Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW TI HDLS COMP 4.5X38MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700599
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$2,687.50
Rate for Payer: Aetna Commercial	$1,612.50
Rate for Payer: Aetna Medicare Advantage	$1,612.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,370.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,370.62
Rate for Payer: Cigna Commercial	$2,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW TI HDLS COMP 4.5X38MM

Facility

$5,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270700599
Hospital Revenue Code	278
Min. Negotiated Rate	$806.25
Max. Negotiated Rate	$1,300.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,075.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.75
Rate for Payer: Qualcare PPO/HMO/WC	$806.25

SCREW TI INCORE 3.5 X 54MM

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688019
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$690.00
Rate for Payer: Aetna Commercial	$414.00
Rate for Payer: Aetna Medicare Advantage	$414.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.90
Rate for Payer: Cigna Commercial	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

SCREW TI INCORE 3.5 X 54MM

Facility

$1,380.00

Service Code	HCPCS C1713
Hospital Charge Code	270688019
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$333.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$333.96
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

SCREW Ti LAG 010.5x75mm

Facility

$4,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270671132
Hospital Revenue Code	278
Min. Negotiated Rate	$664.50
Max. Negotiated Rate	$1,072.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$886.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,072.06
Rate for Payer: Qualcare PPO/HMO/WC	$664.50

SCREW Ti LAG 010.5x75mm

Facility

$4,430.00

Service Code	HCPCS C1713
Hospital Charge Code	270671132
Hospital Revenue Code	278
Min. Negotiated Rate	$664.50
Max. Negotiated Rate	$2,215.00
Rate for Payer: Aetna Commercial	$1,329.00
Rate for Payer: Aetna Medicare Advantage	$1,329.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,129.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,129.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$886.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,129.65
Rate for Payer: Cigna Commercial	$2,215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,072.06
Rate for Payer: Qualcare PPO/HMO/WC	$664.50

SCREW Ti LAG 010.5x75MM

Facility

$3,685.00

Hospital Charge Code	270648351
Hospital Revenue Code	278
Min. Negotiated Rate	$552.75
Max. Negotiated Rate	$1,842.50
Rate for Payer: Aetna Commercial	$1,105.50
Rate for Payer: Aetna Medicare Advantage	$1,105.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$939.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$939.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$737.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$939.67
Rate for Payer: Cigna Commercial	$1,842.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$891.77
Rate for Payer: Qualcare PPO/HMO/WC	$552.75

SCREW Ti LAG 010.5x75MM

Facility

$3,685.00

Hospital Charge Code	270648351
Hospital Revenue Code	278
Min. Negotiated Rate	$552.75
Max. Negotiated Rate	$891.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$737.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$891.77
Rate for Payer: Qualcare PPO/HMO/WC	$552.75

SCREW TI LKG LP 3.5X12MM

Facility

$812.50

Service Code	HCPCS C1713
Hospital Charge Code	270688318
Hospital Revenue Code	278
Min. Negotiated Rate	$121.88
Max. Negotiated Rate	$406.25
Rate for Payer: Aetna Commercial	$243.75
Rate for Payer: Aetna Medicare Advantage	$243.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.19
Rate for Payer: Cigna Commercial	$406.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.62
Rate for Payer: Qualcare PPO/HMO/WC	$121.88

SCREW TI LKG LP 3.5X12MM

Facility

$812.50

Service Code	HCPCS C1713
Hospital Charge Code	270688318
Hospital Revenue Code	278
Min. Negotiated Rate	$121.88
Max. Negotiated Rate	$196.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.62
Rate for Payer: Qualcare PPO/HMO/WC	$121.88

SCREW TI LOCKING 5.0x42 458942

Facility

$649.85

Hospital Charge Code	270633855
Hospital Revenue Code	278
Min. Negotiated Rate	$97.48
Max. Negotiated Rate	$157.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$129.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.26
Rate for Payer: Qualcare PPO/HMO/WC	$97.48

SCREW TI LOCKING 5.0x42 458942

Facility

$649.85

Hospital Charge Code	270633855
Hospital Revenue Code	278
Min. Negotiated Rate	$97.48
Max. Negotiated Rate	$324.93
Rate for Payer: Aetna Commercial	$194.96
Rate for Payer: Aetna Medicare Advantage	$194.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$129.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.71
Rate for Payer: Cigna Commercial	$324.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.26
Rate for Payer: Qualcare PPO/HMO/WC	$97.48

