Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING 5 x 32MM

Facility

$1,530.00

Service Code	HCPCS C1713
Hospital Charge Code	270701090
Hospital Revenue Code	278
Min. Negotiated Rate	$229.50
Max. Negotiated Rate	$370.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.26
Rate for Payer: Qualcare PPO/HMO/WC	$229.50

SCREW LOCKING 5 x 32MM

Facility

$1,530.00

Service Code	HCPCS C1713
Hospital Charge Code	270701090
Hospital Revenue Code	278
Min. Negotiated Rate	$229.50
Max. Negotiated Rate	$765.00
Rate for Payer: Aetna Commercial	$459.00
Rate for Payer: Aetna Medicare Advantage	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$390.15
Rate for Payer: Cigna Commercial	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$370.26
Rate for Payer: Qualcare PPO/HMO/WC	$229.50

SCREW LOCKING 5 X 32 X 5 MM

Facility

$1,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270662869
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$700.00
Rate for Payer: Aetna Commercial	$420.00
Rate for Payer: Aetna Medicare Advantage	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$357.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$357.00
Rate for Payer: Cigna Commercial	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.80
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

SCREW LOCKING 5 X 32 X 5 MM

Facility

$1,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270662869
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$338.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$338.80
Rate for Payer: Qualcare PPO/HMO/WC	$210.00

SCREW LOCKING 5X34MM XL 25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692728
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 LOCKING 5X34MM XL 25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692728
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 LOCKING 5X35mm 18965035S

Facility

$979.25

Service Code	HCPCS C1713
Hospital Charge Code	270645795
Hospital Revenue Code	278
Min. Negotiated Rate	$146.89
Max. Negotiated Rate	$236.98
Rate for Payer: Qualcare PPO/HMO/WC	$146.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.98

SCREW LOCKING 5X35mm 18965035S

Facility

$979.25

Service Code	HCPCS C1713
Hospital Charge Code	270645795
Hospital Revenue Code	278
Min. Negotiated Rate	$146.89
Max. Negotiated Rate	$489.62
Rate for Payer: Aetna Commercial	$293.77
Rate for Payer: Aetna Medicare Advantage	$293.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.71
Rate for Payer: Cigna Commercial	$489.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.98
Rate for Payer: Qualcare PPO/HMO/WC	$146.89

SCREW LOCKING 5x36MM

Facility

$924.00

Hospital Charge Code	270665480
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 LOCKING 5x36MM

Facility

$924.00

Hospital Charge Code	270665480
Hospital Revenue Code	278
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$223.61
Rate for Payer: Qualcare PPO/HMO/WC	$138.60
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

SCREW LOCKING 5X36MM XL25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692729
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 LOCKING 5X36MM XL25

Facility

$888.30

Service Code	HCPCS C1713
Hospital Charge Code	270692729
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 LOCKING 5X50MM PART THD

Facility

$1,545.00

Hospital Charge Code	270670467
Hospital Revenue Code	278
Min. Negotiated Rate	$231.75
Max. Negotiated Rate	$772.50
Rate for Payer: Aetna Commercial	$463.50
Rate for Payer: Aetna Medicare Advantage	$463.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$393.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$393.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$309.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$393.98
Rate for Payer: Cigna Commercial	$772.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.89
Rate for Payer: Qualcare PPO/HMO/WC	$231.75

SCREW LOCKING 5X50MM PART THD

Facility

$1,545.00

Hospital Charge Code	270670467
Hospital Revenue Code	278
Min. Negotiated Rate	$231.75
Max. Negotiated Rate	$373.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$309.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.89
Rate for Payer: Qualcare PPO/HMO/WC	$231.75

SCREW LOCKING 5x55 1896-5055S

Facility

$910.00

Service Code	HCPCS C1713
Hospital Charge Code	270638643
Hospital Revenue Code	278
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$220.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

SCREW LOCKING 5x55 1896-5055S

Facility

$910.00

Service Code	HCPCS C1713
Hospital Charge Code	270638643
Hospital Revenue Code	278
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$455.00
Rate for Payer: Aetna Commercial	$273.00
Rate for Payer: Aetna Medicare Advantage	$273.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$182.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.05
Rate for Payer: Cigna Commercial	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.22
Rate for Payer: Qualcare PPO/HMO/WC	$136.50

