Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB 6-0 UNDYED

Facility

$54.59

Hospital Charge Code	270658909
Hospital Revenue Code	272
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$8.19
Rate for Payer: Qualcare PPO/HMO/WC	$8.19

SUTURE POLYSORB 6-0 UNDYED

Facility

$54.59

Hospital Charge Code	270658909
Hospital Revenue Code	272
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$27.30
Rate for Payer: Aetna Commercial	$16.38
Rate for Payer: Aetna Medicare Advantage	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.92
Rate for Payer: Cigna Commercial	$27.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.10
Rate for Payer: Oxford Commercial	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$8.19
Rate for Payer: UnitedHealthcare Commercial	$27.30

SUTURE POLYSORB 8-0 8 VL

Facility

$1,151.35

Hospital Charge Code	270658910
Hospital Revenue Code	272
Min. Negotiated Rate	$172.70
Max. Negotiated Rate	$172.70
Rate for Payer: Qualcare PPO/HMO/WC	$172.70

SUTURE POLYSORB 8-0 8 VL

Facility

$1,151.35

Hospital Charge Code	270658910
Hospital Revenue Code	272
Min. Negotiated Rate	$149.68
Max. Negotiated Rate	$575.67
Rate for Payer: Aetna Commercial	$345.40
Rate for Payer: Aetna Medicare Advantage	$345.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.59
Rate for Payer: Cigna Commercial	$575.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.68
Rate for Payer: Oxford Commercial	$575.67
Rate for Payer: Qualcare PPO/HMO/WC	$172.70
Rate for Payer: UnitedHealthcare Commercial	$575.67

SUTURE POLYSORB BGS21 0

Facility

$19.25

Hospital Charge Code	270600565
Hospital Revenue Code	272
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

SUTURE POLYSORB BGS21 0

Facility

$19.25

Hospital Charge Code	270600565
Hospital Revenue Code	272
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$9.62
Rate for Payer: Aetna Commercial	$5.78
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.91
Rate for Payer: Cigna Commercial	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.50
Rate for Payer: Oxford Commercial	$9.62
Rate for Payer: Qualcare PPO/HMO/WC	$2.89
Rate for Payer: UnitedHealthcare Commercial	$9.62

SUTURE POLYSORB BGS-21 3-0 36

Facility

$6.75

Hospital Charge Code	270651136
Hospital Revenue Code	272
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$3.38
Rate for Payer: Aetna Commercial	$2.02
Rate for Payer: Aetna Medicare Advantage	$2.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.72
Rate for Payer: Cigna Commercial	$3.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.88
Rate for Payer: Oxford Commercial	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$1.01
Rate for Payer: UnitedHealthcare Commercial	$3.38

SUTURE POLYSORB BGS-21 3-0 36

Facility

$6.75

Hospital Charge Code	270651136
Hospital Revenue Code	272
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$1.01
Rate for Payer: Qualcare PPO/HMO/WC	$1.01

SUTURE POLYSORB CV-23 3.0

Facility

$5.77

Hospital Charge Code	270648137
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$2.88
Rate for Payer: Aetna Commercial	$1.73
Rate for Payer: Aetna Medicare Advantage	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.47
Rate for Payer: Cigna Commercial	$2.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.75
Rate for Payer: Oxford Commercial	$2.88
Rate for Payer: Qualcare PPO/HMO/WC	$0.87
Rate for Payer: UnitedHealthcare Commercial	$2.88

SUTURE POLYSORB CV-23 3.0

Facility

$5.77

Hospital Charge Code	270648137
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 CVF-23 4-0 27

Facility

$20.95

Hospital Charge Code	2706501237
Hospital Revenue Code	272
Min. Negotiated Rate	$2.72
Max. Negotiated Rate	$10.47
Rate for Payer: Aetna Commercial	$6.29
Rate for Payer: Aetna Medicare Advantage	$6.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.34
Rate for Payer: Cigna Commercial	$10.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.72
Rate for Payer: Oxford Commercial	$10.47
Rate for Payer: Qualcare PPO/HMO/WC	$3.14
Rate for Payer: UnitedHealthcare Commercial	$10.47

SUTURE POLYSORB CVF-23 4-0 27

Facility

$20.95

Hospital Charge Code	2706501237
Hospital Revenue Code	272
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$3.14
Rate for Payer: Qualcare PPO/HMO/WC	$3.14

