Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW MINIMON HDLS 2.5X30MM

Facility

$1,141.25

Service Code	HCPCS C1713
Hospital Charge Code	270700687
Hospital Revenue Code	278
Min. Negotiated Rate	$171.19
Max. Negotiated Rate	$570.62
Rate for Payer: Aetna Commercial	$342.38
Rate for Payer: Aetna Medicare Advantage	$342.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$291.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$291.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$291.02
Rate for Payer: Cigna Commercial	$570.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.18
Rate for Payer: Qualcare PPO/HMO/WC	$171.19

SCREW MINIMON HDLS ST 2X20MM

Facility

$1,141.25

Service Code	HCPCS C1713
Hospital Charge Code	270700688
Hospital Revenue Code	278
Min. Negotiated Rate	$171.19
Max. Negotiated Rate	$276.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.18
Rate for Payer: Qualcare PPO/HMO/WC	$171.19

SCREW MINIMON HDLS ST 2X20MM

Facility

$1,141.25

Service Code	HCPCS C1713
Hospital Charge Code	270700688
Hospital Revenue Code	278
Min. Negotiated Rate	$171.19
Max. Negotiated Rate	$570.62
Rate for Payer: Aetna Commercial	$342.38
Rate for Payer: Aetna Medicare Advantage	$342.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$291.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$291.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$291.02
Rate for Payer: Cigna Commercial	$570.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.18
Rate for Payer: Qualcare PPO/HMO/WC	$171.19

SCREW MINIMON HDLS ST 2X24MM

Facility

$1,141.25

Service Code	HCPCS C1713
Hospital Charge Code	270700686
Hospital Revenue Code	278
Min. Negotiated Rate	$171.19
Max. Negotiated Rate	$570.62
Rate for Payer: Aetna Commercial	$342.38
Rate for Payer: Aetna Medicare Advantage	$342.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$291.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$291.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$291.02
Rate for Payer: Cigna Commercial	$570.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.18
Rate for Payer: Qualcare PPO/HMO/WC	$171.19

SCREW MINIMON HDLS ST 2X24MM

Facility

$1,141.25

Service Code	HCPCS C1713
Hospital Charge Code	270700686
Hospital Revenue Code	278
Min. Negotiated Rate	$171.19
Max. Negotiated Rate	$276.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.18
Rate for Payer: Qualcare PPO/HMO/WC	$171.19

SCREW MINI MONSTER SH TH2X14MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270700629
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW MINI MONSTER SH TH2X14MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270700629
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$288.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW MINI MONST HD ST3.5X32MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270700644
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW MINI MONST HD ST3.5X32MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270700644
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$288.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW MIS ALT VALENC 6.5X35MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695410
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW MIS ALT VALENC 6.5X35MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695410
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$3,225.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW MIS ALT VALENCI 6.5X35MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693535
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW MIS ALT VALENCI 6.5X35MM

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270693535
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$3,225.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW MIS CAN PEDICLE 5.5X40MM

Facility

$23,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698198
Hospital Revenue Code	278
Min. Negotiated Rate	$3,487.50
Max. Negotiated Rate	$11,625.00
Rate for Payer: Aetna Commercial	$6,975.00
Rate for Payer: Aetna Medicare Advantage	$6,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,928.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,928.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,928.75
Rate for Payer: Cigna Commercial	$11,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,626.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,487.50

SCREW MIS CAN PEDICLE 5.5X40MM

Facility

$23,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698198
Hospital Revenue Code	278
Min. Negotiated Rate	$3,487.50
Max. Negotiated Rate	$5,626.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,626.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,487.50

SCREW MIS CAN PEDICLE 5.5X45MM

Facility

$23,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698197
Hospital Revenue Code	278
Min. Negotiated Rate	$3,487.50
Max. Negotiated Rate	$5,626.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,626.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,487.50

SCREW MIS CAN PEDICLE 5.5X45MM

Facility

$23,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698197
Hospital Revenue Code	278
Min. Negotiated Rate	$3,487.50
Max. Negotiated Rate	$11,625.00
Rate for Payer: Aetna Commercial	$6,975.00
Rate for Payer: Aetna Medicare Advantage	$6,975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,928.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,928.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,928.75
Rate for Payer: Cigna Commercial	$11,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,626.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,487.50

SCREW MIS EXT TAB 8.5X50MM

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270696482
Hospital Revenue Code	278
Min. Negotiated Rate	$630.00
Max. Negotiated Rate	$1,016.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$840.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.40
Rate for Payer: Qualcare PPO/HMO/WC	$630.00

SCREW MIS EXT TAB 8.5X50MM

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270696482
Hospital Revenue Code	278
Min. Negotiated Rate	$630.00
Max. Negotiated Rate	$2,100.00
Rate for Payer: Aetna Commercial	$1,260.00
Rate for Payer: Aetna Medicare Advantage	$1,260.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,071.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,071.00
Rate for Payer: Cigna Commercial	$2,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,016.40
Rate for Payer: Qualcare PPO/HMO/WC	$630.00

SCREW MIS EXT TAB TULIP TI

Facility

$6,140.80

Service Code	HCPCS C1713
Hospital Charge Code	270695963
Hospital Revenue Code	278
Min. Negotiated Rate	$921.12
Max. Negotiated Rate	$1,486.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,228.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,486.07
Rate for Payer: Qualcare PPO/HMO/WC	$921.12

SCREW MIS EXT TAB TULIP TI

Facility

$6,140.80

Service Code	HCPCS C1713
Hospital Charge Code	270695963
Hospital Revenue Code	278
Min. Negotiated Rate	$921.12
Max. Negotiated Rate	$3,070.40
Rate for Payer: Aetna Commercial	$1,842.24
Rate for Payer: Aetna Medicare Advantage	$1,842.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,565.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,565.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,228.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,565.90
Rate for Payer: Cigna Commercial	$3,070.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,486.07
Rate for Payer: Qualcare PPO/HMO/WC	$921.12

SCREW MIS EXT TAB TULIP TOWER

Facility

$6,140.80

Service Code	HCPCS C1713
Hospital Charge Code	270695296
Hospital Revenue Code	278
Min. Negotiated Rate	$921.12
Max. Negotiated Rate	$3,070.40
Rate for Payer: Aetna Commercial	$1,842.24
Rate for Payer: Aetna Medicare Advantage	$1,842.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,565.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,565.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,228.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,565.90
Rate for Payer: Cigna Commercial	$3,070.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,486.07
Rate for Payer: Qualcare PPO/HMO/WC	$921.12

SCREW MIS EXT TAB TULIP TOWER

Facility

$6,140.80

Service Code	HCPCS C1713
Hospital Charge Code	270695296
Hospital Revenue Code	278
Min. Negotiated Rate	$921.12
Max. Negotiated Rate	$1,486.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,228.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,486.07
Rate for Payer: Qualcare PPO/HMO/WC	$921.12

SCREW MIS NON-MOD CANN 6.5X40

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694160
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$2,601.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

SCREW MIS NON-MOD CANN 6.5X40

Facility

$10,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270694160
Hospital Revenue Code	278
Min. Negotiated Rate	$1,612.50
Max. Negotiated Rate	$5,375.00
Rate for Payer: Aetna Commercial	$3,225.00
Rate for Payer: Aetna Medicare Advantage	$3,225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,741.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,741.25
Rate for Payer: Cigna Commercial	$5,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,601.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,612.50

Know your out-of-pocket cost for care.

All Charges