Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE VICRYL SZ 0 CT-1 18 IN

Facility

$32.32

Hospital Charge Code	270688291
Hospital Revenue Code	272
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$16.16
Rate for Payer: Aetna Commercial	$9.70
Rate for Payer: Aetna Medicare Advantage	$9.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.24
Rate for Payer: Cigna Commercial	$16.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.20
Rate for Payer: Oxford Commercial	$16.16
Rate for Payer: Qualcare PPO/HMO/WC	$4.85
Rate for Payer: UnitedHealthcare Commercial	$16.16

SUTURE VICRYL SZ 0 CT-1 18 IN

Facility

$32.32

Hospital Charge Code	270688291
Hospital Revenue Code	272
Min. Negotiated Rate	$4.85
Max. Negotiated Rate	$4.85
Rate for Payer: Qualcare PPO/HMO/WC	$4.85

SUTURE VICRYL SZ 2-0 CT-2

Facility

$58.86

Hospital Charge Code	270688292
Hospital Revenue Code	272
Min. Negotiated Rate	$8.83
Max. Negotiated Rate	$8.83
Rate for Payer: Qualcare PPO/HMO/WC	$8.83

SUTURE VICRYL SZ 2-0 CT-2

Facility

$58.86

Hospital Charge Code	270688292
Hospital Revenue Code	272
Min. Negotiated Rate	$7.65
Max. Negotiated Rate	$29.43
Rate for Payer: Aetna Commercial	$17.66
Rate for Payer: Aetna Medicare Advantage	$17.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.01
Rate for Payer: Cigna Commercial	$29.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.65
Rate for Payer: Oxford Commercial	$29.43
Rate for Payer: Qualcare PPO/HMO/WC	$8.83
Rate for Payer: UnitedHealthcare Commercial	$29.43

SUTURE VICRYL VIOLET CTD 27IN

Facility

$10.99

Service Code	HCPCS A4649
Hospital Charge Code	270672130
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 VIOLET CTD 27IN

Facility

$10.99

Service Code	HCPCS A4649
Hospital Charge Code	270672130
Hospital Revenue Code	272
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$5.50
Rate for Payer: Aetna Commercial	$3.30
Rate for Payer: Aetna Medicare Advantage	$3.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.80
Rate for Payer: Cigna Commercial	$5.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.43
Rate for Payer: Oxford Commercial	$5.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.65
Rate for Payer: UnitedHealthcare Commercial	$5.50

SUTURE V-LOC 180 2-0 GS-21

Facility

$110.00

Hospital Charge Code	270665291
Hospital Revenue Code	272
Min. Negotiated Rate	$14.30
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$33.00
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$55.00

SUTURE V-LOC 180 2-0 GS-21

Facility

$110.00

Hospital Charge Code	270665291
Hospital Revenue Code	272
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

SUTURE VLOC 180 2/0 GS-21

Facility

$267.86

Hospital Charge Code	270683239
Hospital Revenue Code	272
Min. Negotiated Rate	$40.18
Max. Negotiated Rate	$40.18
Rate for Payer: Qualcare PPO/HMO/WC	$40.18

SUTURE VLOC 180 2/0 GS-21

Facility

$267.86

Hospital Charge Code	270683239
Hospital Revenue Code	272
Min. Negotiated Rate	$34.82
Max. Negotiated Rate	$133.93
Rate for Payer: Aetna Commercial	$80.36
Rate for Payer: Aetna Medicare Advantage	$80.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$133.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.82
Rate for Payer: Oxford Commercial	$133.93
Rate for Payer: Qualcare PPO/HMO/WC	$40.18
Rate for Payer: UnitedHealthcare Commercial	$133.93

SUTURE V-LOC 180 ABS

Facility

$220.80

Hospital Charge Code	270667871
Hospital Revenue Code	272
Min. Negotiated Rate	$33.12
Max. Negotiated Rate	$33.12
Rate for Payer: Qualcare PPO/HMO/WC	$33.12

SUTURE V-LOC 180 ABS

Facility

$220.80

Hospital Charge Code	270667871
Hospital Revenue Code	272
Min. Negotiated Rate	$28.70
Max. Negotiated Rate	$110.40
Rate for Payer: Aetna Commercial	$66.24
Rate for Payer: Aetna Medicare Advantage	$66.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.30
Rate for Payer: Cigna Commercial	$110.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.70
Rate for Payer: Oxford Commercial	$110.40
Rate for Payer: Qualcare PPO/HMO/WC	$33.12
Rate for Payer: UnitedHealthcare Commercial	$110.40

SUTURE VLOC 180 GR9 GS 21

Facility

$110.00

Hospital Charge Code	270660299
Hospital Revenue Code	272
Min. Negotiated Rate	$14.30
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$33.00
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$55.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$55.00

SUTURE VLOC 180 GR9 GS 21

Facility

$110.00

Hospital Charge Code	270660299
Hospital Revenue Code	272
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

