Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$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 4.5CANNCOMPHDLS LT 32

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270693422
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$949.00
Rate for Payer: Aetna Commercial	$569.40
Rate for Payer: Aetna Medicare Advantage	$569.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.99
Rate for Payer: Cigna Commercial	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW TI 4.5CANNCOMPHDLS LT 32

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270693422
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$459.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW TI 4.5CANNCOMPHDLS LT 36

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270693423
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$459.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW TI 4.5CANNCOMPHDLS LT 36

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270693423
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$949.00
Rate for Payer: Aetna Commercial	$569.40
Rate for Payer: Aetna Medicare Advantage	$569.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.99
Rate for Payer: Cigna Commercial	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW TI 4.5CANNCOMPHDLS LT 46

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270693424
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$459.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW TI 4.5CANNCOMPHDLS LT 46

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270693424
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$949.00
Rate for Payer: Aetna Commercial	$569.40
Rate for Payer: Aetna Medicare Advantage	$569.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.99
Rate for Payer: Cigna Commercial	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW TI 4.5CANNCOMPHDLS ST 50

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270693421
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$949.00
Rate for Payer: Aetna Commercial	$569.40
Rate for Payer: Aetna Medicare Advantage	$569.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.99
Rate for Payer: Cigna Commercial	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW TI 4.5CANNCOMPHDLS ST 50

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270693421
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$459.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW Ti 4.5 x 16MM 345316

Facility

$401.65

Hospital Charge Code	270612316
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 4.5 x 16MM 345316

Facility

$401.65

Hospital Charge Code	270612316
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 5.0X45mm 33-345428

Facility

$813.65

Hospital Charge Code	270612853
Hospital Revenue Code	278
Min. Negotiated Rate	$122.05
Max. Negotiated Rate	$196.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.90
Rate for Payer: Qualcare PPO/HMO/WC	$122.05

SCREW Ti 5.0X45mm 33-345428

Facility

$813.65

Hospital Charge Code	270612853
Hospital Revenue Code	278
Min. Negotiated Rate	$122.05
Max. Negotiated Rate	$406.82
Rate for Payer: Aetna Commercial	$244.09
Rate for Payer: Aetna Medicare Advantage	$244.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.48
Rate for Payer: Cigna Commercial	$406.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.90
Rate for Payer: Qualcare PPO/HMO/WC	$122.05

SCREW TI 5.0x70mm

Facility

$675.00

Hospital Charge Code	270638904
Hospital Revenue Code	278
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$337.50
Rate for Payer: Aetna Commercial	$202.50
Rate for Payer: Aetna Medicare Advantage	$202.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.12
Rate for Payer: Cigna Commercial	$337.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

SCREW TI 5.0x70mm

Facility

$675.00

Hospital Charge Code	270638904
Hospital Revenue Code	278
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$163.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.35
Rate for Payer: Qualcare PPO/HMO/WC	$101.25

SCREW Ti 6.5 x 20mm 103531

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270612161
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$180.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW Ti 6.5 x 20mm 103531

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270612161
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SCREW TI 6.5 X 40MM

Facility

$540.00

Hospital Charge Code	207612169
Hospital Revenue Code	275
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$162.00
Rate for Payer: Aetna Medicare Advantage	$162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.70
Rate for Payer: Cigna Commercial	$270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: Qualcare PPO/HMO/WC	$81.00

SCREW TI 6.5 X 40MM

Facility

$540.00

Hospital Charge Code	207612169
Hospital Revenue Code	275
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$130.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.68
Rate for Payer: Qualcare PPO/HMO/WC	$81.00

SCREW TIBIAL INSERT SZ1 30MM

Facility

$6,903.00

Service Code	HCPCS C1713
Hospital Charge Code	270680671
Hospital Revenue Code	278
Min. Negotiated Rate	$1,035.45
Max. Negotiated Rate	$3,451.50
Rate for Payer: Aetna Commercial	$2,070.90
Rate for Payer: Aetna Medicare Advantage	$2,070.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,760.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,760.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,380.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,760.27
Rate for Payer: Cigna Commercial	$3,451.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,670.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.45

SCREW TIBIAL INSERT SZ1 30MM

Facility

$6,903.00

Service Code	HCPCS C1713
Hospital Charge Code	270680671
Hospital Revenue Code	278
Min. Negotiated Rate	$1,035.45
Max. Negotiated Rate	$1,670.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,380.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,670.53
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.45

SCREW TIBIAL INSERT SZ2 15MM

Facility

$6,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270680185
Hospital Revenue Code	278
Min. Negotiated Rate	$1,035.00
Max. Negotiated Rate	$3,450.00
Rate for Payer: Aetna Commercial	$2,070.00
Rate for Payer: Aetna Medicare Advantage	$2,070.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,759.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,759.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,380.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,759.50
Rate for Payer: Cigna Commercial	$3,450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,669.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.00

SCREW TIBIAL INSERT SZ2 15MM

Facility

$6,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270680185
Hospital Revenue Code	278
Min. Negotiated Rate	$1,035.00
Max. Negotiated Rate	$1,669.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,380.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,669.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,035.00

SCREW TIBIAL INSERT SZ2 30MM

Facility

$6,930.30

Hospital Charge Code	270677339
Hospital Revenue Code	278
Min. Negotiated Rate	$1,039.55
Max. Negotiated Rate	$3,465.15
Rate for Payer: Aetna Commercial	$2,079.09
Rate for Payer: Aetna Medicare Advantage	$2,079.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,767.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,767.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,386.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,767.23
Rate for Payer: Cigna Commercial	$3,465.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,677.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,039.55

SCREW TIBIAL INSERT SZ2 30MM

Facility

$6,930.30

Hospital Charge Code	270677339
Hospital Revenue Code	278
Min. Negotiated Rate	$1,039.55
Max. Negotiated Rate	$1,677.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,386.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,677.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,039.55

Know your out-of-pocket cost for care.

All Charges