Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$166.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.98
Rate for Payer: Qualcare PPO/HMO/WC	$103.50

SCREW TI MOD CANN 8.5X50MM

Facility

$7,751.00

Service Code	HCPCS C1713
Hospital Charge Code	270695297
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.65
Max. Negotiated Rate	$3,875.50
Rate for Payer: Aetna Commercial	$2,325.30
Rate for Payer: Aetna Medicare Advantage	$2,325.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,976.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,976.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,976.51
Rate for Payer: Cigna Commercial	$3,875.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.65

SCREW TI MOD CANN 8.5X50MM

Facility

$7,751.00

Service Code	HCPCS C1713
Hospital Charge Code	270695297
Hospital Revenue Code	278
Min. Negotiated Rate	$1,162.65
Max. Negotiated Rate	$1,875.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,550.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,875.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,162.65

SCREW TI MOD CANN 9.5X50MM

Facility

$5,751.00

Service Code	HCPCS C1713
Hospital Charge Code	270695298
Hospital Revenue Code	278
Min. Negotiated Rate	$862.65
Max. Negotiated Rate	$1,391.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.74
Rate for Payer: Qualcare PPO/HMO/WC	$862.65

SCREW TI MOD CANN 9.5X50MM

Facility

$5,751.00

Service Code	HCPCS C1713
Hospital Charge Code	270695298
Hospital Revenue Code	278
Min. Negotiated Rate	$862.65
Max. Negotiated Rate	$2,875.50
Rate for Payer: Aetna Commercial	$1,725.30
Rate for Payer: Aetna Medicare Advantage	$1,725.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.51
Rate for Payer: Cigna Commercial	$2,875.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.74
Rate for Payer: Qualcare PPO/HMO/WC	$862.65

SCREW TI MOD MIS CANN 7.5X40MM

Facility

$6,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270695962
Hospital Revenue Code	278
Min. Negotiated Rate	$1,048.50
Max. Negotiated Rate	$1,691.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,398.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,691.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,048.50

SCREW TI MOD MIS CANN 7.5X40MM

Facility

$6,990.00

Service Code	HCPCS C1713
Hospital Charge Code	270695962
Hospital Revenue Code	278
Min. Negotiated Rate	$1,048.50
Max. Negotiated Rate	$3,495.00
Rate for Payer: Aetna Commercial	$2,097.00
Rate for Payer: Aetna Medicare Advantage	$2,097.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,782.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,782.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,398.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,782.45
Rate for Payer: Cigna Commercial	$3,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,691.58
Rate for Payer: Qualcare PPO/HMO/WC	$1,048.50

SCREW TI MODULAR GRN 6.5X50MM

Facility

$6,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270699662
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 TI MODULAR GRN 6.5X50MM

Facility

$6,900.00

Service Code	HCPCS C1713
Hospital Charge Code	270699662
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 TI PEDICLE POLY 6.5X40MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270694184
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$3,370.00
Rate for Payer: Aetna Commercial	$2,022.00
Rate for Payer: Aetna Medicare Advantage	$2,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,718.70
Rate for Payer: Cigna Commercial	$3,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW TI PEDICLE POLY 6.5X40MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270694184
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$1,631.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW TI PEDICLE POLY 8.5X40MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270694812
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$3,370.00
Rate for Payer: Aetna Commercial	$2,022.00
Rate for Payer: Aetna Medicare Advantage	$2,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,718.70
Rate for Payer: Cigna Commercial	$3,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW TI PEDICLE POLY 8.5X40MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270694812
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$1,631.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW TI POLYAX 8.5X35MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270695705
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$1,631.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW TI POLYAX 8.5X35MM

Facility

$6,740.00

Service Code	HCPCS C1713
Hospital Charge Code	270695705
Hospital Revenue Code	278
Min. Negotiated Rate	$1,011.00
Max. Negotiated Rate	$3,370.00
Rate for Payer: Aetna Commercial	$2,022.00
Rate for Payer: Aetna Medicare Advantage	$2,022.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,718.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,348.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,718.70
Rate for Payer: Cigna Commercial	$3,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,631.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,011.00

SCREW TI SD MAXTORQUE 4X45MM

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270700602
Hospital Revenue Code	278
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$532.50
Rate for Payer: Aetna Commercial	$319.50
Rate for Payer: Aetna Medicare Advantage	$319.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$271.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$271.57
Rate for Payer: Cigna Commercial	$532.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: Qualcare PPO/HMO/WC	$159.75

SCREW TI SD MAXTORQUE 4X45MM

Facility

$1,065.00

Service Code	HCPCS C1713
Hospital Charge Code	270700602
Hospital Revenue Code	278
Min. Negotiated Rate	$159.75
Max. Negotiated Rate	$257.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$213.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$257.73
Rate for Payer: Qualcare PPO/HMO/WC	$159.75

SCREW TI SD VA 4.0X14MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697204
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

SCREW TI SD VA 4.0X14MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697204
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$900.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

SCREW TI SELFTAP 4.5MMX14MM

Facility

$1,465.00

Service Code	HCPCS C1713
Hospital Charge Code	270693705
Hospital Revenue Code	278
Min. Negotiated Rate	$219.75
Max. Negotiated Rate	$732.50
Rate for Payer: Aetna Commercial	$439.50
Rate for Payer: Aetna Medicare Advantage	$439.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$293.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.57
Rate for Payer: Cigna Commercial	$732.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.53
Rate for Payer: Qualcare PPO/HMO/WC	$219.75

SCREW TI SELFTAP 4.5MMX14MM

Facility

$1,465.00

Service Code	HCPCS C1713
Hospital Charge Code	270693705
Hospital Revenue Code	278
Min. Negotiated Rate	$219.75
Max. Negotiated Rate	$354.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$293.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$354.53
Rate for Payer: Qualcare PPO/HMO/WC	$219.75

SCREW TI SNAP OFF 2.75X16MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699707
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$937.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SCREW TI SNAP OFF 2.75X16MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699707
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SCREW TI SNAP OFF 2.75X18MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699706
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$756.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

SCREW TI SNAP OFF 2.75X18MM

Facility

$3,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270699706
Hospital Revenue Code	278
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$937.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$625.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$756.25
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

Know your out-of-pocket cost for care.

All Charges