Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE MONOSOF 6/0 18 BLK P13

Facility

$47.20

Hospital Charge Code	270651310
Hospital Revenue Code	272
Min. Negotiated Rate	$7.08
Max. Negotiated Rate	$7.08
Rate for Payer: Qualcare PPO/HMO/WC	$7.08

SUTURE MONOSOF 6/0 18 BLK PC1

Facility

$17.14

Hospital Charge Code	270600773
Hospital Revenue Code	272
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$2.57
Rate for Payer: Qualcare PPO/HMO/WC	$2.57

SUTURE MONOSOF 6/0 18 BLK PC1

Facility

$17.14

Hospital Charge Code	270600773
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 MONOSOF 6/0 18 BLK PC3

Facility

$17.14

Hospital Charge Code	270600774
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 MONOSOF 6/0 18 BLK PC3

Facility

$17.14

Hospital Charge Code	270600774
Hospital Revenue Code	272
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$2.57
Rate for Payer: Qualcare PPO/HMO/WC	$2.57

SUTURE MONOSOF 6/0 18 CLR P1

Facility

$13.77

Hospital Charge Code	270604518
Hospital Revenue Code	272
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$2.07
Rate for Payer: Qualcare PPO/HMO/WC	$2.07

SUTURE MONOSOF 6/0 18 CLR P1

Facility

$13.77

Hospital Charge Code	270604518
Hospital Revenue Code	272
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$6.88
Rate for Payer: Aetna Commercial	$4.13
Rate for Payer: Aetna Medicare Advantage	$4.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.51
Rate for Payer: Cigna Commercial	$6.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.79
Rate for Payer: Oxford Commercial	$6.88
Rate for Payer: Qualcare PPO/HMO/WC	$2.07
Rate for Payer: UnitedHealthcare Commercial	$6.88

SUTURE MONOSOF 9-0 BLACK

Facility

$102.71

Hospital Charge Code	270651163
Hospital Revenue Code	272
Min. Negotiated Rate	$15.41
Max. Negotiated Rate	$15.41
Rate for Payer: Qualcare PPO/HMO/WC	$15.41

SUTURE MONOSOF 9-0 BLACK

Facility

$102.71

Hospital Charge Code	270651163
Hospital Revenue Code	272
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$51.35
Rate for Payer: Aetna Commercial	$30.81
Rate for Payer: Aetna Medicare Advantage	$30.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.19
Rate for Payer: Cigna Commercial	$51.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.35
Rate for Payer: Oxford Commercial	$51.35
Rate for Payer: Qualcare PPO/HMO/WC	$15.41
Rate for Payer: UnitedHealthcare Commercial	$51.35

SUTURE MONOSOF C-14 2-0 30

Facility

$5.82

Hospital Charge Code	270651173
Hospital Revenue Code	272
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$0.87
Rate for Payer: Qualcare PPO/HMO/WC	$0.87

SUTURE MONOSOF C-14 2-0 30

Facility

$5.82

Hospital Charge Code	270651173
Hospital Revenue Code	272
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$2.91
Rate for Payer: Aetna Commercial	$1.75
Rate for Payer: Aetna Medicare Advantage	$1.75
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	$2.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.76
Rate for Payer: Oxford Commercial	$2.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.87
Rate for Payer: UnitedHealthcare Commercial	$2.91

SUTURE MONOSOF C-15 2-0

Facility

$14.43

Hospital Charge Code	270604509
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$7.21
Rate for Payer: Aetna Commercial	$4.33
Rate for Payer: Aetna Medicare Advantage	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.68
Rate for Payer: Cigna Commercial	$7.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.88
Rate for Payer: Oxford Commercial	$7.21
Rate for Payer: Qualcare PPO/HMO/WC	$2.16
Rate for Payer: UnitedHealthcare Commercial	$7.21

SUTURE MONOSOF C-15 2-0

Facility

$14.43

Hospital Charge Code	270604509
Hospital Revenue Code	272
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.16
Rate for Payer: Qualcare PPO/HMO/WC	$2.16

SUTURE MONOSOF C-17 2-0 30

Facility

$6.03

Hospital Charge Code	270651174
Hospital Revenue Code	272
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$3.02
Rate for Payer: Aetna Commercial	$1.81
Rate for Payer: Aetna Medicare Advantage	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.54
Rate for Payer: Cigna Commercial	$3.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$3.02
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$3.02

