Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB 3/0 12x18 U/D

Facility

IP

$28.66

Hospital Charge Code	270655783
Hospital Revenue Code	272
Min. Negotiated Rate	$4.30
Max. Negotiated Rate	$4.30
Rate for Payer: Qualcare PPO/HMO/WC	$4.30

SUTURE POLYSORB 3/0 18IN UNDYE

Facility

OP

$12.83

Hospital Charge Code	2709007228
Hospital Revenue Code	272
Min. Negotiated Rate	$1.67
Max. Negotiated Rate	$6.42
Rate for Payer: Aetna Commercial	$3.85
Rate for Payer: Aetna Medicare Advantage	$3.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.27
Rate for Payer: Cigna Commercial	$6.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.67
Rate for Payer: Oxford Commercial	$6.42
Rate for Payer: Qualcare PPO/HMO/WC	$1.92
Rate for Payer: UnitedHealthcare Commercial	$6.42

SUTURE POLYSORB 3/0 18IN UNDYE

Facility

IP

$13.33

Hospital Charge Code	270661668N
Hospital Revenue Code	272
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.00

SUTURE POLYSORB 3/0 18IN UNDYE

Facility

IP

$13.13

Hospital Charge Code	270661668
Hospital Revenue Code	272
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$1.97
Rate for Payer: Qualcare PPO/HMO/WC	$1.97

SUTURE POLYSORB 3/0 18IN UNDYE

Facility

OP

$13.13

Hospital Charge Code	270661668
Hospital Revenue Code	272
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$6.57
Rate for Payer: Aetna Commercial	$3.94
Rate for Payer: Aetna Medicare Advantage	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.35
Rate for Payer: Cigna Commercial	$6.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.71
Rate for Payer: Oxford Commercial	$6.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.97
Rate for Payer: UnitedHealthcare Commercial	$6.57

SUTURE POLYSORB 3/0 18IN UNDYE

Facility

IP

$12.83

Hospital Charge Code	2709007228
Hospital Revenue Code	272
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.92

SUTURE POLYSORB 3/0 18IN UNDYE

Facility

IP

$13.13

Hospital Charge Code	270661668S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$1.97
Rate for Payer: Qualcare PPO/HMO/WC	$1.97

SUTURE POLYSORB 3/0 18IN UNDYE

Facility

OP

$13.33

Hospital Charge Code	270661668N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$6.67
Rate for Payer: Aetna Commercial	$4.00
Rate for Payer: Aetna Medicare Advantage	$4.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.40
Rate for Payer: Cigna Commercial	$6.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.73
Rate for Payer: Oxford Commercial	$6.67
Rate for Payer: Qualcare PPO/HMO/WC	$2.00
Rate for Payer: UnitedHealthcare Commercial	$6.67

SUTURE POLYSORB 3/0 18IN UNDYE

Facility

OP

$13.13

Hospital Charge Code	270661668S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$6.57
Rate for Payer: Aetna Commercial	$3.94
Rate for Payer: Aetna Medicare Advantage	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.35
Rate for Payer: Cigna Commercial	$6.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.71
Rate for Payer: Oxford Commercial	$6.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.97
Rate for Payer: UnitedHealthcare Commercial	$6.57

SUTURE POLYSORB 3/0 18 U/D P12

Facility

IP

$14.08

Hospital Charge Code	270656154N
Hospital Revenue Code	272
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$2.11
Rate for Payer: Qualcare PPO/HMO/WC	$2.11

SUTURE POLYSORB 3/0 18 U/D P12

Facility

OP

$14.08

Hospital Charge Code	270656154
Hospital Revenue Code	272
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$7.04
Rate for Payer: Aetna Commercial	$4.22
Rate for Payer: Aetna Medicare Advantage	$4.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.59
Rate for Payer: Cigna Commercial	$7.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.83
Rate for Payer: Oxford Commercial	$7.04
Rate for Payer: Qualcare PPO/HMO/WC	$2.11
Rate for Payer: UnitedHealthcare Commercial	$7.04

SUTURE POLYSORB 3/0 18 U/D P12

Facility

OP

$14.08

Hospital Charge Code	270656154S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$7.04
Rate for Payer: Aetna Commercial	$4.22
Rate for Payer: Aetna Medicare Advantage	$4.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.59
Rate for Payer: Cigna Commercial	$7.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.83
Rate for Payer: Oxford Commercial	$7.04
Rate for Payer: Qualcare PPO/HMO/WC	$2.11
Rate for Payer: UnitedHealthcare Commercial	$7.04

SUTURE POLYSORB 3/0 18 U/D P12

Facility

IP

$14.08

Hospital Charge Code	270656154S
Hospital Revenue Code	272
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$2.11
Rate for Payer: Qualcare PPO/HMO/WC	$2.11

SUTURE POLYSORB 3/0 18 U/D P12

Facility

IP

$14.08

Hospital Charge Code	270656154
Hospital Revenue Code	272
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$2.11
Rate for Payer: Qualcare PPO/HMO/WC	$2.11

SUTURE POLYSORB 3/0 18 U/D P12

Facility

OP

$14.08

Hospital Charge Code	270656154N
Hospital Revenue Code	272
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$7.04
Rate for Payer: Aetna Commercial	$4.22
Rate for Payer: Aetna Medicare Advantage	$4.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.59
Rate for Payer: Cigna Commercial	$7.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.83
Rate for Payer: Oxford Commercial	$7.04
Rate for Payer: Qualcare PPO/HMO/WC	$2.11
Rate for Payer: UnitedHealthcare Commercial	$7.04

SUTURE POLYSORB 3/0 30 CT1

Facility

OP

$6.07

Hospital Charge Code	270604550
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 3/0 30 CT1

Facility

IP

$6.07

Hospital Charge Code	270604550
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 3/0 30 GS10

Facility

OP

$6.78

Hospital Charge Code	270651130
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 3/0 30 GS10

Facility

IP

$6.78

Hospital Charge Code	270651130
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 3/0 30 U/D P12

Facility

OP

$13.92

Hospital Charge Code	270604577
Hospital Revenue Code	272
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$6.96
Rate for Payer: Aetna Commercial	$4.18
Rate for Payer: Aetna Medicare Advantage	$4.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.55
Rate for Payer: Cigna Commercial	$6.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.81
Rate for Payer: Oxford Commercial	$6.96
Rate for Payer: Qualcare PPO/HMO/WC	$2.09
Rate for Payer: UnitedHealthcare Commercial	$6.96

SUTURE POLYSORB 3/0 30 U/D P12

Facility

IP

$13.92

Hospital Charge Code	270604577
Hospital Revenue Code	272
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$2.09
Rate for Payer: Qualcare PPO/HMO/WC	$2.09

SUTURE POLYSORB 3/0 30 UD V20

Facility

IP

$6.07

Hospital Charge Code	270651281N
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 3/0 30 UD V20

Facility

OP

$6.07

Hospital Charge Code	270651281
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 3/0 30 UD V20

Facility

OP

$6.07

Hospital Charge Code	270604578
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 3/0 30 UD V20

Facility

IP

$6.07

Hospital Charge Code	270651281
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.91