Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE PROLENE 5-0 C-1

Facility

$51.22

Hospital Charge Code	270671418
Hospital Revenue Code	272
Min. Negotiated Rate	$6.66
Max. Negotiated Rate	$25.61
Rate for Payer: Aetna Commercial	$15.37
Rate for Payer: Aetna Medicare Advantage	$15.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.06
Rate for Payer: Cigna Commercial	$25.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.66
Rate for Payer: Oxford Commercial	$25.61
Rate for Payer: Qualcare PPO/HMO/WC	$7.68
Rate for Payer: UnitedHealthcare Commercial	$25.61

SUTURE PROLENE 5-0 CC-1

Facility

$81.78

Hospital Charge Code	270671420
Hospital Revenue Code	272
Min. Negotiated Rate	$10.63
Max. Negotiated Rate	$40.89
Rate for Payer: Aetna Commercial	$24.53
Rate for Payer: Aetna Medicare Advantage	$24.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.85
Rate for Payer: Cigna Commercial	$40.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.63
Rate for Payer: Oxford Commercial	$40.89
Rate for Payer: Qualcare PPO/HMO/WC	$12.27
Rate for Payer: UnitedHealthcare Commercial	$40.89

SUTURE PROLENE 5-0 CC-1

Facility

$81.78

Hospital Charge Code	270671420
Hospital Revenue Code	272
Min. Negotiated Rate	$12.27
Max. Negotiated Rate	$12.27
Rate for Payer: Qualcare PPO/HMO/WC	$12.27

SUTURE PROLENE 5-0 FS-2

Facility

$13.18

Hospital Charge Code	270671410
Hospital Revenue Code	272
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$6.59
Rate for Payer: Aetna Commercial	$3.95
Rate for Payer: Aetna Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.36
Rate for Payer: Cigna Commercial	$6.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.71
Rate for Payer: Oxford Commercial	$6.59
Rate for Payer: Qualcare PPO/HMO/WC	$1.98
Rate for Payer: UnitedHealthcare Commercial	$6.59

SUTURE PROLENE 5-0 FS-2

Facility

$13.18

Hospital Charge Code	270671410
Hospital Revenue Code	272
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$1.98
Rate for Payer: Qualcare PPO/HMO/WC	$1.98

SUTURE PROLENE 5-0 P-3

Facility

$26.51

Hospital Charge Code	270663644
Hospital Revenue Code	272
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$13.26
Rate for Payer: Aetna Commercial	$7.95
Rate for Payer: Aetna Medicare Advantage	$7.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.76
Rate for Payer: Cigna Commercial	$13.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.45
Rate for Payer: Oxford Commercial	$13.26
Rate for Payer: Qualcare PPO/HMO/WC	$3.98
Rate for Payer: UnitedHealthcare Commercial	$13.26

SUTURE PROLENE 5-0 P-3

Facility

$23.00

Hospital Charge Code	270604660
Hospital Revenue Code	272
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$6.90
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Oxford Commercial	$11.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$11.50

SUTURE PROLENE 5-0 P-3

Facility

$23.00

Hospital Charge Code	270604660
Hospital Revenue Code	272
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

SUTURE PROLENE 5-0 P-3

Facility

$26.51

Hospital Charge Code	270663644
Hospital Revenue Code	272
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$3.98
Rate for Payer: Qualcare PPO/HMO/WC	$3.98

SUTURE PROLENE 5-0 PC-1

Facility

$25.56

Hospital Charge Code	270649099
Hospital Revenue Code	272
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$3.83
Rate for Payer: Qualcare PPO/HMO/WC	$3.83

SUTURE PROLENE 5-0 PC-1

Facility

$25.56

Hospital Charge Code	270649099
Hospital Revenue Code	272
Min. Negotiated Rate	$3.32
Max. Negotiated Rate	$12.78
Rate for Payer: Aetna Commercial	$7.67
Rate for Payer: Aetna Medicare Advantage	$7.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.52
Rate for Payer: Cigna Commercial	$12.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.32
Rate for Payer: Oxford Commercial	$12.78
Rate for Payer: Qualcare PPO/HMO/WC	$3.83
Rate for Payer: UnitedHealthcare Commercial	$12.78

SUTURE PROLENE 5-0 PC-3

Facility

$25.56

Hospital Charge Code	270661970
Hospital Revenue Code	272
Min. Negotiated Rate	$3.32
Max. Negotiated Rate	$12.78
Rate for Payer: Aetna Commercial	$7.67
Rate for Payer: Aetna Medicare Advantage	$7.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.52
Rate for Payer: Cigna Commercial	$12.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.32
Rate for Payer: Oxford Commercial	$12.78
Rate for Payer: Qualcare PPO/HMO/WC	$3.83
Rate for Payer: UnitedHealthcare Commercial	$12.78

SUTURE PROLENE 5-0 PC-3

Facility

$25.56

Hospital Charge Code	270661970
Hospital Revenue Code	272
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$3.83
Rate for Payer: Qualcare PPO/HMO/WC	$3.83

