Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SCHANZ SD 4.0X125 SS

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270699299
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$187.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW SCHANZ SD 5.0X175 SS

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270699300
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

SCREW SCHANZ SD 5.0X175 SS

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270699300
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$187.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW SCHANZ SD THRD 6.0X175MM

Facility

$1,067.80

Service Code	HCPCS C1713
Hospital Charge Code	270697237
Hospital Revenue Code	278
Min. Negotiated Rate	$160.17
Max. Negotiated Rate	$533.90
Rate for Payer: Aetna Commercial	$320.34
Rate for Payer: Aetna Medicare Advantage	$320.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.29
Rate for Payer: Cigna Commercial	$533.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.41
Rate for Payer: Qualcare PPO/HMO/WC	$160.17

SCREW SCHANZ SD THRD 6.0X175MM

Facility

$1,067.80

Service Code	HCPCS C1713
Hospital Charge Code	270697237
Hospital Revenue Code	278
Min. Negotiated Rate	$160.17
Max. Negotiated Rate	$258.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.41
Rate for Payer: Qualcare PPO/HMO/WC	$160.17

SCREW SCHANZ SLF DRILL 5x175MM

Facility

$891.00

Service Code	HCPCS C1713
Hospital Charge Code	270675471
Hospital Revenue Code	278
Min. Negotiated Rate	$133.65
Max. Negotiated Rate	$445.50
Rate for Payer: Aetna Commercial	$267.30
Rate for Payer: Aetna Medicare Advantage	$267.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.21
Rate for Payer: Cigna Commercial	$445.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.62
Rate for Payer: Qualcare PPO/HMO/WC	$133.65

SCREW SCHANZ SLF DRILL 5x175MM

Facility

$891.00

Service Code	HCPCS C1713
Hospital Charge Code	270675471
Hospital Revenue Code	278
Min. Negotiated Rate	$133.65
Max. Negotiated Rate	$215.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.62
Rate for Payer: Qualcare PPO/HMO/WC	$133.65

SCREW SCHANZ SLF DRILL 5x200MM

Facility

$891.00

Service Code	HCPCS C1713
Hospital Charge Code	270675470
Hospital Revenue Code	278
Min. Negotiated Rate	$133.65
Max. Negotiated Rate	$445.50
Rate for Payer: Aetna Commercial	$267.30
Rate for Payer: Aetna Medicare Advantage	$267.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$227.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$227.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$227.21
Rate for Payer: Cigna Commercial	$445.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.62
Rate for Payer: Qualcare PPO/HMO/WC	$133.65

SCREW SCHANZ SLF DRILL 5x200MM

Facility

$891.00

Service Code	HCPCS C1713
Hospital Charge Code	270675470
Hospital Revenue Code	278
Min. Negotiated Rate	$133.65
Max. Negotiated Rate	$215.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$178.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.62
Rate for Payer: Qualcare PPO/HMO/WC	$133.65

SCREW SCHANZ WITH ADP 4.0MM

Facility

$786.00

Service Code	HCPCS C1713
Hospital Charge Code	270661253
Hospital Revenue Code	278
Min. Negotiated Rate	$117.90
Max. Negotiated Rate	$190.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.21
Rate for Payer: Qualcare PPO/HMO/WC	$117.90

SCREW SCHANZ WITH ADP 4.0MM

Facility

$786.00

Service Code	HCPCS C1713
Hospital Charge Code	270661253
Hospital Revenue Code	278
Min. Negotiated Rate	$117.90
Max. Negotiated Rate	$393.00
Rate for Payer: Aetna Commercial	$235.80
Rate for Payer: Aetna Medicare Advantage	$235.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$200.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$200.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$157.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$200.43
Rate for Payer: Cigna Commercial	$393.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.21
Rate for Payer: Qualcare PPO/HMO/WC	$117.90

SCREW S.D. 16MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270668254
Hospital Revenue Code	278
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$332.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

SCREW S.D. 16MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270668254
Hospital Revenue Code	278
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$412.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.75
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

SCREW SD 16MM

Facility

$730.00

Service Code	HCPCS C1713
Hospital Charge Code	270705064
Hospital Revenue Code	278
Min. Negotiated Rate	$109.50
Max. Negotiated Rate	$176.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.66
Rate for Payer: Qualcare PPO/HMO/WC	$109.50

SCREW SD 16MM

Facility

$730.00

Service Code	HCPCS C1713
Hospital Charge Code	270705064
Hospital Revenue Code	278
Min. Negotiated Rate	$109.50
Max. Negotiated Rate	$365.00
Rate for Payer: Aetna Commercial	$219.00
Rate for Payer: Aetna Medicare Advantage	$219.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$186.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$146.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$186.15
Rate for Payer: Cigna Commercial	$365.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.66
Rate for Payer: Qualcare PPO/HMO/WC	$109.50

SCREW SD 3.5X12MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270699101
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$254.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW SD 3.5X12MM

Facility

$1,050.00

Service Code	HCPCS C1713
Hospital Charge Code	270699101
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$525.00
Rate for Payer: Aetna Commercial	$315.00
Rate for Payer: Aetna Medicare Advantage	$315.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$267.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$267.75
Rate for Payer: Cigna Commercial	$525.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$254.10
Rate for Payer: Qualcare PPO/HMO/WC	$157.50

SCREW SD DAKOTA 3.5X12MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270696091
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW SD DAKOTA 3.5X12MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270696091
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,025.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW SD DAKOTA 3.5X14MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697665
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,025.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW SD DAKOTA 3.5X14MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697665
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW SD DAKOTA ACDF 4X12MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697751
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,633.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW SD DAKOTA ACDF 4X12MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270697751
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,025.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,633.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

SCREW SD FIXED 4.0X14MM

Facility

$2,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270695867
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

SCREW SD FIXED 4.0X14MM

Facility

$2,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270695867
Hospital Revenue Code	278
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$508.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
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