Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE #2 TW BRAID POLYBLEND

Facility

$115.00

Hospital Charge Code	270677966
Hospital Revenue Code	272
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

SUTURE #2 TW BRAID POLYBLEND

Facility

$115.00

Hospital Charge Code	270677966
Hospital Revenue Code	272
Min. Negotiated Rate	$14.95
Max. Negotiated Rate	$57.50
Rate for Payer: Aetna Commercial	$34.50
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.95
Rate for Payer: Oxford Commercial	$57.50
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Commercial	$57.50

SUTURE #2 W/BLACK

Facility

$230.00

Hospital Charge Code	270672174
Hospital Revenue Code	272
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

SUTURE #2 W/BLACK

Facility

$230.00

Hospital Charge Code	270672174
Hospital Revenue Code	272
Min. Negotiated Rate	$29.90
Max. Negotiated Rate	$115.00
Rate for Payer: Aetna Commercial	$69.00
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.90
Rate for Payer: Oxford Commercial	$115.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Commercial	$115.00

SUTURE #2 W/BLUE

Facility

$230.00

Hospital Charge Code	270672175
Hospital Revenue Code	272
Min. Negotiated Rate	$29.90
Max. Negotiated Rate	$115.00
Rate for Payer: Aetna Commercial	$69.00
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.90
Rate for Payer: Oxford Commercial	$115.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Commercial	$115.00

SUTURE #2 W/BLUE

Facility

$230.00

Hospital Charge Code	270672175
Hospital Revenue Code	272
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

SUTURE 3-0 27 PDS PLUS SH

Facility

$11.80

Hospital Charge Code	270664319
Hospital Revenue Code	272
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$5.90
Rate for Payer: Aetna Commercial	$3.54
Rate for Payer: Aetna Medicare Advantage	$3.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.01
Rate for Payer: Cigna Commercial	$5.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.53
Rate for Payer: Oxford Commercial	$5.90
Rate for Payer: Qualcare PPO/HMO/WC	$1.77
Rate for Payer: UnitedHealthcare Commercial	$5.90

SUTURE 3-0 27 PDS PLUS SH

Facility

$11.80

Hospital Charge Code	270664319
Hospital Revenue Code	272
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$1.77
Rate for Payer: Qualcare PPO/HMO/WC	$1.77

SUTURE 3/0 PDS MONO CT-2

Facility

$16.00

Hospital Charge Code	270683594
Hospital Revenue Code	272
Min. Negotiated Rate	$2.08
Max. Negotiated Rate	$8.00
Rate for Payer: Aetna Commercial	$4.80
Rate for Payer: Aetna Medicare Advantage	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.08
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.08
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.40
Rate for Payer: UnitedHealthcare Commercial	$8.00

SUTURE 3/0 PDS MONO CT-2

Facility

$16.00

Hospital Charge Code	270683594
Hospital Revenue Code	272
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

SUTURE 3-0 POLYSORB V-20 NEEDL

Facility

$313.35

Hospital Charge Code	270654989
Hospital Revenue Code	272
Min. Negotiated Rate	$47.00
Max. Negotiated Rate	$47.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.00

SUTURE 3-0 POLYSORB V-20 NEEDL

Facility

$313.35

Hospital Charge Code	270654989
Hospital Revenue Code	272
Min. Negotiated Rate	$40.74
Max. Negotiated Rate	$156.68
Rate for Payer: Aetna Commercial	$94.00
Rate for Payer: Aetna Medicare Advantage	$94.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.90
Rate for Payer: Cigna Commercial	$156.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.74
Rate for Payer: Oxford Commercial	$156.68
Rate for Payer: Qualcare PPO/HMO/WC	$47.00
Rate for Payer: UnitedHealthcare Commercial	$156.68

SUTURE 3-0 VICRYL PLUS

Facility

$59.57

Service Code	HCPCS A4649
Hospital Charge Code	270664981S
Hospital Revenue Code	272
Min. Negotiated Rate	$7.74
Max. Negotiated Rate	$29.79
Rate for Payer: Aetna Commercial	$17.87
Rate for Payer: Aetna Medicare Advantage	$17.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.19
Rate for Payer: Cigna Commercial	$29.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.74
Rate for Payer: Oxford Commercial	$29.79
Rate for Payer: Qualcare PPO/HMO/WC	$8.94
Rate for Payer: UnitedHealthcare Commercial	$29.79

SUTURE 3-0 VICRYL PLUS

Facility

$59.57

Service Code	HCPCS A4649
Hospital Charge Code	270664981S
Hospital Revenue Code	272
Min. Negotiated Rate	$8.94
Max. Negotiated Rate	$8.94
Rate for Payer: Qualcare PPO/HMO/WC	$8.94

SUTURE 4-0 18PDS PLUS PS-2 CLR

Facility

$22.90

Hospital Charge Code	270664320
Hospital Revenue Code	272
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$3.44
Rate for Payer: Qualcare PPO/HMO/WC	$3.44

