Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SELF DRILLING 4.0X 14 MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688700
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW SELF DRILLING 4.0X 14 MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270688700
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW SELF-DRILL VAR 4.0X14MM

Facility

$1,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270694189
Hospital Revenue Code	278
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$800.00
Rate for Payer: Aetna Commercial	$480.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$408.00
Rate for Payer: Cigna Commercial	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

SCREW SELF-DRILL VAR 4.0X14MM

Facility

$1,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270694189
Hospital Revenue Code	278
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$387.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

SCREW SELF-DRILL VAR 4.5X14MM

Facility

$1,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270694190
Hospital Revenue Code	278
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$387.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

SCREW SELF-DRILL VAR 4.5X14MM

Facility

$1,600.00

Service Code	HCPCS C1713
Hospital Charge Code	270694190
Hospital Revenue Code	278
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$800.00
Rate for Payer: Aetna Commercial	$480.00
Rate for Payer: Aetna Medicare Advantage	$480.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$408.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$408.00
Rate for Payer: Cigna Commercial	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.20
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

SCREW SELF DRIL VA 17MM 4.5MM

Facility

$2,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270691796
Hospital Revenue Code	278
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$840.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.60
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

SCREW SELF DRIL VA 17MM 4.5MM

Facility

$2,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270691796
Hospital Revenue Code	278
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$677.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.60
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

SCREW SELF DRIL VA 4.5MMX15MM

Facility

$2,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270691797
Hospital Revenue Code	278
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$677.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.60
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

SCREW SELF DRIL VA 4.5MMX15MM

Facility

$2,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270691797
Hospital Revenue Code	278
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$1,400.00
Rate for Payer: Aetna Commercial	$840.00
Rate for Payer: Aetna Medicare Advantage	$840.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$714.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$560.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$714.00
Rate for Payer: Cigna Commercial	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$677.60
Rate for Payer: Qualcare PPO/HMO/WC	$420.00

SCREW SELFDRL VA14MM ATLANTIS

Facility

$2,515.00

Service Code	HCPCS C1713
Hospital Charge Code	270691794
Hospital Revenue Code	278
Min. Negotiated Rate	$377.25
Max. Negotiated Rate	$608.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$503.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$608.63
Rate for Payer: Qualcare PPO/HMO/WC	$377.25

SCREW SELFDRL VA14MM ATLANTIS

Facility

$2,515.00

Service Code	HCPCS C1713
Hospital Charge Code	270691794
Hospital Revenue Code	278
Min. Negotiated Rate	$377.25
Max. Negotiated Rate	$1,257.50
Rate for Payer: Aetna Commercial	$754.50
Rate for Payer: Aetna Medicare Advantage	$754.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$641.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$641.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$503.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$641.33
Rate for Payer: Cigna Commercial	$1,257.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$608.63
Rate for Payer: Qualcare PPO/HMO/WC	$377.25

SCREW SELF STARTING 4.5X 12 MM

Facility

$2,930.00

Service Code	HCPCS C1713
Hospital Charge Code	270689799
Hospital Revenue Code	278
Min. Negotiated Rate	$439.50
Max. Negotiated Rate	$1,465.00
Rate for Payer: Aetna Commercial	$879.00
Rate for Payer: Aetna Medicare Advantage	$879.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$747.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$747.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$586.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$747.15
Rate for Payer: Cigna Commercial	$1,465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$709.06
Rate for Payer: Qualcare PPO/HMO/WC	$439.50

SCREW SELF STARTING 4.5X 12 MM

Facility

$2,930.00

Service Code	HCPCS C1713
Hospital Charge Code	270689799
Hospital Revenue Code	278
Min. Negotiated Rate	$439.50
Max. Negotiated Rate	$709.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$586.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$709.06
Rate for Payer: Qualcare PPO/HMO/WC	$439.50

SCREW SELF-TAP 3.5X14 3235114

Facility

$240.00

Hospital Charge Code	270643382
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$72.00
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

SCREW SELF-TAP 3.5X14 3235114

Facility

$240.00

Hospital Charge Code	270643382
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

SCREW SELF-TAP 3.5X16 3235116

Facility

$240.00

Hospital Charge Code	270643383
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

SCREW SELF-TAP 3.5X16 3235116

Facility

$240.00

Hospital Charge Code	270643383
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$72.00
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

SCREW SELF-TAP 3.5X20 3235120

Facility

$240.00

Hospital Charge Code	270643384
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

SCREW SELF-TAP 3.5X20 3235120

Facility

$240.00

Hospital Charge Code	270643384
Hospital Revenue Code	278
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$72.00
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.08
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

SCREW SELF-TAP 3.5X30 3235130

Facility

$295.00

Hospital Charge Code	270643385
Hospital Revenue Code	278
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$71.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

SCREW SELF-TAP 3.5X30 3235130

Facility

$295.00

Hospital Charge Code	270643385
Hospital Revenue Code	278
Min. Negotiated Rate	$44.25
Max. Negotiated Rate	$147.50
Rate for Payer: Aetna Commercial	$88.50
Rate for Payer: Aetna Medicare Advantage	$88.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.22
Rate for Payer: Cigna Commercial	$147.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.39
Rate for Payer: Qualcare PPO/HMO/WC	$44.25

SCREW SELF TAP CAR 4.0X14MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692536
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$625.00
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
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW SELF TAP CAR 4.0X14MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270692536
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 SELFTAP CORT 4.5mm 56mm

Facility

$40.85

Hospital Charge Code	270613663
Hospital Revenue Code	278
Min. Negotiated Rate	$6.13
Max. Negotiated Rate	$9.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.89
Rate for Payer: Qualcare PPO/HMO/WC	$6.13

Know your out-of-pocket cost for care.

All Charges