Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW MNTR OC 4.5x8MM

Facility

$1,505.00

Service Code	HCPCS C1713
Hospital Charge Code	270677389
Hospital Revenue Code	278
Min. Negotiated Rate	$225.75
Max. Negotiated Rate	$364.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.21
Rate for Payer: Qualcare PPO/HMO/WC	$225.75

SCREW MNTR OC INNER

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270677390
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$160.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

SCREW MNTR OC INNER

Facility

$665.00

Service Code	HCPCS C1713
Hospital Charge Code	270677390
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$332.50
Rate for Payer: Aetna Commercial	$199.50
Rate for Payer: Aetna Medicare Advantage	$199.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.57
Rate for Payer: Cigna Commercial	$332.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.93
Rate for Payer: Qualcare PPO/HMO/WC	$99.75

SCREW MOD 5.5 X 35 MM A 2C

Facility

$3,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270693097
Hospital Revenue Code	278
Min. Negotiated Rate	$453.75
Max. Negotiated Rate	$1,512.50
Rate for Payer: Aetna Commercial	$907.50
Rate for Payer: Aetna Medicare Advantage	$907.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$771.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$771.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$771.38
Rate for Payer: Cigna Commercial	$1,512.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.05
Rate for Payer: Qualcare PPO/HMO/WC	$453.75

SCREW MOD 5.5 X 35 MM A 2C

Facility

$3,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270693097
Hospital Revenue Code	278
Min. Negotiated Rate	$453.75
Max. Negotiated Rate	$732.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.05
Rate for Payer: Qualcare PPO/HMO/WC	$453.75

SCREW MOD CANN 6.5X50MM

Facility

$13,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270697211
Hospital Revenue Code	278
Min. Negotiated Rate	$2,022.00
Max. Negotiated Rate	$6,740.00
Rate for Payer: Aetna Commercial	$4,044.00
Rate for Payer: Aetna Medicare Advantage	$4,044.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,437.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,437.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,696.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,437.40
Rate for Payer: Cigna Commercial	$6,740.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,262.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,022.00

SCREW MOD CANN 6.5X50MM

Facility

$13,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270697211
Hospital Revenue Code	278
Min. Negotiated Rate	$2,022.00
Max. Negotiated Rate	$3,262.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,696.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,262.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,022.00

SCREW MOD CANN 7.5X45MM

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270695221
Hospital Revenue Code	278
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,087.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

SCREW MOD CANN 7.5X45MM

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270695221
Hospital Revenue Code	278
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$877.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

SCREW MOD CANN 7.5X50MM

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270695222
Hospital Revenue Code	278
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$877.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

SCREW MOD CANN 7.5X50MM

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270695222
Hospital Revenue Code	278
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,087.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

SCREW MOD ROBOTIC 7.5X45MM

Facility

$4,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270694878
Hospital Revenue Code	278
Min. Negotiated Rate	$652.50
Max. Negotiated Rate	$2,175.00
Rate for Payer: Aetna Commercial	$1,305.00
Rate for Payer: Aetna Medicare Advantage	$1,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,109.25
Rate for Payer: Cigna Commercial	$2,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: Qualcare PPO/HMO/WC	$652.50

SCREW MOD ROBOTIC 7.5X45MM

Facility

$4,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270694878
Hospital Revenue Code	278
Min. Negotiated Rate	$652.50
Max. Negotiated Rate	$1,052.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: Qualcare PPO/HMO/WC	$652.50

SCREW MOD ROBOTIC 7.5X50MM

Facility

$4,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270694879
Hospital Revenue Code	278
Min. Negotiated Rate	$652.50
Max. Negotiated Rate	$2,175.00
Rate for Payer: Aetna Commercial	$1,305.00
Rate for Payer: Aetna Medicare Advantage	$1,305.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,109.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,109.25
Rate for Payer: Cigna Commercial	$2,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: Qualcare PPO/HMO/WC	$652.50

SCREW MOD ROBOTIC 7.5X50MM

Facility

$4,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270694879
Hospital Revenue Code	278
Min. Negotiated Rate	$652.50
Max. Negotiated Rate	$1,052.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$870.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,052.70
Rate for Payer: Qualcare PPO/HMO/WC	$652.50

SCREW MOD SELFTAP CANN 7.5X45

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692293
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,500.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SCREW MOD SELFTAP CANN 7.5X45

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692293
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SCREW MOD SELFTAP CANN 7.5X50

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692292
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,500.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SCREW MOD SELFTAP CANN 7.5X50

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692292
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

SCREW MOD TI 7.5X35MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270696850
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$1,631.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW MOD TI 7.5X35MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270696850
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$3,370.00
Rate for Payer: Aetna Commercial	$2,022.00
Rate for Payer: Aetna Medicare Advantage	$2,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,718.70
Rate for Payer: Cigna Commercial	$3,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW MOD TI PED 6.5X45MM GRN

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270696847
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$1,631.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW MOD TI PED 6.5X45MM GRN

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270696847
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$3,370.00
Rate for Payer: Aetna Commercial	$2,022.00
Rate for Payer: Aetna Medicare Advantage	$2,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,718.70
Rate for Payer: Cigna Commercial	$3,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW MOD TI PED 7.5X40MM DKBL

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270696848
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$3,370.00
Rate for Payer: Aetna Commercial	$2,022.00
Rate for Payer: Aetna Medicare Advantage	$2,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,718.70
Rate for Payer: Cigna Commercial	$3,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW MOD TI PED 7.5X40MM DKBL

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270696848
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$1,631.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

Know your out-of-pocket cost for care.

All Charges