Heights University Hospital

All Charges

Charge

Type

Setting

Price

BONE SCREW 6.5X 30

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270662348
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

BONE SCREW 6.5x30MM

Facility

$125.00

Hospital Charge Code	270676366
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

BONE SCREW 6.5x30MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270685176
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BONE SCREW 6.5x30MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270685176
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$114.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

BONE SCREW 6.5x30MM

Facility

$125.00

Hospital Charge Code	270676366
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

BONE SCREW 6.5 X 30 SELF TAP

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270663518
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

BONE SCREW 6.5 X 30 SELF TAP

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270663518
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

BONE SCREW 6.5 X 35 MM SELFTAP

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270681827
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

BONE SCREW 6.5 X 35 MM SELFTAP

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270681827
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

BONE SCREW 6.5X35 SELF TAP

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270682196
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

BONE SCREW 6.5X35 SELF TAP

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270682196
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

BONE SCREW 6.5X40 SELFTAP

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270680801
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

BONE SCREW 6.5X40 SELFTAP

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270680801
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$37.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

BONE SCREW CANC P/THD 4x14MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270668164
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$35.15
Rate for Payer: Aetna Commercial	$21.09
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.93
Rate for Payer: Cigna Commercial	$35.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

BONE SCREW CANC P/THD 4x14MM

Facility

$70.30

Service Code	HCPCS C1713
Hospital Charge Code	270668164
Hospital Revenue Code	278
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$17.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.01
Rate for Payer: Qualcare PPO/HMO/WC	$10.54

BONE SCREW SELF TAP 3.5x20MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270648601
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$205.50
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

BONE SCREW SELF TAP 3.5x20MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270648601
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

BONE SCREW SELF TAP 3.5x22MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270662027
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

BONE SCREW SELF TAP 3.5x22MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270662027
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$205.50
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

BONE SCREW SELF TAP 3.5x34MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270673669
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$342.50
Rate for Payer: Aetna Commercial	$205.50
Rate for Payer: Aetna Medicare Advantage	$205.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.68
Rate for Payer: Cigna Commercial	$342.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

BONE SCREW SELF TAP 3.5x34MM

Facility

$685.00

Service Code	HCPCS C1713
Hospital Charge Code	270673669
Hospital Revenue Code	278
Min. Negotiated Rate	$102.75
Max. Negotiated Rate	$165.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.77
Rate for Payer: Qualcare PPO/HMO/WC	$102.75

BONE SCREW T10 3.5MMXL28

Facility

$383.15

Service Code	HCPCS C1713
Hospital Charge Code	270700424
Hospital Revenue Code	278
Min. Negotiated Rate	$57.47
Max. Negotiated Rate	$92.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.72
Rate for Payer: Qualcare PPO/HMO/WC	$57.47

BONE SCREW T10 3.5MMXL28

Facility

$383.15

Service Code	HCPCS C1713
Hospital Charge Code	270700424
Hospital Revenue Code	278
Min. Negotiated Rate	$57.47
Max. Negotiated Rate	$191.57
Rate for Payer: Aetna Commercial	$114.94
Rate for Payer: Aetna Medicare Advantage	$114.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.70
Rate for Payer: Cigna Commercial	$191.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.72
Rate for Payer: Qualcare PPO/HMO/WC	$57.47

BONE SCREW T10 3.5MMXL30

Facility

$383.15

Service Code	HCPCS C1713
Hospital Charge Code	270700425
Hospital Revenue Code	278
Min. Negotiated Rate	$57.47
Max. Negotiated Rate	$191.57
Rate for Payer: Aetna Commercial	$114.94
Rate for Payer: Aetna Medicare Advantage	$114.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.70
Rate for Payer: Cigna Commercial	$191.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.72
Rate for Payer: Qualcare PPO/HMO/WC	$57.47

BONE SCREW T10 3.5MMXL30

Facility

$383.15

Service Code	HCPCS C1713
Hospital Charge Code	270700425
Hospital Revenue Code	278
Min. Negotiated Rate	$57.47
Max. Negotiated Rate	$92.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.72
Rate for Payer: Qualcare PPO/HMO/WC	$57.47

Know your out-of-pocket cost for care.

All Charges