Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW UNICORTICAL 5.0X18MM

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270699606
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 UNICORTICAL 5.0X18MM

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	270699606
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 UNIPL ANT CERV 4.6X15MM

Facility

$1,365.90

Service Code	HCPCS C1713
Hospital Charge Code	270693870
Hospital Revenue Code	278
Min. Negotiated Rate	$204.88
Max. Negotiated Rate	$682.95
Rate for Payer: Aetna Commercial	$409.77
Rate for Payer: Aetna Medicare Advantage	$409.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$348.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$348.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$348.30
Rate for Payer: Cigna Commercial	$682.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.55
Rate for Payer: Qualcare PPO/HMO/WC	$204.88

SCREW UNIPL ANT CERV 4.6X15MM

Facility

$1,365.90

Service Code	HCPCS C1713
Hospital Charge Code	270693870
Hospital Revenue Code	278
Min. Negotiated Rate	$204.88
Max. Negotiated Rate	$330.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.55
Rate for Payer: Qualcare PPO/HMO/WC	$204.88

SCREW UNIPLATE 2SELF DRILL 16m

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270663295
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$474.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

SCREW UNIPLATE 2SELF DRILL 16m

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270663295
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$980.00
Rate for Payer: Aetna Commercial	$588.00
Rate for Payer: Aetna Medicare Advantage	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.80
Rate for Payer: Cigna Commercial	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

SCREW UNIPLATE SELF DRILL 12MM

Facility

$1,870.00

Service Code	HCPCS C1713
Hospital Charge Code	270687813
Hospital Revenue Code	278
Min. Negotiated Rate	$280.50
Max. Negotiated Rate	$935.00
Rate for Payer: Aetna Commercial	$561.00
Rate for Payer: Aetna Medicare Advantage	$561.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$476.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$476.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$374.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$476.85
Rate for Payer: Cigna Commercial	$935.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$452.54
Rate for Payer: Qualcare PPO/HMO/WC	$280.50

SCREW UNIPLATE SELF DRILL 12MM

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270676851
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$980.00
Rate for Payer: Aetna Commercial	$588.00
Rate for Payer: Aetna Medicare Advantage	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.80
Rate for Payer: Cigna Commercial	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

SCREW UNIPLATE SELF DRILL 12MM

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270676851
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$474.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

SCREW UNIPLATE SELF DRILL 12MM

Facility

$1,870.00

Service Code	HCPCS C1713
Hospital Charge Code	270687813
Hospital Revenue Code	278
Min. Negotiated Rate	$280.50
Max. Negotiated Rate	$452.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$374.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$452.54
Rate for Payer: Qualcare PPO/HMO/WC	$280.50

SCREW UNIPLATE SELF DRILL 14MM

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270671112
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$980.00
Rate for Payer: Aetna Commercial	$588.00
Rate for Payer: Aetna Medicare Advantage	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.80
Rate for Payer: Cigna Commercial	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

SCREW UNIPLATE SELF DRILL 14MM

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270671112
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$474.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

SCREW UNIPLATE SELF DRILL 16MM

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270677698
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$474.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

SCREW UNIPLATE SELF DRILL 16MM

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270663104
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$474.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

SCREW UNIPLATE SELF DRILL 16MM

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270663104
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$980.00
Rate for Payer: Aetna Commercial	$588.00
Rate for Payer: Aetna Medicare Advantage	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.80
Rate for Payer: Cigna Commercial	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

SCREW UNIPLATE SELF DRILL 16MM

Facility

$1,960.00

Service Code	HCPCS C1713
Hospital Charge Code	270677698
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$980.00
Rate for Payer: Aetna Commercial	$588.00
Rate for Payer: Aetna Medicare Advantage	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.80
Rate for Payer: Cigna Commercial	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

SCREW UNIPLATE SELF DRILL 18MM

Facility

$1,960.00

Hospital Charge Code	270676536
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$474.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

SCREW UNIPLATE SELF DRILL 18MM

Facility

$1,960.00

Hospital Charge Code	270676536
Hospital Revenue Code	278
Min. Negotiated Rate	$294.00
Max. Negotiated Rate	$980.00
Rate for Payer: Aetna Commercial	$588.00
Rate for Payer: Aetna Medicare Advantage	$588.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$499.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$392.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$499.80
Rate for Payer: Cigna Commercial	$980.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$474.32
Rate for Payer: Qualcare PPO/HMO/WC	$294.00

SCREW VA 2.3X14MM

Facility

$765.00

Hospital Charge Code	270668129
Hospital Revenue Code	278
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$382.50
Rate for Payer: Aetna Commercial	$229.50
Rate for Payer: Aetna Medicare Advantage	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.07
Rate for Payer: Cigna Commercial	$382.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: Qualcare PPO/HMO/WC	$114.75

SCREW VA 2.3X14MM

Facility

$765.00

Hospital Charge Code	270668129
Hospital Revenue Code	278
Min. Negotiated Rate	$114.75
Max. Negotiated Rate	$185.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.13
Rate for Payer: Qualcare PPO/HMO/WC	$114.75

SCREW VA 4X16MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270704156
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW VA 4X16MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270704156
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$187.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

SCREW VAL 2.0 X 10MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689899
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 VAL 2.0 X 10MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689899
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 VAL 2.0 X 8MM

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270689900
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

Know your out-of-pocket cost for care.

All Charges