Heights University Hospital

All Charges

Charge

Type

Setting

Price

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	$4.10
Max. Negotiated Rate	$4.10
Rate for Payer: Qualcare PPO/HMO/WC	$4.10

SUTURE 5-0 PLAIN GUT 12 S-14

Facility

$98.89

Hospital Charge Code	270674245
Hospital Revenue Code	272
Min. Negotiated Rate	$12.86
Max. Negotiated Rate	$49.45
Rate for Payer: Aetna Commercial	$29.67
Rate for Payer: Aetna Medicare Advantage	$29.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.22
Rate for Payer: Cigna Commercial	$49.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.86
Rate for Payer: Oxford Commercial	$49.45
Rate for Payer: Qualcare PPO/HMO/WC	$14.83
Rate for Payer: UnitedHealthcare Commercial	$49.45

SUTURE 5-0 PLAIN GUT 12 S-14

Facility

$98.89

Hospital Charge Code	270674245
Hospital Revenue Code	272
Min. Negotiated Rate	$14.83
Max. Negotiated Rate	$14.83
Rate for Payer: Qualcare PPO/HMO/WC	$14.83

SUTURE 5-0 RB-1 VICRYL

Facility

$9.96

Hospital Charge Code	270690404
Hospital Revenue Code	272
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$1.49
Rate for Payer: Qualcare PPO/HMO/WC	$1.49

SUTURE 5-0 RB-1 VICRYL

Facility

$9.96

Hospital Charge Code	270690404
Hospital Revenue Code	272
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$4.98
Rate for Payer: Aetna Commercial	$2.99
Rate for Payer: Aetna Medicare Advantage	$2.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.54
Rate for Payer: Cigna Commercial	$4.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.29
Rate for Payer: Oxford Commercial	$4.98
Rate for Payer: Qualcare PPO/HMO/WC	$1.49
Rate for Payer: UnitedHealthcare Commercial	$4.98

SUTURE 5-0 VICRYL RB-1

Facility

$8.24

Hospital Charge Code	270690131
Hospital Revenue Code	272
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$4.12
Rate for Payer: Aetna Commercial	$2.47
Rate for Payer: Aetna Medicare Advantage	$2.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.10
Rate for Payer: Cigna Commercial	$4.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.07
Rate for Payer: Oxford Commercial	$4.12
Rate for Payer: Qualcare PPO/HMO/WC	$1.24
Rate for Payer: UnitedHealthcare Commercial	$4.12

SUTURE 5-0 VICRYL RB-1

Facility

$8.24

Hospital Charge Code	270690131
Hospital Revenue Code	272
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$1.24
Rate for Payer: Qualcare PPO/HMO/WC	$1.24

SUTURE 5-0 VICRYL UNDYES PC-3

Facility

$31.85

Hospital Charge Code	270684897
Hospital Revenue Code	272
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$15.93
Rate for Payer: Aetna Commercial	$9.55
Rate for Payer: Aetna Medicare Advantage	$9.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.12
Rate for Payer: Cigna Commercial	$15.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.14
Rate for Payer: Oxford Commercial	$15.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.78
Rate for Payer: UnitedHealthcare Commercial	$15.93

SUTURE 5-0 VICRYL UNDYES PC-3

Facility

$31.85

Hospital Charge Code	270684897
Hospital Revenue Code	272
Min. Negotiated Rate	$4.78
Max. Negotiated Rate	$4.78
Rate for Payer: Qualcare PPO/HMO/WC	$4.78

SUTURE 5-0 VICRYL UNDYES PC-3

Facility

$33.50

Hospital Charge Code	270684898
Hospital Revenue Code	272
Min. Negotiated Rate	$4.36
Max. Negotiated Rate	$16.75
Rate for Payer: Aetna Commercial	$10.05
Rate for Payer: Aetna Medicare Advantage	$10.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.54
Rate for Payer: Cigna Commercial	$16.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.36
Rate for Payer: Oxford Commercial	$16.75
Rate for Payer: Qualcare PPO/HMO/WC	$5.03
Rate for Payer: UnitedHealthcare Commercial	$16.75

SUTURE 5-0 VICRYL UNDYES PC-3

Facility

$33.50

Hospital Charge Code	270684898
Hospital Revenue Code	272
Min. Negotiated Rate	$5.03
Max. Negotiated Rate	$5.03
Rate for Payer: Qualcare PPO/HMO/WC	$5.03

SUTURE 5 SILK 60 IN

Facility

$17.85

Hospital Charge Code	270702978
Hospital Revenue Code	278
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$8.93
Rate for Payer: Aetna Commercial	$5.36
Rate for Payer: Aetna Medicare Advantage	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.55
Rate for Payer: Cigna Commercial	$8.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.32
Rate for Payer: Qualcare PPO/HMO/WC	$2.68

SUTURE 5 SILK 60 IN

Facility

$17.85

Hospital Charge Code	270702978
Hospital Revenue Code	278
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$4.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.32
Rate for Payer: Qualcare PPO/HMO/WC	$2.68

