Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE SURGIPRO V-26 3-0 VP842

Facility

$36.00

Hospital Charge Code	270612623
Hospital Revenue Code	272
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

SUTURE SURGIPRO V-26 3-0 VP842

Facility

$36.00

Hospital Charge Code	270612623
Hospital Revenue Code	272
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$18.00
Rate for Payer: Aetna Commercial	$10.80
Rate for Payer: Aetna Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.18
Rate for Payer: Cigna Commercial	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.68
Rate for Payer: Oxford Commercial	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.40
Rate for Payer: UnitedHealthcare Commercial	$18.00

SUTURE SURGISTEEL V26 4-0

Facility

$81.69

Hospital Charge Code	270604725
Hospital Revenue Code	272
Min. Negotiated Rate	$12.25
Max. Negotiated Rate	$12.25
Rate for Payer: Qualcare PPO/HMO/WC	$12.25

SUTURE SURGISTEEL V26 4-0

Facility

$81.69

Hospital Charge Code	270604725
Hospital Revenue Code	272
Min. Negotiated Rate	$10.62
Max. Negotiated Rate	$40.84
Rate for Payer: Aetna Commercial	$24.51
Rate for Payer: Aetna Medicare Advantage	$24.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.83
Rate for Payer: Cigna Commercial	$40.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.62
Rate for Payer: Oxford Commercial	$40.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.25
Rate for Payer: UnitedHealthcare Commercial	$40.84

SUTURE SURGITIE LIG LOOP

Facility

$94.24

Hospital Charge Code	270655348
Hospital Revenue Code	272
Min. Negotiated Rate	$12.25
Max. Negotiated Rate	$47.12
Rate for Payer: Aetna Commercial	$28.27
Rate for Payer: Aetna Medicare Advantage	$28.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.03
Rate for Payer: Cigna Commercial	$47.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.25
Rate for Payer: Oxford Commercial	$47.12
Rate for Payer: Qualcare PPO/HMO/WC	$14.14
Rate for Payer: UnitedHealthcare Commercial	$47.12

SUTURE SURGITIE LIG LOOP

Facility

$94.24

Hospital Charge Code	270655348
Hospital Revenue Code	272
Min. Negotiated Rate	$14.14
Max. Negotiated Rate	$14.14
Rate for Payer: Qualcare PPO/HMO/WC	$14.14

SUTURE SURGITIE LIG LOOP W/

Facility

$453.15

Hospital Charge Code	270655608
Hospital Revenue Code	272
Min. Negotiated Rate	$58.91
Max. Negotiated Rate	$226.57
Rate for Payer: Aetna Commercial	$135.94
Rate for Payer: Aetna Medicare Advantage	$135.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$115.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$115.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$115.55
Rate for Payer: Cigna Commercial	$226.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.91
Rate for Payer: Oxford Commercial	$226.57
Rate for Payer: Qualcare PPO/HMO/WC	$67.97
Rate for Payer: UnitedHealthcare Commercial	$226.57

SUTURE SURGITIE LIG LOOP W/

Facility

$453.15

Hospital Charge Code	270655608
Hospital Revenue Code	272
Min. Negotiated Rate	$67.97
Max. Negotiated Rate	$67.97
Rate for Payer: Qualcare PPO/HMO/WC	$67.97

SUTURE SURGITIE LOOP POLY 0

Facility

$112.71

Hospital Charge Code	270604729
Hospital Revenue Code	272
Min. Negotiated Rate	$16.91
Max. Negotiated Rate	$16.91
Rate for Payer: Qualcare PPO/HMO/WC	$16.91

SUTURE SURGITIE LOOP POLY 0

Facility

$112.71

Hospital Charge Code	270604729
Hospital Revenue Code	272
Min. Negotiated Rate	$14.65
Max. Negotiated Rate	$56.35
Rate for Payer: Aetna Commercial	$33.81
Rate for Payer: Aetna Medicare Advantage	$33.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.74
Rate for Payer: Cigna Commercial	$56.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.65
Rate for Payer: Oxford Commercial	$56.35
Rate for Payer: Qualcare PPO/HMO/WC	$16.91
Rate for Payer: UnitedHealthcare Commercial	$56.35

SUTURE SURG STEEL 2-0 SS28G

Facility

$93.65

Hospital Charge Code	270608066
Hospital Revenue Code	272
Min. Negotiated Rate	$12.17
Max. Negotiated Rate	$46.83
Rate for Payer: Aetna Commercial	$28.09
Rate for Payer: Aetna Medicare Advantage	$28.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.88
Rate for Payer: Cigna Commercial	$46.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.17
Rate for Payer: Oxford Commercial	$46.83
Rate for Payer: Qualcare PPO/HMO/WC	$14.05
Rate for Payer: UnitedHealthcare Commercial	$46.83

