Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB SC2 2-0

Facility

$13.65

Hospital Charge Code	270600566
Hospital Revenue Code	272
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$4.09
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.77
Rate for Payer: Oxford Commercial	$6.83
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$6.83

SUTURE POLYSORB SC2 2-0

Facility

$13.65

Hospital Charge Code	270600566
Hospital Revenue Code	272
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

SUTURE POLYSORB SC2 3-0

Facility

$13.65

Hospital Charge Code	270600567
Hospital Revenue Code	272
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$4.09
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.77
Rate for Payer: Oxford Commercial	$6.83
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$6.83

SUTURE POLYSORB SC2 3-0

Facility

$13.65

Hospital Charge Code	270600567
Hospital Revenue Code	272
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

SUTURE POLYSORB SC-2 3/0 27

Facility

$6.27

Hospital Charge Code	270651170
Hospital Revenue Code	272
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$3.13
Rate for Payer: Aetna Commercial	$1.88
Rate for Payer: Aetna Medicare Advantage	$1.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.60
Rate for Payer: Cigna Commercial	$3.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.82
Rate for Payer: Oxford Commercial	$3.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.94
Rate for Payer: UnitedHealthcare Commercial	$3.13

SUTURE POLYSORB SC-2 3/0 27

Facility

$6.27

Hospital Charge Code	270651170
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$0.94
Rate for Payer: Qualcare PPO/HMO/WC	$0.94

SUTURE POLYSORB SE1408

Facility

$150.45

Hospital Charge Code	270604698
Hospital Revenue Code	272
Min. Negotiated Rate	$22.57
Max. Negotiated Rate	$22.57
Rate for Payer: Qualcare PPO/HMO/WC	$22.57

SUTURE POLYSORB SE1408

Facility

$150.45

Hospital Charge Code	270604698
Hospital Revenue Code	272
Min. Negotiated Rate	$19.56
Max. Negotiated Rate	$75.22
Rate for Payer: Aetna Commercial	$45.13
Rate for Payer: Aetna Medicare Advantage	$45.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.36
Rate for Payer: Cigna Commercial	$75.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.56
Rate for Payer: Oxford Commercial	$75.22
Rate for Payer: Qualcare PPO/HMO/WC	$22.57
Rate for Payer: UnitedHealthcare Commercial	$75.22

SUTURE POLYSORB SE1408 7-0

Facility

$141.65

Hospital Charge Code	270604696
Hospital Revenue Code	272
Min. Negotiated Rate	$18.41
Max. Negotiated Rate	$70.83
Rate for Payer: Aetna Commercial	$42.49
Rate for Payer: Aetna Medicare Advantage	$42.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.12
Rate for Payer: Cigna Commercial	$70.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.41
Rate for Payer: Oxford Commercial	$70.83
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$70.83

SUTURE POLYSORB SE1408 7-0

Facility

$141.65

Hospital Charge Code	270604699
Hospital Revenue Code	272
Min. Negotiated Rate	$18.41
Max. Negotiated Rate	$70.83
Rate for Payer: Aetna Commercial	$42.49
Rate for Payer: Aetna Medicare Advantage	$42.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.12
Rate for Payer: Cigna Commercial	$70.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.41
Rate for Payer: Oxford Commercial	$70.83
Rate for Payer: Qualcare PPO/HMO/WC	$21.25
Rate for Payer: UnitedHealthcare Commercial	$70.83

SUTURE POLYSORB SE1408 7-0

Facility

$141.65

Hospital Charge Code	270604699
Hospital Revenue Code	272
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

SUTURE POLYSORB SE1408 7-0

Facility

$141.65

Hospital Charge Code	270604696
Hospital Revenue Code	272
Min. Negotiated Rate	$21.25
Max. Negotiated Rate	$21.25
Rate for Payer: Qualcare PPO/HMO/WC	$21.25

SUTURE POLYSORB SS14 5-0

Facility

$116.85

Hospital Charge Code	270604694
Hospital Revenue Code	272
Min. Negotiated Rate	$15.19
Max. Negotiated Rate	$58.42
Rate for Payer: Aetna Commercial	$35.05
Rate for Payer: Aetna Medicare Advantage	$35.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.80
Rate for Payer: Cigna Commercial	$58.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.19
Rate for Payer: Oxford Commercial	$58.42
Rate for Payer: Qualcare PPO/HMO/WC	$17.53
Rate for Payer: UnitedHealthcare Commercial	$58.42