SUTURE MONOSOF C-17 2-0 30

Facility

$6.03

Hospital Charge Code	270651174
Hospital Revenue Code	272
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

SUTURE MONOSOF MV1355 8-0

Facility

$49.12

Hospital Charge Code	270604515
Hospital Revenue Code	272
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$24.56
Rate for Payer: Aetna Commercial	$14.74
Rate for Payer: Aetna Medicare Advantage	$14.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.53
Rate for Payer: Cigna Commercial	$24.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.39
Rate for Payer: Oxford Commercial	$24.56
Rate for Payer: Qualcare PPO/HMO/WC	$7.37
Rate for Payer: UnitedHealthcare Commercial	$24.56

SUTURE MONOSOF MV1355 8-0

Facility

$49.12

Hospital Charge Code	270604515
Hospital Revenue Code	272
Min. Negotiated Rate	$7.37
Max. Negotiated Rate	$7.37
Rate for Payer: Qualcare PPO/HMO/WC	$7.37

SUTURE MONOSOF MVK1004 10-0

Facility

$211.25

Hospital Charge Code	270604516
Hospital Revenue Code	272
Min. Negotiated Rate	$27.46
Max. Negotiated Rate	$105.62
Rate for Payer: Aetna Commercial	$63.38
Rate for Payer: Aetna Medicare Advantage	$63.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.87
Rate for Payer: Cigna Commercial	$105.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.46
Rate for Payer: Oxford Commercial	$105.62
Rate for Payer: Qualcare PPO/HMO/WC	$31.69
Rate for Payer: UnitedHealthcare Commercial	$105.62

SUTURE MONOSOF MVK1004 10-0

Facility

$211.25

Hospital Charge Code	270604516
Hospital Revenue Code	272
Min. Negotiated Rate	$31.69
Max. Negotiated Rate	$31.69
Rate for Payer: Qualcare PPO/HMO/WC	$31.69

SUTURE MONOSOF P-10 7-0 BLK

Facility

$13.57

Hospital Charge Code	270649088
Hospital Revenue Code	272
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$2.04
Rate for Payer: Qualcare PPO/HMO/WC	$2.04

SUTURE MONOSOF P-10 7-0 BLK

Facility

$13.57

Hospital Charge Code	270649088
Hospital Revenue Code	272
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$6.79
Rate for Payer: Aetna Commercial	$4.07
Rate for Payer: Aetna Medicare Advantage	$4.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.46
Rate for Payer: Cigna Commercial	$6.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.76
Rate for Payer: Oxford Commercial	$6.79
Rate for Payer: Qualcare PPO/HMO/WC	$2.04
Rate for Payer: UnitedHealthcare Commercial	$6.79

SUTURE MONOSOF P-12 5-0 18

Facility

$12.90

Hospital Charge Code	270651305
Hospital Revenue Code	272
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$6.45
Rate for Payer: Aetna Commercial	$3.87
Rate for Payer: Aetna Medicare Advantage	$3.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.29
Rate for Payer: Cigna Commercial	$6.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.68
Rate for Payer: Oxford Commercial	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.94
Rate for Payer: UnitedHealthcare Commercial	$6.45

SUTURE MONOSOF P-12 5-0 18

Facility

$12.90

Hospital Charge Code	270651305
Hospital Revenue Code	272
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$1.94
Rate for Payer: Qualcare PPO/HMO/WC	$1.94

SUTURE MONOSOF P13 4-0 SN5691

Facility

$12.67

Hospital Charge Code	270633023
Hospital Revenue Code	272
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$6.33
Rate for Payer: Aetna Commercial	$3.80
Rate for Payer: Aetna Medicare Advantage	$3.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.23
Rate for Payer: Cigna Commercial	$6.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.65
Rate for Payer: Oxford Commercial	$6.33
Rate for Payer: Qualcare PPO/HMO/WC	$1.90
Rate for Payer: UnitedHealthcare Commercial	$6.33

SUTURE MONOSOF P13 4-0 SN5691

Facility

$12.67

Hospital Charge Code	270633023
Hospital Revenue Code	272
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$1.90
Rate for Payer: Qualcare PPO/HMO/WC	$1.90

Know your out-of-pocket cost for care.

All Charges