Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE VICRYL CTD 3-0 TIES

Facility

$9.55

Hospital Charge Code	270677553
Hospital Revenue Code	272
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$1.43
Rate for Payer: Qualcare PPO/HMO/WC	$1.43

SUTURE VICRYL O UR-6 DBL ARM

Facility

$69.10

Hospital Charge Code	270677493
Hospital Revenue Code	272
Min. Negotiated Rate	$8.98
Max. Negotiated Rate	$34.55
Rate for Payer: Aetna Commercial	$20.73
Rate for Payer: Aetna Medicare Advantage	$20.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.62
Rate for Payer: Cigna Commercial	$34.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.98
Rate for Payer: Oxford Commercial	$34.55
Rate for Payer: Qualcare PPO/HMO/WC	$10.37
Rate for Payer: UnitedHealthcare Commercial	$34.55

SUTURE VICRYL O UR-6 DBL ARM

Facility

$69.10

Hospital Charge Code	270677493
Hospital Revenue Code	272
Min. Negotiated Rate	$10.37
Max. Negotiated Rate	$10.37
Rate for Payer: Qualcare PPO/HMO/WC	$10.37

SUTURE VICRYL P-3 5/0

Facility

$15.00

Hospital Charge Code	270649110
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

SUTURE VICRYL P-3 5/0

Facility

$15.00

Hospital Charge Code	270649110
Hospital Revenue Code	272
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

SUTURE VICRYL P-3 5/0

Facility

$15.00

Hospital Charge Code	2706491110
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

SUTURE VICRYL P-3 5/0

Facility

$15.00

Hospital Charge Code	2706491110
Hospital Revenue Code	272
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$4.50
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.95
Rate for Payer: Oxford Commercial	$7.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$7.50

SUTURE VICRYL PLUS 0 CT 1

Facility

$172.05

Hospital Charge Code	270663655
Hospital Revenue Code	272
Min. Negotiated Rate	$25.81
Max. Negotiated Rate	$25.81
Rate for Payer: Qualcare PPO/HMO/WC	$25.81

SUTURE VICRYL PLUS 0 CT 1

Facility

$172.05

Hospital Charge Code	270663655
Hospital Revenue Code	272
Min. Negotiated Rate	$22.37
Max. Negotiated Rate	$86.03
Rate for Payer: Aetna Commercial	$51.62
Rate for Payer: Aetna Medicare Advantage	$51.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.87
Rate for Payer: Cigna Commercial	$86.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.37
Rate for Payer: Oxford Commercial	$86.03
Rate for Payer: Qualcare PPO/HMO/WC	$25.81
Rate for Payer: UnitedHealthcare Commercial	$86.03

SUTURE VICRYL PLUS 0-CT-1

Facility

$25.00

Hospital Charge Code	270669358
Hospital Revenue Code	272
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$12.50
Rate for Payer: Aetna Commercial	$7.50
Rate for Payer: Aetna Medicare Advantage	$7.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.38
Rate for Payer: Cigna Commercial	$12.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.25
Rate for Payer: Oxford Commercial	$12.50
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$12.50

SUTURE VICRYL PLUS 0-CT-1

Facility

$25.00

Hospital Charge Code	270669358
Hospital Revenue Code	272
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

SUTURE VICRYLPLUS 0 CTX

Facility

$8.84

Hospital Charge Code	270678680
Hospital Revenue Code	272
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$1.33
Rate for Payer: Qualcare PPO/HMO/WC	$1.33

SUTURE VICRYLPLUS 0 CTX

Facility

$8.84

Hospital Charge Code	270678680
Hospital Revenue Code	272
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$4.42
Rate for Payer: Aetna Commercial	$2.65
Rate for Payer: Aetna Medicare Advantage	$2.65
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	$4.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.15
Rate for Payer: Oxford Commercial	$4.42
Rate for Payer: Qualcare PPO/HMO/WC	$1.33
Rate for Payer: UnitedHealthcare Commercial	$4.42

SUTURE VICRYL PLUS 2-0 27IN 26

Facility

$60.05

Hospital Charge Code	270697869
Hospital Revenue Code	272
Min. Negotiated Rate	$7.81
Max. Negotiated Rate	$30.02
Rate for Payer: Aetna Commercial	$18.02
Rate for Payer: Aetna Medicare Advantage	$18.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.31
Rate for Payer: Cigna Commercial	$30.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.81
Rate for Payer: Oxford Commercial	$30.02
Rate for Payer: Qualcare PPO/HMO/WC	$9.01
Rate for Payer: UnitedHealthcare Commercial	$30.02

