Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW MODULAR CANN 7.5X45MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270695930
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 MODULAR CANN 7.5X45MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270695930
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 MODULAR CANN 7.5X50MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270697432
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 MODULAR CANN 7.5X50MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270697432
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 MODULAR CREO 6.5X40MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697759
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,200.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

SCREW MODULAR CREO 6.5X40MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697759
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

SCREW MODULAR SET

Facility

$1,780.00

Service Code	HCPCS C1713
Hospital Charge Code	270698869
Hospital Revenue Code	278
Min. Negotiated Rate	$267.00
Max. Negotiated Rate	$430.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$356.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$430.76
Rate for Payer: Qualcare PPO/HMO/WC	$267.00

SCREW MODULAR SET

Facility

$1,780.00

Service Code	HCPCS C1713
Hospital Charge Code	270698869
Hospital Revenue Code	278
Min. Negotiated Rate	$267.00
Max. Negotiated Rate	$890.00
Rate for Payer: Aetna Commercial	$534.00
Rate for Payer: Aetna Medicare Advantage	$534.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$453.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$453.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$356.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$453.90
Rate for Payer: Cigna Commercial	$890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$430.76
Rate for Payer: Qualcare PPO/HMO/WC	$267.00

SCREW MONET ACIF 3.5X12MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270700105
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 MONET ACIF 3.5X12MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270700105
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 MONSTER JONES 4.5X54MM

Facility

$5,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270680220
Hospital Revenue Code	278
Min. Negotiated Rate	$881.25
Max. Negotiated Rate	$2,937.50
Rate for Payer: Aetna Commercial	$1,762.50
Rate for Payer: Aetna Medicare Advantage	$1,762.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,498.12
Rate for Payer: Cigna Commercial	$2,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: Qualcare PPO/HMO/WC	$881.25

SCREW MONSTER JONES 4.5X54MM

Facility

$5,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270680220
Hospital Revenue Code	278
Min. Negotiated Rate	$881.25
Max. Negotiated Rate	$1,421.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: Qualcare PPO/HMO/WC	$881.25

SCREW MONSTER LONG TH 2X12MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695046
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW MONSTER LONG TH 2X12MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695046
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW MOSTER JONES 5.5MM

Facility

$5,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270680221
Hospital Revenue Code	278
Min. Negotiated Rate	$881.25
Max. Negotiated Rate	$1,421.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: Qualcare PPO/HMO/WC	$881.25

SCREW MOSTER JONES 5.5MM

Facility

$5,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270680221
Hospital Revenue Code	278
Min. Negotiated Rate	$881.25
Max. Negotiated Rate	$2,937.50
Rate for Payer: Aetna Commercial	$1,762.50
Rate for Payer: Aetna Medicare Advantage	$1,762.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,498.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,498.12
Rate for Payer: Cigna Commercial	$2,937.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,421.75
Rate for Payer: Qualcare PPO/HMO/WC	$881.25

SCREW MT LKG TI 3.5X14MM

Facility

$1,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270698964
Hospital Revenue Code	278
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$602.50
Rate for Payer: Aetna Commercial	$361.50
Rate for Payer: Aetna Medicare Advantage	$361.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.27
Rate for Payer: Cigna Commercial	$602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.61
Rate for Payer: Qualcare PPO/HMO/WC	$180.75

SCREW MT LKG TI 3.5X14MM

Facility

$1,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270698964
Hospital Revenue Code	278
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$291.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.61
Rate for Payer: Qualcare PPO/HMO/WC	$180.75

SCREW MT LKG TI 3.5X26MM

Facility

$1,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270698960
Hospital Revenue Code	278
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$602.50
Rate for Payer: Aetna Commercial	$361.50
Rate for Payer: Aetna Medicare Advantage	$361.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.27
Rate for Payer: Cigna Commercial	$602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.61
Rate for Payer: Qualcare PPO/HMO/WC	$180.75

SCREW MT LKG TI 3.5X26MM

Facility

$1,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270698962
Hospital Revenue Code	278
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$602.50
Rate for Payer: Aetna Commercial	$361.50
Rate for Payer: Aetna Medicare Advantage	$361.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.27
Rate for Payer: Cigna Commercial	$602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.61
Rate for Payer: Qualcare PPO/HMO/WC	$180.75

SCREW MT LKG TI 3.5X26MM

Facility

$1,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270698960
Hospital Revenue Code	278
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$291.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.61
Rate for Payer: Qualcare PPO/HMO/WC	$180.75

SCREW MT LKG TI 3.5X26MM

Facility

$1,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270698962
Hospital Revenue Code	278
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$291.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.61
Rate for Payer: Qualcare PPO/HMO/WC	$180.75

SCREW MT LKG TI 3.5X40MM

Facility

$1,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270698957
Hospital Revenue Code	278
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$602.50
Rate for Payer: Aetna Commercial	$361.50
Rate for Payer: Aetna Medicare Advantage	$361.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.27
Rate for Payer: Cigna Commercial	$602.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.61
Rate for Payer: Qualcare PPO/HMO/WC	$180.75

SCREW MT LKG TI 3.5X40MM

Facility

$1,205.00

Service Code	HCPCS C1713
Hospital Charge Code	270698957
Hospital Revenue Code	278
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$291.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$241.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.61
Rate for Payer: Qualcare PPO/HMO/WC	$180.75

SCREW MTP TI LP 3.0X14MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693497
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

Know your out-of-pocket cost for care.

All Charges