Heights University Hospital

All Charges

Charge

Type

Setting

Price

SCREW VARIABLE SD 4.0X16MM

Facility

$2,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270697005
Hospital Revenue Code	278
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$1,050.00
Rate for Payer: Aetna Commercial	$630.00
Rate for Payer: Aetna Medicare Advantage	$630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$535.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$535.50
Rate for Payer: Cigna Commercial	$1,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: Qualcare PPO/HMO/WC	$315.00

SCREW VARIABLE SD 4.0X16MM

Facility

$2,100.00

Service Code	HCPCS C1713
Hospital Charge Code	270697005
Hospital Revenue Code	278
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$508.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$508.20
Rate for Payer: Qualcare PPO/HMO/WC	$315.00

SCREW VARIA SELFDRILL 4.0X14MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694451
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$675.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW VARIA SELFDRILL 4.0X14MM

Facility

$2,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270694451
Hospital Revenue Code	278
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$544.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$544.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

SCREW VARIAX 3.5X18MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270700726
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW VARIAX 3.5X18MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270700726
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$225.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

SCREW VARIAX FT T8 2.7X16MM

Facility

$344.00

Service Code	HCPCS C1713
Hospital Charge Code	270699659
Hospital Revenue Code	278
Min. Negotiated Rate	$51.60
Max. Negotiated Rate	$172.00
Rate for Payer: Aetna Commercial	$103.20
Rate for Payer: Aetna Medicare Advantage	$103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.72
Rate for Payer: Cigna Commercial	$172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.25
Rate for Payer: Qualcare PPO/HMO/WC	$51.60

SCREW VARIAX FT T8 2.7X16MM

Facility

$344.00

Service Code	HCPCS C1713
Hospital Charge Code	270699659
Hospital Revenue Code	278
Min. Negotiated Rate	$51.60
Max. Negotiated Rate	$83.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.25
Rate for Payer: Qualcare PPO/HMO/WC	$51.60

SCREW VARIAX FT T8 2.7X18MM

Facility

$344.00

Service Code	HCPCS C1713
Hospital Charge Code	270699660
Hospital Revenue Code	278
Min. Negotiated Rate	$51.60
Max. Negotiated Rate	$83.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.25
Rate for Payer: Qualcare PPO/HMO/WC	$51.60

SCREW VARIAX FT T8 2.7X18MM

Facility

$344.00

Service Code	HCPCS C1713
Hospital Charge Code	270699660
Hospital Revenue Code	278
Min. Negotiated Rate	$51.60
Max. Negotiated Rate	$172.00
Rate for Payer: Aetna Commercial	$103.20
Rate for Payer: Aetna Medicare Advantage	$103.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$68.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.72
Rate for Payer: Cigna Commercial	$172.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.25
Rate for Payer: Qualcare PPO/HMO/WC	$51.60

SCREW VARIAX LKG T8 FT2.4X16MM

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270700470
Hospital Revenue Code	278
Min. Negotiated Rate	$186.34
Max. Negotiated Rate	$621.15
Rate for Payer: Aetna Commercial	$372.69
Rate for Payer: Aetna Medicare Advantage	$372.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.79
Rate for Payer: Cigna Commercial	$621.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: Qualcare PPO/HMO/WC	$186.34

SCREW VARIAX LKG T8 FT2.4X16MM

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270700470
Hospital Revenue Code	278
Min. Negotiated Rate	$186.34
Max. Negotiated Rate	$300.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: Qualcare PPO/HMO/WC	$186.34

SCREW VARIAX LKG T8 FT2.4X18MM

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270700485
Hospital Revenue Code	278
Min. Negotiated Rate	$186.34
Max. Negotiated Rate	$621.15
Rate for Payer: Aetna Commercial	$372.69
Rate for Payer: Aetna Medicare Advantage	$372.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.79
Rate for Payer: Cigna Commercial	$621.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: Qualcare PPO/HMO/WC	$186.34

SCREW VARIAX LKG T8 FT2.4X18MM

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270700485
Hospital Revenue Code	278
Min. Negotiated Rate	$186.34
Max. Negotiated Rate	$300.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: Qualcare PPO/HMO/WC	$186.34

SCREW VARIAX T6 2X11MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270700742
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$217.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW VARIAX T6 2X11MM

Facility

$725.00

Service Code	HCPCS C1713
Hospital Charge Code	270700742
Hospital Revenue Code	278
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$175.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.45
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

SCREW VARIAX T8 FT 2.7X12MM

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270700620
Hospital Revenue Code	278
Min. Negotiated Rate	$109.08
Max. Negotiated Rate	$363.60
Rate for Payer: Aetna Commercial	$218.16
Rate for Payer: Aetna Medicare Advantage	$218.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.44
Rate for Payer: Cigna Commercial	$363.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08

SCREW VARIAX T8 FT 2.7X12MM

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270700620
Hospital Revenue Code	278
Min. Negotiated Rate	$109.08
Max. Negotiated Rate	$175.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08

SCREW VARIAX T8 FT 2.7X40MM

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270699832
Hospital Revenue Code	278
Min. Negotiated Rate	$109.08
Max. Negotiated Rate	$363.60
Rate for Payer: Aetna Commercial	$218.16
Rate for Payer: Aetna Medicare Advantage	$218.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$185.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$185.44
Rate for Payer: Cigna Commercial	$363.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08

SCREW VARIAX T8 FT 2.7X40MM

Facility

$727.20

Service Code	HCPCS C1713
Hospital Charge Code	270699832
Hospital Revenue Code	278
Min. Negotiated Rate	$109.08
Max. Negotiated Rate	$175.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$145.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.98
Rate for Payer: Qualcare PPO/HMO/WC	$109.08

SCREW VARIAX T8 FT LKG2.7X40MM

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270699828
Hospital Revenue Code	278
Min. Negotiated Rate	$186.34
Max. Negotiated Rate	$300.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: Qualcare PPO/HMO/WC	$186.34

SCREW VARIAX T8 FT LKG2.7X40MM

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270699828
Hospital Revenue Code	278
Min. Negotiated Rate	$186.34
Max. Negotiated Rate	$621.15
Rate for Payer: Aetna Commercial	$372.69
Rate for Payer: Aetna Medicare Advantage	$372.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.79
Rate for Payer: Cigna Commercial	$621.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: Qualcare PPO/HMO/WC	$186.34

SCREW VARI S/TAPPING 4.0x12MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270677683
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$302.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW VARI S/TAPPING 4.0x12MM

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270677683
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$375.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$302.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

SCREW VAR LOCKING TI 3.0X12MM

Facility

$1,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270696249
Hospital Revenue Code	278
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$356.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.95
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

Know your out-of-pocket cost for care.

All Charges