Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SHANK RELINE 7.5X45MM 2C

Facility

$3,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270692445
Hospital Revenue Code	278
Min. Negotiated Rate	$453.75
Max. Negotiated Rate	$732.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$605.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$732.05
Rate for Payer: Qualcare PPO/HMO/WC	$453.75

SCREW SHEATH 4.0 75MM

Facility

$2,695.00

Service Code	HCPCS C1713
Hospital Charge Code	270687082
Hospital Revenue Code	278
Min. Negotiated Rate	$404.25
Max. Negotiated Rate	$652.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$539.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$652.19
Rate for Payer: Qualcare PPO/HMO/WC	$404.25

SCREW SHEATH 4.0 75MM

Facility

$2,695.00

Service Code	HCPCS C1713
Hospital Charge Code	270687082
Hospital Revenue Code	278
Min. Negotiated Rate	$404.25
Max. Negotiated Rate	$1,347.50
Rate for Payer: Aetna Commercial	$808.50
Rate for Payer: Aetna Medicare Advantage	$808.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$687.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$687.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$539.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$687.23
Rate for Payer: Cigna Commercial	$1,347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$652.19
Rate for Payer: Qualcare PPO/HMO/WC	$404.25

SCREW SHEATH 4.0 X 50MM

Facility

$2,680.00

Service Code	HCPCS C1713
Hospital Charge Code	270687086
Hospital Revenue Code	278
Min. Negotiated Rate	$402.00
Max. Negotiated Rate	$648.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$536.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.56
Rate for Payer: Qualcare PPO/HMO/WC	$402.00

SCREW SHEATH 4.0 X 50MM

Facility

$2,680.00

Service Code	HCPCS C1713
Hospital Charge Code	270687086
Hospital Revenue Code	278
Min. Negotiated Rate	$402.00
Max. Negotiated Rate	$1,340.00
Rate for Payer: Aetna Commercial	$804.00
Rate for Payer: Aetna Medicare Advantage	$804.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$683.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$683.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$683.40
Rate for Payer: Cigna Commercial	$1,340.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$648.56
Rate for Payer: Qualcare PPO/HMO/WC	$402.00

SCREW SHEATH 7.3 X 55MM

Facility

$2,695.00

Service Code	HCPCS C1713
Hospital Charge Code	270687083
Hospital Revenue Code	278
Min. Negotiated Rate	$404.25
Max. Negotiated Rate	$1,347.50
Rate for Payer: Aetna Commercial	$808.50
Rate for Payer: Aetna Medicare Advantage	$808.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$687.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$687.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$539.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$687.23
Rate for Payer: Cigna Commercial	$1,347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$652.19
Rate for Payer: Qualcare PPO/HMO/WC	$404.25

SCREW SHEATH 7.3 X 55MM

Facility

$2,695.00

Service Code	HCPCS C1713
Hospital Charge Code	270687083
Hospital Revenue Code	278
Min. Negotiated Rate	$404.25
Max. Negotiated Rate	$652.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$539.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$652.19
Rate for Payer: Qualcare PPO/HMO/WC	$404.25

SCREW SHORT 2.5 X 17MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701200
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$288.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW SHORT 2.5 X 17MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701200
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW SHORT THD 4x24MM

Facility

$1,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270674312
Hospital Revenue Code	278
Min. Negotiated Rate	$170.25
Max. Negotiated Rate	$567.50
Rate for Payer: Aetna Commercial	$340.50
Rate for Payer: Aetna Medicare Advantage	$340.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$289.43
Rate for Payer: Cigna Commercial	$567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.67
Rate for Payer: Qualcare PPO/HMO/WC	$170.25

SCREW SHORT THD 4x24MM

Facility

$1,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270674312
Hospital Revenue Code	278
Min. Negotiated Rate	$170.25
Max. Negotiated Rate	$274.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.67
Rate for Payer: Qualcare PPO/HMO/WC	$170.25

SCREW SHORT THD 4x28MM

Facility

$1,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270674311
Hospital Revenue Code	278
Min. Negotiated Rate	$170.25
Max. Negotiated Rate	$274.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.67
Rate for Payer: Qualcare PPO/HMO/WC	$170.25

