Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SP PED MAXCESS-C 14MM

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270693751
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$205.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCREW SP PED MAXCESS-C 14MM

Facility

$850.00

Service Code	HCPCS C1713
Hospital Charge Code	270693751
Hospital Revenue Code	278
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$255.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$205.70
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SCREW S/S 4.0 x 12mm 20114012D

Facility

$2,970.00

Hospital Charge Code	270648862
Hospital Revenue Code	278
Min. Negotiated Rate	$445.50
Max. Negotiated Rate	$718.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$594.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$718.74
Rate for Payer: Qualcare PPO/HMO/WC	$445.50

SCREW S/S 4.0 x 12mm 20114012D

Facility

$2,970.00

Hospital Charge Code	270648862
Hospital Revenue Code	278
Min. Negotiated Rate	$445.50
Max. Negotiated Rate	$1,485.00
Rate for Payer: Aetna Commercial	$891.00
Rate for Payer: Aetna Medicare Advantage	$891.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$757.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$757.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$594.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$757.35
Rate for Payer: Cigna Commercial	$1,485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$718.74
Rate for Payer: Qualcare PPO/HMO/WC	$445.50

SCREW SS CMP KREULOCK 3.5X14MM

Facility

$1,599.00

Service Code	HCPCS C1713
Hospital Charge Code	270700081
Hospital Revenue Code	278
Min. Negotiated Rate	$239.85
Max. Negotiated Rate	$799.50
Rate for Payer: Aetna Commercial	$479.70
Rate for Payer: Aetna Medicare Advantage	$479.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$407.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$407.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$319.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$407.75
Rate for Payer: Cigna Commercial	$799.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.96
Rate for Payer: Qualcare PPO/HMO/WC	$239.85

SCREW SS CMP KREULOCK 3.5X14MM

Facility

$1,599.00

Service Code	HCPCS C1713
Hospital Charge Code	270700081
Hospital Revenue Code	278
Min. Negotiated Rate	$239.85
Max. Negotiated Rate	$386.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$319.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$386.96
Rate for Payer: Qualcare PPO/HMO/WC	$239.85

SCREWS SET

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270681179
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

SCREWS SET

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270681179
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 STALIF C ABO 4MM X 15

Facility

$3,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270667978
Hospital Revenue Code	278
Min. Negotiated Rate	$461.25
Max. Negotiated Rate	$744.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$615.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.15
Rate for Payer: Qualcare PPO/HMO/WC	$461.25

SCREW STALIF C ABO 4MM X 15

Facility

$3,075.00

Service Code	HCPCS C1713
Hospital Charge Code	270667978
Hospital Revenue Code	278
Min. Negotiated Rate	$461.25
Max. Negotiated Rate	$1,537.50
Rate for Payer: Aetna Commercial	$922.50
Rate for Payer: Aetna Medicare Advantage	$922.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$784.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$784.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$615.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$784.12
Rate for Payer: Cigna Commercial	$1,537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$744.15
Rate for Payer: Qualcare PPO/HMO/WC	$461.25

SCREW STALIF C ABO 4X13CM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270693226
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

SCREW STALIF C ABO 4X13CM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270693226
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$450.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

SCREW STALIF C CERV ABO 4X14MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270695144
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$450.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

SCREW STALIF C CERV ABO 4X14MM

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270695144
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

SCREW S/TAPPING 5.0x14MM STER

Facility

$1,257.00

Hospital Charge Code	270677139
Hospital Revenue Code	278
Min. Negotiated Rate	$188.55
Max. Negotiated Rate	$628.50
Rate for Payer: Aetna Commercial	$377.10
Rate for Payer: Aetna Medicare Advantage	$377.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.54
Rate for Payer: Cigna Commercial	$628.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.19
Rate for Payer: Qualcare PPO/HMO/WC	$188.55

SCREW S/TAPPING 5.0x14MM STER

Facility

$1,257.00

Hospital Charge Code	270677139
Hospital Revenue Code	278
Min. Negotiated Rate	$188.55
Max. Negotiated Rate	$304.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.19
Rate for Payer: Qualcare PPO/HMO/WC	$188.55

SCREW S/TAPPING 5.0x16MM STER

Facility

$1,257.00

Hospital Charge Code	270677140
Hospital Revenue Code	278
Min. Negotiated Rate	$188.55
Max. Negotiated Rate	$304.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.19
Rate for Payer: Qualcare PPO/HMO/WC	$188.55

SCREW S/TAPPING 5.0x16MM STER

Facility

$1,257.00

Hospital Charge Code	270677140
Hospital Revenue Code	278
Min. Negotiated Rate	$188.55
Max. Negotiated Rate	$628.50
Rate for Payer: Aetna Commercial	$377.10
Rate for Payer: Aetna Medicare Advantage	$377.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.54
Rate for Payer: Cigna Commercial	$628.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.19
Rate for Payer: Qualcare PPO/HMO/WC	$188.55

SCREW S/TAPPING 5.0x18MM STER

Facility

$1,257.00

Hospital Charge Code	270677141
Hospital Revenue Code	278
Min. Negotiated Rate	$188.55
Max. Negotiated Rate	$628.50
Rate for Payer: Aetna Commercial	$377.10
Rate for Payer: Aetna Medicare Advantage	$377.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$320.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$320.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$320.54
Rate for Payer: Cigna Commercial	$628.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.19
Rate for Payer: Qualcare PPO/HMO/WC	$188.55

SCREW S/TAPPING 5.0x18MM STER

Facility

$1,257.00

Hospital Charge Code	270677141
Hospital Revenue Code	278
Min. Negotiated Rate	$188.55
Max. Negotiated Rate	$304.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.19
Rate for Payer: Qualcare PPO/HMO/WC	$188.55

SCREW STAR DRIVER 5.0 MM 12 MM

Facility

$1,296.15

Service Code	HCPCS C1713
Hospital Charge Code	270691469
Hospital Revenue Code	278
Min. Negotiated Rate	$194.42
Max. Negotiated Rate	$313.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.67
Rate for Payer: Qualcare PPO/HMO/WC	$194.42

SCREW STAR DRIVER 5.0 MM 12 MM

Facility

$1,296.15

Service Code	HCPCS C1713
Hospital Charge Code	270691469
Hospital Revenue Code	278
Min. Negotiated Rate	$194.42
Max. Negotiated Rate	$648.08
Rate for Payer: Aetna Commercial	$388.85
Rate for Payer: Aetna Medicare Advantage	$388.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$330.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$330.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$259.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$330.52
Rate for Payer: Cigna Commercial	$648.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.67
Rate for Payer: Qualcare PPO/HMO/WC	$194.42

SCREW STD SELF DRILL 3.5X12MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695548
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 STD SELF DRILL 3.5X12MM

Facility

$6,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270695548
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 ST FA RESCUE 4.5X18MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270700538
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

Know your out-of-pocket cost for care.

All Charges