Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE 0 VICRYL PLUS

Facility

$77.98

Hospital Charge Code	270670523
Hospital Revenue Code	272
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$38.99
Rate for Payer: Aetna Commercial	$29.63
Rate for Payer: Aetna Medicare Advantage	$23.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.88
Rate for Payer: Cigna Commercial	$38.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.27
Rate for Payer: Oxford Commercial	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$11.70
Rate for Payer: UnitedHealthcare Commercial	$15.60
Rate for Payer: UnitedHealthcare Community & State	$2.46
Rate for Payer: Wellpoint Medicaid Managed Care	$2.21

SUTURE 0 VICRYL PLUS

Facility

$77.98

Hospital Charge Code	270670523
Hospital Revenue Code	272
Min. Negotiated Rate	$11.70
Max. Negotiated Rate	$11.70
Rate for Payer: Qualcare PPO/HMO/WC	$11.70

SUTURE 1 CHROMIC GS-25 36 105P

Facility

$7.63

Hospital Charge Code	270655755
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$1.14
Rate for Payer: Qualcare PPO/HMO/WC	$1.14

SUTURE 1 CHROMIC GS-25 36 105P

Facility

$7.63

Hospital Charge Code	270655755
Hospital Revenue Code	272
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$3.81
Rate for Payer: Aetna Commercial	$2.90
Rate for Payer: Aetna Medicare Advantage	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.95
Rate for Payer: Cigna Commercial	$3.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.98
Rate for Payer: Oxford Commercial	$1.53
Rate for Payer: Qualcare PPO/HMO/WC	$1.14
Rate for Payer: UnitedHealthcare Commercial	$1.53
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

SUTURE 2-0 CHROMIC GS-21 30

Facility

$6.40

Hospital Charge Code	270655768
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.20
Rate for Payer: Aetna Commercial	$2.43
Rate for Payer: Aetna Medicare Advantage	$1.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.63
Rate for Payer: Cigna Commercial	$3.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.66
Rate for Payer: Oxford Commercial	$1.28
Rate for Payer: Qualcare PPO/HMO/WC	$0.96
Rate for Payer: UnitedHealthcare Commercial	$1.28
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE 2-0 CHROMIC GS-21 30

Facility

$6.40

Hospital Charge Code	270655768
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$0.96
Rate for Payer: Qualcare PPO/HMO/WC	$0.96

SUTURE 2-0 POLYSORB GS-21 36U

Facility

$6.40

Hospital Charge Code	270655789
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.20
Rate for Payer: Aetna Commercial	$2.43
Rate for Payer: Aetna Medicare Advantage	$1.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.63
Rate for Payer: Cigna Commercial	$3.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.66
Rate for Payer: Oxford Commercial	$1.28
Rate for Payer: Qualcare PPO/HMO/WC	$0.96
Rate for Payer: UnitedHealthcare Commercial	$1.28
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE 2-0 POLYSORB GS-21 36U

Facility

$6.40

Hospital Charge Code	270655789
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$0.96
Rate for Payer: Qualcare PPO/HMO/WC	$0.96

SUTURE 2-0 SILK SH POP OFF MUL

Facility

$65.15

Hospital Charge Code	270685433
Hospital Revenue Code	272
Min. Negotiated Rate	$9.77
Max. Negotiated Rate	$9.77
Rate for Payer: Qualcare PPO/HMO/WC	$9.77

SUTURE 2-0 SILK SH POP OFF MUL

Facility

$65.15

Hospital Charge Code	270685433
Hospital Revenue Code	272
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$32.58
Rate for Payer: Aetna Commercial	$24.76
Rate for Payer: Aetna Medicare Advantage	$19.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.61
Rate for Payer: Cigna Commercial	$32.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.94
Rate for Payer: Oxford Commercial	$13.03
Rate for Payer: Qualcare PPO/HMO/WC	$9.77
Rate for Payer: UnitedHealthcare Commercial	$13.03
Rate for Payer: UnitedHealthcare Community & State	$2.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

SUTURE 2 CO-BRAID UL TRABRAID

Facility

$645.00

Hospital Charge Code	270681121
Hospital Revenue Code	272
Min. Negotiated Rate	$18.32
Max. Negotiated Rate	$322.50
Rate for Payer: Aetna Commercial	$245.10
Rate for Payer: Aetna Medicare Advantage	$193.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.47
Rate for Payer: Cigna Commercial	$322.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$167.70
Rate for Payer: Oxford Commercial	$129.00
Rate for Payer: Qualcare PPO/HMO/WC	$96.75
Rate for Payer: UnitedHealthcare Commercial	$129.00
Rate for Payer: UnitedHealthcare Community & State	$20.38
Rate for Payer: Wellpoint Medicaid Managed Care	$18.32

