Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB 0 12x18 U/D

Facility

$26.93

Hospital Charge Code	270654266
Hospital Revenue Code	272
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$13.46
Rate for Payer: Aetna Commercial	$8.08
Rate for Payer: Aetna Medicare Advantage	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.87
Rate for Payer: Cigna Commercial	$13.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.50
Rate for Payer: Oxford Commercial	$13.46
Rate for Payer: Qualcare PPO/HMO/WC	$4.04
Rate for Payer: UnitedHealthcare Commercial	$13.46

SUTURE POLYSORB 0 18 VIOLET

Facility

$12.65

Hospital Charge Code	270665290
Hospital Revenue Code	272
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$6.33
Rate for Payer: Aetna Commercial	$3.79
Rate for Payer: Aetna Medicare Advantage	$3.79
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	$1.64
Rate for Payer: Oxford Commercial	$6.33
Rate for Payer: Qualcare PPO/HMO/WC	$1.90
Rate for Payer: UnitedHealthcare Commercial	$6.33

SUTURE POLYSORB 0 18 VIOLET

Facility

$12.65

Hospital Charge Code	270665290
Hospital Revenue Code	272
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$1.90
Rate for Payer: Qualcare PPO/HMO/WC	$1.90

SUTURE POLYSORB 0 30 CT2

Facility

$6.48

Hospital Charge Code	270604538
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.97

SUTURE POLYSORB 0 30 CT2

Facility

$6.48

Hospital Charge Code	270604538
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$3.24
Rate for Payer: Aetna Commercial	$1.94
Rate for Payer: Aetna Medicare Advantage	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.65
Rate for Payer: Cigna Commercial	$3.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.84
Rate for Payer: Oxford Commercial	$3.24
Rate for Payer: Qualcare PPO/HMO/WC	$0.97
Rate for Payer: UnitedHealthcare Commercial	$3.24

SUTURE POLYSORB 0 30IN CT1

Facility

$6.27

Hospital Charge Code	270604537
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$0.94
Rate for Payer: Qualcare PPO/HMO/WC	$0.94

SUTURE POLYSORB 0 30IN CT1

Facility

$6.27

Hospital Charge Code	270604537
Hospital Revenue Code	272
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$3.13
Rate for Payer: Aetna Commercial	$1.88
Rate for Payer: Aetna Medicare Advantage	$1.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.60
Rate for Payer: Cigna Commercial	$3.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.82
Rate for Payer: Oxford Commercial	$3.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.94
Rate for Payer: UnitedHealthcare Commercial	$3.13

SUTURE POLYSORB 0 30 VIOLET

Facility

$8.62

Hospital Charge Code	270604536
Hospital Revenue Code	272
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$1.29

SUTURE POLYSORB 0 30 VIOLET

Facility

$7.96

Hospital Charge Code	270604542
Hospital Revenue Code	272
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$3.98
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	$3.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.03
Rate for Payer: Oxford Commercial	$3.98
Rate for Payer: Qualcare PPO/HMO/WC	$1.19
Rate for Payer: UnitedHealthcare Commercial	$3.98

SUTURE POLYSORB 0 30 VIOLET

Facility

$7.60

Hospital Charge Code	270651238
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$1.14
Rate for Payer: Qualcare PPO/HMO/WC	$1.14

SUTURE POLYSORB 0 30 VIOLET

Facility

$7.96

Hospital Charge Code	270604542
Hospital Revenue Code	272
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.19

SUTURE POLYSORB 0 30 VIOLET

Facility

$8.62

Hospital Charge Code	270604536
Hospital Revenue Code	272
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$4.31
Rate for Payer: Aetna Commercial	$2.59
Rate for Payer: Aetna Medicare Advantage	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.20
Rate for Payer: Cigna Commercial	$4.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.12
Rate for Payer: Oxford Commercial	$4.31
Rate for Payer: Qualcare PPO/HMO/WC	$1.29
Rate for Payer: UnitedHealthcare Commercial	$4.31

SUTURE POLYSORB 0 30 VIOLET

Facility

$7.25

Hospital Charge Code	270656167
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

SUTURE POLYSORB 0 30 VIOLET

Facility

$7.25

Hospital Charge Code	270656167
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 POLYSORB 0 30 VIOLET

Facility

$7.60

Hospital Charge Code	270651238
Hospital Revenue Code	272
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$3.80
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.94
Rate for Payer: Cigna Commercial	$3.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.99
Rate for Payer: Oxford Commercial	$3.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.14
Rate for Payer: UnitedHealthcare Commercial	$3.80

SUTURE POLYSORB 0 36 U/D CT1

Facility

$7.34

Hospital Charge Code	270600564
Hospital Revenue Code	272
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$3.67
Rate for Payer: Aetna Commercial	$2.20
Rate for Payer: Aetna Medicare Advantage	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.87
Rate for Payer: Cigna Commercial	$3.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.95
Rate for Payer: Oxford Commercial	$3.67
Rate for Payer: Qualcare PPO/HMO/WC	$1.10
Rate for Payer: UnitedHealthcare Commercial	$3.67

SUTURE POLYSORB 0 36 U/D CT1

Facility

$7.34

Hospital Charge Code	270600564
Hospital Revenue Code	272
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$1.10
Rate for Payer: Qualcare PPO/HMO/WC	$1.10

SUTURE POLYSORB 0 36U/D GS24

Facility

$6.83

Hospital Charge Code	270651133
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 POLYSORB 0 36U/D GS24

Facility

$6.83

Hospital Charge Code	270651133
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.02

SUTURE POLYSORB 0 36 VIO GS24

Facility

$6.78

Hospital Charge Code	270656125
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.02

SUTURE POLYSORB 0 36 VIO GS24

Facility

$6.78

Hospital Charge Code	270656125
Hospital Revenue Code	272
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$3.39
Rate for Payer: Aetna Commercial	$2.03
Rate for Payer: Aetna Medicare Advantage	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.73
Rate for Payer: Cigna Commercial	$3.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.88
Rate for Payer: Oxford Commercial	$3.39
Rate for Payer: Qualcare PPO/HMO/WC	$1.02
Rate for Payer: UnitedHealthcare Commercial	$3.39

SUTURE POLYSORB 0 36 VIOLET

Facility

$8.11

Hospital Charge Code	270604716
Hospital Revenue Code	272
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$4.05
Rate for Payer: Aetna Commercial	$2.43
Rate for Payer: Aetna Medicare Advantage	$2.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.07
Rate for Payer: Cigna Commercial	$4.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.05
Rate for Payer: Oxford Commercial	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.22
Rate for Payer: UnitedHealthcare Commercial	$4.05

SUTURE POLYSORB 0 36 VIOLET

Facility

$8.11

Hospital Charge Code	270604716
Hospital Revenue Code	272
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$1.22
Rate for Payer: Qualcare PPO/HMO/WC	$1.22

SUTURE POLYSORB 0 3x27 VIOLET

Facility

$7.24

Hospital Charge Code	270604525
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

SUTURE POLYSORB 0 3x27 VIOLET

Facility

$7.24

Hospital Charge Code	270604525
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

Know your out-of-pocket cost for care.

All Charges