Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SPINAL STFA GRUVE 4X18MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698921
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 SPINAL TI ALLOY DTRAX

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692494
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

SCREW SPINAL TI ALLOY DTRAX

Facility

$7,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270692494
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,100.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

SCREW SPINAL VAR SD 3.5X12MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694922
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$300.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW SPINAL VAR SD 3.5X12MM

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270694922
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SCREW SPIN DIAM 2MM LG 12MM

Facility

$1,477.45

Hospital Charge Code	270660951
Hospital Revenue Code	278
Min. Negotiated Rate	$221.62
Max. Negotiated Rate	$738.73
Rate for Payer: Aetna Commercial	$443.24
Rate for Payer: Aetna Medicare Advantage	$443.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.75
Rate for Payer: Cigna Commercial	$738.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$357.54
Rate for Payer: Qualcare PPO/HMO/WC	$221.62

SCREW SPIN DIAM 2MM LG 12MM

Facility

$1,477.45

Hospital Charge Code	270660951
Hospital Revenue Code	278
Min. Negotiated Rate	$221.62
Max. Negotiated Rate	$357.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$357.54
Rate for Payer: Qualcare PPO/HMO/WC	$221.62

SCREW SPIN DIAM 2MM LG 14MM

Facility

$1,477.45

Hospital Charge Code	270660950
Hospital Revenue Code	278
Min. Negotiated Rate	$221.62
Max. Negotiated Rate	$357.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$357.54
Rate for Payer: Qualcare PPO/HMO/WC	$221.62

SCREW SPIN DIAM 2MM LG 14MM

Facility

$1,477.45

Hospital Charge Code	270660950
Hospital Revenue Code	278
Min. Negotiated Rate	$221.62
Max. Negotiated Rate	$738.73
Rate for Payer: Aetna Commercial	$443.24
Rate for Payer: Aetna Medicare Advantage	$443.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.75
Rate for Payer: Cigna Commercial	$738.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$357.54
Rate for Payer: Qualcare PPO/HMO/WC	$221.62

SCREW SPINE OC 4.5 X 6 MM

Facility

$1,505.00

Service Code	HCPCS C1713
Hospital Charge Code	270683736
Hospital Revenue Code	278
Min. Negotiated Rate	$225.75
Max. Negotiated Rate	$364.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.21
Rate for Payer: Qualcare PPO/HMO/WC	$225.75

SCREW SPINE OC 4.5 X 6 MM

Facility

$1,505.00

Service Code	HCPCS C1713
Hospital Charge Code	270683736
Hospital Revenue Code	278
Min. Negotiated Rate	$225.75
Max. Negotiated Rate	$752.50
Rate for Payer: Aetna Commercial	$451.50
Rate for Payer: Aetna Medicare Advantage	$451.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$383.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$383.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$301.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$383.77
Rate for Payer: Cigna Commercial	$752.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$364.21
Rate for Payer: Qualcare PPO/HMO/WC	$225.75

SCREW SPINE OC 5.25 X 10 MM

Facility

$1,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270683738
Hospital Revenue Code	278
Min. Negotiated Rate	$241.50
Max. Negotiated Rate	$389.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.62
Rate for Payer: Qualcare PPO/HMO/WC	$241.50

SCREW SPINE OC 5.25 X 10 MM

Facility

$1,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270683738
Hospital Revenue Code	278
Min. Negotiated Rate	$241.50
Max. Negotiated Rate	$805.00
Rate for Payer: Aetna Commercial	$483.00
Rate for Payer: Aetna Medicare Advantage	$483.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.55
Rate for Payer: Cigna Commercial	$805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.62
Rate for Payer: Qualcare PPO/HMO/WC	$241.50

SCREW SPINE OC 5.25 X 8 MM

Facility

$1,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270683737
Hospital Revenue Code	278
Min. Negotiated Rate	$241.50
Max. Negotiated Rate	$389.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.62
Rate for Payer: Qualcare PPO/HMO/WC	$241.50

SCREW SPINE OC 5.25 X 8 MM

Facility

$1,610.00

Service Code	HCPCS C1713
Hospital Charge Code	270683737
Hospital Revenue Code	278
Min. Negotiated Rate	$241.50
Max. Negotiated Rate	$805.00
Rate for Payer: Aetna Commercial	$483.00
Rate for Payer: Aetna Medicare Advantage	$483.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$322.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.55
Rate for Payer: Cigna Commercial	$805.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.62
Rate for Payer: Qualcare PPO/HMO/WC	$241.50

SCREW SPIN TI CA SD 4.6X15MM

Facility

$1,365.90

Service Code	HCPCS C1713
Hospital Charge Code	270693878
Hospital Revenue Code	278
Min. Negotiated Rate	$204.88
Max. Negotiated Rate	$330.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.55
Rate for Payer: Qualcare PPO/HMO/WC	$204.88

SCREW SPIN TI CA SD 4.6X15MM

Facility

$1,365.90

Service Code	HCPCS C1713
Hospital Charge Code	270693878
Hospital Revenue Code	278
Min. Negotiated Rate	$204.88
Max. Negotiated Rate	$682.95
Rate for Payer: Aetna Commercial	$409.77
Rate for Payer: Aetna Medicare Advantage	$409.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$348.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$348.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$348.30
Rate for Payer: Cigna Commercial	$682.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.55
Rate for Payer: Qualcare PPO/HMO/WC	$204.88

SCREW SPNL CORT FIX 5X26MM

Facility

$7,836.15

Service Code	HCPCS C1713
Hospital Charge Code	270693345
Hospital Revenue Code	278
Min. Negotiated Rate	$1,175.42
Max. Negotiated Rate	$3,918.07
Rate for Payer: Aetna Commercial	$2,350.84
Rate for Payer: Aetna Medicare Advantage	$2,350.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,998.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,998.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,567.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,998.22
Rate for Payer: Cigna Commercial	$3,918.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,896.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,175.42

SCREW SPNL CORT FIX 5X26MM

Facility

$7,836.15

Service Code	HCPCS C1713
Hospital Charge Code	270693345
Hospital Revenue Code	278
Min. Negotiated Rate	$1,175.42
Max. Negotiated Rate	$1,896.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,567.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,896.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,175.42

SCREW SPNL CORT FIX 5X30MM

Facility

$7,836.15

Service Code	HCPCS C1713
Hospital Charge Code	270693344
Hospital Revenue Code	278
Min. Negotiated Rate	$1,175.42
Max. Negotiated Rate	$3,918.07
Rate for Payer: Aetna Commercial	$2,350.84
Rate for Payer: Aetna Medicare Advantage	$2,350.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,998.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,998.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,567.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,998.22
Rate for Payer: Cigna Commercial	$3,918.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,896.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,175.42

SCREW SPNL CORT FIX 5X30MM

Facility

$7,836.15

Service Code	HCPCS C1713
Hospital Charge Code	270693344
Hospital Revenue Code	278
Min. Negotiated Rate	$1,175.42
Max. Negotiated Rate	$1,896.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,567.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,896.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,175.42

SCREW SPNL FXD 3.75X14MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270699547
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$1,650.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

SCREW SPNL FXD 3.75X14MM

Facility

$5,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270699547
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

SCREW SPNL HD PLYAX HD MARINER

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270695154
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW SPNL HD PLYAX HD MARINER

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270695154
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$1,612.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

Know your out-of-pocket cost for care.

All Charges