Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING VA T25 5x65MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270675831
Hospital Revenue Code	278
Min. Negotiated Rate	$112.95
Max. Negotiated Rate	$182.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: Qualcare PPO/HMO/WC	$112.95

SCREW LOCKING VA T25 5x65MM

Facility

$753.00

Service Code	HCPCS C1713
Hospital Charge Code	270675831
Hospital Revenue Code	278
Min. Negotiated Rate	$112.95
Max. Negotiated Rate	$376.50
Rate for Payer: Aetna Commercial	$225.90
Rate for Payer: Aetna Medicare Advantage	$225.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.01
Rate for Payer: Cigna Commercial	$376.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.23
Rate for Payer: Qualcare PPO/HMO/WC	$112.95

SCREW LOCKING XL25 5.0X52MM

Facility

$2,730.00

Service Code	HCPCS C1713
Hospital Charge Code	270699429
Hospital Revenue Code	278
Min. Negotiated Rate	$409.50
Max. Negotiated Rate	$660.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$660.66
Rate for Payer: Qualcare PPO/HMO/WC	$409.50

SCREW LOCKING XL25 5.0X52MM

Facility

$2,730.00

Service Code	HCPCS C1713
Hospital Charge Code	270699429
Hospital Revenue Code	278
Min. Negotiated Rate	$409.50
Max. Negotiated Rate	$1,365.00
Rate for Payer: Aetna Commercial	$819.00
Rate for Payer: Aetna Medicare Advantage	$819.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.15
Rate for Payer: Cigna Commercial	$1,365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$660.66
Rate for Payer: Qualcare PPO/HMO/WC	$409.50

SCREW LOCKING XL25 5.0X84MM

Facility

$2,730.00

Service Code	HCPCS C1713
Hospital Charge Code	270699425
Hospital Revenue Code	278
Min. Negotiated Rate	$409.50
Max. Negotiated Rate	$660.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$660.66
Rate for Payer: Qualcare PPO/HMO/WC	$409.50

SCREW LOCKING XL25 5.0X84MM

Facility

$2,730.00

Service Code	HCPCS C1713
Hospital Charge Code	270699425
Hospital Revenue Code	278
Min. Negotiated Rate	$409.50
Max. Negotiated Rate	$1,365.00
Rate for Payer: Aetna Commercial	$819.00
Rate for Payer: Aetna Medicare Advantage	$819.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$696.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$696.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$546.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$696.15
Rate for Payer: Cigna Commercial	$1,365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$660.66
Rate for Payer: Qualcare PPO/HMO/WC	$409.50

SCREW LOCK MINIBUNION 3X16MM

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693665
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

SCREW LOCK MINIBUNION 3X16MM

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693665
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$487.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

SCREW LOCK MINIBUNION 3X20MM

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693666
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$487.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

SCREW LOCK MINIBUNION 3X20MM

Facility

$1,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693666
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$393.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$393.25
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

SCREW LOCK MULTI DIR 3.5x22MM

Facility

$1,320.00

Service Code	HCPCS C1713
Hospital Charge Code	270673649
Hospital Revenue Code	278
Min. Negotiated Rate	$198.00
Max. Negotiated Rate	$660.00
Rate for Payer: Aetna Commercial	$396.00
Rate for Payer: Aetna Medicare Advantage	$396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$336.60
Rate for Payer: Cigna Commercial	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: Qualcare PPO/HMO/WC	$198.00

SCREW LOCK MULTI DIR 3.5x22MM

Facility

$1,320.00

Service Code	HCPCS C1713
Hospital Charge Code	270673649
Hospital Revenue Code	278
Min. Negotiated Rate	$198.00
Max. Negotiated Rate	$319.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: Qualcare PPO/HMO/WC	$198.00

SCREW LOCK MULTI DIR 3.5x34MM

Facility

$1,320.00

Service Code	HCPCS C1713
Hospital Charge Code	270673650
Hospital Revenue Code	278
Min. Negotiated Rate	$198.00
Max. Negotiated Rate	$319.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: Qualcare PPO/HMO/WC	$198.00