SCREW SHORT THD 4x28MM

Facility

$1,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270674311
Hospital Revenue Code	278
Min. Negotiated Rate	$170.25
Max. Negotiated Rate	$567.50
Rate for Payer: Aetna Commercial	$340.50
Rate for Payer: Aetna Medicare Advantage	$340.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$289.43
Rate for Payer: Cigna Commercial	$567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.67
Rate for Payer: Qualcare PPO/HMO/WC	$170.25

SCREW SHORT THD 4x32MM

Facility

$1,135.00

Hospital Charge Code	270656797
Hospital Revenue Code	278
Min. Negotiated Rate	$170.25
Max. Negotiated Rate	$274.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.67
Rate for Payer: Qualcare PPO/HMO/WC	$170.25

SCREW SHORT THD 4x32MM

Facility

$1,135.00

Hospital Charge Code	270656797
Hospital Revenue Code	278
Min. Negotiated Rate	$170.25
Max. Negotiated Rate	$567.50
Rate for Payer: Aetna Commercial	$340.50
Rate for Payer: Aetna Medicare Advantage	$340.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$289.43
Rate for Payer: Cigna Commercial	$567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.67
Rate for Payer: Qualcare PPO/HMO/WC	$170.25

SCREW SHORT THREAD 6.2 X 56 MM

Facility

$3,231.25

Service Code	HCPCS C1713
Hospital Charge Code	270701365
Hospital Revenue Code	278
Min. Negotiated Rate	$484.69
Max. Negotiated Rate	$781.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.96
Rate for Payer: Qualcare PPO/HMO/WC	$484.69

SCREW SHORT THREAD 6.2 X 56 MM

Facility

$3,231.25

Service Code	HCPCS C1713
Hospital Charge Code	270701365
Hospital Revenue Code	278
Min. Negotiated Rate	$484.69
Max. Negotiated Rate	$1,615.62
Rate for Payer: Aetna Commercial	$969.38
Rate for Payer: Aetna Medicare Advantage	$969.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$823.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$823.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$646.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$823.97
Rate for Payer: Cigna Commercial	$1,615.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$781.96
Rate for Payer: Qualcare PPO/HMO/WC	$484.69

SCREW SHRF GAMMA LAG 12/90MM

Facility

$1,447.25

Hospital Charge Code	270601378
Hospital Revenue Code	278
Min. Negotiated Rate	$217.09
Max. Negotiated Rate	$723.62
Rate for Payer: Aetna Commercial	$434.18
Rate for Payer: Aetna Medicare Advantage	$434.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.05
Rate for Payer: Cigna Commercial	$723.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.23
Rate for Payer: Qualcare PPO/HMO/WC	$217.09

SCREW SHRF GAMMA LAG 12/90MM

Facility

$1,447.25

Hospital Charge Code	270601378
Hospital Revenue Code	278
Min. Negotiated Rate	$217.09
Max. Negotiated Rate	$350.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.23
Rate for Payer: Qualcare PPO/HMO/WC	$217.09

SCREW SHRF GAMMA SET

Facility

$396.85

Hospital Charge Code	270601377
Hospital Revenue Code	278
Min. Negotiated Rate	$59.53
Max. Negotiated Rate	$96.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.04
Rate for Payer: Qualcare PPO/HMO/WC	$59.53

SCREW SHRF GAMMA SET

Facility

$396.85

Hospital Charge Code	270601377
Hospital Revenue Code	278
Min. Negotiated Rate	$59.53
Max. Negotiated Rate	$198.43
Rate for Payer: Aetna Commercial	$119.06
Rate for Payer: Aetna Medicare Advantage	$119.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$79.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.20
Rate for Payer: Cigna Commercial	$198.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.04
Rate for Payer: Qualcare PPO/HMO/WC	$59.53

SCREW SI 14MM

Facility

$600.00

Hospital Charge Code	270703568
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 SI 14MM

Facility

$600.00

Hospital Charge Code	270703568
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 SI 5.5 POLYAX 7X45MM

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698986
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$1,800.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

SCREW SI 5.5 POLYAX 7X45MM

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270698986
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

Know your out-of-pocket cost for care.

All Charges