Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE MAXON 2/0 5x18 GRN T12

Facility

$36.93

Hospital Charge Code	270651253
Hospital Revenue Code	272
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$5.54
Rate for Payer: Qualcare PPO/HMO/WC	$5.54

SUTURE MAXON 2/0 5x18 GRN T12

Facility

$36.93

Hospital Charge Code	270651253
Hospital Revenue Code	272
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$18.46
Rate for Payer: Aetna Commercial	$11.08
Rate for Payer: Aetna Medicare Advantage	$11.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.42
Rate for Payer: Cigna Commercial	$18.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.80
Rate for Payer: Oxford Commercial	$18.46
Rate for Payer: Qualcare PPO/HMO/WC	$5.54
Rate for Payer: UnitedHealthcare Commercial	$18.46

SUTURE MAXON 3-0 V-20 T5 GREEN

Facility

$7.98

Hospital Charge Code	270656056
Hospital Revenue Code	272
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

SUTURE MAXON 3-0 V-20 T5 GREEN

Facility

$7.98

Hospital Charge Code	270656056
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$3.99
Rate for Payer: Aetna Commercial	$2.39
Rate for Payer: Aetna Medicare Advantage	$2.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.03
Rate for Payer: Cigna Commercial	$3.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$3.99
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$3.99

SUTURE MAXON 5-0 CV-23

Facility

$8.05

Hospital Charge Code	270664718
Hospital Revenue Code	272
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$1.21

SUTURE MAXON 5-0 CV-23

Facility

$8.05

Hospital Charge Code	270664718
Hospital Revenue Code	272
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$4.03
Rate for Payer: Aetna Commercial	$2.42
Rate for Payer: Aetna Medicare Advantage	$2.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.05
Rate for Payer: Cigna Commercial	$4.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.05
Rate for Payer: Oxford Commercial	$4.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.21
Rate for Payer: UnitedHealthcare Commercial	$4.03

SUTURE MAXON 6-0 CI CV-22

Facility

$9.55

Hospital Charge Code	270664719
Hospital Revenue Code	272
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$4.78
Rate for Payer: Aetna Commercial	$2.87
Rate for Payer: Aetna Medicare Advantage	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.44
Rate for Payer: Cigna Commercial	$4.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.24
Rate for Payer: Oxford Commercial	$4.78
Rate for Payer: Qualcare PPO/HMO/WC	$1.43
Rate for Payer: UnitedHealthcare Commercial	$4.78

SUTURE MAXON 6-0 CI CV-22

Facility

$9.55

Hospital Charge Code	270664719
Hospital Revenue Code	272
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$1.43
Rate for Payer: Qualcare PPO/HMO/WC	$1.43

SUTURE MAXON 7-0 CV-310/CV-1

Facility

$24.70

Hospital Charge Code	270664720
Hospital Revenue Code	272
Min. Negotiated Rate	$3.71
Max. Negotiated Rate	$3.71
Rate for Payer: Qualcare PPO/HMO/WC	$3.71

SUTURE MAXON 7-0 CV-310/CV-1

Facility

$24.70

Hospital Charge Code	270664720
Hospital Revenue Code	272
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$12.35
Rate for Payer: Aetna Commercial	$7.41
Rate for Payer: Aetna Medicare Advantage	$7.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.30
Rate for Payer: Cigna Commercial	$12.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.21
Rate for Payer: Oxford Commercial	$12.35
Rate for Payer: Qualcare PPO/HMO/WC	$3.71
Rate for Payer: UnitedHealthcare Commercial	$12.35

SUTURE MAXON GREEN 1

Facility

$8.34

Hospital Charge Code	270651252
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$1.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.25

SUTURE MAXON GREEN 1

Facility

$8.34

Hospital Charge Code	270651252
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$4.17
Rate for Payer: Aetna Commercial	$2.50
Rate for Payer: Aetna Medicare Advantage	$2.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.13
Rate for Payer: Cigna Commercial	$4.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.08
Rate for Payer: Oxford Commercial	$4.17
Rate for Payer: Qualcare PPO/HMO/WC	$1.25
Rate for Payer: UnitedHealthcare Commercial	$4.17

SUTURE MAXON GREEN V-20 5 X 8

Facility

$37.85

Hospital Charge Code	270666934
Hospital Revenue Code	272
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$5.68
Rate for Payer: Qualcare PPO/HMO/WC	$5.68

