Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE PROLENE 6-0 30 BV-1 BV1

Facility

$91.00

Hospital Charge Code	270636869
Hospital Revenue Code	272
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

SUTURE PROLENE 6-0 30 BV-1 BV1

Facility

$91.00

Hospital Charge Code	270636869
Hospital Revenue Code	272
Min. Negotiated Rate	$11.83
Max. Negotiated Rate	$45.50
Rate for Payer: Aetna Commercial	$27.30
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.20
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.83
Rate for Payer: Oxford Commercial	$45.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$45.50

SUTURE PROLENE 6-0 BV-1

Facility

$242.77

Hospital Charge Code	270676672
Hospital Revenue Code	272
Min. Negotiated Rate	$36.42
Max. Negotiated Rate	$36.42
Rate for Payer: Qualcare PPO/HMO/WC	$36.42

SUTURE PROLENE 6-0 BV-1

Facility

$242.77

Hospital Charge Code	270676672
Hospital Revenue Code	272
Min. Negotiated Rate	$31.56
Max. Negotiated Rate	$121.39
Rate for Payer: Aetna Commercial	$72.83
Rate for Payer: Aetna Medicare Advantage	$72.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.91
Rate for Payer: Cigna Commercial	$121.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.56
Rate for Payer: Oxford Commercial	$121.39
Rate for Payer: Qualcare PPO/HMO/WC	$36.42
Rate for Payer: UnitedHealthcare Commercial	$121.39

SUTURE PROLENE 6-0 BV-1

Facility

$63.15

Hospital Charge Code	270655714
Hospital Revenue Code	272
Min. Negotiated Rate	$8.21
Max. Negotiated Rate	$31.57
Rate for Payer: Aetna Commercial	$18.95
Rate for Payer: Aetna Medicare Advantage	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.10
Rate for Payer: Cigna Commercial	$31.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.21
Rate for Payer: Oxford Commercial	$31.57
Rate for Payer: Qualcare PPO/HMO/WC	$9.47
Rate for Payer: UnitedHealthcare Commercial	$31.57

SUTURE PROLENE 6-0 BV-1

Facility

$41.53

Hospital Charge Code	270688285
Hospital Revenue Code	272
Min. Negotiated Rate	$6.23
Max. Negotiated Rate	$6.23
Rate for Payer: Qualcare PPO/HMO/WC	$6.23

SUTURE PROLENE 6-0 BV-1

Facility

$82.10

Hospital Charge Code	270674246
Hospital Revenue Code	272
Min. Negotiated Rate	$12.31
Max. Negotiated Rate	$12.31
Rate for Payer: Qualcare PPO/HMO/WC	$12.31

SUTURE PROLENE 6-0 BV-1

Facility

$82.10

Hospital Charge Code	270674246
Hospital Revenue Code	272
Min. Negotiated Rate	$10.67
Max. Negotiated Rate	$41.05
Rate for Payer: Aetna Commercial	$24.63
Rate for Payer: Aetna Medicare Advantage	$24.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.94
Rate for Payer: Cigna Commercial	$41.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.67
Rate for Payer: Oxford Commercial	$41.05
Rate for Payer: Qualcare PPO/HMO/WC	$12.31
Rate for Payer: UnitedHealthcare Commercial	$41.05

SUTURE PROLENE 6-0 BV-1

Facility

$41.53

Hospital Charge Code	270688285
Hospital Revenue Code	272
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$20.77
Rate for Payer: Aetna Commercial	$12.46
Rate for Payer: Aetna Medicare Advantage	$12.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.59
Rate for Payer: Cigna Commercial	$20.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$20.77
Rate for Payer: Qualcare PPO/HMO/WC	$6.23
Rate for Payer: UnitedHealthcare Commercial	$20.77

SUTURE PROLENE 6-0 BV-1

Facility

$63.15

Hospital Charge Code	270655714
Hospital Revenue Code	272
Min. Negotiated Rate	$9.47
Max. Negotiated Rate	$9.47
Rate for Payer: Qualcare PPO/HMO/WC	$9.47

SUTURE PROLENE 6-0 C-1

Facility

$201.09

Hospital Charge Code	270676671
Hospital Revenue Code	272
Min. Negotiated Rate	$30.16
Max. Negotiated Rate	$30.16
Rate for Payer: Qualcare PPO/HMO/WC	$30.16

SUTURE PROLENE 6-0 C-1

Facility

$201.09

Hospital Charge Code	270676671
Hospital Revenue Code	272
Min. Negotiated Rate	$26.14
Max. Negotiated Rate	$100.55
Rate for Payer: Aetna Commercial	$60.33
Rate for Payer: Aetna Medicare Advantage	$60.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.28
Rate for Payer: Cigna Commercial	$100.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.14
Rate for Payer: Oxford Commercial	$100.55
Rate for Payer: Qualcare PPO/HMO/WC	$30.16
Rate for Payer: UnitedHealthcare Commercial	$100.55

SUTURE PROLENE 6-0 C-1

Facility

$85.00

Hospital Charge Code	270677256
Hospital Revenue Code	272
Min. Negotiated Rate	$11.05
Max. Negotiated Rate	$42.50
Rate for Payer: Aetna Commercial	$25.50
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.05
Rate for Payer: Oxford Commercial	$42.50
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
Rate for Payer: UnitedHealthcare Commercial	$42.50

