Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB GS-22 3-0

Facility

$7.65

Hospital Charge Code	270617107
Hospital Revenue Code	272
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$1.15
Rate for Payer: Qualcare PPO/HMO/WC	$1.15

SUTURE POLYSORB GS-22 3-0

Facility

$7.65

Hospital Charge Code	270617107
Hospital Revenue Code	272
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$3.83
Rate for Payer: Aetna Commercial	$2.29
Rate for Payer: Aetna Medicare Advantage	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.95
Rate for Payer: Cigna Commercial	$3.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.99
Rate for Payer: Oxford Commercial	$3.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.15
Rate for Payer: UnitedHealthcare Commercial	$3.83

SUTURE POLYSORB GS23 2-0

Facility

$16.85

Hospital Charge Code	270600570
Hospital Revenue Code	272
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$5.05
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.19
Rate for Payer: Oxford Commercial	$8.43
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$8.43

SUTURE POLYSORB GS23 2-0

Facility

$16.85

Hospital Charge Code	270600570
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

SUTURE POLYSORB GS23 3-0

Facility

$6.15

Hospital Charge Code	270600569
Hospital Revenue Code	272
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$3.08
Rate for Payer: Aetna Commercial	$1.84
Rate for Payer: Aetna Medicare Advantage	$1.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.57
Rate for Payer: Cigna Commercial	$3.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.80
Rate for Payer: Oxford Commercial	$3.08
Rate for Payer: Qualcare PPO/HMO/WC	$0.92
Rate for Payer: UnitedHealthcare Commercial	$3.08

SUTURE POLYSORB GS23 3-0

Facility

$6.15

Hospital Charge Code	270600569
Hospital Revenue Code	272
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$0.92
Rate for Payer: Qualcare PPO/HMO/WC	$0.92

SUTURE POLYSORB GS-24 0 UNDYED

Facility

$6.90

Hospital Charge Code	270651137
Hospital Revenue Code	272
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$3.45
Rate for Payer: Aetna Commercial	$2.07
Rate for Payer: Aetna Medicare Advantage	$2.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.76
Rate for Payer: Cigna Commercial	$3.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.03
Rate for Payer: UnitedHealthcare Commercial	$3.45

SUTURE POLYSORB GS-24 0 UNDYED

Facility

$6.90

Hospital Charge Code	270651137
Hospital Revenue Code	272
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$1.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.03

SUTURE POLYSORB GS24 2-0

Facility

$16.85

Hospital Charge Code	270600571
Hospital Revenue Code	272
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$5.05
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.19
Rate for Payer: Oxford Commercial	$8.43
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$8.43

SUTURE POLYSORB GS24 2-0

Facility

$16.85

Hospital Charge Code	270600571
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

SUTURE POLYSORB GS26 1

Facility

$14.35

Hospital Charge Code	270604531
Hospital Revenue Code	272
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$2.15
Rate for Payer: Qualcare PPO/HMO/WC	$2.15

SUTURE POLYSORB GS26 1

Facility

$14.35

Hospital Charge Code	270604531
Hospital Revenue Code	272
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$7.17
Rate for Payer: Aetna Commercial	$4.30
Rate for Payer: Aetna Medicare Advantage	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.66
Rate for Payer: Cigna Commercial	$7.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.87
Rate for Payer: Oxford Commercial	$7.17
Rate for Payer: Qualcare PPO/HMO/WC	$2.15
Rate for Payer: UnitedHealthcare Commercial	$7.17

SUTURE POLYSORB HOS-11 1 30

Facility

$10.04

Hospital Charge Code	270651129
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$5.02
Rate for Payer: Aetna Commercial	$3.01
Rate for Payer: Aetna Medicare Advantage	$3.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.56
Rate for Payer: Cigna Commercial	$5.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.31
Rate for Payer: Oxford Commercial	$5.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.51
Rate for Payer: UnitedHealthcare Commercial	$5.02

