Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE BIOSYN 4/0 30 U/D V20

Facility

$6.83

Hospital Charge Code	270604710
Hospital Revenue Code	272
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$3.42
Rate for Payer: Aetna Commercial	$2.05
Rate for Payer: Aetna Medicare Advantage	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.74
Rate for Payer: Cigna Commercial	$3.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.89
Rate for Payer: Oxford Commercial	$3.42
Rate for Payer: Qualcare PPO/HMO/WC	$1.02
Rate for Payer: UnitedHealthcare Commercial	$3.42

SUTURE BIOSYN 4-0 P-12 SM5637

Facility

$15.20

Hospital Charge Code	270641077
Hospital Revenue Code	272
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$7.60
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$4.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.88
Rate for Payer: Cigna Commercial	$7.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.98
Rate for Payer: Oxford Commercial	$7.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.28
Rate for Payer: UnitedHealthcare Commercial	$7.60

SUTURE BIOSYN 4-0 P-12 SM5637

Facility

$15.20

Hospital Charge Code	270641077
Hospital Revenue Code	272
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$2.28
Rate for Payer: Qualcare PPO/HMO/WC	$2.28

SUTURE BIOSYN 5/0 18 U/D P12

Facility

$17.14

Hospital Charge Code	270675604
Hospital Revenue Code	272
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$2.57
Rate for Payer: Qualcare PPO/HMO/WC	$2.57

SUTURE BIOSYN 5/0 18 U/D P12

Facility

$17.14

Hospital Charge Code	270675604
Hospital Revenue Code	272
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$8.57
Rate for Payer: Aetna Commercial	$5.14
Rate for Payer: Aetna Medicare Advantage	$5.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.37
Rate for Payer: Cigna Commercial	$8.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.23
Rate for Payer: Oxford Commercial	$8.57
Rate for Payer: Qualcare PPO/HMO/WC	$2.57
Rate for Payer: UnitedHealthcare Commercial	$8.57

SUTURE BIOSYN 5/0 18 UNDYED

Facility

$17.14

Hospital Charge Code	270604713
Hospital Revenue Code	272
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$2.57
Rate for Payer: Qualcare PPO/HMO/WC	$2.57

SUTURE BIOSYN 5/0 18 UNDYED

Facility

$17.14

Hospital Charge Code	270604713
Hospital Revenue Code	272
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$8.57
Rate for Payer: Aetna Commercial	$5.14
Rate for Payer: Aetna Medicare Advantage	$5.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.37
Rate for Payer: Cigna Commercial	$8.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.23
Rate for Payer: Oxford Commercial	$8.57
Rate for Payer: Qualcare PPO/HMO/WC	$2.57
Rate for Payer: UnitedHealthcare Commercial	$8.57

SUTURE BIOSYN C14 2-0

Facility

$16.85

Hospital Charge Code	270600575
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

SUTURE BIOSYN C14 2-0

Facility

$16.85

Hospital Charge Code	270600575
Hospital Revenue Code	272
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$5.05
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.19
Rate for Payer: Oxford Commercial	$8.43
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$8.43

SUTURE BIOSYN CV-23 30

Facility

$5.80

Hospital Charge Code	270666890
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$2.90
Rate for Payer: Aetna Commercial	$1.74
Rate for Payer: Aetna Medicare Advantage	$1.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.48
Rate for Payer: Cigna Commercial	$2.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.75
Rate for Payer: Oxford Commercial	$2.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.87
Rate for Payer: UnitedHealthcare Commercial	$2.90

SUTURE BIOSYN CV-23 30

Facility

$5.80

Hospital Charge Code	270666890
Hospital Revenue Code	272
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$0.87
Rate for Payer: Qualcare PPO/HMO/WC	$0.87

SUTURE BIOSYN CV23 5-0

Facility

$65.65

Hospital Charge Code	270604714
Hospital Revenue Code	272
Min. Negotiated Rate	$8.53
Max. Negotiated Rate	$32.83
Rate for Payer: Aetna Commercial	$19.70
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.53
Rate for Payer: Oxford Commercial	$32.83
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$32.83

