Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB 1 36 VIOLET

Facility

$6.83

Hospital Charge Code	270651134
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 1 5x30 VIOLET

Facility

$26.37

Hospital Charge Code	270656027
Hospital Revenue Code	272
Min. Negotiated Rate	$3.43
Max. Negotiated Rate	$13.19
Rate for Payer: Aetna Commercial	$7.91
Rate for Payer: Aetna Medicare Advantage	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.72
Rate for Payer: Cigna Commercial	$13.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.43
Rate for Payer: Oxford Commercial	$13.19
Rate for Payer: Qualcare PPO/HMO/WC	$3.96
Rate for Payer: UnitedHealthcare Commercial	$13.19

SUTURE POLYSORB 1 5x30 VIOLET

Facility

$26.37

Hospital Charge Code	270656027
Hospital Revenue Code	272
Min. Negotiated Rate	$3.96
Max. Negotiated Rate	$3.96
Rate for Payer: Qualcare PPO/HMO/WC	$3.96

SUTURE POLYSORB 1 60 U/D TIES

Facility

$6.07

Hospital Charge Code	270659484
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.91

SUTURE POLYSORB 1 60 U/D TIES

Facility

$6.07

Hospital Charge Code	270659484
Hospital Revenue Code	272
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$3.04
Rate for Payer: Aetna Commercial	$1.82
Rate for Payer: Aetna Medicare Advantage	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.55
Rate for Payer: Cigna Commercial	$3.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.79
Rate for Payer: Oxford Commercial	$3.04
Rate for Payer: Qualcare PPO/HMO/WC	$0.91
Rate for Payer: UnitedHealthcare Commercial	$3.04

SUTURE POLYSORB 1 GS-21 36 UD

Facility

$6.95

Hospital Charge Code	270656028
Hospital Revenue Code	272
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$3.48
Rate for Payer: Aetna Commercial	$2.08
Rate for Payer: Aetna Medicare Advantage	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.77
Rate for Payer: Cigna Commercial	$3.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$3.48
Rate for Payer: Qualcare PPO/HMO/WC	$1.04
Rate for Payer: UnitedHealthcare Commercial	$3.48

SUTURE POLYSORB 1 GS-21 36 UD

Facility

$6.95

Hospital Charge Code	270656028
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$1.04
Rate for Payer: Qualcare PPO/HMO/WC	$1.04

SUTURE POLYSORB 1 GS-21 36 UD

Facility

$7.00

Hospital Charge Code	2703111186
Hospital Revenue Code	272
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

SUTURE POLYSORB 1 GS-21 36 UD

Facility

$7.00

Hospital Charge Code	2703111186
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.10
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.91
Rate for Payer: Oxford Commercial	$3.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$3.50

SUTURE POLYSORB 2/0 12x18 U/D

Facility

$29.28

Hospital Charge Code	270656145
Hospital Revenue Code	272
Min. Negotiated Rate	$4.39
Max. Negotiated Rate	$4.39
Rate for Payer: Qualcare PPO/HMO/WC	$4.39

SUTURE POLYSORB 2/0 12x18 U/D

Facility

$29.28

Hospital Charge Code	270656145
Hospital Revenue Code	272
Min. Negotiated Rate	$3.81
Max. Negotiated Rate	$14.64
Rate for Payer: Aetna Commercial	$8.78
Rate for Payer: Aetna Medicare Advantage	$8.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.47
Rate for Payer: Cigna Commercial	$14.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.81
Rate for Payer: Oxford Commercial	$14.64
Rate for Payer: Qualcare PPO/HMO/WC	$4.39
Rate for Payer: UnitedHealthcare Commercial	$14.64

SUTURE POLYSORB 2-0 18 U/D

Facility

$29.99

Hospital Charge Code	270651492
Hospital Revenue Code	272
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$14.99
Rate for Payer: Aetna Commercial	$9.00
Rate for Payer: Aetna Medicare Advantage	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.65
Rate for Payer: Cigna Commercial	$14.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$14.99
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$14.99

SUTURE POLYSORB 2-0 18 U/D

Facility

$29.99

Hospital Charge Code	270651492
Hospital Revenue Code	272
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

