Heights University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE WIRE ZIM SS .048 191-44

Facility

$190.45

Hospital Charge Code	270601262
Hospital Revenue Code	272
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

SUTURE WIRE ZIM SS .048 191-44

Facility

$190.45

Hospital Charge Code	270601262
Hospital Revenue Code	272
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$95.22
Rate for Payer: Aetna Commercial	$57.13
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.76
Rate for Payer: Oxford Commercial	$95.22
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$95.22

SUTURE WIRE ZIM SS 19G 191-34

Facility

$131.25

Hospital Charge Code	270601260
Hospital Revenue Code	272
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$19.69
Rate for Payer: Qualcare PPO/HMO/WC	$19.69

SUTURE WIRE ZIM SS 19G 191-34

Facility

$131.25

Hospital Charge Code	270601260
Hospital Revenue Code	272
Min. Negotiated Rate	$17.06
Max. Negotiated Rate	$65.62
Rate for Payer: Aetna Commercial	$39.38
Rate for Payer: Aetna Medicare Advantage	$39.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.47
Rate for Payer: Cigna Commercial	$65.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.06
Rate for Payer: Oxford Commercial	$65.62
Rate for Payer: Qualcare PPO/HMO/WC	$19.69
Rate for Payer: UnitedHealthcare Commercial	$65.62

SUTUR SILK 2-0 36 IN NONABS

Facility

$438.30

Hospital Charge Code	270702977
Hospital Revenue Code	278
Min. Negotiated Rate	$65.75
Max. Negotiated Rate	$219.15
Rate for Payer: Aetna Commercial	$131.49
Rate for Payer: Aetna Medicare Advantage	$131.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.77
Rate for Payer: Cigna Commercial	$219.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.07
Rate for Payer: Qualcare PPO/HMO/WC	$65.75

SUTUR SILK 2-0 36 IN NONABS

Facility

$438.30

Hospital Charge Code	270702977
Hospital Revenue Code	278
Min. Negotiated Rate	$65.75
Max. Negotiated Rate	$106.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$87.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.07
Rate for Payer: Qualcare PPO/HMO/WC	$65.75

SUTURTAK PEEK CURVED 2.0MM

Facility

$1,375.00

Hospital Charge Code	270677689
Hospital Revenue Code	272
Min. Negotiated Rate	$178.75
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$412.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$178.75
Rate for Payer: Oxford Commercial	$687.50
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Commercial	$687.50

SUTURTAK PEEK CURVED 2.0MM

Facility

$1,375.00

Hospital Charge Code	270677689
Hospital Revenue Code	272
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$206.25
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

SUTUTE SIK 6-0 TG 140-8

Facility

$56.90

Hospital Charge Code	270665523
Hospital Revenue Code	270
Min. Negotiated Rate	$7.40
Max. Negotiated Rate	$28.45
Rate for Payer: Aetna Commercial	$17.07
Rate for Payer: Aetna Medicare Advantage	$17.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.51
Rate for Payer: Cigna Commercial	$28.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.40
Rate for Payer: Oxford Commercial	$28.45
Rate for Payer: Qualcare PPO/HMO/WC	$8.54
Rate for Payer: UnitedHealthcare Commercial	$28.45

SUTUTE SIK 6-0 TG 140-8

Facility

$56.90

Hospital Charge Code	270665523
Hospital Revenue Code	270
Min. Negotiated Rate	$8.54
Max. Negotiated Rate	$8.54
Rate for Payer: Qualcare PPO/HMO/WC	$8.54

SUT VICRYL RAPIDE2-0 CT-1/CP-1

Facility

$28.88

Hospital Charge Code	270667334
Hospital Revenue Code	272
Min. Negotiated Rate	$4.33
Max. Negotiated Rate	$4.33
Rate for Payer: Qualcare PPO/HMO/WC	$4.33

SUT VICRYL RAPIDE2-0 CT-1/CP-1

Facility

$28.88

Hospital Charge Code	270667334
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

