Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW PEEK 10 X 12 MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688310
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW PEEK 10 X 12 MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270688310
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW PEEK 5.5 X 15MM

Facility

$1,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270688397
Hospital Revenue Code	278
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$477.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.95
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

SCREW PEEK 5.5 X 15MM

Facility

$1,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270688397
Hospital Revenue Code	278
Min. Negotiated Rate	$296.25
Max. Negotiated Rate	$987.50
Rate for Payer: Aetna Commercial	$592.50
Rate for Payer: Aetna Medicare Advantage	$592.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.62
Rate for Payer: Cigna Commercial	$987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.95
Rate for Payer: Qualcare PPO/HMO/WC	$296.25

SCREW PEEK 7X20MM PEEK NON VEN

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270691000
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW PEEK 7X20MM PEEK NON VEN

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270691000
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW PEEK IF NON VENT 8X20MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693723
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW PEEK IF NON VENT 8X20MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270693723
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW PEEK INTER 4.5X15MM STRL

Facility

$2,461.25

Hospital Charge Code	270701720
Hospital Revenue Code	278
Min. Negotiated Rate	$369.19
Max. Negotiated Rate	$595.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$492.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$595.62
Rate for Payer: Qualcare PPO/HMO/WC	$369.19

SCREW PEEK INTER 4.5X15MM STRL

Facility

$2,461.25

Hospital Charge Code	270701720
Hospital Revenue Code	278
Min. Negotiated Rate	$369.19
Max. Negotiated Rate	$1,230.62
Rate for Payer: Aetna Commercial	$738.38
Rate for Payer: Aetna Medicare Advantage	$738.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$627.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$627.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$492.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$627.62
Rate for Payer: Cigna Commercial	$1,230.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$595.62
Rate for Payer: Qualcare PPO/HMO/WC	$369.19

SCREW PEEK INTER 7.0X23.MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270675568
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 PEEK INTER 7.0X23.MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270675568
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$625.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
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

SCREW PEEK TENO VENT

Facility

$1,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270691579
Hospital Revenue Code	278
Min. Negotiated Rate	$236.25
Max. Negotiated Rate	$787.50
Rate for Payer: Aetna Commercial	$472.50
Rate for Payer: Aetna Medicare Advantage	$472.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$401.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$401.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$401.62
Rate for Payer: Cigna Commercial	$787.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.15
Rate for Payer: Qualcare PPO/HMO/WC	$236.25

SCREW PEEK TENO VENT

Facility

$1,575.00

Service Code	HCPCS C1713
Hospital Charge Code	270691579
Hospital Revenue Code	278
Min. Negotiated Rate	$236.25
Max. Negotiated Rate	$381.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$315.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$381.15
Rate for Payer: Qualcare PPO/HMO/WC	$236.25

SCREW PEG 2.5x20MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270648152
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG 2.5x20MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270648152
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$175.50
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG 2.5x22MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270648153
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$175.50
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG 2.5x22MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270648153
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG 2.5x26MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270648155
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$175.50
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG 2.5x26MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270648155
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG 2.5x30MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270671104
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG 2.5x30MM PARTIAL THD

Facility

$585.00

Hospital Charge Code	270671104
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$175.50
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG NON LOCKING 2.5x14mm

Facility

$585.00

Hospital Charge Code	270671836
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$141.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG NON LOCKING 2.5x14mm

Facility

$585.00

Hospital Charge Code	270671836
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$175.50
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

SCREW PEG NON LOCKING 2.5X26MM

Facility

$585.00

Hospital Charge Code	270671105
Hospital Revenue Code	278
Min. Negotiated Rate	$87.75
Max. Negotiated Rate	$292.50
Rate for Payer: Aetna Commercial	$175.50
Rate for Payer: Aetna Medicare Advantage	$175.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.18
Rate for Payer: Cigna Commercial	$292.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.57
Rate for Payer: Qualcare PPO/HMO/WC	$87.75

Know your out-of-pocket cost for care.

All Charges