SCREW LOCK MULTI DIR 3.5x34MM

Facility

$1,320.00

Service Code	HCPCS C1713
Hospital Charge Code	270673650
Hospital Revenue Code	278
Min. Negotiated Rate	$198.00
Max. Negotiated Rate	$660.00
Rate for Payer: Aetna Commercial	$396.00
Rate for Payer: Aetna Medicare Advantage	$396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$336.60
Rate for Payer: Cigna Commercial	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: Qualcare PPO/HMO/WC	$198.00

SCREW LOCK MULTI DIR 3.5x36MM

Facility

$1,320.00

Service Code	HCPCS C1713
Hospital Charge Code	270673648
Hospital Revenue Code	278
Min. Negotiated Rate	$198.00
Max. Negotiated Rate	$660.00
Rate for Payer: Aetna Commercial	$396.00
Rate for Payer: Aetna Medicare Advantage	$396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$336.60
Rate for Payer: Cigna Commercial	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: Qualcare PPO/HMO/WC	$198.00

SCREW LOCK MULTI DIR 3.5x36MM

Facility

$1,320.00

Service Code	HCPCS C1713
Hospital Charge Code	270673648
Hospital Revenue Code	278
Min. Negotiated Rate	$198.00
Max. Negotiated Rate	$319.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: Qualcare PPO/HMO/WC	$198.00

SCREW LOCK MULTI DIR 3.5x38MM

Facility

$1,320.00

Service Code	HCPCS C1713
Hospital Charge Code	270673647
Hospital Revenue Code	278
Min. Negotiated Rate	$198.00
Max. Negotiated Rate	$660.00
Rate for Payer: Aetna Commercial	$396.00
Rate for Payer: Aetna Medicare Advantage	$396.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$336.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$336.60
Rate for Payer: Cigna Commercial	$660.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: Qualcare PPO/HMO/WC	$198.00

SCREW LOCK MULTI DIR 3.5x38MM

Facility

$1,320.00

Service Code	HCPCS C1713
Hospital Charge Code	270673647
Hospital Revenue Code	278
Min. Negotiated Rate	$198.00
Max. Negotiated Rate	$319.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$264.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.44
Rate for Payer: Qualcare PPO/HMO/WC	$198.00

SCREW LOCKNG CAN 5.0x50 222540

Facility

$644.85

Hospital Charge Code	270632185
Hospital Revenue Code	278
Min. Negotiated Rate	$96.73
Max. Negotiated Rate	$156.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.05
Rate for Payer: Qualcare PPO/HMO/WC	$96.73

SCREW LOCKNG CAN 5.0x50 222540

Facility

$644.85

Hospital Charge Code	270632185
Hospital Revenue Code	278
Min. Negotiated Rate	$96.73
Max. Negotiated Rate	$322.43
Rate for Payer: Aetna Commercial	$193.46
Rate for Payer: Aetna Medicare Advantage	$193.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$128.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.44
Rate for Payer: Cigna Commercial	$322.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.05
Rate for Payer: Qualcare PPO/HMO/WC	$96.73

SCREW LOCKNG CAN 5.0x55 222541

Facility

$754.00

Hospital Charge Code	270634360
Hospital Revenue Code	278
Min. Negotiated Rate	$113.10
Max. Negotiated Rate	$377.00
Rate for Payer: Aetna Commercial	$226.20
Rate for Payer: Aetna Medicare Advantage	$226.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$192.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$192.27
Rate for Payer: Cigna Commercial	$377.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: Qualcare PPO/HMO/WC	$113.10

SCREW LOCKNG CAN 5.0x55 222541

Facility

$754.00

Hospital Charge Code	270634360
Hospital Revenue Code	278
Min. Negotiated Rate	$113.10
Max. Negotiated Rate	$182.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$182.47
Rate for Payer: Qualcare PPO/HMO/WC	$113.10

SCREW LOCK OUT

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688389
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW LOCK OUT

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688389
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW LOCK SD 5.5X40MM

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694589
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$825.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

Know your out-of-pocket cost for care.

All Charges