Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB V-20 2-0 30

Facility

$6.13

Hospital Charge Code	270651149
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 V-20 2/0 30

Facility

$6.07

Hospital Charge Code	270656135S
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 V-20 2/0 30

Facility

$6.07

Hospital Charge Code	270656135N
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 V-20 2/0 30

Facility

$6.07

Hospital Charge Code	270656135
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 V-20 2/0 30

Facility

$6.07

Hospital Charge Code	270656135N
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 V-20 2/0 30

Facility

$6.07

Hospital Charge Code	270656135S
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 V-20 2/0 30

Facility

$6.07

Hospital Charge Code	270656135
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 V20 2-0 GL61MG

Facility

$1,055.25

Hospital Charge Code	270610528
Hospital Revenue Code	272
Min. Negotiated Rate	$158.29
Max. Negotiated Rate	$158.29
Rate for Payer: Qualcare PPO/HMO/WC	$158.29

SUTURE POLYSORB V20 2-0 GL61MG

Facility

$1,055.25

Hospital Charge Code	270610528
Hospital Revenue Code	272
Min. Negotiated Rate	$137.18
Max. Negotiated Rate	$527.62
Rate for Payer: Aetna Commercial	$316.57
Rate for Payer: Aetna Medicare Advantage	$316.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.09
Rate for Payer: Cigna Commercial	$527.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.18
Rate for Payer: Oxford Commercial	$527.62
Rate for Payer: Qualcare PPO/HMO/WC	$158.29
Rate for Payer: UnitedHealthcare Commercial	$527.62

SUTURE POLYSORB V-20 2-0 U/D

Facility

$5.67

Hospital Charge Code	270651670
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

SUTURE POLYSORB V-20 2-0 U/D

Facility

$5.67

Hospital Charge Code	270651670
Hospital Revenue Code	272
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$1.70
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.45
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.74
Rate for Payer: Oxford Commercial	$2.83
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$2.83

SUTURE POLYSORB V-20 3-0

Facility

$6.13

Hospital Charge Code	270651148
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 V-20 3-0

Facility

$6.13

Hospital Charge Code	270651148
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

SUTURE POLYSORB V-20 3-0 18

Facility

$26.11

Hospital Charge Code	270651276
Hospital Revenue Code	272
Min. Negotiated Rate	$3.39
Max. Negotiated Rate	$13.05
Rate for Payer: Aetna Commercial	$7.83
Rate for Payer: Aetna Medicare Advantage	$7.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.66
Rate for Payer: Cigna Commercial	$13.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.39
Rate for Payer: Oxford Commercial	$13.05
Rate for Payer: Qualcare PPO/HMO/WC	$3.92
Rate for Payer: UnitedHealthcare Commercial	$13.05

SUTURE POLYSORB V-20 3-0 18

Facility

$26.11

Hospital Charge Code	270651276
Hospital Revenue Code	272
Min. Negotiated Rate	$3.92
Max. Negotiated Rate	$3.92
Rate for Payer: Qualcare PPO/HMO/WC	$3.92

SUTURE POLYSORB V-20 4-0

Facility

$6.49

Hospital Charge Code	270651279S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$3.25
Rate for Payer: Aetna Commercial	$1.95
Rate for Payer: Aetna Medicare Advantage	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.65
Rate for Payer: Cigna Commercial	$3.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.84
Rate for Payer: Oxford Commercial	$3.25
Rate for Payer: Qualcare PPO/HMO/WC	$0.97
Rate for Payer: UnitedHealthcare Commercial	$3.25

SUTURE POLYSORB V-20 4-0

Facility

$6.49

Hospital Charge Code	270651279S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.97

SUTURE POLYSORB V-20 4-0

Facility

$1.26

Hospital Charge Code	270651279N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.63
Rate for Payer: Aetna Commercial	$0.38
Rate for Payer: Aetna Medicare Advantage	$0.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.32
Rate for Payer: Cigna Commercial	$0.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.16
Rate for Payer: Oxford Commercial	$0.63
Rate for Payer: Qualcare PPO/HMO/WC	$0.19
Rate for Payer: UnitedHealthcare Commercial	$0.63

SUTURE POLYSORB V-20 4-0

Facility

$6.49

Hospital Charge Code	270651279
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.97

SUTURE POLYSORB V-20 4-0

Facility

$6.49

Hospital Charge Code	270651279
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$3.25
Rate for Payer: Aetna Commercial	$1.95
Rate for Payer: Aetna Medicare Advantage	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.65
Rate for Payer: Cigna Commercial	$3.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.84
Rate for Payer: Oxford Commercial	$3.25
Rate for Payer: Qualcare PPO/HMO/WC	$0.97
Rate for Payer: UnitedHealthcare Commercial	$3.25

SUTURE POLYSORB V-20 4-0

Facility

$1.26

Hospital Charge Code	270651279N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.19
Rate for Payer: Qualcare PPO/HMO/WC	$0.19

SUTURE POLYSSORB 2-0 GS-21

Facility

$25.23

Hospital Charge Code	270669983
Hospital Revenue Code	272
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$3.78
Rate for Payer: Qualcare PPO/HMO/WC	$3.78

SUTURE POLYSSORB 2-0 GS-21

Facility

$25.23

Hospital Charge Code	270669983
Hospital Revenue Code	272
Min. Negotiated Rate	$3.28
Max. Negotiated Rate	$12.62
Rate for Payer: Aetna Commercial	$7.57
Rate for Payer: Aetna Medicare Advantage	$7.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.43
Rate for Payer: Cigna Commercial	$12.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.28
Rate for Payer: Oxford Commercial	$12.62
Rate for Payer: Qualcare PPO/HMO/WC	$3.78
Rate for Payer: UnitedHealthcare Commercial	$12.62

SUTURE POLYSURB GS-12 1

Facility

$8.06

Hospital Charge Code	270617432
Hospital Revenue Code	272
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$1.21

SUTURE POLYSURB GS-12 1

Facility

$8.06

Hospital Charge Code	270617432
Hospital Revenue Code	272
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$4.03
Rate for Payer: Aetna Commercial	$2.42
Rate for Payer: Aetna Medicare Advantage	$2.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.06
Rate for Payer: Cigna Commercial	$4.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.05
Rate for Payer: Oxford Commercial	$4.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.21
Rate for Payer: UnitedHealthcare Commercial	$4.03

Know your out-of-pocket cost for care.

All Charges