SUTURE POLYSORB 2/0 30 CT2

Facility

$6.68

Hospital Charge Code	270604546
Hospital Revenue Code	272
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$3.34
Rate for Payer: Aetna Commercial	$2.00
Rate for Payer: Aetna Medicare Advantage	$2.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.70
Rate for Payer: Cigna Commercial	$3.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.87
Rate for Payer: Oxford Commercial	$3.34
Rate for Payer: Qualcare PPO/HMO/WC	$1.00
Rate for Payer: UnitedHealthcare Commercial	$3.34

SUTURE POLYSORB 2/0 30 CT2

Facility

$6.68

Hospital Charge Code	270604546
Hospital Revenue Code	272
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.00

SUTURE POLYSORB 2/0 30 GS10

Facility

$7.45

Hospital Charge Code	270651131
Hospital Revenue Code	272
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$1.12
Rate for Payer: Qualcare PPO/HMO/WC	$1.12

SUTURE POLYSORB 2/0 30 GS10

Facility

$7.45

Hospital Charge Code	270651131
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$3.73
Rate for Payer: Aetna Commercial	$2.23
Rate for Payer: Aetna Medicare Advantage	$2.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.90
Rate for Payer: Cigna Commercial	$3.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.97
Rate for Payer: Oxford Commercial	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$1.12
Rate for Payer: UnitedHealthcare Commercial	$3.73

SUTURE POLYSORB 2/0 30IN CT1

Facility

$6.07

Hospital Charge Code	270604545
Hospital Revenue Code	272
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$3.04
Rate for Payer: Aetna Commercial	$1.82
Rate for Payer: Aetna Medicare Advantage	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.55
Rate for Payer: Cigna Commercial	$3.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.79
Rate for Payer: Oxford Commercial	$3.04
Rate for Payer: Qualcare PPO/HMO/WC	$0.91
Rate for Payer: UnitedHealthcare Commercial	$3.04

SUTURE POLYSORB 2/0 30IN CT1

Facility

$6.07

Hospital Charge Code	270604545
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.91

SUTURE POLYSORB 2/0 30 U/D FS1

Facility

$6.94

Hospital Charge Code	270606996
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$1.04
Rate for Payer: Qualcare PPO/HMO/WC	$1.04

SUTURE POLYSORB 2/0 30 U/D FS1

Facility

$6.94

Hospital Charge Code	270606996
Hospital Revenue Code	272
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$3.47
Rate for Payer: Aetna Commercial	$2.08
Rate for Payer: Aetna Medicare Advantage	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.77
Rate for Payer: Cigna Commercial	$3.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$3.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.04
Rate for Payer: UnitedHealthcare Commercial	$3.47

SUTURE POLYSORB 2/0 30 UD V20

Facility

$2.24

Hospital Charge Code	270605250
Hospital Revenue Code	272
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$1.12
Rate for Payer: Aetna Commercial	$0.67
Rate for Payer: Aetna Medicare Advantage	$0.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.57
Rate for Payer: Cigna Commercial	$1.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.29
Rate for Payer: Oxford Commercial	$1.12
Rate for Payer: Qualcare PPO/HMO/WC	$0.34
Rate for Payer: UnitedHealthcare Commercial	$1.12

SUTURE POLYSORB 2/0 30 UD V20

Facility

$2.24

Hospital Charge Code	270605250
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.34
Rate for Payer: Qualcare PPO/HMO/WC	$0.34

SUTURE POLYSORB 2/0 30 VIOLET

Facility

$8.82

Hospital Charge Code	270604548
Hospital Revenue Code	272
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$4.41
Rate for Payer: Aetna Commercial	$2.65
Rate for Payer: Aetna Medicare Advantage	$2.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.25
Rate for Payer: Cigna Commercial	$4.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.15
Rate for Payer: Oxford Commercial	$4.41
Rate for Payer: Qualcare PPO/HMO/WC	$1.32
Rate for Payer: UnitedHealthcare Commercial	$4.41

SUTURE POLYSORB 2/0 30 VIOLET

Facility

$7.96

Hospital Charge Code	270604543
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

Know your out-of-pocket cost for care.

All Charges