Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

SCREW LOCK SQUARE 2.7MM X 14MM

Facility

$980.00

Hospital Charge Code	270663851
Hospital Revenue Code	278
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$490.00
Rate for Payer: Aetna Commercial	$294.00
Rate for Payer: Aetna Medicare Advantage	$294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$249.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$249.90
Rate for Payer: Cigna Commercial	$490.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: Qualcare PPO/HMO/WC	$147.00

SCREW LOCK SQUARE 2.7MM X 14MM

Facility

$980.00

Hospital Charge Code	270663851
Hospital Revenue Code	278
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$237.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.16
Rate for Payer: Qualcare PPO/HMO/WC	$147.00

SCREW LOCK T2 ALPHA 5.0X35MM

Facility

$1,443.75

Service Code	HCPCS C1713
Hospital Charge Code	270694563
Hospital Revenue Code	278
Min. Negotiated Rate	$216.56
Max. Negotiated Rate	$349.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$288.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$349.39
Rate for Payer: Qualcare PPO/HMO/WC	$216.56

SCREW LOCK T2 ALPHA 5.0X35MM

Facility

$1,443.75

Service Code	HCPCS C1713
Hospital Charge Code	270694563
Hospital Revenue Code	278
Min. Negotiated Rate	$216.56
Max. Negotiated Rate	$721.88
Rate for Payer: Aetna Commercial	$433.12
Rate for Payer: Aetna Medicare Advantage	$433.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$368.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$368.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$368.16
Rate for Payer: Cigna Commercial	$721.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$349.39
Rate for Payer: Qualcare PPO/HMO/WC	$216.56

SCREW LOCK T2 ALPHA 5X30MM

Facility

$1,443.75

Service Code	HCPCS C1713
Hospital Charge Code	270694562
Hospital Revenue Code	278
Min. Negotiated Rate	$216.56
Max. Negotiated Rate	$721.88
Rate for Payer: Aetna Commercial	$433.12
Rate for Payer: Aetna Medicare Advantage	$433.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$368.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$368.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$368.16
Rate for Payer: Cigna Commercial	$721.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$349.39
Rate for Payer: Qualcare PPO/HMO/WC	$216.56

SCREW LOCK T2 ALPHA 5X30MM

Facility

$1,443.75

Service Code	HCPCS C1713
Hospital Charge Code	270694562
Hospital Revenue Code	278
Min. Negotiated Rate	$216.56
Max. Negotiated Rate	$349.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$288.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$349.39
Rate for Payer: Qualcare PPO/HMO/WC	$216.56

SCREW LONG THREAD 6.7 X 60 MM

Facility

$1,250.00

Hospital Charge Code	270669798
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$375.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW LONG THREAD 6.7 X 60 MM

Facility

$1,250.00

Hospital Charge Code	270669798
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW LO-PRO 3.5X12MM

Facility

$325.00

Service Code	HCPCS C1713
Hospital Charge Code	270699385
Hospital Revenue Code	278
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$162.50
Rate for Payer: Aetna Commercial	$97.50
Rate for Payer: Aetna Medicare Advantage	$97.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.88
Rate for Payer: Cigna Commercial	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

SCREW LO-PRO 3.5X12MM

Facility

$325.00

Service Code	HCPCS C1713
Hospital Charge Code	270699385
Hospital Revenue Code	278
Min. Negotiated Rate	$48.75
Max. Negotiated Rate	$78.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.65
Rate for Payer: Qualcare PPO/HMO/WC	$48.75

SCREW LO-PRO 6.5mm HEX 25mm

Facility

$309.80

Service Code	HCPCS C1713
Hospital Charge Code	270685520
Hospital Revenue Code	278
Min. Negotiated Rate	$46.47
Max. Negotiated Rate	$154.90
Rate for Payer: Aetna Commercial	$92.94
Rate for Payer: Aetna Medicare Advantage	$92.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.00
Rate for Payer: Cigna Commercial	$154.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.97
Rate for Payer: Qualcare PPO/HMO/WC	$46.47

SCREW LO-PRO 6.5mm HEX 25mm

Facility

$309.80

Service Code	HCPCS C1713
Hospital Charge Code	270685520
Hospital Revenue Code	278
Min. Negotiated Rate	$46.47
Max. Negotiated Rate	$74.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.97
Rate for Payer: Qualcare PPO/HMO/WC	$46.47

SCREW LO PRO 6.7x65MM THD 18MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270674233
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW LO PRO 6.7x65MM THD 18MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270674233
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$375.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW LO PRO 6.7x65MM THD 28MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270674232
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW LO PRO 6.7x65MM THD 28MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270674232
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$375.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW LO PRO 6.7x75MM THD 18MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270674234
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$375.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW LO PRO 6.7x75MM THD 18MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270674234
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW LO PRO 6.7x75MM THD 28MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270677563
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW LO PRO 6.7x75MM THD 28MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270677563
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$375.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW LOPRO PT THD TI 4.5X50MM

Facility

$6,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270698764
Hospital Revenue Code	278
Min. Negotiated Rate	$993.75
Max. Negotiated Rate	$3,312.50
Rate for Payer: Aetna Commercial	$1,987.50
Rate for Payer: Aetna Medicare Advantage	$1,987.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,689.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,689.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,325.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,689.38
Rate for Payer: Cigna Commercial	$3,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,603.25
Rate for Payer: Qualcare PPO/HMO/WC	$993.75

SCREW LOPRO PT THD TI 4.5X50MM

Facility

$6,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270698764
Hospital Revenue Code	278
Min. Negotiated Rate	$993.75
Max. Negotiated Rate	$1,603.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,603.25
Rate for Payer: Qualcare PPO/HMO/WC	$993.75

SCREW LO PRO TI 3X34MM CORT

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270669333
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$165.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

SCREW LO PRO TI 3X34MM CORT

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	270669333
Hospital Revenue Code	278
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$133.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.10
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

Know your out-of-pocket cost for care.

All Charges