Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW NL 535 34

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270687134
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$163.50
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

SCREW NL 535 34

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270687134
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$131.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

SCREW NL 5.5 50

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270687132
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$131.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

SCREW NL 5.5 50

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270687132
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$163.50
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

SCREW NL 5.5 X 45

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270687133
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$272.50
Rate for Payer: Aetna Commercial	$163.50
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

SCREW NL 5.5 X 45

Facility

$545.00

Service Code	HCPCS C1713
Hospital Charge Code	270687133
Hospital Revenue Code	278
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$131.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.89
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

SCREW NL ANCHORAGE 3X10MM

Facility

$1,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270698993
Hospital Revenue Code	278
Min. Negotiated Rate	$222.00
Max. Negotiated Rate	$358.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.16
Rate for Payer: Qualcare PPO/HMO/WC	$222.00

SCREW NL ANCHORAGE 3X10MM

Facility

$1,480.00

Service Code	HCPCS C1713
Hospital Charge Code	270698993
Hospital Revenue Code	278
Min. Negotiated Rate	$222.00
Max. Negotiated Rate	$740.00
Rate for Payer: Aetna Commercial	$444.00
Rate for Payer: Aetna Medicare Advantage	$444.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$377.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$377.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$377.40
Rate for Payer: Cigna Commercial	$740.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$358.16
Rate for Payer: Qualcare PPO/HMO/WC	$222.00

SCREW NLKING PLT SCREW 3.5X10

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270701418
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$159.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

SCREW NLKING PLT SCREW 3.5X10

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	270701418
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$330.00
Rate for Payer: Aetna Commercial	$198.00
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

SCREW N/LOCKING 24MM

Facility

$540.00

Hospital Charge Code	270658035
Hospital Revenue Code	278
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$162.00
Rate for Payer: Aetna Medicare Advantage	$162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.70
Rate for Payer: Cigna Commercial	$270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: Qualcare PPO/HMO/WC	$81.00

SCREW N/LOCKING 24MM

Facility

$540.00

Hospital Charge Code	270658035
Hospital Revenue Code	278
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$130.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: Qualcare PPO/HMO/WC	$81.00

SCREW N-LOCKING 3.5X56MM

Facility

$660.00

Service Code	HCPCS C1716
Hospital Charge Code	270701409
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$1,197.08
Rate for Payer: Aetna Commercial	$198.00
Rate for Payer: Aetna Medicare Advantage	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.30
Rate for Payer: Cigna Commercial	$1,197.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

SCREW N-LOCKING 3.5X56MM

Facility

$660.00

Service Code	HCPCS C1716
Hospital Charge Code	270701409
Hospital Revenue Code	278
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$159.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.72
Rate for Payer: Qualcare PPO/HMO/WC	$99.00

SCREW N-LOCKING CANC LAG 4.x14

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	270672331
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$102.00
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

SCREW N-LOCKING CANC LAG 4.x14

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	270672331
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$82.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

SCREW N-LOCKING CANC LAG 4.x18

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	270672332
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$82.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

SCREW N-LOCKING CANC LAG 4.x18

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	270672332
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$102.00
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

SCREW N-LOCKING CANC LAG 4.x24

Facility

$340.00

Hospital Charge Code	270672333
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$82.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

SCREW N-LOCKING CANC LAG 4.x24

Facility

$340.00

Hospital Charge Code	270672333
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$102.00
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

SCREW N-LOCKING CANC LAG 4.x26

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	270672336
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$82.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

SCREW N-LOCKING CANC LAG 4.x26

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	270672336
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$102.00
Rate for Payer: Aetna Medicare Advantage	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.70
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.28
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

SCREW NL PERIPH 4.5X36MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270699154
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$180.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW NL PERIPH 4.5X36MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270699154
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW NON LCKNG LG HD 2.7x18MM

Facility

$570.00

Service Code	HCPCS C1713
Hospital Charge Code	270675121
Hospital Revenue Code	278
Min. Negotiated Rate	$85.50
Max. Negotiated Rate	$137.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.94
Rate for Payer: Qualcare PPO/HMO/WC	$85.50

Know your out-of-pocket cost for care.

All Charges