Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LP-PRO 5.5X 55MM

Facility

$4,100.00

Hospital Charge Code	270703177
Hospital Revenue Code	278
Min. Negotiated Rate	$615.00
Max. Negotiated Rate	$992.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$820.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$992.20
Rate for Payer: Qualcare PPO/HMO/WC	$615.00

SCREW LP PTD THD TI 6X55MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270697347
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$961.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

SCREW LP PTD THD TI 6X55MM

Facility

$3,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270697347
Hospital Revenue Code	278
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,192.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$795.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$961.95
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

SCREW LP TI 4.0MM X 38 MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270685936
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW LP TI 4.0MM X 38 MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270685936
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW LP TI 4.0X16MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270697468
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW LP TI 4.0X16MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270697468
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW LP TI 4X14MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270696334
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW LP TI 4X14MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270696334
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW LP TI CORTICAL 3.0X46MM

Facility

$598.00

Service Code	HCPCS C1713
Hospital Charge Code	270699066
Hospital Revenue Code	278
Min. Negotiated Rate	$89.70
Max. Negotiated Rate	$299.00
Rate for Payer: Aetna Commercial	$179.40
Rate for Payer: Aetna Medicare Advantage	$179.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$152.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$152.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$152.49
Rate for Payer: Cigna Commercial	$299.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.72
Rate for Payer: Qualcare PPO/HMO/WC	$89.70

SCREW LP TI CORTICAL 3.0X46MM

Facility

$598.00

Service Code	HCPCS C1713
Hospital Charge Code	270699066
Hospital Revenue Code	278
Min. Negotiated Rate	$89.70
Max. Negotiated Rate	$144.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.72
Rate for Payer: Qualcare PPO/HMO/WC	$89.70

SCREW LP TI CORT MTP 3.0X12MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270696251
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW LP TI CORT MTP 3.0X12MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270696251
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$187.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW LP TI CORT MTP 3.0X16MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693498
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW LP TI CORT MTP 3.0X16MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693498
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$187.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW LP TI CORT MTP 3.0X18MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693499
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW LP TI CORT MTP 3.0X18MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693499
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$187.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW LP TM SS CORTEX 2.7X32MM

Facility

$243.75

Service Code	HCPCS C1713
Hospital Charge Code	270699396
Hospital Revenue Code	278
Min. Negotiated Rate	$36.56
Max. Negotiated Rate	$58.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.99
Rate for Payer: Qualcare PPO/HMO/WC	$36.56

SCREW LP TM SS CORTEX 2.7X32MM

Facility

$243.75

Service Code	HCPCS C1713
Hospital Charge Code	270699396
Hospital Revenue Code	278
Min. Negotiated Rate	$36.56
Max. Negotiated Rate	$121.88
Rate for Payer: Aetna Commercial	$73.12
Rate for Payer: Aetna Medicare Advantage	$73.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.16
Rate for Payer: Cigna Commercial	$121.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.99
Rate for Payer: Qualcare PPO/HMO/WC	$36.56

SCREW LP TRID II 6.5X40MM

Facility

$1,040.00

Service Code	HCPCS C1713
Hospital Charge Code	270695171
Hospital Revenue Code	278
Min. Negotiated Rate	$156.00
Max. Negotiated Rate	$251.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$208.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$251.68
Rate for Payer: Qualcare PPO/HMO/WC	$156.00

SCREW LP TRID II 6.5X40MM

Facility

$1,040.00

Service Code	HCPCS C1713
Hospital Charge Code	270695171
Hospital Revenue Code	278
Min. Negotiated Rate	$156.00
Max. Negotiated Rate	$520.00
Rate for Payer: Aetna Commercial	$312.00
Rate for Payer: Aetna Medicare Advantage	$312.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$265.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$265.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$208.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$265.20
Rate for Payer: Cigna Commercial	$520.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$251.68
Rate for Payer: Qualcare PPO/HMO/WC	$156.00

SCREW L SOLID 115mm TITA 29262

Facility

$2,160.00

Hospital Charge Code	270644215
Hospital Revenue Code	278
Min. Negotiated Rate	$324.00
Max. Negotiated Rate	$1,080.00
Rate for Payer: Aetna Commercial	$648.00
Rate for Payer: Aetna Medicare Advantage	$648.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$550.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$432.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$550.80
Rate for Payer: Cigna Commercial	$1,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$522.72
Rate for Payer: Qualcare PPO/HMO/WC	$324.00

SCREW L SOLID 115mm TITA 29262

Facility

$2,160.00

Hospital Charge Code	270644215
Hospital Revenue Code	278
Min. Negotiated Rate	$324.00
Max. Negotiated Rate	$522.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$432.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$522.72
Rate for Payer: Qualcare PPO/HMO/WC	$324.00

SCREW LUMBAR 5.5X30MM

Facility

$2,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270693948
Hospital Revenue Code	278
Min. Negotiated Rate	$442.50
Max. Negotiated Rate	$713.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$713.90
Rate for Payer: Qualcare PPO/HMO/WC	$442.50

SCREW LUMBAR 5.5X30MM

Facility

$2,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270693948
Hospital Revenue Code	278
Min. Negotiated Rate	$442.50
Max. Negotiated Rate	$1,475.00
Rate for Payer: Aetna Commercial	$885.00
Rate for Payer: Aetna Medicare Advantage	$885.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$752.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$752.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$590.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$752.25
Rate for Payer: Cigna Commercial	$1,475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$713.90
Rate for Payer: Qualcare PPO/HMO/WC	$442.50

Know your out-of-pocket cost for care.

All Charges