Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 3.5X52MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270686582
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 3.5X52MM NS

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	270686582
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 CPORT 3.5 X 12 MM

Facility

$700.00

Hospital Charge Code	270703584
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 CPORT 3.5 X 12 MM

Facility

$700.00

Hospital Charge Code	270703584
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 MD 3.5X34MM NS

Facility

$572.00

Service Code	HCPCS C1713
Hospital Charge Code	270680843
Hospital Revenue Code	278
Min. Negotiated Rate	$85.80
Max. Negotiated Rate	$138.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.42
Rate for Payer: Qualcare PPO/HMO/WC	$85.80

SCREW T15 MD 3.5X34MM NS

Facility

$572.00

Service Code	HCPCS C1713
Hospital Charge Code	270680843
Hospital Revenue Code	278
Min. Negotiated Rate	$85.80
Max. Negotiated Rate	$286.00
Rate for Payer: Aetna Commercial	$171.60
Rate for Payer: Aetna Medicare Advantage	$171.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.86
Rate for Payer: Cigna Commercial	$286.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.42
Rate for Payer: Qualcare PPO/HMO/WC	$85.80

SCREW T15 MD 3.5X36MM NS

Facility

$852.50

Service Code	HCPCS C1713
Hospital Charge Code	270693601
Hospital Revenue Code	278
Min. Negotiated Rate	$127.88
Max. Negotiated Rate	$426.25
Rate for Payer: Aetna Commercial	$255.75
Rate for Payer: Aetna Medicare Advantage	$255.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.39
Rate for Payer: Cigna Commercial	$426.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.31
Rate for Payer: Qualcare PPO/HMO/WC	$127.88

SCREW T15 MD 3.5X36MM NS

Facility

$852.50

Service Code	HCPCS C1713
Hospital Charge Code	270693601
Hospital Revenue Code	278
Min. Negotiated Rate	$127.88
Max. Negotiated Rate	$206.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.31
Rate for Payer: Qualcare PPO/HMO/WC	$127.88

SCREW T15 MD 3.5X40MM NS

Facility

$852.50

Service Code	HCPCS C1713
Hospital Charge Code	270693602
Hospital Revenue Code	278
Min. Negotiated Rate	$127.88
Max. Negotiated Rate	$206.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.31
Rate for Payer: Qualcare PPO/HMO/WC	$127.88

SCREW T15 MD 3.5X40MM NS

Facility

$852.50

Service Code	HCPCS C1713
Hospital Charge Code	270693602
Hospital Revenue Code	278
Min. Negotiated Rate	$127.88
Max. Negotiated Rate	$426.25
Rate for Payer: Aetna Commercial	$255.75
Rate for Payer: Aetna Medicare Advantage	$255.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.39
Rate for Payer: Cigna Commercial	$426.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.31
Rate for Payer: Qualcare PPO/HMO/WC	$127.88

SCREW T15 MD 3.5X42MM NS

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270680844
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$188.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW T15 MD 3.5X42MM NS

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270680844
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$234.00
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW T15 MD 3.5X44MM NS

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270680679
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$188.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW T15 MD 3.5X44MM NS

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270680679
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$234.00
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW T15 MD 3.5X50MM NS

Facility

$852.50

Service Code	HCPCS C1713
Hospital Charge Code	270680680
Hospital Revenue Code	278
Min. Negotiated Rate	$127.88
Max. Negotiated Rate	$206.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.31
Rate for Payer: Qualcare PPO/HMO/WC	$127.88

SCREW T15 MD 3.5X50MM NS

Facility

$852.50

Service Code	HCPCS C1713
Hospital Charge Code	270680680
Hospital Revenue Code	278
Min. Negotiated Rate	$127.88
Max. Negotiated Rate	$426.25
Rate for Payer: Aetna Commercial	$255.75
Rate for Payer: Aetna Medicare Advantage	$255.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.39
Rate for Payer: Cigna Commercial	$426.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.31
Rate for Payer: Qualcare PPO/HMO/WC	$127.88

SCREW T15 MD 3.5X56MM NS

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270680681
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$188.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW T15 MD 3.5X56MM NS

Facility

$780.00

Service Code	HCPCS C1713
Hospital Charge Code	270680681
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$234.00
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.76
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

SCREW T15 MD CORT 3.5X32MM NS

Facility

$852.50

Service Code	HCPCS C1713
Hospital Charge Code	270686583
Hospital Revenue Code	278
Min. Negotiated Rate	$127.88
Max. Negotiated Rate	$426.25
Rate for Payer: Aetna Commercial	$255.75
Rate for Payer: Aetna Medicare Advantage	$255.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.39
Rate for Payer: Cigna Commercial	$426.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.31
Rate for Payer: Qualcare PPO/HMO/WC	$127.88

SCREW T15 MD CORT 3.5X32MM NS

Facility

$852.50

Service Code	HCPCS C1713
Hospital Charge Code	270686583
Hospital Revenue Code	278
Min. Negotiated Rate	$127.88
Max. Negotiated Rate	$206.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.31
Rate for Payer: Qualcare PPO/HMO/WC	$127.88

SCREW T15 MD LKG NS 3.5X22MM

Facility

$852.50

Service Code	HCPCS C1713
Hospital Charge Code	270697456
Hospital Revenue Code	278
Min. Negotiated Rate	$127.88
Max. Negotiated Rate	$206.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.31
Rate for Payer: Qualcare PPO/HMO/WC	$127.88

SCREW T15 MD LKG NS 3.5X22MM

Facility

$852.50

Service Code	HCPCS C1713
Hospital Charge Code	270697456
Hospital Revenue Code	278
Min. Negotiated Rate	$127.88
Max. Negotiated Rate	$426.25
Rate for Payer: Aetna Commercial	$255.75
Rate for Payer: Aetna Medicare Advantage	$255.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.39
Rate for Payer: Cigna Commercial	$426.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.31
Rate for Payer: Qualcare PPO/HMO/WC	$127.88

SCREW T20 EXT TAB 7.5X50MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270699337
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$1,687.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

SCREW T20 EXT TAB 7.5X50MM

Facility

$6,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270699337
Hospital Revenue Code	278
Min. Negotiated Rate	$1,046.25
Max. Negotiated Rate	$3,487.50
Rate for Payer: Aetna Commercial	$2,092.50
Rate for Payer: Aetna Medicare Advantage	$2,092.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,778.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,395.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,778.62
Rate for Payer: Cigna Commercial	$3,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,687.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.25

Know your out-of-pocket cost for care.

All Charges