Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE VICRYL 2-0 CTD NO NDL

Facility

$51.52

Hospital Charge Code	270677690
Hospital Revenue Code	272
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$25.76
Rate for Payer: Aetna Commercial	$15.46
Rate for Payer: Aetna Medicare Advantage	$15.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.14
Rate for Payer: Cigna Commercial	$25.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.70
Rate for Payer: Oxford Commercial	$25.76
Rate for Payer: Qualcare PPO/HMO/WC	$7.73
Rate for Payer: UnitedHealthcare Commercial	$25.76

SUTURE VICRYL 2-0 CTD NO NDL

Facility

$51.52

Hospital Charge Code	270677690
Hospital Revenue Code	272
Min. Negotiated Rate	$7.73
Max. Negotiated Rate	$7.73
Rate for Payer: Qualcare PPO/HMO/WC	$7.73

SUTURE VICRYL 2-0 FS-1

Facility

$9.91

Hospital Charge Code	270671472
Hospital Revenue Code	272
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$1.49
Rate for Payer: Qualcare PPO/HMO/WC	$1.49

SUTURE VICRYL 2-0 FS-1

Facility

$9.91

Hospital Charge Code	270671472
Hospital Revenue Code	272
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$4.96
Rate for Payer: Aetna Commercial	$2.97
Rate for Payer: Aetna Medicare Advantage	$2.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.53
Rate for Payer: Cigna Commercial	$4.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.29
Rate for Payer: Oxford Commercial	$4.96
Rate for Payer: Qualcare PPO/HMO/WC	$1.49
Rate for Payer: UnitedHealthcare Commercial	$4.96

SUTURE VICRYL 2-0 GS-24

Facility

$8.67

Hospital Charge Code	270671490
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$4.33
Rate for Payer: Aetna Commercial	$2.60
Rate for Payer: Aetna Medicare Advantage	$2.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.21
Rate for Payer: Cigna Commercial	$4.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.13
Rate for Payer: Oxford Commercial	$4.33
Rate for Payer: Qualcare PPO/HMO/WC	$1.30
Rate for Payer: UnitedHealthcare Commercial	$4.33

SUTURE VICRYL 2-0 GS-24

Facility

$8.67

Hospital Charge Code	270671490
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$1.30
Rate for Payer: Qualcare PPO/HMO/WC	$1.30

SUTURE VICRYL 2-0 MO-4

Facility

$10.51

Hospital Charge Code	270671469
Hospital Revenue Code	272
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$1.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.58

SUTURE VICRYL 2-0 MO-4

Facility

$10.51

Hospital Charge Code	270671469
Hospital Revenue Code	272
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$5.25
Rate for Payer: Aetna Commercial	$3.15
Rate for Payer: Aetna Medicare Advantage	$3.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.68
Rate for Payer: Cigna Commercial	$5.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.37
Rate for Payer: Oxford Commercial	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.58
Rate for Payer: UnitedHealthcare Commercial	$5.25

SUTURE VICRYL 2-0 OS-6

Facility

$13.42

Hospital Charge Code	270672376
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 2-0 OS-6

Facility

$13.42

Hospital Charge Code	270672376
Hospital Revenue Code	272
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$6.71
Rate for Payer: Aetna Commercial	$4.03
Rate for Payer: Aetna Medicare Advantage	$4.03
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	$6.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.74
Rate for Payer: Oxford Commercial	$6.71
Rate for Payer: Qualcare PPO/HMO/WC	$2.01
Rate for Payer: UnitedHealthcare Commercial	$6.71

SUTURE VICRYL 2-0 PLUS CT-1

Facility

$57.69

Hospital Charge Code	270691711
Hospital Revenue Code	272
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$28.84
Rate for Payer: Aetna Commercial	$17.31
Rate for Payer: Aetna Medicare Advantage	$17.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.71
Rate for Payer: Cigna Commercial	$28.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.50
Rate for Payer: Oxford Commercial	$28.84
Rate for Payer: Qualcare PPO/HMO/WC	$8.65
Rate for Payer: UnitedHealthcare Commercial	$28.84

SUTURE VICRYL 2-0 PLUS CT-1

Facility

$57.69

Hospital Charge Code	270691711
Hospital Revenue Code	272
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$8.65

SUTURE VICRYL 2-0 REEL TIES

Facility

$9.91

Hospital Charge Code	270671449
Hospital Revenue Code	272
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$4.96
Rate for Payer: Aetna Commercial	$2.97
Rate for Payer: Aetna Medicare Advantage	$2.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.53
Rate for Payer: Cigna Commercial	$4.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.29
Rate for Payer: Oxford Commercial	$4.96
Rate for Payer: Qualcare PPO/HMO/WC	$1.49
Rate for Payer: UnitedHealthcare Commercial	$4.96

