50
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

SCREW LOCK CANC 3.0X22 3730222

Facility

$695.00

Hospital Charge Code	270643380
Hospital Revenue Code	278
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$168.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

SCREW LOCK CANC 3.0X22 3730222

Facility

$695.00

Hospital Charge Code	270643380
Hospital Revenue Code	278
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$208.50
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

SCREW LOCK CANC 3.0X30 3730230

Facility

$695.00

Hospital Charge Code	270643381
Hospital Revenue Code	278
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$208.50
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

SCREW LOCK CANC 3.0X30 3730230

Facility

$695.00

Hospital Charge Code	270643381
Hospital Revenue Code	278
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$168.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.19
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

Know your out-of-pocket cost for care.

All Charges