SUTURE BIOSYN CV23 5-0

Facility

$65.65

Hospital Charge Code	270604714
Hospital Revenue Code	272
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

SUTURE BIOSYN FS3 C13 4/0 UD

Facility

$7.24

Hospital Charge Code	270656159
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

SUTURE BIOSYN FS3 C13 4/0 UD

Facility

$7.24

Hospital Charge Code	270656159
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.17
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.94
Rate for Payer: Oxford Commercial	$3.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$3.62

SUTURE BIOSYN GS-11 0

Facility

$8.70

Hospital Charge Code	270613633
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$1.30
Rate for Payer: Qualcare PPO/HMO/WC	$1.30

SUTURE BIOSYN GS-11 0

Facility

$8.70

Hospital Charge Code	270613633
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$4.35
Rate for Payer: Aetna Commercial	$2.61
Rate for Payer: Aetna Medicare Advantage	$2.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.22
Rate for Payer: Cigna Commercial	$4.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.13
Rate for Payer: Oxford Commercial	$4.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.30
Rate for Payer: UnitedHealthcare Commercial	$4.35

SUTURE BIOSYN GU-45 2-0

Facility

$8.79

Hospital Charge Code	270613700
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$4.39
Rate for Payer: Aetna Commercial	$2.64
Rate for Payer: Aetna Medicare Advantage	$2.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.24
Rate for Payer: Cigna Commercial	$4.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.14
Rate for Payer: Oxford Commercial	$4.39
Rate for Payer: Qualcare PPO/HMO/WC	$1.32
Rate for Payer: UnitedHealthcare Commercial	$4.39

SUTURE BIOSYN GU-45 2-0

Facility

$8.79

Hospital Charge Code	270613700
Hospital Revenue Code	272
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$1.32
Rate for Payer: Qualcare PPO/HMO/WC	$1.32

SUTURE BIOSYN GU-46 2/0 VIO 36

Facility

$7.91

Hospital Charge Code	270656168
Hospital Revenue Code	272
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$3.96
Rate for Payer: Aetna Commercial	$2.37
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.02
Rate for Payer: Cigna Commercial	$3.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.03
Rate for Payer: Oxford Commercial	$3.96
Rate for Payer: Qualcare PPO/HMO/WC	$1.19
Rate for Payer: UnitedHealthcare Commercial	$3.96

SUTURE BIOSYN GU-46 2/0 VIO 36

Facility

$7.91

Hospital Charge Code	270656168
Hospital Revenue Code	272
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.19

SUTURE BIOSYN HOS11 2-0

Facility

$100.85

Hospital Charge Code	270604705
Hospital Revenue Code	272
Min. Negotiated Rate	$13.11
Max. Negotiated Rate	$50.42
Rate for Payer: Aetna Commercial	$30.25
Rate for Payer: Aetna Medicare Advantage	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.72
Rate for Payer: Cigna Commercial	$50.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.11
Rate for Payer: Oxford Commercial	$50.42
Rate for Payer: Qualcare PPO/HMO/WC	$15.13
Rate for Payer: UnitedHealthcare Commercial	$50.42

SUTURE BIOSYN HOS11 2-0

Facility

$100.85

Hospital Charge Code	270604705
Hospital Revenue Code	272
Min. Negotiated Rate	$15.13
Max. Negotiated Rate	$15.13
Rate for Payer: Qualcare PPO/HMO/WC	$15.13

SUTURE BIOSYN P-14 4-0 SM5679

Facility

$26.30

Hospital Charge Code	270632941C
Hospital Revenue Code	272
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$13.15
Rate for Payer: Aetna Commercial	$7.89
Rate for Payer: Aetna Medicare Advantage	$7.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.71
Rate for Payer: Cigna Commercial	$13.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.42
Rate for Payer: Oxford Commercial	$13.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.94
Rate for Payer: UnitedHealthcare Commercial	$13.15

SUTURE BIOSYN P-14 4-0 SM5679

Facility

$26.30

Hospital Charge Code	270632941C
Hospital Revenue Code	272
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$3.94
Rate for Payer: Qualcare PPO/HMO/WC	$3.94

Know your out-of-pocket cost for care.

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