Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB 2/0 30 VIOLET

Facility

$7.96

Hospital Charge Code	270604543
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 2/0 30 VIOLET

Facility

$8.82

Hospital Charge Code	270604548
Hospital Revenue Code	272
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$1.32
Rate for Payer: Qualcare PPO/HMO/WC	$1.32

SUTURE POLYSORB 2/0 36 U/D CT

Facility

$6.83

Hospital Charge Code	270651346
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 2/0 36 U/D CT

Facility

$6.83

Hospital Charge Code	270651346
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 2/0 3x18 VIO

Facility

$7.34

Hospital Charge Code	270670965
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 2/0 3x18 VIO

Facility

$7.34

Hospital Charge Code	270670965
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 2/0 3x27 VIO

Facility

$7.24

Hospital Charge Code	270604526
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 2/0 3x27 VIO

Facility

$7.24

Hospital Charge Code	270604526
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 2/0 60 U/D

Facility

$7.40

Hospital Charge Code	270651156
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$3.70
Rate for Payer: Aetna Commercial	$2.22
Rate for Payer: Aetna Medicare Advantage	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.89
Rate for Payer: Cigna Commercial	$3.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.96
Rate for Payer: Oxford Commercial	$3.70
Rate for Payer: Qualcare PPO/HMO/WC	$1.11
Rate for Payer: UnitedHealthcare Commercial	$3.70

SUTURE POLYSORB 2/0 60 U/D

Facility

$7.40

Hospital Charge Code	270651156
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$1.11
Rate for Payer: Qualcare PPO/HMO/WC	$1.11

SUTURE POLYSORB 2/0 60 UNDYED

Facility

$5.97

Hospital Charge Code	270656138
Hospital Revenue Code	272
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$2.98
Rate for Payer: Aetna Commercial	$1.79
Rate for Payer: Aetna Medicare Advantage	$1.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.52
Rate for Payer: Cigna Commercial	$2.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$2.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$2.98

SUTURE POLYSORB 2/0 60 UNDYED

Facility

$5.97

Hospital Charge Code	270656138
Hospital Revenue Code	272
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

SUTURE POLYSORB 2/0 60 VIO

Facility

$7.40

Hospital Charge Code	270604522
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$1.11
Rate for Payer: Qualcare PPO/HMO/WC	$1.11

SUTURE POLYSORB 2/0 60 VIO

Facility

$7.40

Hospital Charge Code	270604522
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$3.70
Rate for Payer: Aetna Commercial	$2.22
Rate for Payer: Aetna Medicare Advantage	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.89
Rate for Payer: Cigna Commercial	$3.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.96
Rate for Payer: Oxford Commercial	$3.70
Rate for Payer: Qualcare PPO/HMO/WC	$1.11
Rate for Payer: UnitedHealthcare Commercial	$3.70

SUTURE POLYSORB 2 0 GS21

Facility

$6.81

Hospital Charge Code	270662049N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$3.40
Rate for Payer: Aetna Commercial	$2.04
Rate for Payer: Aetna Medicare Advantage	$2.04
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	$3.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.89
Rate for Payer: Oxford Commercial	$3.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.02
Rate for Payer: UnitedHealthcare Commercial	$3.40

SUTURE POLYSORB 2 0 GS21

Facility

$6.81

Hospital Charge Code	270662049S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$3.40
Rate for Payer: Aetna Commercial	$2.04
Rate for Payer: Aetna Medicare Advantage	$2.04
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	$3.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.89
Rate for Payer: Oxford Commercial	$3.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.02
Rate for Payer: UnitedHealthcare Commercial	$3.40

SUTURE POLYSORB 2 0 GS21

Facility

$6.81

Hospital Charge Code	270662049N
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 2 0 GS21

Facility

$6.81

Hospital Charge Code	270662049
Hospital Revenue Code	272
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$3.40
Rate for Payer: Aetna Commercial	$2.04
Rate for Payer: Aetna Medicare Advantage	$2.04
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	$3.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.89
Rate for Payer: Oxford Commercial	$3.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.02
Rate for Payer: UnitedHealthcare Commercial	$3.40

SUTURE POLYSORB 2 0 GS21

Facility

$6.81

Hospital Charge Code	270662049S
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 2 0 GS21

Facility

$6.81

Hospital Charge Code	270662049
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 2-0 VL 60 PCT

Facility

$5.80

Hospital Charge Code	270656143
Hospital Revenue Code	272
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$0.87
Rate for Payer: Qualcare PPO/HMO/WC	$0.87

SUTURE POLYSORB 2-0 VL 60 PCT

Facility

$5.80

Hospital Charge Code	270656143
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 POLYSORB 2 5x30 VIOLET

Facility

$59.26

Hospital Charge Code	270663266
Hospital Revenue Code	272
Min. Negotiated Rate	$8.89
Max. Negotiated Rate	$8.89
Rate for Payer: Qualcare PPO/HMO/WC	$8.89

SUTURE POLYSORB 2 5x30 VIOLET

Facility

$59.26

Hospital Charge Code	270663266
Hospital Revenue Code	272
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$29.63
Rate for Payer: Aetna Commercial	$17.78
Rate for Payer: Aetna Medicare Advantage	$17.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.11
Rate for Payer: Cigna Commercial	$29.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.70
Rate for Payer: Oxford Commercial	$29.63
Rate for Payer: Qualcare PPO/HMO/WC	$8.89
Rate for Payer: UnitedHealthcare Commercial	$29.63

SUTURE POLYSORB 3/0 12x18 U/D

Facility

$28.66

Hospital Charge Code	270655783
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$14.33
Rate for Payer: Aetna Commercial	$8.60
Rate for Payer: Aetna Medicare Advantage	$8.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.31
Rate for Payer: Cigna Commercial	$14.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.73
Rate for Payer: Oxford Commercial	$14.33
Rate for Payer: Qualcare PPO/HMO/WC	$4.30
Rate for Payer: UnitedHealthcare Commercial	$14.33

Know your out-of-pocket cost for care.

All Charges