SUTURE PROLENE 5-0 PC 5

Facility

$25.56

Hospital Charge Code	270651497
Hospital Revenue Code	272
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$3.83
Rate for Payer: Qualcare PPO/HMO/WC	$3.83

SUTURE PROLENE 5-0 PC 5

Facility

$25.56

Hospital Charge Code	270651497
Hospital Revenue Code	272
Min. Negotiated Rate	$3.32
Max. Negotiated Rate	$12.78
Rate for Payer: Aetna Commercial	$7.67
Rate for Payer: Aetna Medicare Advantage	$7.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.52
Rate for Payer: Cigna Commercial	$12.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.32
Rate for Payer: Oxford Commercial	$12.78
Rate for Payer: Qualcare PPO/HMO/WC	$3.83
Rate for Payer: UnitedHealthcare Commercial	$12.78

SUTURE PROLENE 5-0 PS-2

Facility

$21.33

Hospital Charge Code	270672395
Hospital Revenue Code	272
Min. Negotiated Rate	$3.20
Max. Negotiated Rate	$3.20
Rate for Payer: Qualcare PPO/HMO/WC	$3.20

SUTURE PROLENE 5-0 PS-2

Facility

$21.33

Hospital Charge Code	270672395
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$10.66
Rate for Payer: Aetna Commercial	$6.40
Rate for Payer: Aetna Medicare Advantage	$6.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.44
Rate for Payer: Cigna Commercial	$10.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.77
Rate for Payer: Oxford Commercial	$10.66
Rate for Payer: Qualcare PPO/HMO/WC	$3.20
Rate for Payer: UnitedHealthcare Commercial	$10.66

SUTURE PROLENE 5-0 RB-1

Facility

$14.28

Hospital Charge Code	270671425
Hospital Revenue Code	272
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$2.14
Rate for Payer: Qualcare PPO/HMO/WC	$2.14

SUTURE PROLENE 5-0 RB-1

Facility

$26.78

Hospital Charge Code	270655741
Hospital Revenue Code	272
Min. Negotiated Rate	$3.48
Max. Negotiated Rate	$13.39
Rate for Payer: Aetna Commercial	$8.03
Rate for Payer: Aetna Medicare Advantage	$8.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.83
Rate for Payer: Cigna Commercial	$13.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.48
Rate for Payer: Oxford Commercial	$13.39
Rate for Payer: Qualcare PPO/HMO/WC	$4.02
Rate for Payer: UnitedHealthcare Commercial	$13.39

SUTURE PROLENE 5-0 RB-1

Facility

$26.78

Hospital Charge Code	270655741
Hospital Revenue Code	272
Min. Negotiated Rate	$4.02
Max. Negotiated Rate	$4.02
Rate for Payer: Qualcare PPO/HMO/WC	$4.02

SUTURE PROLENE 5-0 RB-1

Facility

$14.28

Hospital Charge Code	270671425
Hospital Revenue Code	272
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$7.14
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.64
Rate for Payer: Cigna Commercial	$7.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.86
Rate for Payer: Oxford Commercial	$7.14
Rate for Payer: Qualcare PPO/HMO/WC	$2.14
Rate for Payer: UnitedHealthcare Commercial	$7.14

SUTURE PROLENE 5-0 RB-2

Facility

$40.78

Hospital Charge Code	270671416
Hospital Revenue Code	272
Min. Negotiated Rate	$6.12
Max. Negotiated Rate	$6.12
Rate for Payer: Qualcare PPO/HMO/WC	$6.12

SUTURE PROLENE 5-0 RB-2

Facility

$25.39

Hospital Charge Code	270672396
Hospital Revenue Code	272
Min. Negotiated Rate	$3.81
Max. Negotiated Rate	$3.81
Rate for Payer: Qualcare PPO/HMO/WC	$3.81

SUTURE PROLENE 5-0 RB-2

Facility

$25.39

Hospital Charge Code	270672396
Hospital Revenue Code	272
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$12.70
Rate for Payer: Aetna Commercial	$7.62
Rate for Payer: Aetna Medicare Advantage	$7.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.47
Rate for Payer: Cigna Commercial	$12.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.30
Rate for Payer: Oxford Commercial	$12.70
Rate for Payer: Qualcare PPO/HMO/WC	$3.81
Rate for Payer: UnitedHealthcare Commercial	$12.70

SUTURE PROLENE 5-0 RB-2

Facility

$40.78

Hospital Charge Code	270671416
Hospital Revenue Code	272
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$20.39
Rate for Payer: Aetna Commercial	$12.23
Rate for Payer: Aetna Medicare Advantage	$12.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.40
Rate for Payer: Cigna Commercial	$20.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.30
Rate for Payer: Oxford Commercial	$20.39
Rate for Payer: Qualcare PPO/HMO/WC	$6.12
Rate for Payer: UnitedHealthcare Commercial	$20.39

Know your out-of-pocket cost for care.

All Charges