SV16 2.5X 16MM CANN SCREW

Facility

$1,918.80

Service Code	HCPCS C1713
Hospital Charge Code	270667213
Hospital Revenue Code	278
Min. Negotiated Rate	$287.82
Max. Negotiated Rate	$959.40
Rate for Payer: Aetna Commercial	$575.64
Rate for Payer: Aetna Medicare Advantage	$575.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$489.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$489.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$489.29
Rate for Payer: Cigna Commercial	$959.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.35
Rate for Payer: Qualcare PPO/HMO/WC	$287.82

SV16 2.5X 16MM CANN SCREW

Facility

$1,918.80

Service Code	HCPCS C1713
Hospital Charge Code	270667213
Hospital Revenue Code	278
Min. Negotiated Rate	$287.82
Max. Negotiated Rate	$464.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.35
Rate for Payer: Qualcare PPO/HMO/WC	$287.82

SV20 2.5X20MM CANN SCREW

Facility

$1,918.80

Service Code	HCPCS C1713
Hospital Charge Code	270678804
Hospital Revenue Code	278
Min. Negotiated Rate	$287.82
Max. Negotiated Rate	$464.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.35
Rate for Payer: Qualcare PPO/HMO/WC	$287.82

SV20 2.5X20MM CANN SCREW

Facility

$1,918.80

Service Code	HCPCS C1713
Hospital Charge Code	270678804
Hospital Revenue Code	278
Min. Negotiated Rate	$287.82
Max. Negotiated Rate	$959.40
Rate for Payer: Aetna Commercial	$575.64
Rate for Payer: Aetna Medicare Advantage	$575.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$489.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$489.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$489.29
Rate for Payer: Cigna Commercial	$959.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.35
Rate for Payer: Qualcare PPO/HMO/WC	$287.82

SVG INJ

Facility

$414.45

Service Code	HCPCS 93563
Hospital Charge Code	5100037
Hospital Revenue Code	481
Min. Negotiated Rate	$47.86
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.68
Rate for Payer: Cigna Commercial	$47.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SVG INJ

Facility

$414.45

Service Code	HCPCS 93563
Hospital Charge Code	74110004
Hospital Revenue Code	481
Min. Negotiated Rate	$47.86
Max. Negotiated Rate	$4,350.00
Rate for Payer: Aetna Commercial	$124.33
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.68
Rate for Payer: Cigna Commercial	$47.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.88
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

SVG INJ

Facility

$414.45

Service Code	HCPCS 93563
Hospital Charge Code	74110004
Hospital Revenue Code	481
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

SVG INJ

Facility

$414.45

Service Code	HCPCS 93563
Hospital Charge Code	5100037
Hospital Revenue Code	481
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

SWAB GYN 8 INCH

Facility

$260.85

Hospital Charge Code	270654564
Hospital Revenue Code	270
Min. Negotiated Rate	$39.13
Max. Negotiated Rate	$39.13
Rate for Payer: Qualcare PPO/HMO/WC	$39.13

SWAB GYN 8 INCH

Facility

$260.85

Hospital Charge Code	270654564
Hospital Revenue Code	270
Min. Negotiated Rate	$33.91
Max. Negotiated Rate	$130.43
Rate for Payer: Aetna Commercial	$78.25
Rate for Payer: Aetna Medicare Advantage	$78.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.52
Rate for Payer: Cigna Commercial	$130.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.91
Rate for Payer: Oxford Commercial	$130.43
Rate for Payer: Qualcare PPO/HMO/WC	$39.13
Rate for Payer: UnitedHealthcare Commercial	$130.43

SWAB LEMON GLYCERINE

Facility

$2.45

Hospital Charge Code	270302080
Hospital Revenue Code	270
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

SWAB LEMON GLYCERINE

Facility

$2.45

Hospital Charge Code	270302080
Hospital Revenue Code	270
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$0.74
Rate for Payer: Aetna Medicare Advantage	$0.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.62
Rate for Payer: Cigna Commercial	$1.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.32
Rate for Payer: Oxford Commercial	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$1.23

SWABSTICK BETADINE SINGLE

Facility

$2.45

Hospital Charge Code	270302090
Hospital Revenue Code	270
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

Know your out-of-pocket cost for care.

All Charges