SCREW TI LOCKING 5.0x44 458944

Facility

$649.85

Hospital Charge Code	270633688
Hospital Revenue Code	278
Min. Negotiated Rate	$97.48
Max. Negotiated Rate	$157.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$129.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.26
Rate for Payer: Qualcare PPO/HMO/WC	$97.48

SCREW TI LOCKING 5.0x44 458944

Facility

$649.85

Hospital Charge Code	270633688
Hospital Revenue Code	278
Min. Negotiated Rate	$97.48
Max. Negotiated Rate	$324.93
Rate for Payer: Aetna Commercial	$194.96
Rate for Payer: Aetna Medicare Advantage	$194.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$129.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.71
Rate for Payer: Cigna Commercial	$324.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.26
Rate for Payer: Qualcare PPO/HMO/WC	$97.48

SCREW TI LOCKING 5X50MM

Facility

$945.00

Service Code	HCPCS C1713
Hospital Charge Code	270645391
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$228.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW TI LOCKING 5X50MM

Facility

$945.00

Service Code	HCPCS C1713
Hospital Charge Code	270645391
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$283.50
Rate for Payer: Aetna Medicare Advantage	$283.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.97
Rate for Payer: Cigna Commercial	$472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW TI LOCKING 5X56MM

Facility

$945.00

Hospital Charge Code	270670733
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$472.50
Rate for Payer: Aetna Commercial	$283.50
Rate for Payer: Aetna Medicare Advantage	$283.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.97
Rate for Payer: Cigna Commercial	$472.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW TI LOCKING 5X56MM

Facility

$945.00

Hospital Charge Code	270670733
Hospital Revenue Code	278
Min. Negotiated Rate	$141.75
Max. Negotiated Rate	$228.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$189.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$228.69
Rate for Payer: Qualcare PPO/HMO/WC	$141.75

SCREW TILOCK SET

Facility

$804.75

Service Code	HCPCS C1713
Hospital Charge Code	270699239
Hospital Revenue Code	278
Min. Negotiated Rate	$120.71
Max. Negotiated Rate	$194.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.71

SCREW TILOCK SET

Facility

$804.75

Service Code	HCPCS C1713
Hospital Charge Code	270699239
Hospital Revenue Code	278
Min. Negotiated Rate	$120.71
Max. Negotiated Rate	$402.38
Rate for Payer: Aetna Commercial	$241.43
Rate for Payer: Aetna Medicare Advantage	$241.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$205.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$205.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$160.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$205.21
Rate for Payer: Cigna Commercial	$402.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.75
Rate for Payer: Qualcare PPO/HMO/WC	$120.71

SCREW TILOC WT25 STR DR 5X76MM

Facility

$747.80

Service Code	HCPCS C1713
Hospital Charge Code	270680163
Hospital Revenue Code	278
Min. Negotiated Rate	$112.17
Max. Negotiated Rate	$180.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.17

SCREW TILOC WT25 STR DR 5X76MM

Facility

$747.80

Service Code	HCPCS C1713
Hospital Charge Code	270680163
Hospital Revenue Code	278
Min. Negotiated Rate	$112.17
Max. Negotiated Rate	$373.90
Rate for Payer: Aetna Commercial	$224.34
Rate for Payer: Aetna Medicare Advantage	$224.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$190.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$190.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$149.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$190.69
Rate for Payer: Cigna Commercial	$373.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.97
Rate for Payer: Qualcare PPO/HMO/WC	$112.17

SCREW TI LOW PROFILE 4X24MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270677408
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW TI LOW PROFILE 4X24MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	270677408
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$90.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

SCREW TI MATRIXNEURO SD 3MM

Facility

$690.00

Service Code	HCPCS C1713
Hospital Charge Code	270697090
Hospital Revenue Code	278
Min. Negotiated Rate	$103.50
Max. Negotiated Rate	$345.00
Rate for Payer: Aetna Commercial	$207.00
Rate for Payer: Aetna Medicare Advantage	$207.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.95
Rate for Payer: Cigna Commercial	$345.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.98
Rate for Payer: Qualcare PPO/HMO/WC	$103.50

Know your out-of-pocket cost for care.

All Charges