Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE VICRYL 4-0 PC-1

Facility

$20.00

Hospital Charge Code	270661073
Hospital Revenue Code	272
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

SUTURE VICRYL 4-0 PC-1

Facility

$20.00

Hospital Charge Code	270661073
Hospital Revenue Code	272
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$6.00
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$10.00

SUTURE VICRYL 4-0 PC-5

Facility

$20.00

Hospital Charge Code	270675773
Hospital Revenue Code	272
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

SUTURE VICRYL 4-0 PC-5

Facility

$20.00

Hospital Charge Code	270675773
Hospital Revenue Code	272
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$6.00
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$10.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$10.00

SUTURE VICRYL 4-0 PS-1

Facility

$29.92

Hospital Charge Code	270671488
Hospital Revenue Code	272
Min. Negotiated Rate	$4.49
Max. Negotiated Rate	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$4.49

SUTURE VICRYL 4-0 PS-1

Facility

$29.92

Hospital Charge Code	270671488
Hospital Revenue Code	272
Min. Negotiated Rate	$3.89
Max. Negotiated Rate	$14.96
Rate for Payer: Aetna Commercial	$8.98
Rate for Payer: Aetna Medicare Advantage	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.63
Rate for Payer: Cigna Commercial	$14.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.89
Rate for Payer: Oxford Commercial	$14.96
Rate for Payer: Qualcare PPO/HMO/WC	$4.49
Rate for Payer: UnitedHealthcare Commercial	$14.96

SUTURE VICRYL 4-0 PS-2

Facility

$18.48

Hospital Charge Code	270671477
Hospital Revenue Code	272
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$9.24
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	$9.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$9.24
Rate for Payer: Qualcare PPO/HMO/WC	$2.77
Rate for Payer: UnitedHealthcare Commercial	$9.24

SUTURE VICRYL 4-0 PS-2

Facility

$18.48

Hospital Charge Code	270671477
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 4-0 PS-2

Facility

$19.96

Hospital Charge Code	270672392
Hospital Revenue Code	272
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$2.99
Rate for Payer: Qualcare PPO/HMO/WC	$2.99

SUTURE VICRYL 4-0 PS-2

Facility

$28.88

Hospital Charge Code	270673500
Hospital Revenue Code	272
Min. Negotiated Rate	$4.33
Max. Negotiated Rate	$4.33
Rate for Payer: Qualcare PPO/HMO/WC	$4.33

SUTURE VICRYL 4-0 PS-2

Facility

$18.23

Hospital Charge Code	270671467
Hospital Revenue Code	272
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.73

SUTURE VICRYL 4-0 PS-2

Facility

$28.88

Hospital Charge Code	270673500
Hospital Revenue Code	272
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$14.44
Rate for Payer: Aetna Commercial	$8.66
Rate for Payer: Aetna Medicare Advantage	$8.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.36
Rate for Payer: Cigna Commercial	$14.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.75
Rate for Payer: Oxford Commercial	$14.44
Rate for Payer: Qualcare PPO/HMO/WC	$4.33
Rate for Payer: UnitedHealthcare Commercial	$14.44

SUTURE VICRYL 4-0 PS-2

Facility

$19.96

Hospital Charge Code	270672392
Hospital Revenue Code	272
Min. Negotiated Rate	$2.59
Max. Negotiated Rate	$9.98
Rate for Payer: Aetna Commercial	$5.99
Rate for Payer: Aetna Medicare Advantage	$5.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.09
Rate for Payer: Cigna Commercial	$9.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.59
Rate for Payer: Oxford Commercial	$9.98
Rate for Payer: Qualcare PPO/HMO/WC	$2.99
Rate for Payer: UnitedHealthcare Commercial	$9.98

