Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB P10 6-0

Facility

$32.00

Hospital Charge Code	270600797
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 P11 4-0

Facility

$33.65

Hospital Charge Code	270600794
Hospital Revenue Code	272
Min. Negotiated Rate	$4.37
Max. Negotiated Rate	$16.82
Rate for Payer: Aetna Commercial	$10.10
Rate for Payer: Aetna Medicare Advantage	$10.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.58
Rate for Payer: Cigna Commercial	$16.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.37
Rate for Payer: Oxford Commercial	$16.82
Rate for Payer: Qualcare PPO/HMO/WC	$5.05
Rate for Payer: UnitedHealthcare Commercial	$16.82

SUTURE POLYSORB P11 4-0

Facility

$33.65

Hospital Charge Code	270600794
Hospital Revenue Code	272
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$5.05
Rate for Payer: Qualcare PPO/HMO/WC	$5.05

SUTURE POLYSORB P12 3-0

Facility

$29.65

Hospital Charge Code	270600798
Hospital Revenue Code	272
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$4.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.45

SUTURE POLYSORB P12 3-0

Facility

$29.65

Hospital Charge Code	270600798
Hospital Revenue Code	272
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$14.82
Rate for Payer: Aetna Commercial	$8.89
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.56
Rate for Payer: Cigna Commercial	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.85
Rate for Payer: Oxford Commercial	$14.82
Rate for Payer: Qualcare PPO/HMO/WC	$4.45
Rate for Payer: UnitedHealthcare Commercial	$14.82

SUTURE POLYSORB P-12 5-0

Facility

$13.96

Hospital Charge Code	270651291
Hospital Revenue Code	272
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$6.98
Rate for Payer: Aetna Commercial	$4.19
Rate for Payer: Aetna Medicare Advantage	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.56
Rate for Payer: Cigna Commercial	$6.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.81
Rate for Payer: Oxford Commercial	$6.98
Rate for Payer: Qualcare PPO/HMO/WC	$2.09
Rate for Payer: UnitedHealthcare Commercial	$6.98

SUTURE POLYSORB P-12 5-0

Facility

$13.96

Hospital Charge Code	270651291
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 P-13 5-0 U/D

Facility

$5.17

Hospital Charge Code	270604584
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$2.58
Rate for Payer: Aetna Commercial	$1.55
Rate for Payer: Aetna Medicare Advantage	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.32
Rate for Payer: Cigna Commercial	$2.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.67
Rate for Payer: Oxford Commercial	$2.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.78
Rate for Payer: UnitedHealthcare Commercial	$2.58

SUTURE POLYSORB P-13 5-0 U/D

Facility

$5.17

Hospital Charge Code	270604584
Hospital Revenue Code	272
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$0.78
Rate for Payer: Qualcare PPO/HMO/WC	$0.78

SUTURE POLYSORB P-13 6-0 18

Facility

$15.65

Hospital Charge Code	270651294
Hospital Revenue Code	272
Min. Negotiated Rate	$2.35
Max. Negotiated Rate	$2.35
Rate for Payer: Qualcare PPO/HMO/WC	$2.35

SUTURE POLYSORB P-13 6-0 18

Facility

$15.65

Hospital Charge Code	270651294
Hospital Revenue Code	272
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$7.83
Rate for Payer: Aetna Commercial	$4.70
Rate for Payer: Aetna Medicare Advantage	$4.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.99
Rate for Payer: Cigna Commercial	$7.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.03
Rate for Payer: Oxford Commercial	$7.83
Rate for Payer: Qualcare PPO/HMO/WC	$2.35
Rate for Payer: UnitedHealthcare Commercial	$7.83

SUTURE POLYSORB P-14 3-0

Facility

$13.01

Hospital Charge Code	270605815
Hospital Revenue Code	272
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

SUTURE POLYSORB P-14 3-0

Facility

$13.01

Hospital Charge Code	270605815
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$3.90
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.32
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Oxford Commercial	$6.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$6.50