SUTURE POLYSORB HOS-11 1 30

Facility

$10.04

Hospital Charge Code	270651129
Hospital Revenue Code	272
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$1.51
Rate for Payer: Qualcare PPO/HMO/WC	$1.51

SUTURE POLYSORB HOS12 0

Facility

$136.85

Hospital Charge Code	270604529
Hospital Revenue Code	272
Min. Negotiated Rate	$17.79
Max. Negotiated Rate	$68.42
Rate for Payer: Aetna Commercial	$41.05
Rate for Payer: Aetna Medicare Advantage	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.90
Rate for Payer: Cigna Commercial	$68.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.79
Rate for Payer: Oxford Commercial	$68.42
Rate for Payer: Qualcare PPO/HMO/WC	$20.53
Rate for Payer: UnitedHealthcare Commercial	$68.42

SUTURE POLYSORB HOS12 0

Facility

$18.64

Hospital Charge Code	270612404
Hospital Revenue Code	272
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$2.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.80

SUTURE POLYSORB HOS12 0

Facility

$136.85

Hospital Charge Code	270604529
Hospital Revenue Code	272
Min. Negotiated Rate	$20.53
Max. Negotiated Rate	$20.53
Rate for Payer: Qualcare PPO/HMO/WC	$20.53

SUTURE POLYSORB HOS12 0

Facility

$18.64

Hospital Charge Code	270612404
Hospital Revenue Code	272
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$9.32
Rate for Payer: Aetna Commercial	$5.59
Rate for Payer: Aetna Medicare Advantage	$5.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.75
Rate for Payer: Cigna Commercial	$9.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.42
Rate for Payer: Oxford Commercial	$9.32
Rate for Payer: Qualcare PPO/HMO/WC	$2.80
Rate for Payer: UnitedHealthcare Commercial	$9.32

SUTURE POLYSORB KV-34 2-0 36

Facility

$10.56

Hospital Charge Code	270651135
Hospital Revenue Code	272
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$5.28
Rate for Payer: Aetna Commercial	$3.17
Rate for Payer: Aetna Medicare Advantage	$3.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.69
Rate for Payer: Cigna Commercial	$5.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.37
Rate for Payer: Oxford Commercial	$5.28
Rate for Payer: Qualcare PPO/HMO/WC	$1.58
Rate for Payer: UnitedHealthcare Commercial	$5.28

SUTURE POLYSORB KV-34 2-0 36

Facility

$10.56

Hospital Charge Code	270651135
Hospital Revenue Code	272
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$1.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.58

SUTURE POLYSORB OGS-22 30 UD

Facility

$6.15

Hospital Charge Code	270655779
Hospital Revenue Code	272
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$0.92
Rate for Payer: Qualcare PPO/HMO/WC	$0.92

SUTURE POLYSORB OGS-22 30 UD

Facility

$6.15

Hospital Charge Code	270655779
Hospital Revenue Code	272
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$3.08
Rate for Payer: Aetna Commercial	$1.84
Rate for Payer: Aetna Medicare Advantage	$1.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.57
Rate for Payer: Cigna Commercial	$3.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.80
Rate for Payer: Oxford Commercial	$3.08
Rate for Payer: Qualcare PPO/HMO/WC	$0.92
Rate for Payer: UnitedHealthcare Commercial	$3.08

SUTURE POLYSORB P10 5-0

Facility

$32.00

Hospital Charge Code	270600793
Hospital Revenue Code	272
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$9.60
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$16.00

SUTURE POLYSORB P10 5-0

Facility

$32.00

Hospital Charge Code	270600793
Hospital Revenue Code	272
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

SUTURE POLYSORB P10 6-0

Facility

$32.00

Hospital Charge Code	270600797
Hospital Revenue Code	272
Min. Negotiated Rate	$4.16
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$9.60
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$16.00

Know your out-of-pocket cost for care.

All Charges