Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW THD HDLS 2 X 22MM

Facility

$1,141.25

Service Code	HCPCS C1713
Hospital Charge Code	270701958
Hospital Revenue Code	278
Min. Negotiated Rate	$171.19
Max. Negotiated Rate	$276.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.18
Rate for Payer: Qualcare PPO/HMO/WC	$171.19

SCREW THD HDLS 2 X 22MM

Facility

$1,141.25

Service Code	HCPCS C1713
Hospital Charge Code	270701958
Hospital Revenue Code	278
Min. Negotiated Rate	$171.19
Max. Negotiated Rate	$570.62
Rate for Payer: Aetna Commercial	$342.38
Rate for Payer: Aetna Medicare Advantage	$342.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$291.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$291.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$228.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$291.02
Rate for Payer: Cigna Commercial	$570.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$276.18
Rate for Payer: Qualcare PPO/HMO/WC	$171.19

SCREW THRD TI LOCKING 3.5X18MM

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270684110
Hospital Revenue Code	278
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$235.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

SCREW THRD TI LOCKING 3.5X18MM

Facility

$975.00

Service Code	HCPCS C1713
Hospital Charge Code	270684110
Hospital Revenue Code	278
Min. Negotiated Rate	$146.25
Max. Negotiated Rate	$487.50
Rate for Payer: Aetna Commercial	$292.50
Rate for Payer: Aetna Medicare Advantage	$292.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$248.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$248.62
Rate for Payer: Cigna Commercial	$487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$235.95
Rate for Payer: Qualcare PPO/HMO/WC	$146.25

SCREW THREADED SI 9.5X40MM

Facility

$18,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698723
Hospital Revenue Code	278
Min. Negotiated Rate	$2,737.50
Max. Negotiated Rate	$4,416.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50

SCREW THREADED SI 9.5X40MM

Facility

$18,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698723
Hospital Revenue Code	278
Min. Negotiated Rate	$2,737.50
Max. Negotiated Rate	$9,125.00
Rate for Payer: Aetna Commercial	$5,475.00
Rate for Payer: Aetna Medicare Advantage	$5,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,653.75
Rate for Payer: Cigna Commercial	$9,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50

SCREW THREADED SI 9.5X45MM

Facility

$18,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698724
Hospital Revenue Code	278
Min. Negotiated Rate	$2,737.50
Max. Negotiated Rate	$9,125.00
Rate for Payer: Aetna Commercial	$5,475.00
Rate for Payer: Aetna Medicare Advantage	$5,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,653.75
Rate for Payer: Cigna Commercial	$9,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50

SCREW THREADED SI 9.5X45MM

Facility

$18,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270698724
Hospital Revenue Code	278
Min. Negotiated Rate	$2,737.50
Max. Negotiated Rate	$4,416.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50

SCREW THREAD HEADED 3.5X 38 MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701529
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$481.25
Rate for Payer: Aetna Commercial	$288.75
Rate for Payer: Aetna Medicare Advantage	$288.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$245.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$245.44
Rate for Payer: Cigna Commercial	$481.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW THREAD HEADED 3.5X 38 MM

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	270701529
Hospital Revenue Code	278
Min. Negotiated Rate	$144.38
Max. Negotiated Rate	$232.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.93
Rate for Payer: Qualcare PPO/HMO/WC	$144.38

SCREW THREAD SHORT 2.4 X 17MM

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270688179
Hospital Revenue Code	278
Min. Negotiated Rate	$128.90
Max. Negotiated Rate	$207.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: Qualcare PPO/HMO/WC	$128.90

SCREW THREAD SHORT 2.4 X 17MM

Facility

$859.35

Service Code	HCPCS C1713
Hospital Charge Code	270688179
Hospital Revenue Code	278
Min. Negotiated Rate	$128.90
Max. Negotiated Rate	$429.68
Rate for Payer: Aetna Commercial	$257.81
Rate for Payer: Aetna Medicare Advantage	$257.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.13
Rate for Payer: Cigna Commercial	$429.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.96
Rate for Payer: Qualcare PPO/HMO/WC	$128.90

SCREW TI 2.4 X 16 MM VAL

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270690211
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 TI 2.4 X 16 MM VAL

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270690211
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 TI 2.4 X 20 MM VAL

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270690212
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 TI 2.4 X 20 MM VAL

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270690212
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 TI 3.0 X 26 MM VAL

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270691747
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW TI 3.0 X 26 MM VAL

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270691747
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW TI 3.0 X 28 MM VAL

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270691748
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$211.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW TI 3.0 X 28 MM VAL

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270691748
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.75
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SCREW Ti 4.0 x 20MM 345264

Facility

$401.65

Hospital Charge Code	270612314
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$97.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.20
Rate for Payer: Qualcare PPO/HMO/WC	$60.25

SCREW Ti 4.0 x 20MM 345264

Facility

$401.65

Hospital Charge Code	270612314
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$200.82
Rate for Payer: Aetna Commercial	$120.50
Rate for Payer: Aetna Medicare Advantage	$120.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.42
Rate for Payer: Cigna Commercial	$200.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.20
Rate for Payer: Qualcare PPO/HMO/WC	$60.25

SCREW Ti 4.0 x 24MM 345268

Facility

$401.65

Hospital Charge Code	270612305
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$200.82
Rate for Payer: Aetna Commercial	$120.50
Rate for Payer: Aetna Medicare Advantage	$120.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.42
Rate for Payer: Cigna Commercial	$200.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.20
Rate for Payer: Qualcare PPO/HMO/WC	$60.25

SCREW Ti 4.0 x 24MM 345268

Facility

$401.65

Hospital Charge Code	270612305
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$97.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.20
Rate for Payer: Qualcare PPO/HMO/WC	$60.25

SCREW Ti 4.0 x 30MM 345274

Facility

$401.65

Hospital Charge Code	270612306
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$200.82
Rate for Payer: Aetna Commercial	$120.50
Rate for Payer: Aetna Medicare Advantage	$120.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.42
Rate for Payer: Cigna Commercial	$200.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.20
Rate for Payer: Qualcare PPO/HMO/WC	$60.25

Know your out-of-pocket cost for care.

All Charges