Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE VICRYL 1 MO-4

Facility

$11.02

Hospital Charge Code	270671471
Hospital Revenue Code	272
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

SUTURE VICRYL 1 MO-5 27INCH

Facility

$82.70

Hospital Charge Code	270677187
Hospital Revenue Code	272
Min. Negotiated Rate	$12.40
Max. Negotiated Rate	$12.40
Rate for Payer: Qualcare PPO/HMO/WC	$12.40

SUTURE VICRYL 1 MO-5 27INCH

Facility

$82.70

Hospital Charge Code	270677187
Hospital Revenue Code	272
Min. Negotiated Rate	$10.75
Max. Negotiated Rate	$41.35
Rate for Payer: Aetna Commercial	$24.81
Rate for Payer: Aetna Medicare Advantage	$24.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.09
Rate for Payer: Cigna Commercial	$41.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.75
Rate for Payer: Oxford Commercial	$41.35
Rate for Payer: Qualcare PPO/HMO/WC	$12.40
Rate for Payer: UnitedHealthcare Commercial	$41.35

SUTURE VICRYL 1 OS-6

Facility

$13.40

Hospital Charge Code	270672374
Hospital Revenue Code	272
Min. Negotiated Rate	$2.01
Max. Negotiated Rate	$2.01
Rate for Payer: Qualcare PPO/HMO/WC	$2.01

SUTURE VICRYL 1 OS-6

Facility

$13.40

Hospital Charge Code	270672374
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$6.70
Rate for Payer: Aetna Commercial	$4.02
Rate for Payer: Aetna Medicare Advantage	$4.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.42
Rate for Payer: Cigna Commercial	$6.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.74
Rate for Payer: Oxford Commercial	$6.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.01
Rate for Payer: UnitedHealthcare Commercial	$6.70

SUTURE VICRYL 1 REEL

Facility

$10.40

Hospital Charge Code	270672864
Hospital Revenue Code	272
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$5.20
Rate for Payer: Aetna Commercial	$3.12
Rate for Payer: Aetna Medicare Advantage	$3.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.65
Rate for Payer: Cigna Commercial	$5.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.35
Rate for Payer: Oxford Commercial	$5.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.56
Rate for Payer: UnitedHealthcare Commercial	$5.20

SUTURE VICRYL 1 REEL

Facility

$10.40

Hospital Charge Code	270672864
Hospital Revenue Code	272
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$1.56
Rate for Payer: Qualcare PPO/HMO/WC	$1.56

SUTURE VICRYL 1 XLH

Facility

$18.03

Hospital Charge Code	270671479
Hospital Revenue Code	272
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$9.02
Rate for Payer: Aetna Commercial	$5.41
Rate for Payer: Aetna Medicare Advantage	$5.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.60
Rate for Payer: Cigna Commercial	$9.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Oxford Commercial	$9.02
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$9.02

SUTURE VICRYL 1 XLH

Facility

$18.03

Hospital Charge Code	270671479
Hospital Revenue Code	272
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

SUTURE VICRYL 2-0 CT

Facility

$9.36

Hospital Charge Code	270667074
Hospital Revenue Code	272
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.40

SUTURE VICRYL 2-0 CT

Facility

$9.36

Hospital Charge Code	270667074
Hospital Revenue Code	272
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$4.68
Rate for Payer: Aetna Commercial	$2.81
Rate for Payer: Aetna Medicare Advantage	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.39
Rate for Payer: Cigna Commercial	$4.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.22
Rate for Payer: Oxford Commercial	$4.68
Rate for Payer: Qualcare PPO/HMO/WC	$1.40
Rate for Payer: UnitedHealthcare Commercial	$4.68

SUTURE VICRYL 2-0 CT-1

Facility

$7.38

Hospital Charge Code	270671460
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$1.11
Rate for Payer: Qualcare PPO/HMO/WC	$1.11

SUTURE VICRYL 2-0 CT-1

Facility

$6.91

Hospital Charge Code	270671452
Hospital Revenue Code	272
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$3.46
Rate for Payer: Aetna Commercial	$2.07
Rate for Payer: Aetna Medicare Advantage	$2.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.76
Rate for Payer: Cigna Commercial	$3.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$3.46
Rate for Payer: Qualcare PPO/HMO/WC	$1.04
Rate for Payer: UnitedHealthcare Commercial	$3.46