SUTURE VICRYL 4-0 PS-2

Facility

$18.23

Hospital Charge Code	270671467
Hospital Revenue Code	272
Min. Negotiated Rate	$2.37
Max. Negotiated Rate	$9.12
Rate for Payer: Aetna Commercial	$5.47
Rate for Payer: Aetna Medicare Advantage	$5.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.65
Rate for Payer: Cigna Commercial	$9.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.37
Rate for Payer: Oxford Commercial	$9.12
Rate for Payer: Qualcare PPO/HMO/WC	$2.73
Rate for Payer: UnitedHealthcare Commercial	$9.12

SUTURE VICRYL 4-0 RB-1

Facility

$8.68

Hospital Charge Code	270672393
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 4-0 RB-1

Facility

$8.68

Hospital Charge Code	270672393
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$4.34
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	$4.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.13
Rate for Payer: Oxford Commercial	$4.34
Rate for Payer: Qualcare PPO/HMO/WC	$1.30
Rate for Payer: UnitedHealthcare Commercial	$4.34

SUTURE VICRYL 4-0 REEL TIES

Facility

$9.71

Hospital Charge Code	270671447
Hospital Revenue Code	272
Min. Negotiated Rate	$1.26
Max. Negotiated Rate	$4.86
Rate for Payer: Aetna Commercial	$2.91
Rate for Payer: Aetna Medicare Advantage	$2.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.48
Rate for Payer: Cigna Commercial	$4.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.26
Rate for Payer: Oxford Commercial	$4.86
Rate for Payer: Qualcare PPO/HMO/WC	$1.46
Rate for Payer: UnitedHealthcare Commercial	$4.86

SUTURE VICRYL 4-0 REEL TIES

Facility

$9.71

Hospital Charge Code	270671447
Hospital Revenue Code	272
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$1.46
Rate for Payer: Qualcare PPO/HMO/WC	$1.46

SUTURE VICRYL 4-0 SC-2

Facility

$9.64

Hospital Charge Code	270655696
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$4.82
Rate for Payer: Aetna Commercial	$2.89
Rate for Payer: Aetna Medicare Advantage	$2.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.25
Rate for Payer: Oxford Commercial	$4.82
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$4.82

SUTURE VICRYL 4-0 SC-2

Facility

$9.64

Hospital Charge Code	270655696
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

SUTURE VICRYL 4-0 SH

Facility

$8.81

Hospital Charge Code	270672305
Hospital Revenue Code	272
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$4.41
Rate for Payer: Aetna Commercial	$2.64
Rate for Payer: Aetna Medicare Advantage	$2.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.25
Rate for Payer: Cigna Commercial	$4.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.15
Rate for Payer: Oxford Commercial	$4.41
Rate for Payer: Qualcare PPO/HMO/WC	$1.32
Rate for Payer: UnitedHealthcare Commercial	$4.41

SUTURE VICRYL 4-0 SH

Facility

$8.81

Hospital Charge Code	270672305
Hospital Revenue Code	272
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$1.32
Rate for Payer: Qualcare PPO/HMO/WC	$1.32

SUTURE VICRYL 4-0 TIES

Facility

$42.33

Hospital Charge Code	270672394
Hospital Revenue Code	272
Min. Negotiated Rate	$6.35
Max. Negotiated Rate	$6.35
Rate for Payer: Qualcare PPO/HMO/WC	$6.35

SUTURE VICRYL 4-0 TIES

Facility

$42.33

Hospital Charge Code	270672394
Hospital Revenue Code	272
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$21.16
Rate for Payer: Aetna Commercial	$12.70
Rate for Payer: Aetna Medicare Advantage	$12.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.79
Rate for Payer: Cigna Commercial	$21.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.50
Rate for Payer: Oxford Commercial	$21.16
Rate for Payer: Qualcare PPO/HMO/WC	$6.35
Rate for Payer: UnitedHealthcare Commercial	$21.16

SUTURE VICRYL 4-0 V-20

Facility

$7.13

Hospital Charge Code	270671464
Hospital Revenue Code	272
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$1.07
Rate for Payer: Qualcare PPO/HMO/WC	$1.07

Know your out-of-pocket cost for care.

All Charges