SUTURE 6-0 PROLENE BL BV-1 36

Facility

$462.48

Hospital Charge Code	270679571
Hospital Revenue Code	272
Min. Negotiated Rate	$69.37
Max. Negotiated Rate	$69.37
Rate for Payer: Qualcare PPO/HMO/WC	$69.37

SUTURE 6-0 PROLENE BL BV-1 36

Facility

$462.48

Hospital Charge Code	270679571
Hospital Revenue Code	272
Min. Negotiated Rate	$60.12
Max. Negotiated Rate	$231.24
Rate for Payer: Aetna Commercial	$138.74
Rate for Payer: Aetna Medicare Advantage	$138.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.93
Rate for Payer: Cigna Commercial	$231.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.12
Rate for Payer: Oxford Commercial	$231.24
Rate for Payer: Qualcare PPO/HMO/WC	$69.37
Rate for Payer: UnitedHealthcare Commercial	$231.24

SUTURE 6-0 PROLENE RB-1 DA 36

Facility

$221.05

Hospital Charge Code	270679572
Hospital Revenue Code	272
Min. Negotiated Rate	$28.74
Max. Negotiated Rate	$110.53
Rate for Payer: Aetna Commercial	$66.31
Rate for Payer: Aetna Medicare Advantage	$66.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.37
Rate for Payer: Cigna Commercial	$110.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.74
Rate for Payer: Oxford Commercial	$110.53
Rate for Payer: Qualcare PPO/HMO/WC	$33.16
Rate for Payer: UnitedHealthcare Commercial	$110.53

SUTURE 6-0 PROLENE RB-1 DA 36

Facility

$221.05

Hospital Charge Code	270679572
Hospital Revenue Code	272
Min. Negotiated Rate	$33.16
Max. Negotiated Rate	$33.16
Rate for Payer: Qualcare PPO/HMO/WC	$33.16

SUTURE 7717G

Facility

$33.57

Hospital Charge Code	270654903
Hospital Revenue Code	272
Min. Negotiated Rate	$5.04
Max. Negotiated Rate	$5.04
Rate for Payer: Qualcare PPO/HMO/WC	$5.04

SUTURE 7717G

Facility

$33.57

Hospital Charge Code	270654903
Hospital Revenue Code	272
Min. Negotiated Rate	$4.36
Max. Negotiated Rate	$16.79
Rate for Payer: Aetna Commercial	$10.07
Rate for Payer: Aetna Medicare Advantage	$10.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.56
Rate for Payer: Cigna Commercial	$16.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.36
Rate for Payer: Oxford Commercial	$16.79
Rate for Payer: Qualcare PPO/HMO/WC	$5.04
Rate for Payer: UnitedHealthcare Commercial	$16.79

SUTURE 90 DEG STRGHT AR406890

Facility

$700.00

Hospital Charge Code	270638447
Hospital Revenue Code	272
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SUTURE 90 DEG STRGHT AR406890

Facility

$700.00

Hospital Charge Code	270638447
Hospital Revenue Code	272
Min. Negotiated Rate	$91.00
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) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$350.00

SUTURE ABS V-LOC 180 P-12 3-0

Facility

$339.86

Hospital Charge Code	270652810
Hospital Revenue Code	272
Min. Negotiated Rate	$44.18
Max. Negotiated Rate	$169.93
Rate for Payer: Aetna Commercial	$101.96
Rate for Payer: Aetna Medicare Advantage	$101.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.66
Rate for Payer: Cigna Commercial	$169.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.18
Rate for Payer: Oxford Commercial	$169.93
Rate for Payer: Qualcare PPO/HMO/WC	$50.98
Rate for Payer: UnitedHealthcare Commercial	$169.93

SUTURE ABS V-LOC 180 P-12 3-0

Facility

$339.86

Hospital Charge Code	270652810
Hospital Revenue Code	272
Min. Negotiated Rate	$50.98
Max. Negotiated Rate	$50.98
Rate for Payer: Qualcare PPO/HMO/WC	$50.98

SUTURE AN BIO-FK 3x14 AR1324BF

Facility

$1,463.25

Hospital Charge Code	270632657
Hospital Revenue Code	272
Min. Negotiated Rate	$190.22
Max. Negotiated Rate	$731.62
Rate for Payer: Aetna Commercial	$438.98
Rate for Payer: Aetna Medicare Advantage	$438.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$373.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$373.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$373.13
Rate for Payer: Cigna Commercial	$731.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.22
Rate for Payer: Oxford Commercial	$731.62
Rate for Payer: Qualcare PPO/HMO/WC	$219.49
Rate for Payer: UnitedHealthcare Commercial	$731.62

SUTURE AN BIO-FK 3x14 AR1324BF

Facility

$1,463.25

Hospital Charge Code	270632657
Hospital Revenue Code	272
Min. Negotiated Rate	$219.49
Max. Negotiated Rate	$219.49
Rate for Payer: Qualcare PPO/HMO/WC	$219.49

Know your out-of-pocket cost for care.

All Charges