SUTURE VICRYL 2-0 CT-1

Facility

$9.02

Hospital Charge Code	270672386
Hospital Revenue Code	272
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

SUTURE VICRYL 2-0 CT-1

Facility

$56.77

Hospital Charge Code	270672601
Hospital Revenue Code	272
Min. Negotiated Rate	$7.38
Max. Negotiated Rate	$28.39
Rate for Payer: Aetna Commercial	$17.03
Rate for Payer: Aetna Medicare Advantage	$17.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.48
Rate for Payer: Cigna Commercial	$28.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.38
Rate for Payer: Oxford Commercial	$28.39
Rate for Payer: Qualcare PPO/HMO/WC	$8.52
Rate for Payer: UnitedHealthcare Commercial	$28.39

SUTURE VICRYL 2-0 CT-1

Facility

$9.02

Hospital Charge Code	270672386
Hospital Revenue Code	272
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$4.51
Rate for Payer: Aetna Commercial	$2.71
Rate for Payer: Aetna Medicare Advantage	$2.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.30
Rate for Payer: Cigna Commercial	$4.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.17
Rate for Payer: Oxford Commercial	$4.51
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.51

SUTURE VICRYL 2-0 CT-1

Facility

$13.30

Hospital Charge Code	270655941
Hospital Revenue Code	272
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.00

SUTURE VICRYL 2-0 CT-1

Facility

$7.38

Hospital Charge Code	270671460
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$3.69
Rate for Payer: Aetna Commercial	$2.21
Rate for Payer: Aetna Medicare Advantage	$2.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.88
Rate for Payer: Cigna Commercial	$3.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.96
Rate for Payer: Oxford Commercial	$3.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.11
Rate for Payer: UnitedHealthcare Commercial	$3.69

SUTURE VICRYL 2-0 CT-1

Facility

$13.30

Hospital Charge Code	270655941
Hospital Revenue Code	272
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$6.65
Rate for Payer: Aetna Commercial	$3.99
Rate for Payer: Aetna Medicare Advantage	$3.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.39
Rate for Payer: Cigna Commercial	$6.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.73
Rate for Payer: Oxford Commercial	$6.65
Rate for Payer: Qualcare PPO/HMO/WC	$2.00
Rate for Payer: UnitedHealthcare Commercial	$6.65

SUTURE VICRYL 2-0 CT-1

Facility

$56.77

Hospital Charge Code	270672601
Hospital Revenue Code	272
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$8.52
Rate for Payer: Qualcare PPO/HMO/WC	$8.52

SUTURE VICRYL 2-0 CT-1

Facility

$6.91

Hospital Charge Code	270671452
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$1.04
Rate for Payer: Qualcare PPO/HMO/WC	$1.04

SUTURE VICRYL 2-0 CT-2

Facility

$7.38

Hospital Charge Code	270674279
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$3.69
Rate for Payer: Aetna Commercial	$2.21
Rate for Payer: Aetna Medicare Advantage	$2.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.88
Rate for Payer: Cigna Commercial	$3.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.96
Rate for Payer: Oxford Commercial	$3.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.11
Rate for Payer: UnitedHealthcare Commercial	$3.69

SUTURE VICRYL 2-0 CT-2

Facility

$7.38

Hospital Charge Code	270674279
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$1.11
Rate for Payer: Qualcare PPO/HMO/WC	$1.11

SUTURE VICRYL 2-0 CT-2

Facility

$8.95

Hospital Charge Code	270672605
Hospital Revenue Code	272
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$1.34
Rate for Payer: Qualcare PPO/HMO/WC	$1.34

SUTURE VICRYL 2-0 CT-2

Facility

$8.95

Hospital Charge Code	270672605
Hospital Revenue Code	272
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$4.47
Rate for Payer: Aetna Commercial	$2.69
Rate for Payer: Aetna Medicare Advantage	$2.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.28
Rate for Payer: Cigna Commercial	$4.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.16
Rate for Payer: Oxford Commercial	$4.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.34
Rate for Payer: UnitedHealthcare Commercial	$4.47

Know your out-of-pocket cost for care.

All Charges