SUTURE VICRYL 2-0 REEL TIES

Facility

$9.91

Hospital Charge Code	270671449
Hospital Revenue Code	272
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$1.49
Rate for Payer: Qualcare PPO/HMO/WC	$1.49

SUTURE VICRYL 2-0 SH

Facility

$7.96

Hospital Charge Code	270672387
Hospital Revenue Code	272
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$3.98
Rate for Payer: Aetna Commercial	$2.39
Rate for Payer: Aetna Medicare Advantage	$2.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.03
Rate for Payer: Cigna Commercial	$3.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.03
Rate for Payer: Oxford Commercial	$3.98
Rate for Payer: Qualcare PPO/HMO/WC	$1.19
Rate for Payer: UnitedHealthcare Commercial	$3.98

SUTURE VICRYL 2-0 SH

Facility

$7.96

Hospital Charge Code	270672387
Hospital Revenue Code	272
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.19

SUTURE VICRYL 2-0 SH 27 IN

Facility

$7.96

Hospital Charge Code	270690134
Hospital Revenue Code	272
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$3.98
Rate for Payer: Aetna Commercial	$2.39
Rate for Payer: Aetna Medicare Advantage	$2.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.03
Rate for Payer: Cigna Commercial	$3.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.03
Rate for Payer: Oxford Commercial	$3.98
Rate for Payer: Qualcare PPO/HMO/WC	$1.19
Rate for Payer: UnitedHealthcare Commercial	$3.98

SUTURE VICRYL 2-0 SH 27 IN

Facility

$7.96

Hospital Charge Code	270690134
Hospital Revenue Code	272
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.19

SUTURE VICRYL 2-0 SH UNDYED CR

Facility

$456.12

Hospital Charge Code	270693822
Hospital Revenue Code	272
Min. Negotiated Rate	$68.42
Max. Negotiated Rate	$68.42
Rate for Payer: Qualcare PPO/HMO/WC	$68.42

SUTURE VICRYL 2-0 SH UNDYED CR

Facility

$456.12

Hospital Charge Code	270693822
Hospital Revenue Code	272
Min. Negotiated Rate	$59.30
Max. Negotiated Rate	$228.06
Rate for Payer: Aetna Commercial	$136.84
Rate for Payer: Aetna Medicare Advantage	$136.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.31
Rate for Payer: Cigna Commercial	$228.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.30
Rate for Payer: Oxford Commercial	$228.06
Rate for Payer: Qualcare PPO/HMO/WC	$68.42
Rate for Payer: UnitedHealthcare Commercial	$228.06

SUTURE VICRYL 2-0 TIES

Facility

$8.73

Hospital Charge Code	270655687
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$1.31

SUTURE VICRYL 2-0 TIES

Facility

$38.58

Hospital Charge Code	270671445
Hospital Revenue Code	272
Min. Negotiated Rate	$5.79
Max. Negotiated Rate	$5.79
Rate for Payer: Qualcare PPO/HMO/WC	$5.79

SUTURE VICRYL 2-0 TIES

Facility

$38.58

Hospital Charge Code	270671445
Hospital Revenue Code	272
Min. Negotiated Rate	$5.02
Max. Negotiated Rate	$19.29
Rate for Payer: Aetna Commercial	$11.57
Rate for Payer: Aetna Medicare Advantage	$11.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.84
Rate for Payer: Cigna Commercial	$19.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.02
Rate for Payer: Oxford Commercial	$19.29
Rate for Payer: Qualcare PPO/HMO/WC	$5.79
Rate for Payer: UnitedHealthcare Commercial	$19.29

SUTURE VICRYL 2-0 TIES

Facility

$8.73

Hospital Charge Code	270655687
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$4.37
Rate for Payer: Aetna Commercial	$2.62
Rate for Payer: Aetna Medicare Advantage	$2.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.23
Rate for Payer: Cigna Commercial	$4.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.13
Rate for Payer: Oxford Commercial	$4.37
Rate for Payer: Qualcare PPO/HMO/WC	$1.31
Rate for Payer: UnitedHealthcare Commercial	$4.37

SUTURE VICRYL 2-0 TIES 18

Facility

$41.84

Hospital Charge Code	270672389
Hospital Revenue Code	272
Min. Negotiated Rate	$6.28
Max. Negotiated Rate	$6.28
Rate for Payer: Qualcare PPO/HMO/WC	$6.28

Know your out-of-pocket cost for care.

All Charges