Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE VICRYL 2-0 TIES 18

Facility

$41.84

Hospital Charge Code	270672389
Hospital Revenue Code	272
Min. Negotiated Rate	$5.44
Max. Negotiated Rate	$20.92
Rate for Payer: Aetna Commercial	$12.55
Rate for Payer: Aetna Medicare Advantage	$12.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.67
Rate for Payer: Cigna Commercial	$20.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.44
Rate for Payer: Oxford Commercial	$20.92
Rate for Payer: Qualcare PPO/HMO/WC	$6.28
Rate for Payer: UnitedHealthcare Commercial	$20.92

SUTURE VICRYL 2-0 TIES 54

Facility

$9.41

Hospital Charge Code	270672388
Hospital Revenue Code	272
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$1.41
Rate for Payer: Qualcare PPO/HMO/WC	$1.41

SUTURE VICRYL 2-0 TIES 54

Facility

$9.41

Hospital Charge Code	270672388
Hospital Revenue Code	272
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$4.71
Rate for Payer: Aetna Commercial	$2.82
Rate for Payer: Aetna Medicare Advantage	$2.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.40
Rate for Payer: Cigna Commercial	$4.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.22
Rate for Payer: Oxford Commercial	$4.71
Rate for Payer: Qualcare PPO/HMO/WC	$1.41
Rate for Payer: UnitedHealthcare Commercial	$4.71

SUTURE VICRYL 2-0 TIES UNDYED

Facility

$9.78

Hospital Charge Code	270671456
Hospital Revenue Code	272
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$1.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.47

SUTURE VICRYL 2-0 TIES UNDYED

Facility

$9.78

Hospital Charge Code	270671456
Hospital Revenue Code	272
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$4.89
Rate for Payer: Aetna Commercial	$2.93
Rate for Payer: Aetna Medicare Advantage	$2.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.49
Rate for Payer: Cigna Commercial	$4.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.27
Rate for Payer: Oxford Commercial	$4.89
Rate for Payer: Qualcare PPO/HMO/WC	$1.47
Rate for Payer: UnitedHealthcare Commercial	$4.89

SUTURE VICRYL 2-0 UR-5

Facility

$15.58

Hospital Charge Code	270671462
Hospital Revenue Code	272
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$7.79
Rate for Payer: Aetna Commercial	$4.67
Rate for Payer: Aetna Medicare Advantage	$4.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.97
Rate for Payer: Cigna Commercial	$7.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.03
Rate for Payer: Oxford Commercial	$7.79
Rate for Payer: Qualcare PPO/HMO/WC	$2.34
Rate for Payer: UnitedHealthcare Commercial	$7.79

SUTURE VICRYL 2-0 UR-5

Facility

$15.58

Hospital Charge Code	270671462
Hospital Revenue Code	272
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$2.34
Rate for Payer: Qualcare PPO/HMO/WC	$2.34

SUTURE VICRYL 2-0 UR-6 27 IN

Facility

$9.98

Hospital Charge Code	270690133
Hospital Revenue Code	272
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

SUTURE VICRYL 2-0 UR-6 27 IN

Facility

$9.98

Hospital Charge Code	270690133
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$4.99
Rate for Payer: Aetna Commercial	$2.99
Rate for Payer: Aetna Medicare Advantage	$2.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.54
Rate for Payer: Cigna Commercial	$4.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$4.99
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$4.99

SUTURE VICRYL 2-0 V-20

Facility

$6.92

Hospital Charge Code	270671465
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 V-20

Facility

$6.92

Hospital Charge Code	270671465
Hospital Revenue Code	272
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$3.46
Rate for Payer: Aetna Commercial	$2.08
Rate for Payer: Aetna Medicare Advantage	$2.08
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 V-20

Facility

$7.91

Hospital Charge Code	270671459
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 V-20

Facility

$7.91

Hospital Charge Code	270671459
Hospital Revenue Code	272
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$3.96
Rate for Payer: Aetna Commercial	$2.37
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.02
Rate for Payer: Cigna Commercial	$3.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.03
Rate for Payer: Oxford Commercial	$3.96
Rate for Payer: Qualcare PPO/HMO/WC	$1.19
Rate for Payer: UnitedHealthcare Commercial	$3.96

SUTURE VICRYL 2 TP-1

Facility

$16.15

Hospital Charge Code	270672379
Hospital Revenue Code	272
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$8.07
Rate for Payer: Aetna Commercial	$4.84
Rate for Payer: Aetna Medicare Advantage	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.12
Rate for Payer: Cigna Commercial	$8.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$8.07
Rate for Payer: Qualcare PPO/HMO/WC	$2.42
Rate for Payer: UnitedHealthcare Commercial	$8.07