SUTURE V-LOC 2-0 30 CM 180 GS

Facility

$249.71

Hospital Charge Code	270665843
Hospital Revenue Code	272
Min. Negotiated Rate	$37.46
Max. Negotiated Rate	$37.46
Rate for Payer: Qualcare PPO/HMO/WC	$37.46

SUTURE V-LOC 2-0 30 CM 180 GS

Facility

$249.71

Hospital Charge Code	270665843
Hospital Revenue Code	272
Min. Negotiated Rate	$32.46
Max. Negotiated Rate	$124.86
Rate for Payer: Aetna Commercial	$74.91
Rate for Payer: Aetna Medicare Advantage	$74.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.68
Rate for Payer: Cigna Commercial	$124.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.46
Rate for Payer: Oxford Commercial	$124.86
Rate for Payer: Qualcare PPO/HMO/WC	$37.46
Rate for Payer: UnitedHealthcare Commercial	$124.86

SUTURE V-LOC 2-0 GS-21

Facility

$215.42

Hospital Charge Code	270666903
Hospital Revenue Code	272
Min. Negotiated Rate	$32.31
Max. Negotiated Rate	$32.31
Rate for Payer: Qualcare PPO/HMO/WC	$32.31

SUTURE V-LOC 2-0 GS-21

Facility

$215.42

Hospital Charge Code	270666903
Hospital Revenue Code	272
Min. Negotiated Rate	$28.00
Max. Negotiated Rate	$107.71
Rate for Payer: Aetna Commercial	$64.63
Rate for Payer: Aetna Medicare Advantage	$64.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.93
Rate for Payer: Cigna Commercial	$107.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.00
Rate for Payer: Oxford Commercial	$107.71
Rate for Payer: Qualcare PPO/HMO/WC	$32.31
Rate for Payer: UnitedHealthcare Commercial	$107.71

SUTURE V-LOC 2-0 GS-22

Facility

$237.63

Hospital Charge Code	270677026
Hospital Revenue Code	272
Min. Negotiated Rate	$35.64
Max. Negotiated Rate	$35.64
Rate for Payer: Qualcare PPO/HMO/WC	$35.64

SUTURE V-LOC 2-0 GS-22

Facility

$237.63

Hospital Charge Code	270677026
Hospital Revenue Code	272
Min. Negotiated Rate	$30.89
Max. Negotiated Rate	$118.81
Rate for Payer: Aetna Commercial	$71.29
Rate for Payer: Aetna Medicare Advantage	$71.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.60
Rate for Payer: Cigna Commercial	$118.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.89
Rate for Payer: Oxford Commercial	$118.81
Rate for Payer: Qualcare PPO/HMO/WC	$35.64
Rate for Payer: UnitedHealthcare Commercial	$118.81

SUTURE VLOC 2-0 GS-22

Facility

$259.95

Hospital Charge Code	270677025
Hospital Revenue Code	272
Min. Negotiated Rate	$38.99
Max. Negotiated Rate	$38.99
Rate for Payer: Qualcare PPO/HMO/WC	$38.99

SUTURE VLOC 2-0 GS-22

Facility

$259.95

Hospital Charge Code	270677025
Hospital Revenue Code	272
Min. Negotiated Rate	$33.79
Max. Negotiated Rate	$129.97
Rate for Payer: Aetna Commercial	$77.98
Rate for Payer: Aetna Medicare Advantage	$77.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.29
Rate for Payer: Cigna Commercial	$129.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.79
Rate for Payer: Oxford Commercial	$129.97
Rate for Payer: Qualcare PPO/HMO/WC	$38.99
Rate for Payer: UnitedHealthcare Commercial	$129.97

SUTURE V-LOC 3-0 P-12

Facility

$231.67

Service Code	HCPCS A4649
Hospital Charge Code	270697937
Hospital Revenue Code	272
Min. Negotiated Rate	$34.75
Max. Negotiated Rate	$34.75
Rate for Payer: Qualcare PPO/HMO/WC	$34.75

SUTURE V-LOC 3-0 P-12

Facility

$231.67

Service Code	HCPCS A4649
Hospital Charge Code	270697937
Hospital Revenue Code	272
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$115.83
Rate for Payer: Aetna Commercial	$69.50
Rate for Payer: Aetna Medicare Advantage	$69.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.08
Rate for Payer: Cigna Commercial	$115.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.12
Rate for Payer: Oxford Commercial	$115.83
Rate for Payer: Qualcare PPO/HMO/WC	$34.75
Rate for Payer: UnitedHealthcare Commercial	$115.83

SUTURE VLOC 3-0 V-20

Facility

$263.14

Hospital Charge Code	270665246
Hospital Revenue Code	272
Min. Negotiated Rate	$34.21
Max. Negotiated Rate	$131.57
Rate for Payer: Aetna Commercial	$78.94
Rate for Payer: Aetna Medicare Advantage	$78.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.10
Rate for Payer: Cigna Commercial	$131.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.21
Rate for Payer: Oxford Commercial	$131.57
Rate for Payer: Qualcare PPO/HMO/WC	$39.47
Rate for Payer: UnitedHealthcare Commercial	$131.57

Know your out-of-pocket cost for care.

All Charges