SUTURE POLYSORB P14 3-0

Facility

$29.65

Hospital Charge Code	270600796
Hospital Revenue Code	272
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$4.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.45

SUTURE POLYSORB P14 3-0

Facility

$29.65

Hospital Charge Code	270600796
Hospital Revenue Code	272
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$14.82
Rate for Payer: Aetna Commercial	$8.89
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.56
Rate for Payer: Cigna Commercial	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.85
Rate for Payer: Oxford Commercial	$14.82
Rate for Payer: Qualcare PPO/HMO/WC	$4.45
Rate for Payer: UnitedHealthcare Commercial	$14.82

SUTURE POLYSORB P-14 4-0

Facility

$36.83

Hospital Charge Code	270604580
Hospital Revenue Code	272
Min. Negotiated Rate	$5.52
Max. Negotiated Rate	$5.52
Rate for Payer: Qualcare PPO/HMO/WC	$5.52

SUTURE POLYSORB P-14 4-0

Facility

$36.83

Hospital Charge Code	270604580
Hospital Revenue Code	272
Min. Negotiated Rate	$4.79
Max. Negotiated Rate	$18.41
Rate for Payer: Aetna Commercial	$11.05
Rate for Payer: Aetna Medicare Advantage	$11.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.39
Rate for Payer: Cigna Commercial	$18.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.79
Rate for Payer: Oxford Commercial	$18.41
Rate for Payer: Qualcare PPO/HMO/WC	$5.52
Rate for Payer: UnitedHealthcare Commercial	$18.41

SUTURE POLYSORB P14 4-0

Facility

$12.00

Hospital Charge Code	270604582
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

SUTURE POLYSORB P14 4-0

Facility

$12.00

Hospital Charge Code	270604582
Hospital Revenue Code	272
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

SUTURE POLYSORB P-3 5-0 18

Facility

$18.05

Hospital Charge Code	270673327
Hospital Revenue Code	272
Min. Negotiated Rate	$2.35
Max. Negotiated Rate	$9.03
Rate for Payer: Aetna Commercial	$5.42
Rate for Payer: Aetna Medicare Advantage	$5.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.60
Rate for Payer: Cigna Commercial	$9.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.35
Rate for Payer: Oxford Commercial	$9.03
Rate for Payer: Qualcare PPO/HMO/WC	$2.71
Rate for Payer: UnitedHealthcare Commercial	$9.03

SUTURE POLYSORB P-3 5-0 18

Facility

$18.05

Hospital Charge Code	270673327
Hospital Revenue Code	272
Min. Negotiated Rate	$2.71
Max. Negotiated Rate	$2.71
Rate for Payer: Qualcare PPO/HMO/WC	$2.71

SUTURE POLYSORB PC-13 6-0 18

Facility

$14.73

Hospital Charge Code	270651290
Hospital Revenue Code	272
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$7.37
Rate for Payer: Aetna Commercial	$4.42
Rate for Payer: Aetna Medicare Advantage	$4.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.76
Rate for Payer: Cigna Commercial	$7.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.91
Rate for Payer: Oxford Commercial	$7.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.21
Rate for Payer: UnitedHealthcare Commercial	$7.37

SUTURE POLYSORB PC-13 6-0 18

Facility

$14.73

Hospital Charge Code	270651290
Hospital Revenue Code	272
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$2.21
Rate for Payer: Qualcare PPO/HMO/WC	$2.21

SUTURE POLYSORB PRCT TIE 4-0

Facility

$2.45

Hospital Charge Code	270604528
Hospital Revenue Code	272
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

SUTURE POLYSORB PRCT TIE 4-0

Facility

$2.45

Hospital Charge Code	270604528
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$0.74
Rate for Payer: Aetna Medicare Advantage	$0.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.62
Rate for Payer: Cigna Commercial	$1.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.32
Rate for Payer: Oxford Commercial	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$1.23

Know your out-of-pocket cost for care.

All Charges