Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW NCB THREADED 4.0X30MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270699611
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW NCB THREADED 4.0X30MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270699611
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW NCB THREADED 4.0X32MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270699612
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW NCB THREADED 4.0X32MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270699612
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW NCB THREADED 4.0X38MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270699613
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW NCB THREADED 4.0X38MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270699613
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW NCB THREADED 4.0X40MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270699614
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW NCB THREADED 4.0X40MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270699614
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW NCB UNCORTICA 5.0 L = 44

Facility

$962.50

Service Code	HCPCS 962.5
Hospital Charge Code	270704923
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 NCB UNCORTICA 5.0 L = 44

Facility

$962.50

Service Code	HCPCS 962.5
Hospital Charge Code	270704923
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 NCB UNICORTICAK 5.0 L =

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270704921
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 NCB UNICORTICAK 5.0 L =

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270704921
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 NCB UNICORTICAL SCR 5.0

Facility

$926.50

Service Code	HCPCS C1713
Hospital Charge Code	270704919
Hospital Revenue Code	278
Min. Negotiated Rate	$138.97
Max. Negotiated Rate	$224.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.21
Rate for Payer: Qualcare PPO/HMO/WC	$138.97

SCREW NCB UNICORTICAL SCR 5.0

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270704920
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 NCB UNICORTICAL SCR 5.0

Facility

$926.50

Service Code	HCPCS C1713
Hospital Charge Code	270704919
Hospital Revenue Code	278
Min. Negotiated Rate	$138.97
Max. Negotiated Rate	$463.25
Rate for Payer: Aetna Commercial	$277.95
Rate for Payer: Aetna Medicare Advantage	$277.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$236.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$236.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$185.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$236.26
Rate for Payer: Cigna Commercial	$463.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$224.21
Rate for Payer: Qualcare PPO/HMO/WC	$138.97

SCREW NCB UNICORTICAL SCR 5.0

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270704920
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 NEURO LOW PROFILE 3MM

Facility

$472.00

Hospital Charge Code	270674573
Hospital Revenue Code	278
Min. Negotiated Rate	$70.80
Max. Negotiated Rate	$236.00
Rate for Payer: Aetna Commercial	$141.60
Rate for Payer: Aetna Medicare Advantage	$141.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.36
Rate for Payer: Cigna Commercial	$236.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.22
Rate for Payer: Qualcare PPO/HMO/WC	$70.80

SCREW NEURO LOW PROFILE 3MM

Facility

$472.00

Hospital Charge Code	270674573
Hospital Revenue Code	278
Min. Negotiated Rate	$70.80
Max. Negotiated Rate	$114.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.22
Rate for Payer: Qualcare PPO/HMO/WC	$70.80

SCREW NEXGEN HEX 3.5X27MM

Facility

$1,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270693275
Hospital Revenue Code	278
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$360.00
Rate for Payer: Aetna Medicare Advantage	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.00
Rate for Payer: Cigna Commercial	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$180.00

SCREW NEXGEN HEX 3.5X27MM

Facility

$1,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270693275
Hospital Revenue Code	278
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$290.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: Qualcare PPO/HMO/WC	$180.00

SCREW NEXGEN HEX 3.5X48MM

Facility

$1,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270693274
Hospital Revenue Code	278
Min. Negotiated Rate	$285.00
Max. Negotiated Rate	$459.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.80
Rate for Payer: Qualcare PPO/HMO/WC	$285.00

SCREW NEXGEN HEX 3.5X48MM

Facility

$1,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270693274
Hospital Revenue Code	278
Min. Negotiated Rate	$285.00
Max. Negotiated Rate	$950.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$570.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$380.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$484.50
Rate for Payer: Cigna Commercial	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.80
Rate for Payer: Qualcare PPO/HMO/WC	$285.00

SCREW NEXGEN KNEE REPLACEME

Facility

$835.00

Hospital Charge Code	270665754
Hospital Revenue Code	278
Min. Negotiated Rate	$125.25
Max. Negotiated Rate	$202.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$167.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.07
Rate for Payer: Qualcare PPO/HMO/WC	$125.25

SCREW NEXGEN KNEE REPLACEME

Facility

$835.00

Hospital Charge Code	270665754
Hospital Revenue Code	278
Min. Negotiated Rate	$125.25
Max. Negotiated Rate	$417.50
Rate for Payer: Aetna Commercial	$250.50
Rate for Payer: Aetna Medicare Advantage	$250.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$167.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.93
Rate for Payer: Cigna Commercial	$417.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$202.07
Rate for Payer: Qualcare PPO/HMO/WC	$125.25

SCREW NEXGEN SDV 4.0X18MM

Facility

$2,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270696974
Hospital Revenue Code	278
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$1,050.00
Rate for Payer: Aetna Commercial	$630.00
Rate for Payer: Aetna Medicare Advantage	$630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$535.50
Rate for Payer: Cigna Commercial	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: Qualcare PPO/HMO/WC	$315.00

Know your out-of-pocket cost for care.

All Charges