Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW SYN TTN 3.5X24MM

Facility

$36.00

Service Code	HCPCS C1713
Hospital Charge Code	270601849
Hospital Revenue Code	278
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.71
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

SCREW SYN TTN 3.5X24MM

Facility

$36.00

Service Code	HCPCS C1713
Hospital Charge Code	270601849
Hospital Revenue Code	278
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$18.00
Rate for Payer: Aetna Commercial	$10.80
Rate for Payer: Aetna Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.18
Rate for Payer: Cigna Commercial	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.71
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

SCREW T10 3.5MM X 36 MM

Facility

$2,015.00

Service Code	HCPCS C1713
Hospital Charge Code	270701154
Hospital Revenue Code	278
Min. Negotiated Rate	$302.25
Max. Negotiated Rate	$487.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$403.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.63
Rate for Payer: Qualcare PPO/HMO/WC	$302.25

SCREW T10 3.5MM X 36 MM

Facility

$2,015.00

Service Code	HCPCS C1713
Hospital Charge Code	270701154
Hospital Revenue Code	278
Min. Negotiated Rate	$302.25
Max. Negotiated Rate	$1,007.50
Rate for Payer: Aetna Commercial	$604.50
Rate for Payer: Aetna Medicare Advantage	$604.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$513.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$513.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$403.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$513.83
Rate for Payer: Cigna Commercial	$1,007.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.63
Rate for Payer: Qualcare PPO/HMO/WC	$302.25

SCREW T15 3.5 X 16 MUL PAK

Facility

$1,000.00

Hospital Charge Code	270703588
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 T15 3.5 X 16 MUL PAK

Facility

$1,000.00

Hospital Charge Code	270703588
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 T15 CORTEX 3.5 X 18MM

Facility

$700.00

Hospital Charge Code	270703587
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW T15 CORTEX 3.5 X 18MM

Facility

$700.00

Hospital Charge Code	270703587
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$210.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW T15 LP CORT 3.5 X 14 MM

Facility

$700.00

Hospital Charge Code	270703585
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$210.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW T15 LP CORT 3.5 X 14 MM

Facility

$700.00

Hospital Charge Code	270703585
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW T15 LP CORT 3.5 X 16MM

Facility

$700.00

Hospital Charge Code	270703586
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW T15 LP CORT 3.5 X 16MM

Facility

$700.00

Hospital Charge Code	270703586
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$210.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SCREW T15 LP CORT 3.5X20MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270686579
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

SCREW T15 LP CORT 3.5X20MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270686579
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$66.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

SCREW T15 LP CORT 3.5X24MM NS

Facility

$234.00

Service Code	HCPCS C1713
Hospital Charge Code	270680845
Hospital Revenue Code	278
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$56.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.63
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

SCREW T15 LP CORT 3.5X24MM NS

Facility

$234.00

Service Code	HCPCS C1713
Hospital Charge Code	270680845
Hospital Revenue Code	278
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$117.00
Rate for Payer: Aetna Commercial	$70.20
Rate for Payer: Aetna Medicare Advantage	$70.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.67
Rate for Payer: Cigna Commercial	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.63
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

SCREW T15 LP CORT 3.5X26MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270680678
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

SCREW T15 LP CORT 3.5X26MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270680678
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$66.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

SCREW T15 LP CORT 3.5X30MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270680677
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

SCREW T15 LP CORT 3.5X30MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270680677
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$66.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

SCREW T15 LP CORT 3.5X32MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270686580
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$66.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

SCREW T15 LP CORT 3.5X32MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270686580
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

SCREW T15 LP CORT 3.5X36MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270686581
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$137.50
Rate for Payer: Aetna Commercial	$82.50
Rate for Payer: Aetna Medicare Advantage	$82.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.12
Rate for Payer: Cigna Commercial	$137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

SCREW T15 LP CORT 3.5X36MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270686581
Hospital Revenue Code	278
Min. Negotiated Rate	$41.25
Max. Negotiated Rate	$66.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.25

SCREW T15 LP CORT 3.5X46MM NS

Facility

$234.00

Service Code	HCPCS C1713
Hospital Charge Code	270680846
Hospital Revenue Code	278
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$117.00
Rate for Payer: Aetna Commercial	$70.20
Rate for Payer: Aetna Medicare Advantage	$70.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.67
Rate for Payer: Cigna Commercial	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.63
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

Know your out-of-pocket cost for care.

All Charges