Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW TENODESIS 5.5x15MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270675073
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$862.50
Rate for Payer: Aetna Commercial	$517.50
Rate for Payer: Aetna Medicare Advantage	$517.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$439.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$439.88
Rate for Payer: Cigna Commercial	$862.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW TENODESIS 5.5x15MM

Facility

$1,725.00

Service Code	HCPCS C1713
Hospital Charge Code	270675073
Hospital Revenue Code	278
Min. Negotiated Rate	$258.75
Max. Negotiated Rate	$417.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$417.45
Rate for Payer: Qualcare PPO/HMO/WC	$258.75

SCREW TENODESIS 6.25 X15 MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688245
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$600.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

SCREW TENODESIS 6.25 X15 MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270688245
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

SCREW TENODESIS 8X12MM BIO-

Facility

$2,250.00

Hospital Charge Code	270664267
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW TENODESIS 8X12MM BIO-

Facility

$2,250.00

Hospital Charge Code	270664267
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW TENODESIS BIO 8X23mm

Facility

$1,463.25

Hospital Charge Code	270636060
Hospital Revenue Code	278
Min. Negotiated Rate	$219.49
Max. Negotiated Rate	$354.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.11
Rate for Payer: Qualcare PPO/HMO/WC	$219.49

SCREW TENODESIS BIO 8X23mm

Facility

$1,463.25

Hospital Charge Code	270636060
Hospital Revenue Code	278
Min. Negotiated Rate	$219.49
Max. Negotiated Rate	$731.62
Rate for Payer: Aetna Commercial	$438.98
Rate for Payer: Aetna Medicare Advantage	$438.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$292.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.13
Rate for Payer: Cigna Commercial	$731.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.11
Rate for Payer: Qualcare PPO/HMO/WC	$219.49

SCREW TENODESIS DISP 2.5 X 6

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270691591
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$442.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW TENODESIS DISP 2.5 X 6

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270691591
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

SCREW TENODESIS PEEK

Facility

$2,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270691590
Hospital Revenue Code	278
Min. Negotiated Rate	$303.75
Max. Negotiated Rate	$490.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: Qualcare PPO/HMO/WC	$303.75

SCREW TENODESIS PEEK

Facility

$2,025.00

Service Code	HCPCS C1713
Hospital Charge Code	270691590
Hospital Revenue Code	278
Min. Negotiated Rate	$303.75
Max. Negotiated Rate	$1,012.50
Rate for Payer: Aetna Commercial	$607.50
Rate for Payer: Aetna Medicare Advantage	$607.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$516.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$516.38
Rate for Payer: Cigna Commercial	$1,012.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$490.05
Rate for Payer: Qualcare PPO/HMO/WC	$303.75

SCREW TENODESIS PEEK

Facility

$2,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270691580
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$637.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

SCREW TENODESIS PEEK

Facility

$2,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270691580
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

SCREW TENODESIS W/DRIVER PK 5.

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679968
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$1,375.00
Rate for Payer: Aetna Commercial	$825.00
Rate for Payer: Aetna Medicare Advantage	$825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$701.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$701.25
Rate for Payer: Cigna Commercial	$1,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

SCREW TENODESIS W/DRIVER PK 5.

Facility

$2,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270679968
Hospital Revenue Code	278
Min. Negotiated Rate	$412.50
Max. Negotiated Rate	$665.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$665.50
Rate for Payer: Qualcare PPO/HMO/WC	$412.50

SCREW TFNA 105MM STERILE

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676514
Hospital Revenue Code	278
Min. Negotiated Rate	$470.45
Max. Negotiated Rate	$759.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45

SCREW TFNA 105MM STERILE

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676514
Hospital Revenue Code	278
Min. Negotiated Rate	$470.45
Max. Negotiated Rate	$1,568.17
Rate for Payer: Aetna Commercial	$940.90
Rate for Payer: Aetna Medicare Advantage	$940.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.77
Rate for Payer: Cigna Commercial	$1,568.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45

SCREW TFNA 75MM

Facility

$3,559.30

Service Code	HCPCS C1713
Hospital Charge Code	270694884
Hospital Revenue Code	278
Min. Negotiated Rate	$533.89
Max. Negotiated Rate	$861.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$711.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$861.35
Rate for Payer: Qualcare PPO/HMO/WC	$533.89

SCREW TFNA 75MM

Facility

$3,559.30

Service Code	HCPCS C1713
Hospital Charge Code	270694884
Hospital Revenue Code	278
Min. Negotiated Rate	$533.89
Max. Negotiated Rate	$1,779.65
Rate for Payer: Aetna Commercial	$1,067.79
Rate for Payer: Aetna Medicare Advantage	$1,067.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$907.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$907.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$711.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$907.62
Rate for Payer: Cigna Commercial	$1,779.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$861.35
Rate for Payer: Qualcare PPO/HMO/WC	$533.89

SCREW TFNA 80MM

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676286
Hospital Revenue Code	278
Min. Negotiated Rate	$470.45
Max. Negotiated Rate	$759.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45

SCREW TFNA 80MM

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676286
Hospital Revenue Code	278
Min. Negotiated Rate	$470.45
Max. Negotiated Rate	$1,568.17
Rate for Payer: Aetna Commercial	$940.90
Rate for Payer: Aetna Medicare Advantage	$940.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.77
Rate for Payer: Cigna Commercial	$1,568.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45

SCREW TFNA 85MM STERILE

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676276
Hospital Revenue Code	278
Min. Negotiated Rate	$470.45
Max. Negotiated Rate	$1,568.17
Rate for Payer: Aetna Commercial	$940.90
Rate for Payer: Aetna Medicare Advantage	$940.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$799.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$799.77
Rate for Payer: Cigna Commercial	$1,568.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45

SCREW TFNA 85MM STERILE

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270676276
Hospital Revenue Code	278
Min. Negotiated Rate	$470.45
Max. Negotiated Rate	$759.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45

SCREW TFNA 90MM STERILE

Facility

$3,136.35

Service Code	HCPCS C1713
Hospital Charge Code	270675685
Hospital Revenue Code	278
Min. Negotiated Rate	$470.45
Max. Negotiated Rate	$759.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$627.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$470.45

Know your out-of-pocket cost for care.

All Charges