Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUT ANCHR OSSIOFIB 4.75 SNARE

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270700794
Hospital Revenue Code	278
Min. Negotiated Rate	$98.69
Max. Negotiated Rate	$1,737.50
Rate for Payer: Aetna Commercial	$1,320.50
Rate for Payer: Aetna Medicare Advantage	$1,042.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$886.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$695.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$886.12
Rate for Payer: Cigna Commercial	$1,737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$840.95
Rate for Payer: Qualcare PPO/HMO/WC	$521.25
Rate for Payer: UnitedHealthcare Community & State	$109.81
Rate for Payer: Wellpoint Medicaid Managed Care	$98.69

SUT FOR FIB #2 W/NDL3910090021

Facility

$110.50

Hospital Charge Code	270641992
Hospital Revenue Code	272
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$55.25
Rate for Payer: Aetna Commercial	$41.99
Rate for Payer: Aetna Medicare Advantage	$33.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.18
Rate for Payer: Cigna Commercial	$55.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.73
Rate for Payer: Oxford Commercial	$22.10
Rate for Payer: Qualcare PPO/HMO/WC	$16.57
Rate for Payer: UnitedHealthcare Commercial	$22.10
Rate for Payer: UnitedHealthcare Community & State	$3.49
Rate for Payer: Wellpoint Medicaid Managed Care	$3.14

SUT FOR FIB #2 W/NDL3910090021

Facility

$110.50

Hospital Charge Code	270641992
Hospital Revenue Code	272
Min. Negotiated Rate	$16.57
Max. Negotiated Rate	$16.57
Rate for Payer: Qualcare PPO/HMO/WC	$16.57

SUTH ANCHOR BIOCOMP P-LOCK

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687858
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

SUTH ANCHOR BIOCOMP P-LOCK

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687858
Hospital Revenue Code	278
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

SUTRE LASSO 30DEG STR AR406830

Facility

$1,125.00

Hospital Charge Code	270640196
Hospital Revenue Code	272
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

SUTRE LASSO 30DEG STR AR406830

Facility

$1,125.00

Hospital Charge Code	270640196
Hospital Revenue Code	272
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$292.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Commercial	$225.00
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$31.95

SUTRELASSO HIP CRESCENT

Facility

$825.00

Hospital Charge Code	270677470
Hospital Revenue Code	272
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$123.75
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SUTRELASSO HIP CRESCENT

Facility

$825.00

Hospital Charge Code	270677470
Hospital Revenue Code	272
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.50
Rate for Payer: Oxford Commercial	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Commercial	$165.00
Rate for Payer: UnitedHealthcare Community & State	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23.43

SUTRLASSO FOR HIP

Facility

$825.00

Hospital Charge Code	270681513
Hospital Revenue Code	272
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$123.75
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SUTRLASSO FOR HIP

Facility

$825.00

Hospital Charge Code	270681513
Hospital Revenue Code	272
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.50
Rate for Payer: Oxford Commercial	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Commercial	$165.00
Rate for Payer: UnitedHealthcare Community & State	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23.43

SUTRLASSO FOR HIP 45DEG L

Facility

$825.00

Hospital Charge Code	270681512
Hospital Revenue Code	272
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.50
Rate for Payer: Oxford Commercial	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Commercial	$165.00
Rate for Payer: UnitedHealthcare Community & State	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23.43

SUTRLASSO FOR HIP 45DEG L

Facility

$825.00

Hospital Charge Code	270681512
Hospital Revenue Code	272
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$123.75
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SUTRLASSO FOR HIP 45DEG R

Facility

$825.00

Hospital Charge Code	270681511
Hospital Revenue Code	272
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$123.75
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SUTRLASSO FOR HIP 45DEG R

Facility

$825.00

Hospital Charge Code	270681511
Hospital Revenue Code	272
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.50
Rate for Payer: Oxford Commercial	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Commercial	$165.00
Rate for Payer: UnitedHealthcare Community & State	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23.43

