Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW OW 7.5X40MM CANN EXT TAB

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693522
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$2,625.00
Rate for Payer: Aetna Commercial	$1,575.00
Rate for Payer: Aetna Medicare Advantage	$1,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,338.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,338.75
Rate for Payer: Cigna Commercial	$2,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

SCREW OW 7.5X40MM CANN EXT TAB

Facility

$5,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270693522
Hospital Revenue Code	278
Min. Negotiated Rate	$787.50
Max. Negotiated Rate	$1,270.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,270.50
Rate for Payer: Qualcare PPO/HMO/WC	$787.50

SCREW PACK

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270681287
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW PACK

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270681287
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW PALISADE SET

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692237
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$150.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW PALISADE SET

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692237
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW PANTA PART. THD 5x75MM

Facility

$1,524.60

Hospital Charge Code	270666227
Hospital Revenue Code	278
Min. Negotiated Rate	$228.69
Max. Negotiated Rate	$368.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$304.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.95
Rate for Payer: Qualcare PPO/HMO/WC	$228.69

SCREW PANTA PART. THD 5x75MM

Facility

$1,524.60

Hospital Charge Code	270666227
Hospital Revenue Code	278
Min. Negotiated Rate	$228.69
Max. Negotiated Rate	$762.30
Rate for Payer: Aetna Commercial	$457.38
Rate for Payer: Aetna Medicare Advantage	$457.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$304.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.77
Rate for Payer: Cigna Commercial	$762.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.95
Rate for Payer: Qualcare PPO/HMO/WC	$228.69

SCREW PANTA PART. THD 5x80MM

Facility

$1,524.60

Hospital Charge Code	270666226
Hospital Revenue Code	278
Min. Negotiated Rate	$228.69
Max. Negotiated Rate	$762.30
Rate for Payer: Aetna Commercial	$457.38
Rate for Payer: Aetna Medicare Advantage	$457.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$388.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$388.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$304.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$388.77
Rate for Payer: Cigna Commercial	$762.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.95
Rate for Payer: Qualcare PPO/HMO/WC	$228.69

SCREW PANTA PART. THD 5x80MM

Facility

$1,524.60

Hospital Charge Code	270666226
Hospital Revenue Code	278
Min. Negotiated Rate	$228.69
Max. Negotiated Rate	$368.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$304.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$368.95
Rate for Payer: Qualcare PPO/HMO/WC	$228.69

SCREW PARTIALLY THREADED 70MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270659861
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 PARTIALLY THREADED 70MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270659861
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 PARTIAL THREAD 4.5X40MM

Facility

$875.00

Hospital Charge Code	270668301
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW PARTIAL THREAD 4.5X40MM

Facility

$875.00

Hospital Charge Code	270668301
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75

SCREW PART THREADED 3.0X28

Facility

$930.00

Hospital Charge Code	270648822
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$279.00
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

SCREW PART THREADED 3.0X28

Facility

$930.00

Hospital Charge Code	270648822
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$225.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

SCREW PART THREADED 3.0X34

Facility

$930.00

Service Code	HCPCS C1713
Hospital Charge Code	270648823
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$279.00
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

SCREW PART THREADED 3.0X34

Facility

$930.00

Service Code	HCPCS C1713
Hospital Charge Code	270648823
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$225.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

SCREW PART THREADED 3.0X42

Facility

$930.00

Hospital Charge Code	270648821
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$279.00
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

SCREW PART THREADED 3.0X42

Facility

$930.00

Hospital Charge Code	270648821
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$225.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

SCREW PART THRED 4.0x28 345528

Facility

$145.00

Hospital Charge Code	270648058
Hospital Revenue Code	278
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

SCREW PART THRED 4.0x28 345528

Facility

$145.00

Hospital Charge Code	270648058
Hospital Revenue Code	278
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$43.50
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

SCREW PART THRED 4.0x30 345430

Facility

$145.00

Hospital Charge Code	270648063
Hospital Revenue Code	278
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

SCREW PART THRED 4.0x30 345430

Facility

$145.00

Hospital Charge Code	270648063
Hospital Revenue Code	278
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$43.50
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

SCREW PART THRED 4.0x30 345530

Facility

$145.00

Hospital Charge Code	270648057
Hospital Revenue Code	278
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$72.50
Rate for Payer: Aetna Commercial	$43.50
Rate for Payer: Aetna Medicare Advantage	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.98
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.09
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

Know your out-of-pocket cost for care.

All Charges