SUTURE POLYSORB SS14 5-0

Facility

$116.85

Hospital Charge Code	270604694
Hospital Revenue Code	272
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$17.53
Rate for Payer: Qualcare PPO/HMO/WC	$17.53

SUTURE POLYSORB SS-14 5-0 18

Facility

$53.46

Hospital Charge Code	270651282
Hospital Revenue Code	272
Min. Negotiated Rate	$8.02
Max. Negotiated Rate	$8.02
Rate for Payer: Qualcare PPO/HMO/WC	$8.02

SUTURE POLYSORB SS-14 5-0 18

Facility

$53.46

Hospital Charge Code	270651282
Hospital Revenue Code	272
Min. Negotiated Rate	$6.95
Max. Negotiated Rate	$26.73
Rate for Payer: Aetna Commercial	$16.04
Rate for Payer: Aetna Medicare Advantage	$16.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.63
Rate for Payer: Cigna Commercial	$26.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.95
Rate for Payer: Oxford Commercial	$26.73
Rate for Payer: Qualcare PPO/HMO/WC	$8.02
Rate for Payer: UnitedHealthcare Commercial	$26.73

SUTURE POLYSORB SS14 6-0

Facility

$116.85

Hospital Charge Code	270604695
Hospital Revenue Code	272
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$17.53
Rate for Payer: Qualcare PPO/HMO/WC	$17.53

SUTURE POLYSORB SS14 6-0

Facility

$116.85

Hospital Charge Code	270604695
Hospital Revenue Code	272
Min. Negotiated Rate	$15.19
Max. Negotiated Rate	$58.42
Rate for Payer: Aetna Commercial	$35.05
Rate for Payer: Aetna Medicare Advantage	$35.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.80
Rate for Payer: Cigna Commercial	$58.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.19
Rate for Payer: Oxford Commercial	$58.42
Rate for Payer: Qualcare PPO/HMO/WC	$17.53
Rate for Payer: UnitedHealthcare Commercial	$58.42

SUTURE POLYSORB ST CUT 4-0

Facility

$16.85

Hospital Charge Code	270607685
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 ST CUT 4-0

Facility

$16.85

Hospital Charge Code	270607685
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 V20 0

Facility

$6.43

Hospital Charge Code	270604540
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$3.21
Rate for Payer: Aetna Commercial	$1.93
Rate for Payer: Aetna Medicare Advantage	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.64
Rate for Payer: Cigna Commercial	$3.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.84
Rate for Payer: Oxford Commercial	$3.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.96
Rate for Payer: UnitedHealthcare Commercial	$3.21

SUTURE POLYSORB V20 0

Facility

$6.43

Hospital Charge Code	270604540
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$0.96
Rate for Payer: Qualcare PPO/HMO/WC	$0.96

SUTURE POLYSORB V20 2-0

Facility

$77.65

Hospital Charge Code	270606735
Hospital Revenue Code	272
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$11.65
Rate for Payer: Qualcare PPO/HMO/WC	$11.65

SUTURE POLYSORB V20 2-0

Facility

$77.65

Hospital Charge Code	270606735
Hospital Revenue Code	272
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$38.83
Rate for Payer: Aetna Commercial	$23.30
Rate for Payer: Aetna Medicare Advantage	$23.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.80
Rate for Payer: Cigna Commercial	$38.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.09
Rate for Payer: Oxford Commercial	$38.83
Rate for Payer: Qualcare PPO/HMO/WC	$11.65
Rate for Payer: UnitedHealthcare Commercial	$38.83

SUTURE POLYSORB V-20 2-0 30

Facility

$6.13

Hospital Charge Code	270651149
Hospital Revenue Code	272
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$3.06
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	$1.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.56
Rate for Payer: Cigna Commercial	$3.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.80
Rate for Payer: Oxford Commercial	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$0.92
Rate for Payer: UnitedHealthcare Commercial	$3.06

Know your out-of-pocket cost for care.

All Charges