SUTURE MAXON GREEN V-20 5 X 8

Facility

$37.85

Hospital Charge Code	270666934
Hospital Revenue Code	272
Min. Negotiated Rate	$4.92
Max. Negotiated Rate	$18.93
Rate for Payer: Aetna Commercial	$11.36
Rate for Payer: Aetna Medicare Advantage	$11.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.65
Rate for Payer: Cigna Commercial	$18.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.92
Rate for Payer: Oxford Commercial	$18.93
Rate for Payer: Qualcare PPO/HMO/WC	$5.68
Rate for Payer: UnitedHealthcare Commercial	$18.93

SUTURE MAXON GS-21 0 GRN 30

Facility

$7.80

Hospital Charge Code	270655960
Hospital Revenue Code	272
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$3.90
Rate for Payer: Aetna Commercial	$2.34
Rate for Payer: Aetna Medicare Advantage	$2.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.99
Rate for Payer: Cigna Commercial	$3.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.01
Rate for Payer: Oxford Commercial	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$1.17
Rate for Payer: UnitedHealthcare Commercial	$3.90

SUTURE MAXON GS-21 0 GRN 30

Facility

$7.80

Hospital Charge Code	270655960
Hospital Revenue Code	272
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$1.17
Rate for Payer: Qualcare PPO/HMO/WC	$1.17

SUTURE MAXON LOOP GS-26 96 GRE

Facility

$65.00

Hospital Charge Code	270655955
Hospital Revenue Code	272
Min. Negotiated Rate	$8.45
Max. Negotiated Rate	$32.50
Rate for Payer: Aetna Commercial	$19.50
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.45
Rate for Payer: Oxford Commercial	$32.50
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$32.50

SUTURE MAXON LOOP GS-26 96 GRE

Facility

$65.00

Hospital Charge Code	270655955
Hospital Revenue Code	272
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

SUTURE MAXON NEEDLE TT-20

Facility

$9.61

Hospital Charge Code	270653046
Hospital Revenue Code	272
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.44

SUTURE MAXON NEEDLE TT-20

Facility

$9.61

Hospital Charge Code	270653046
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$4.80
Rate for Payer: Aetna Commercial	$2.88
Rate for Payer: Aetna Medicare Advantage	$2.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.45
Rate for Payer: Cigna Commercial	$4.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.25
Rate for Payer: Oxford Commercial	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.44
Rate for Payer: UnitedHealthcare Commercial	$4.80

SUTURE MAXON SIZE 01 GREEN1X36

Facility

$8.34

Hospital Charge Code	270651254
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$1.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.25

SUTURE MAXON SIZE 01 GREEN1X36

Facility

$8.34

Hospital Charge Code	270651254
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$4.17
Rate for Payer: Aetna Commercial	$2.50
Rate for Payer: Aetna Medicare Advantage	$2.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.13
Rate for Payer: Cigna Commercial	$4.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.08
Rate for Payer: Oxford Commercial	$4.17
Rate for Payer: Qualcare PPO/HMO/WC	$1.25
Rate for Payer: UnitedHealthcare Commercial	$4.17

SUTURE MAXXON 0 GS-21 NEEDLE

Facility

$8.45

Hospital Charge Code	270651251
Hospital Revenue Code	272
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$4.22
Rate for Payer: Aetna Commercial	$2.54
Rate for Payer: Aetna Medicare Advantage	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.15
Rate for Payer: Cigna Commercial	$4.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.10
Rate for Payer: Oxford Commercial	$4.22
Rate for Payer: Qualcare PPO/HMO/WC	$1.27
Rate for Payer: UnitedHealthcare Commercial	$4.22

SUTURE MAXXON 0 GS-21 NEEDLE

Facility

$8.45

Hospital Charge Code	270651251
Hospital Revenue Code	272
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$1.27
Rate for Payer: Qualcare PPO/HMO/WC	$1.27

SUTURE MCV PGS 0 TC43 80-3248

Facility

$119.25

Hospital Charge Code	270616785
Hospital Revenue Code	272
Min. Negotiated Rate	$17.89
Max. Negotiated Rate	$17.89
Rate for Payer: Qualcare PPO/HMO/WC	$17.89

Know your out-of-pocket cost for care.

All Charges