Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW LUMBAR 5.5X35MM NEXXT

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693628
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW LUMBAR 5.5X35MM NEXXT

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693628
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW LUMBAR LATERAL 35MM

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270695204
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$2,237.50
Rate for Payer: Aetna Commercial	$1,342.50
Rate for Payer: Aetna Medicare Advantage	$1,342.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,141.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,141.12
Rate for Payer: Cigna Commercial	$2,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

SCREW LUMBAR LATERAL 35MM

Facility

$4,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270695204
Hospital Revenue Code	278
Min. Negotiated Rate	$671.25
Max. Negotiated Rate	$1,082.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$895.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,082.95
Rate for Payer: Qualcare PPO/HMO/WC	$671.25

SCREW LX 5.5 X 50 MM

Facility

$9,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688580
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$4,875.00
Rate for Payer: Aetna Commercial	$2,925.00
Rate for Payer: Aetna Medicare Advantage	$2,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,486.25
Rate for Payer: Cigna Commercial	$4,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

SCREW LX 5.5 X 50 MM

Facility

$9,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688580
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$2,359.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

SCREW LX 6.5 X 40 MM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688416
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$4,125.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

SCREW LX 6.5 X 40 MM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688416
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

SCREW LX 6.5 X 40MM

Facility

$9,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688578
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$2,359.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

SCREW LX 6.5 X 40MM

Facility

$9,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688578
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$4,875.00
Rate for Payer: Aetna Commercial	$2,925.00
Rate for Payer: Aetna Medicare Advantage	$2,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,486.25
Rate for Payer: Cigna Commercial	$4,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

SCREW LX 6.5 X 45 MM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688415
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$4,125.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

SCREW LX 6.5 X 45 MM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688415
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

SCREW LX 7.5 X 40MM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688417
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$3,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

SCREW LX 7.5 X 40MM

Facility

$9,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688579
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$2,359.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

SCREW LX 7.5 X 40MM

Facility

$9,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688579
Hospital Revenue Code	278
Min. Negotiated Rate	$1,462.50
Max. Negotiated Rate	$4,875.00
Rate for Payer: Aetna Commercial	$2,925.00
Rate for Payer: Aetna Medicare Advantage	$2,925.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,486.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,486.25
Rate for Payer: Cigna Commercial	$4,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,359.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.50

SCREW LX 7.5 X 40MM

Facility

$13,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270688417
Hospital Revenue Code	278
Min. Negotiated Rate	$2,062.50
Max. Negotiated Rate	$6,875.00
Rate for Payer: Aetna Commercial	$4,125.00
Rate for Payer: Aetna Medicare Advantage	$4,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,506.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,506.25
Rate for Payer: Cigna Commercial	$6,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,327.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,062.50

SCREW M10 6.5x35mm 969535

Facility

$5,753.65

Hospital Charge Code	270630635
Hospital Revenue Code	278
Min. Negotiated Rate	$863.05
Max. Negotiated Rate	$2,876.82
Rate for Payer: Aetna Commercial	$1,726.10
Rate for Payer: Aetna Medicare Advantage	$1,726.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,467.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,467.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,467.18
Rate for Payer: Cigna Commercial	$2,876.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,392.38
Rate for Payer: Qualcare PPO/HMO/WC	$863.05

SCREW M10 6.5x35mm 969535

Facility

$5,753.65

Hospital Charge Code	270630635
Hospital Revenue Code	278
Min. Negotiated Rate	$863.05
Max. Negotiated Rate	$1,392.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,392.38
Rate for Payer: Qualcare PPO/HMO/WC	$863.05

SCREW M10 6.5x50mm 969550

Facility

$5,753.65

Hospital Charge Code	270630634
Hospital Revenue Code	278
Min. Negotiated Rate	$863.05
Max. Negotiated Rate	$2,876.82
Rate for Payer: Aetna Commercial	$1,726.10
Rate for Payer: Aetna Medicare Advantage	$1,726.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,467.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,467.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,467.18
Rate for Payer: Cigna Commercial	$2,876.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,392.38
Rate for Payer: Qualcare PPO/HMO/WC	$863.05

SCREW M10 6.5x50mm 969550

Facility

$5,753.65

Hospital Charge Code	270630634
Hospital Revenue Code	278
Min. Negotiated Rate	$863.05
Max. Negotiated Rate	$1,392.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,392.38
Rate for Payer: Qualcare PPO/HMO/WC	$863.05

SCREW MAGNUM 5.5X20MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270695738
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW MAGNUM 5.5X20MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270695738
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW MAGNUM 5.5X25MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270695739
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW MAGNUM 5.5X25MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270695739
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW MALLEOLAR 4.5x65mm

Facility

$132.00

Hospital Charge Code	270673437
Hospital Revenue Code	278
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$31.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.94
Rate for Payer: Qualcare PPO/HMO/WC	$19.80

Know your out-of-pocket cost for care.

All Charges