SUTURE POLYSORB ENDOSTI ES9

Facility

$228.85

Hospital Charge Code	270604727
Hospital Revenue Code	272
Min. Negotiated Rate	$34.33
Max. Negotiated Rate	$34.33
Rate for Payer: Qualcare PPO/HMO/WC	$34.33

SUTURE POLYSORB ENDOSTI ES9

Facility

$228.85

Hospital Charge Code	270604727
Hospital Revenue Code	272
Min. Negotiated Rate	$29.75
Max. Negotiated Rate	$114.42
Rate for Payer: Aetna Commercial	$68.66
Rate for Payer: Aetna Medicare Advantage	$68.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.36
Rate for Payer: Cigna Commercial	$114.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.75
Rate for Payer: Oxford Commercial	$114.42
Rate for Payer: Qualcare PPO/HMO/WC	$34.33
Rate for Payer: UnitedHealthcare Commercial	$114.42

SUTURE POLYSORB ENDOSTITCH 2-0

Facility

$115.90

Hospital Charge Code	270658690
Hospital Revenue Code	272
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$17.39
Rate for Payer: Qualcare PPO/HMO/WC	$17.39

SUTURE POLYSORB ENDOSTITCH 2-0

Facility

$115.90

Hospital Charge Code	270658690
Hospital Revenue Code	272
Min. Negotiated Rate	$15.07
Max. Negotiated Rate	$57.95
Rate for Payer: Aetna Commercial	$34.77
Rate for Payer: Aetna Medicare Advantage	$34.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.55
Rate for Payer: Cigna Commercial	$57.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.07
Rate for Payer: Oxford Commercial	$57.95
Rate for Payer: Qualcare PPO/HMO/WC	$17.39
Rate for Payer: UnitedHealthcare Commercial	$57.95

SUTURE POLYSORB EV20 0

Facility

$178.45

Hospital Charge Code	270604736
Hospital Revenue Code	272
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$89.22
Rate for Payer: Aetna Commercial	$53.53
Rate for Payer: Aetna Medicare Advantage	$53.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.50
Rate for Payer: Cigna Commercial	$89.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.20
Rate for Payer: Oxford Commercial	$89.22
Rate for Payer: Qualcare PPO/HMO/WC	$26.77
Rate for Payer: UnitedHealthcare Commercial	$89.22

SUTURE POLYSORB EV20 0

Facility

$178.45

Hospital Charge Code	270604736
Hospital Revenue Code	272
Min. Negotiated Rate	$26.77
Max. Negotiated Rate	$26.77
Rate for Payer: Qualcare PPO/HMO/WC	$26.77

SUTURE POLYSORB EV20 2-0

Facility

$178.45

Hospital Charge Code	270604737
Hospital Revenue Code	272
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$89.22
Rate for Payer: Aetna Commercial	$53.53
Rate for Payer: Aetna Medicare Advantage	$53.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.50
Rate for Payer: Cigna Commercial	$89.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.20
Rate for Payer: Oxford Commercial	$89.22
Rate for Payer: Qualcare PPO/HMO/WC	$26.77
Rate for Payer: UnitedHealthcare Commercial	$89.22

SUTURE POLYSORB EV20 2-0

Facility

$178.45

Hospital Charge Code	270604737
Hospital Revenue Code	272
Min. Negotiated Rate	$26.77
Max. Negotiated Rate	$26.77
Rate for Payer: Qualcare PPO/HMO/WC	$26.77

SUTURE POLYSORB EV23 3-0

Facility

$88.00

Hospital Charge Code	270604579
Hospital Revenue Code	272
Min. Negotiated Rate	$11.44
Max. Negotiated Rate	$44.00
Rate for Payer: Aetna Commercial	$26.40
Rate for Payer: Aetna Medicare Advantage	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.44
Rate for Payer: Cigna Commercial	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.44
Rate for Payer: Oxford Commercial	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.20
Rate for Payer: UnitedHealthcare Commercial	$44.00

SUTURE POLYSORB EV23 3-0

Facility

$88.00

Hospital Charge Code	270604579
Hospital Revenue Code	272
Min. Negotiated Rate	$13.20
Max. Negotiated Rate	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$13.20

SUTURE POLYSORB FS-2 C13 UD 30

Facility

$6.94

Hospital Charge Code	270656157
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 FS-2 C13 UD 30

Facility

$6.94

Hospital Charge Code	270656157
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 GS-10 3-0

Facility

$26.37

Hospital Charge Code	270623469
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

Know your out-of-pocket cost for care.

All Charges