SUTURE VICRYL PLUS 2-0 27IN 26

Facility

$60.05

Hospital Charge Code	270697869
Hospital Revenue Code	272
Min. Negotiated Rate	$9.01
Max. Negotiated Rate	$9.01
Rate for Payer: Qualcare PPO/HMO/WC	$9.01

SUTURE VICRYL RAPIDE 2-0 CT-1

Facility

$15.81

Hospital Charge Code	270664583
Hospital Revenue Code	272
Min. Negotiated Rate	$2.37
Max. Negotiated Rate	$2.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.37

SUTURE VICRYL RAPIDE 2-0 CT-1

Facility

$15.81

Hospital Charge Code	270664583
Hospital Revenue Code	272
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$7.91
Rate for Payer: Aetna Commercial	$4.74
Rate for Payer: Aetna Medicare Advantage	$4.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.03
Rate for Payer: Cigna Commercial	$7.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.06
Rate for Payer: Oxford Commercial	$7.91
Rate for Payer: Qualcare PPO/HMO/WC	$2.37
Rate for Payer: UnitedHealthcare Commercial	$7.91

SUTURE VICRYL RAPIDE 2-0 SH

Facility

$14.90

Hospital Charge Code	270677270
Hospital Revenue Code	272
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$7.45
Rate for Payer: Aetna Commercial	$4.47
Rate for Payer: Aetna Medicare Advantage	$4.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.80
Rate for Payer: Cigna Commercial	$7.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.94
Rate for Payer: Oxford Commercial	$7.45
Rate for Payer: Qualcare PPO/HMO/WC	$2.23
Rate for Payer: UnitedHealthcare Commercial	$7.45

SUTURE VICRYL RAPIDE 2-0 SH

Facility

$14.90

Hospital Charge Code	270677270
Hospital Revenue Code	272
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$2.23
Rate for Payer: Qualcare PPO/HMO/WC	$2.23

SUTURE VICRYL RAPIDE 3/0 27

Facility

$23.05

Hospital Charge Code	270657588
Hospital Revenue Code	272
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$11.53
Rate for Payer: Aetna Commercial	$6.92
Rate for Payer: Aetna Medicare Advantage	$6.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.88
Rate for Payer: Cigna Commercial	$11.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.00
Rate for Payer: Oxford Commercial	$11.53
Rate for Payer: Qualcare PPO/HMO/WC	$3.46
Rate for Payer: UnitedHealthcare Commercial	$11.53

SUTURE VICRYL RAPIDE 3/0 27

Facility

$23.05

Hospital Charge Code	270657588
Hospital Revenue Code	272
Min. Negotiated Rate	$3.46
Max. Negotiated Rate	$3.46
Rate for Payer: Qualcare PPO/HMO/WC	$3.46

SUTURE VICRYL RAPIDE 3-0 SH

Facility

$14.90

Hospital Charge Code	270677269
Hospital Revenue Code	272
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$2.23
Rate for Payer: Qualcare PPO/HMO/WC	$2.23

SUTURE VICRYL RAPIDE 3-0 SH

Facility

$14.90

Hospital Charge Code	270677269
Hospital Revenue Code	272
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$7.45
Rate for Payer: Aetna Commercial	$4.47
Rate for Payer: Aetna Medicare Advantage	$4.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.80
Rate for Payer: Cigna Commercial	$7.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.94
Rate for Payer: Oxford Commercial	$7.45
Rate for Payer: Qualcare PPO/HMO/WC	$2.23
Rate for Payer: UnitedHealthcare Commercial	$7.45

SUTURE VICRYL RAPIDE 4-0 PS-2

Facility

$30.80

Hospital Charge Code	270661984
Hospital Revenue Code	272
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$15.40
Rate for Payer: Aetna Commercial	$9.24
Rate for Payer: Aetna Medicare Advantage	$9.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.85
Rate for Payer: Cigna Commercial	$15.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.00
Rate for Payer: Oxford Commercial	$15.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.62
Rate for Payer: UnitedHealthcare Commercial	$15.40

SUTURE VICRYL RAPIDE 4-0 PS-2

Facility

$30.80

Hospital Charge Code	270661984
Hospital Revenue Code	272
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$4.62
Rate for Payer: Qualcare PPO/HMO/WC	$4.62

Know your out-of-pocket cost for care.

All Charges