SUTURE PROLENE 6-0 C-1

Facility

$85.00

Hospital Charge Code	270677256
Hospital Revenue Code	272
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

SUTURE PROLENE 6-0 C1

Facility

$73.31

Hospital Charge Code	270677065
Hospital Revenue Code	272
Min. Negotiated Rate	$11.00
Max. Negotiated Rate	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.00

SUTURE PROLENE 6-0 C1

Facility

$73.31

Hospital Charge Code	270677065
Hospital Revenue Code	272
Min. Negotiated Rate	$9.53
Max. Negotiated Rate	$36.66
Rate for Payer: Aetna Commercial	$21.99
Rate for Payer: Aetna Medicare Advantage	$21.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.69
Rate for Payer: Cigna Commercial	$36.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.53
Rate for Payer: Oxford Commercial	$36.66
Rate for Payer: Qualcare PPO/HMO/WC	$11.00
Rate for Payer: UnitedHealthcare Commercial	$36.66

SUTURE PROLENE 6-0 C-1/CV-11

Facility

$80.04

Hospital Charge Code	270655738
Hospital Revenue Code	272
Min. Negotiated Rate	$12.01
Max. Negotiated Rate	$12.01
Rate for Payer: Qualcare PPO/HMO/WC	$12.01

SUTURE PROLENE 6-0 C-1/CV-11

Facility

$80.04

Hospital Charge Code	270655738
Hospital Revenue Code	272
Min. Negotiated Rate	$10.41
Max. Negotiated Rate	$40.02
Rate for Payer: Aetna Commercial	$24.01
Rate for Payer: Aetna Medicare Advantage	$24.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.41
Rate for Payer: Cigna Commercial	$40.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.41
Rate for Payer: Oxford Commercial	$40.02
Rate for Payer: Qualcare PPO/HMO/WC	$12.01
Rate for Payer: UnitedHealthcare Commercial	$40.02

SUTURE PROLENE 6-0 CC-1

Facility

$231.78

Hospital Charge Code	270655694
Hospital Revenue Code	272
Min. Negotiated Rate	$30.13
Max. Negotiated Rate	$115.89
Rate for Payer: Aetna Commercial	$69.53
Rate for Payer: Aetna Medicare Advantage	$69.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.10
Rate for Payer: Cigna Commercial	$115.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.13
Rate for Payer: Oxford Commercial	$115.89
Rate for Payer: Qualcare PPO/HMO/WC	$34.77
Rate for Payer: UnitedHealthcare Commercial	$115.89

SUTURE PROLENE 6-0 CC-1

Facility

$85.36

Hospital Charge Code	270671415
Hospital Revenue Code	272
Min. Negotiated Rate	$11.10
Max. Negotiated Rate	$42.68
Rate for Payer: Aetna Commercial	$25.61
Rate for Payer: Aetna Medicare Advantage	$25.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.77
Rate for Payer: Cigna Commercial	$42.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.10
Rate for Payer: Oxford Commercial	$42.68
Rate for Payer: Qualcare PPO/HMO/WC	$12.80
Rate for Payer: UnitedHealthcare Commercial	$42.68

SUTURE PROLENE 6-0 CC-1

Facility

$85.36

Hospital Charge Code	270671415
Hospital Revenue Code	272
Min. Negotiated Rate	$12.80
Max. Negotiated Rate	$12.80
Rate for Payer: Qualcare PPO/HMO/WC	$12.80

SUTURE PROLENE 6-0 CC-1

Facility

$231.78

Hospital Charge Code	270655694
Hospital Revenue Code	272
Min. Negotiated Rate	$34.77
Max. Negotiated Rate	$34.77
Rate for Payer: Qualcare PPO/HMO/WC	$34.77

SUTURE PROLENE 6-0 P-1

Facility

$28.41

Hospital Charge Code	270671414
Hospital Revenue Code	272
Min. Negotiated Rate	$3.69
Max. Negotiated Rate	$14.21
Rate for Payer: Aetna Commercial	$8.52
Rate for Payer: Aetna Medicare Advantage	$8.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.24
Rate for Payer: Cigna Commercial	$14.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.69
Rate for Payer: Oxford Commercial	$14.21
Rate for Payer: Qualcare PPO/HMO/WC	$4.26
Rate for Payer: UnitedHealthcare Commercial	$14.21

SUTURE PROLENE 6-0 P-1

Facility

$28.41

Hospital Charge Code	270671414
Hospital Revenue Code	272
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$4.26
Rate for Payer: Qualcare PPO/HMO/WC	$4.26

SUTURE PROLENE 6-0 P-1/P-10

Facility

$24.82

Hospital Charge Code	270671409
Hospital Revenue Code	272
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$12.41
Rate for Payer: Aetna Commercial	$7.45
Rate for Payer: Aetna Medicare Advantage	$7.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.33
Rate for Payer: Cigna Commercial	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.23
Rate for Payer: Oxford Commercial	$12.41
Rate for Payer: Qualcare PPO/HMO/WC	$3.72
Rate for Payer: UnitedHealthcare Commercial	$12.41

Know your out-of-pocket cost for care.

All Charges