SCREW LOCKING 5X60MM PART THD

Facility

$1,545.00

Hospital Charge Code	270670469
Hospital Revenue Code	278
Min. Negotiated Rate	$231.75
Max. Negotiated Rate	$373.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$309.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.89
Rate for Payer: Qualcare PPO/HMO/WC	$231.75

SCREW LOCKING 5X60MM PART THD

Facility

$1,545.00

Hospital Charge Code	270670469
Hospital Revenue Code	278
Min. Negotiated Rate	$231.75
Max. Negotiated Rate	$772.50
Rate for Payer: Aetna Commercial	$463.50
Rate for Payer: Aetna Medicare Advantage	$463.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$393.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$393.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$309.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$393.98
Rate for Payer: Cigna Commercial	$772.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.89
Rate for Payer: Qualcare PPO/HMO/WC	$231.75

SCREW LOCKING 5X75MM FULLY THD

Facility

$1,470.00

Service Code	HCPCS C1713
Hospital Charge Code	270670468
Hospital Revenue Code	278
Min. Negotiated Rate	$220.50
Max. Negotiated Rate	$735.00
Rate for Payer: Aetna Commercial	$441.00
Rate for Payer: Aetna Medicare Advantage	$441.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$374.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$374.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$374.85
Rate for Payer: Cigna Commercial	$735.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.74
Rate for Payer: Qualcare PPO/HMO/WC	$220.50

SCREW LOCKING 5X75MM FULLY THD

Facility

$1,470.00

Service Code	HCPCS C1713
Hospital Charge Code	270670468
Hospital Revenue Code	278
Min. Negotiated Rate	$220.50
Max. Negotiated Rate	$355.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$355.74
Rate for Payer: Qualcare PPO/HMO/WC	$220.50

SCREW LOCKING 6.0X72MM T25 SD

Facility

$994.85

Service Code	HCPCS C1713
Hospital Charge Code	270693259
Hospital Revenue Code	278
Min. Negotiated Rate	$149.23
Max. Negotiated Rate	$497.43
Rate for Payer: Aetna Commercial	$298.45
Rate for Payer: Aetna Medicare Advantage	$298.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.69
Rate for Payer: Cigna Commercial	$497.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.75
Rate for Payer: Qualcare PPO/HMO/WC	$149.23

SCREW LOCKING 6.0X72MM T25 SD

Facility

$994.85

Service Code	HCPCS C1713
Hospital Charge Code	270693259
Hospital Revenue Code	278
Min. Negotiated Rate	$149.23
Max. Negotiated Rate	$240.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.75
Rate for Payer: Qualcare PPO/HMO/WC	$149.23

SCREW LOCKING 6.0X80MM T25

Facility

$698.85

Service Code	HCPCS C1713
Hospital Charge Code	270693315
Hospital Revenue Code	278
Min. Negotiated Rate	$104.83
Max. Negotiated Rate	$349.43
Rate for Payer: Aetna Commercial	$209.66
Rate for Payer: Aetna Medicare Advantage	$209.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.21
Rate for Payer: Cigna Commercial	$349.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.12
Rate for Payer: Qualcare PPO/HMO/WC	$104.83

SCREW LOCKING 6.0X80MM T25

Facility

$698.85

Service Code	HCPCS C1713
Hospital Charge Code	270693315
Hospital Revenue Code	278
Min. Negotiated Rate	$104.83
Max. Negotiated Rate	$169.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.12
Rate for Payer: Qualcare PPO/HMO/WC	$104.83

SCREW LOCKING 6.0X80MM T25 SD

Facility

$994.85

Service Code	HCPCS C1713
Hospital Charge Code	270693258
Hospital Revenue Code	278
Min. Negotiated Rate	$149.23
Max. Negotiated Rate	$240.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.75
Rate for Payer: Qualcare PPO/HMO/WC	$149.23

Know your out-of-pocket cost for care.

All Charges