SUTURE SURG STEEL 2-0 SS28G

Facility

$93.65

Hospital Charge Code	270608066
Hospital Revenue Code	272
Min. Negotiated Rate	$14.05
Max. Negotiated Rate	$14.05
Rate for Payer: Qualcare PPO/HMO/WC	$14.05

SUTURE SURG STEEL 3-0

Facility

$91.25

Hospital Charge Code	270604721
Hospital Revenue Code	272
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

SUTURE SURG STEEL 3-0

Facility

$91.25

Hospital Charge Code	270604721
Hospital Revenue Code	272
Min. Negotiated Rate	$11.86
Max. Negotiated Rate	$45.62
Rate for Payer: Aetna Commercial	$27.38
Rate for Payer: Aetna Medicare Advantage	$27.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.27
Rate for Payer: Cigna Commercial	$45.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.86
Rate for Payer: Oxford Commercial	$45.62
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$45.62

SUTURE SURG STEEL M654G

Facility

$133.25

Hospital Charge Code	270634808
Hospital Revenue Code	272
Min. Negotiated Rate	$19.99
Max. Negotiated Rate	$19.99
Rate for Payer: Qualcare PPO/HMO/WC	$19.99

SUTURE SURG STEEL M654G

Facility

$133.25

Hospital Charge Code	270634808
Hospital Revenue Code	272
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$66.62
Rate for Payer: Aetna Commercial	$39.98
Rate for Payer: Aetna Medicare Advantage	$39.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.98
Rate for Payer: Cigna Commercial	$66.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.32
Rate for Payer: Oxford Commercial	$66.62
Rate for Payer: Qualcare PPO/HMO/WC	$19.99
Rate for Payer: UnitedHealthcare Commercial	$66.62

SUTURE SWANSON PASSER

Facility

$438.90

Hospital Charge Code	270657893
Hospital Revenue Code	272
Min. Negotiated Rate	$57.06
Max. Negotiated Rate	$219.45
Rate for Payer: Aetna Commercial	$131.67
Rate for Payer: Aetna Medicare Advantage	$131.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.92
Rate for Payer: Cigna Commercial	$219.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.06
Rate for Payer: Oxford Commercial	$219.45
Rate for Payer: Qualcare PPO/HMO/WC	$65.83
Rate for Payer: UnitedHealthcare Commercial	$219.45

SUTURE SWANSON PASSER

Facility

$438.90

Hospital Charge Code	270657893
Hospital Revenue Code	272
Min. Negotiated Rate	$65.83
Max. Negotiated Rate	$65.83
Rate for Payer: Qualcare PPO/HMO/WC	$65.83

SUTURE TAK GUIDE CL OF AR1934G

Facility

$719.25

Hospital Charge Code	270633583
Hospital Revenue Code	272
Min. Negotiated Rate	$93.50
Max. Negotiated Rate	$359.62
Rate for Payer: Aetna Commercial	$215.78
Rate for Payer: Aetna Medicare Advantage	$215.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.41
Rate for Payer: Cigna Commercial	$359.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.50
Rate for Payer: Oxford Commercial	$359.62
Rate for Payer: Qualcare PPO/HMO/WC	$107.89
Rate for Payer: UnitedHealthcare Commercial	$359.62

SUTURE TAK GUIDE CL OF AR1934G

Facility

$719.25

Hospital Charge Code	270633583
Hospital Revenue Code	272
Min. Negotiated Rate	$107.89
Max. Negotiated Rate	$107.89
Rate for Payer: Qualcare PPO/HMO/WC	$107.89

SUTURETAK MINI BIOCOMP

Facility

$1,625.00

Hospital Charge Code	270655938
Hospital Revenue Code	272
Min. Negotiated Rate	$211.25
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$487.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$211.25
Rate for Payer: Oxford Commercial	$812.50
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Commercial	$812.50

SUTURETAK MINI BIOCOMP

Facility

$1,625.00

Hospital Charge Code	270655938
Hospital Revenue Code	272
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$243.75
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

SUTURETAK MINI DISP KIT

Facility

$875.00

Hospital Charge Code	270655939
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SUTURETAK MINI DISP KIT

Facility

$875.00

Hospital Charge Code	270655939
Hospital Revenue Code	272
Min. Negotiated Rate	$113.75
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$262.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.75
Rate for Payer: Oxford Commercial	$437.50
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$437.50

SUTURE TAKS W TAPE

Facility

$2,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270692653
Hospital Revenue Code	278
Min. Negotiated Rate	$348.75
Max. Negotiated Rate	$1,162.50
Rate for Payer: Aetna Commercial	$697.50
Rate for Payer: Aetna Medicare Advantage	$697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.88
Rate for Payer: Cigna Commercial	$1,162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: Qualcare PPO/HMO/WC	$348.75

Know your out-of-pocket cost for care.

All Charges