SUTURE VICRYL 2 TP-1

Facility

$16.15

Hospital Charge Code	270672379
Hospital Revenue Code	272
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$2.42
Rate for Payer: Qualcare PPO/HMO/WC	$2.42

SUTURE VICRYL 2 TP-1

Facility

$75.04

Hospital Charge Code	270671481
Hospital Revenue Code	272
Min. Negotiated Rate	$9.76
Max. Negotiated Rate	$37.52
Rate for Payer: Aetna Commercial	$22.51
Rate for Payer: Aetna Medicare Advantage	$22.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.14
Rate for Payer: Cigna Commercial	$37.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.76
Rate for Payer: Oxford Commercial	$37.52
Rate for Payer: Qualcare PPO/HMO/WC	$11.26
Rate for Payer: UnitedHealthcare Commercial	$37.52

SUTURE VICRYL 2 TP-1

Facility

$15.24

Hospital Charge Code	270671486
Hospital Revenue Code	272
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$7.62
Rate for Payer: Aetna Commercial	$4.57
Rate for Payer: Aetna Medicare Advantage	$4.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.89
Rate for Payer: Cigna Commercial	$7.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.98
Rate for Payer: Oxford Commercial	$7.62
Rate for Payer: Qualcare PPO/HMO/WC	$2.29
Rate for Payer: UnitedHealthcare Commercial	$7.62

SUTURE VICRYL 2 TP-1

Facility

$15.24

Hospital Charge Code	270671486
Hospital Revenue Code	272
Min. Negotiated Rate	$2.29
Max. Negotiated Rate	$2.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.29

SUTURE VICRYL 2 TP-1

Facility

$75.04

Hospital Charge Code	270671481
Hospital Revenue Code	272
Min. Negotiated Rate	$11.26
Max. Negotiated Rate	$11.26
Rate for Payer: Qualcare PPO/HMO/WC	$11.26

SUTURE VICRYL 3-0 CP-1/CT-1

Facility

$18.46

Hospital Charge Code	270672375
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$2.77
Rate for Payer: Qualcare PPO/HMO/WC	$2.77

SUTURE VICRYL 3-0 CP-1/CT-1

Facility

$18.46

Hospital Charge Code	270672375
Hospital Revenue Code	272
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$9.23
Rate for Payer: Aetna Commercial	$5.54
Rate for Payer: Aetna Medicare Advantage	$5.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.71
Rate for Payer: Cigna Commercial	$9.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$9.23
Rate for Payer: Qualcare PPO/HMO/WC	$2.77
Rate for Payer: UnitedHealthcare Commercial	$9.23

SUTURE VICRYL 3-0 CP-2

Facility

$75.55

Hospital Charge Code	270676654
Hospital Revenue Code	272
Min. Negotiated Rate	$11.33
Max. Negotiated Rate	$11.33
Rate for Payer: Qualcare PPO/HMO/WC	$11.33

SUTURE VICRYL 3-0 CP-2

Facility

$75.55

Hospital Charge Code	270676654
Hospital Revenue Code	272
Min. Negotiated Rate	$9.82
Max. Negotiated Rate	$37.77
Rate for Payer: Aetna Commercial	$22.66
Rate for Payer: Aetna Medicare Advantage	$22.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.27
Rate for Payer: Cigna Commercial	$37.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.82
Rate for Payer: Oxford Commercial	$37.77
Rate for Payer: Qualcare PPO/HMO/WC	$11.33
Rate for Payer: UnitedHealthcare Commercial	$37.77

SUTURE VICRYL 3-0 CT-1

Facility

$8.57

Hospital Charge Code	270667910
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$4.29
Rate for Payer: Aetna Commercial	$2.57
Rate for Payer: Aetna Medicare Advantage	$2.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.19
Rate for Payer: Cigna Commercial	$4.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.11
Rate for Payer: Oxford Commercial	$4.29
Rate for Payer: Qualcare PPO/HMO/WC	$1.29
Rate for Payer: UnitedHealthcare Commercial	$4.29

SUTURE VICRYL 3-0 CT-1

Facility

$6.93

Hospital Charge Code	270671451
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$1.04
Rate for Payer: Qualcare PPO/HMO/WC	$1.04

Know your out-of-pocket cost for care.

All Charges