Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW TREP ATT 9.5MM

Facility

$1,483.75

Service Code	HCPCS C1713
Hospital Charge Code	270691898
Hospital Revenue Code	278
Min. Negotiated Rate	$222.56
Max. Negotiated Rate	$741.88
Rate for Payer: Aetna Commercial	$445.12
Rate for Payer: Aetna Medicare Advantage	$445.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$378.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$378.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$296.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$378.36
Rate for Payer: Cigna Commercial	$741.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$359.07
Rate for Payer: Qualcare PPO/HMO/WC	$222.56

SCREW TRIO 35MM VERSAFIT CUP

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270684304
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$125.00
Rate for Payer: Aetna Commercial	$75.00
Rate for Payer: Aetna Medicare Advantage	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.75
Rate for Payer: Cigna Commercial	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

SCREW TRIO 35MM VERSAFIT CUP

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	270684304
Hospital Revenue Code	278
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$60.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.50
Rate for Payer: Qualcare PPO/HMO/WC	$37.50

SCREW TRIO 40MM VERSAFITCUP

Facility

$3,290.85

Service Code	HCPCS C1713
Hospital Charge Code	270684246
Hospital Revenue Code	278
Min. Negotiated Rate	$493.63
Max. Negotiated Rate	$796.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$658.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$796.39
Rate for Payer: Qualcare PPO/HMO/WC	$493.63

SCREW TRIO 40MM VERSAFITCUP

Facility

$3,290.85

Service Code	HCPCS C1713
Hospital Charge Code	270684246
Hospital Revenue Code	278
Min. Negotiated Rate	$493.63
Max. Negotiated Rate	$1,645.42
Rate for Payer: Aetna Commercial	$987.25
Rate for Payer: Aetna Medicare Advantage	$987.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$839.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$839.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$658.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$839.17
Rate for Payer: Cigna Commercial	$1,645.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$796.39
Rate for Payer: Qualcare PPO/HMO/WC	$493.63

SCREW TRITON 12X40

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696331
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$11,250.00
Rate for Payer: Aetna Commercial	$6,750.00
Rate for Payer: Aetna Medicare Advantage	$6,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,737.50
Rate for Payer: Cigna Commercial	$11,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SCREW TRITON 12X40

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696331
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$5,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SCREW TRITON 12X55MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270695039
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$11,250.00
Rate for Payer: Aetna Commercial	$6,750.00
Rate for Payer: Aetna Medicare Advantage	$6,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,737.50
Rate for Payer: Cigna Commercial	$11,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SCREW TRITON 12X55MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270695039
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$5,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SCREW TRITON 12X60

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696330
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$5,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SCREW TRITON 12X60

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696330
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$11,250.00
Rate for Payer: Aetna Commercial	$6,750.00
Rate for Payer: Aetna Medicare Advantage	$6,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,737.50
Rate for Payer: Cigna Commercial	$11,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SCREW TRITON S 12X45MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270699823
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$11,250.00
Rate for Payer: Aetna Commercial	$6,750.00
Rate for Payer: Aetna Medicare Advantage	$6,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,737.50
Rate for Payer: Cigna Commercial	$11,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SCREW TRITON S 12X45MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270699823
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$5,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SCREW TRITON S 8X40MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270699824
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$5,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SCREW TRITON S 8X40MM

Facility

$22,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270699824
Hospital Revenue Code	278
Min. Negotiated Rate	$3,375.00
Max. Negotiated Rate	$11,250.00
Rate for Payer: Aetna Commercial	$6,750.00
Rate for Payer: Aetna Medicare Advantage	$6,750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,737.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,737.50
Rate for Payer: Cigna Commercial	$11,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,445.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,375.00

SCREW TULIP MODUL MIS 30MM

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693890
Hospital Revenue Code	278
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$877.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

SCREW TULIP MODUL MIS 30MM

Facility

$3,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270693890
Hospital Revenue Code	278
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,087.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.25
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

SCREW TWIST 2.7MMX12MM

Facility

$1,560.00

Service Code	HCPCS C1713
Hospital Charge Code	270694776
Hospital Revenue Code	278
Min. Negotiated Rate	$234.00
Max. Negotiated Rate	$377.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$312.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$377.52
Rate for Payer: Qualcare PPO/HMO/WC	$234.00

SCREW TWIST 2.7MMX12MM

Facility

$1,560.00

Service Code	HCPCS C1713
Hospital Charge Code	270694776
Hospital Revenue Code	278
Min. Negotiated Rate	$234.00
Max. Negotiated Rate	$780.00
Rate for Payer: Aetna Commercial	$468.00
Rate for Payer: Aetna Medicare Advantage	$468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$397.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$397.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$312.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$397.80
Rate for Payer: Cigna Commercial	$780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$377.52
Rate for Payer: Qualcare PPO/HMO/WC	$234.00

SCREW TWIST OFF 2.0 X 11

Facility

$1,560.00

Service Code	HCPCS C1713
Hospital Charge Code	270688766
Hospital Revenue Code	278
Min. Negotiated Rate	$234.00
Max. Negotiated Rate	$780.00
Rate for Payer: Aetna Commercial	$468.00
Rate for Payer: Aetna Medicare Advantage	$468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$397.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$397.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$312.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$397.80
Rate for Payer: Cigna Commercial	$780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$377.52
Rate for Payer: Qualcare PPO/HMO/WC	$234.00

SCREW TWIST OFF 2.0 X 11

Facility

$1,560.00

Service Code	HCPCS C1713
Hospital Charge Code	270688766
Hospital Revenue Code	278
Min. Negotiated Rate	$234.00
Max. Negotiated Rate	$377.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$312.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$377.52
Rate for Payer: Qualcare PPO/HMO/WC	$234.00

SCREW TWIST OFF 2X12MM

Facility

$3,910.00

Service Code	HCPCS C1713
Hospital Charge Code	270694568
Hospital Revenue Code	278
Min. Negotiated Rate	$586.50
Max. Negotiated Rate	$1,955.00
Rate for Payer: Aetna Commercial	$1,173.00
Rate for Payer: Aetna Medicare Advantage	$1,173.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$997.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$997.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$782.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$997.05
Rate for Payer: Cigna Commercial	$1,955.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$946.22
Rate for Payer: Qualcare PPO/HMO/WC	$586.50

SCREW TWIST OFF 2X12MM

Facility

$3,910.00

Service Code	HCPCS C1713
Hospital Charge Code	270694568
Hospital Revenue Code	278
Min. Negotiated Rate	$586.50
Max. Negotiated Rate	$946.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$782.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$946.22
Rate for Payer: Qualcare PPO/HMO/WC	$586.50

SCREW TYPHOON FACET 4.5X23MM

Facility

$7,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270696187
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$3,987.50
Rate for Payer: Aetna Commercial	$2,392.50
Rate for Payer: Aetna Medicare Advantage	$2,392.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,033.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,033.62
Rate for Payer: Cigna Commercial	$3,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

SCREW TYPHOON FACET 4.5X23MM

Facility

$7,975.00

Service Code	HCPCS C1713
Hospital Charge Code	270696187
Hospital Revenue Code	278
Min. Negotiated Rate	$1,196.25
Max. Negotiated Rate	$1,929.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,595.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.95
Rate for Payer: Qualcare PPO/HMO/WC	$1,196.25

Know your out-of-pocket cost for care.

All Charges