SUTRLASSO HIP 90 STR

Facility

$825.00

Hospital Charge Code	270681514
Hospital Revenue Code	272
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.50
Rate for Payer: Oxford Commercial	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Commercial	$165.00
Rate for Payer: UnitedHealthcare Community & State	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23.43

SUTRLASSO HIP 90 STR

Facility

$825.00

Hospital Charge Code	270681514
Hospital Revenue Code	272
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$123.75
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SUTR ORTH BLUE WO/NEED 223111

Facility

$1,325.00

Hospital Charge Code	270635836
Hospital Revenue Code	272
Min. Negotiated Rate	$198.75
Max. Negotiated Rate	$198.75
Rate for Payer: Qualcare PPO/HMO/WC	$198.75

SUTR ORTH BLUE WO/NEED 223111

Facility

$1,325.00

Hospital Charge Code	270635836
Hospital Revenue Code	272
Min. Negotiated Rate	$37.63
Max. Negotiated Rate	$662.50
Rate for Payer: Aetna Commercial	$503.50
Rate for Payer: Aetna Medicare Advantage	$397.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$337.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$337.88
Rate for Payer: Cigna Commercial	$662.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$344.50
Rate for Payer: Oxford Commercial	$265.00
Rate for Payer: Qualcare PPO/HMO/WC	$198.75
Rate for Payer: UnitedHealthcare Commercial	$265.00
Rate for Payer: UnitedHealthcare Community & State	$41.87
Rate for Payer: Wellpoint Medicaid Managed Care	$37.63

SUT SOFSIL 3-0 C-14 BLK SS684G

Facility

$5.35

Hospital Charge Code	270640893
Hospital Revenue Code	272
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.80

SUT SOFSIL 3-0 C-14 BLK SS684G

Facility

$5.35

Hospital Charge Code	270640893
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$2.67
Rate for Payer: Aetna Commercial	$2.03
Rate for Payer: Aetna Medicare Advantage	$1.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.36
Rate for Payer: Cigna Commercial	$2.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.39
Rate for Payer: Oxford Commercial	$1.07
Rate for Payer: Qualcare PPO/HMO/WC	$0.80
Rate for Payer: UnitedHealthcare Commercial	$1.07
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

SUTURE

Facility

$108.41

Hospital Charge Code	270999002
Hospital Revenue Code	272
Min. Negotiated Rate	$16.26
Max. Negotiated Rate	$16.26
Rate for Payer: Qualcare PPO/HMO/WC	$16.26

SUTURE

Facility

$108.41

Hospital Charge Code	270999002
Hospital Revenue Code	272
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$54.20
Rate for Payer: Aetna Commercial	$41.20
Rate for Payer: Aetna Medicare Advantage	$32.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.64
Rate for Payer: Cigna Commercial	$54.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.19
Rate for Payer: Oxford Commercial	$21.68
Rate for Payer: Qualcare PPO/HMO/WC	$16.26
Rate for Payer: UnitedHealthcare Commercial	$21.68
Rate for Payer: UnitedHealthcare Community & State	$3.43
Rate for Payer: Wellpoint Medicaid Managed Care	$3.08

SUTURE 0 POLYSORB GS-21 NEEDLE

Facility

$26.11

Hospital Charge Code	270654988
Hospital Revenue Code	272
Min. Negotiated Rate	$3.92
Max. Negotiated Rate	$3.92
Rate for Payer: Qualcare PPO/HMO/WC	$3.92

SUTURE 0 POLYSORB GS-21 NEEDLE

Facility

$26.11

Hospital Charge Code	270654988
Hospital Revenue Code	272
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$13.05
Rate for Payer: Aetna Commercial	$9.92
Rate for Payer: Aetna Medicare Advantage	$7.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.66
Rate for Payer: Cigna Commercial	$13.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.79
Rate for Payer: Oxford Commercial	$5.22
Rate for Payer: Qualcare PPO/HMO/WC	$3.92
Rate for Payer: UnitedHealthcare Commercial	$5.22
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

Know your out-of-pocket cost for care.

All Charges