SUTURE 4-0 18PDS PLUS PS-2 CLR

Facility

$22.90

Hospital Charge Code	270664320
Hospital Revenue Code	272
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$11.45
Rate for Payer: Aetna Commercial	$6.87
Rate for Payer: Aetna Medicare Advantage	$6.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.84
Rate for Payer: Cigna Commercial	$11.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.98
Rate for Payer: Oxford Commercial	$11.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.44
Rate for Payer: UnitedHealthcare Commercial	$11.45

SUTURE 4-0 PROLENE BLUE MONO

Facility

$35.14

Service Code	HCPCS A4649
Hospital Charge Code	270693787
Hospital Revenue Code	272
Min. Negotiated Rate	$5.27
Max. Negotiated Rate	$5.27
Rate for Payer: Qualcare PPO/HMO/WC	$5.27

SUTURE 4-0 PROLENE BLUE MONO

Facility

$35.14

Service Code	HCPCS A4649
Hospital Charge Code	270693787
Hospital Revenue Code	272
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$17.57
Rate for Payer: Aetna Commercial	$10.54
Rate for Payer: Aetna Medicare Advantage	$10.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.96
Rate for Payer: Cigna Commercial	$17.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.57
Rate for Payer: Oxford Commercial	$17.57
Rate for Payer: Qualcare PPO/HMO/WC	$5.27
Rate for Payer: UnitedHealthcare Commercial	$17.57

SUTURE 4-0 SILK SH POP OFF MUL

Facility

$64.80

Hospital Charge Code	270685435
Hospital Revenue Code	272
Min. Negotiated Rate	$8.42
Max. Negotiated Rate	$32.40
Rate for Payer: Aetna Commercial	$19.44
Rate for Payer: Aetna Medicare Advantage	$19.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.52
Rate for Payer: Cigna Commercial	$32.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.42
Rate for Payer: Oxford Commercial	$32.40
Rate for Payer: Qualcare PPO/HMO/WC	$9.72
Rate for Payer: UnitedHealthcare Commercial	$32.40

SUTURE 4-0 SILK SH POP OFF MUL

Facility

$64.80

Hospital Charge Code	270685435
Hospital Revenue Code	272
Min. Negotiated Rate	$9.72
Max. Negotiated Rate	$9.72
Rate for Payer: Qualcare PPO/HMO/WC	$9.72

SUTURE 4-0 VICRYL RB-1 18 IN

Facility

$70.40

Hospital Charge Code	270690132
Hospital Revenue Code	272
Min. Negotiated Rate	$10.56
Max. Negotiated Rate	$10.56
Rate for Payer: Qualcare PPO/HMO/WC	$10.56

SUTURE 4-0 VICRYL RB-1 18 IN

Facility

$70.40

Hospital Charge Code	270690132
Hospital Revenue Code	272
Min. Negotiated Rate	$9.15
Max. Negotiated Rate	$35.20
Rate for Payer: Aetna Commercial	$21.12
Rate for Payer: Aetna Medicare Advantage	$21.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.95
Rate for Payer: Cigna Commercial	$35.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.15
Rate for Payer: Oxford Commercial	$35.20
Rate for Payer: Qualcare PPO/HMO/WC	$10.56
Rate for Payer: UnitedHealthcare Commercial	$35.20

SUTURE 5-0 18IN VICRYL PC-3

Facility

$22.65

Hospital Charge Code	270671350
Hospital Revenue Code	272
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$3.40
Rate for Payer: Qualcare PPO/HMO/WC	$3.40

SUTURE 5-0 18IN VICRYL PC-3

Facility

$22.65

Hospital Charge Code	270671350
Hospital Revenue Code	272
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$11.32
Rate for Payer: Aetna Commercial	$6.79
Rate for Payer: Aetna Medicare Advantage	$6.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.78
Rate for Payer: Cigna Commercial	$11.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.94
Rate for Payer: Oxford Commercial	$11.32
Rate for Payer: Qualcare PPO/HMO/WC	$3.40
Rate for Payer: UnitedHealthcare Commercial	$11.32

SUTURE 5-0 MONOCRYL PLUS PS-2

Facility

$27.36

Service Code	HCPCS A4649
Hospital Charge Code	270671353
Hospital Revenue Code	272
Min. Negotiated Rate	$3.56
Max. Negotiated Rate	$13.68
Rate for Payer: Aetna Commercial	$8.21
Rate for Payer: Aetna Medicare Advantage	$8.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.98
Rate for Payer: Cigna Commercial	$13.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.56
Rate for Payer: Oxford Commercial	$13.68
Rate for Payer: Qualcare PPO/HMO/WC	$4.10
Rate for Payer: UnitedHealthcare Commercial	$13.68

Know your out-of-pocket cost for care.

All Charges