SUTURE 2 CO-BRAID UL TRABRAID

Facility

$645.00

Hospital Charge Code	270681121
Hospital Revenue Code	272
Min. Negotiated Rate	$96.75
Max. Negotiated Rate	$96.75
Rate for Payer: Qualcare PPO/HMO/WC	$96.75

SUTURE 2 LR 20 IN

Facility

$50.83

Hospital Charge Code	270690998
Hospital Revenue Code	272
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$25.41
Rate for Payer: Aetna Commercial	$19.32
Rate for Payer: Aetna Medicare Advantage	$15.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.96
Rate for Payer: Cigna Commercial	$25.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.22
Rate for Payer: Oxford Commercial	$10.17
Rate for Payer: Qualcare PPO/HMO/WC	$7.62
Rate for Payer: UnitedHealthcare Commercial	$10.17
Rate for Payer: UnitedHealthcare Community & State	$1.61
Rate for Payer: Wellpoint Medicaid Managed Care	$1.44

SUTURE 2 LR 20 IN

Facility

$50.83

Hospital Charge Code	270690998
Hospital Revenue Code	272
Min. Negotiated Rate	$7.62
Max. Negotiated Rate	$7.62
Rate for Payer: Qualcare PPO/HMO/WC	$7.62

SUTURE #2 TW BRAID POLYBLEND

Facility

$115.00

Hospital Charge Code	270677966
Hospital Revenue Code	272
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

SUTURE #2 TW BRAID POLYBLEND

Facility

$115.00

Hospital Charge Code	270677966
Hospital Revenue Code	272
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$57.50
Rate for Payer: Aetna Commercial	$43.70
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.90
Rate for Payer: Oxford Commercial	$23.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Commercial	$23.00
Rate for Payer: UnitedHealthcare Community & State	$3.63
Rate for Payer: Wellpoint Medicaid Managed Care	$3.27

SUTURE #2 W/BLACK

Facility

$230.00

Hospital Charge Code	270672174
Hospital Revenue Code	272
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$115.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.80
Rate for Payer: Oxford Commercial	$46.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Commercial	$46.00
Rate for Payer: UnitedHealthcare Community & State	$7.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.53

SUTURE #2 W/BLACK

Facility

$230.00

Hospital Charge Code	270672174
Hospital Revenue Code	272
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

SUTURE #2 W/BLUE

Facility

$230.00

Hospital Charge Code	270672175
Hospital Revenue Code	272
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

SUTURE #2 W/BLUE

Facility

$230.00

Hospital Charge Code	270672175
Hospital Revenue Code	272
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$115.00
Rate for Payer: Aetna Commercial	$87.40
Rate for Payer: Aetna Medicare Advantage	$69.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.65
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.80
Rate for Payer: Oxford Commercial	$46.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Commercial	$46.00
Rate for Payer: UnitedHealthcare Community & State	$7.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.53

SUTURE 3/0 PDS MONO CT-2

Facility

$16.00

Hospital Charge Code	270683594
Hospital Revenue Code	272
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$8.00
Rate for Payer: Aetna Commercial	$6.08
Rate for Payer: Aetna Medicare Advantage	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.08
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$3.20
Rate for Payer: Qualcare PPO/HMO/WC	$2.40
Rate for Payer: UnitedHealthcare Commercial	$3.20
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

SUTURE 3/0 PDS MONO CT-2

Facility

$16.00

Hospital Charge Code	270683594
Hospital Revenue Code	272
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

SUTURE 3-0 POLYSORB V-20 NEEDL

Facility

$313.35

Hospital Charge Code	270654989
Hospital Revenue Code	272
Min. Negotiated Rate	$8.90
Max. Negotiated Rate	$156.68
Rate for Payer: Aetna Commercial	$119.07
Rate for Payer: Aetna Medicare Advantage	$94.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.90
Rate for Payer: Cigna Commercial	$156.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.47
Rate for Payer: Oxford Commercial	$62.67
Rate for Payer: Qualcare PPO/HMO/WC	$47.00
Rate for Payer: UnitedHealthcare Commercial	$62.67
Rate for Payer: UnitedHealthcare Community & State	$9.90
Rate for Payer: Wellpoint Medicaid Managed Care	$8.90

SUTURE 3-0 POLYSORB V-20 NEEDL

Facility

$313.35

Hospital Charge Code	270654989
Hospital Revenue Code	272
Min. Negotiated Rate	$47.00
Max. Negotiated Rate	$47.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.00

SUTURE 3-0 VICRYL PLUS

Facility

$59.57

Service Code	HCPCS A4649
Hospital Charge Code	270664981S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$29.79
Rate for Payer: Aetna Commercial	$22.64
Rate for Payer: Aetna Medicare Advantage	$17.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.19
Rate for Payer: Cigna Commercial	$29.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.49
Rate for Payer: Oxford Commercial	$11.91
Rate for Payer: Qualcare PPO/HMO/WC	$8.94
Rate for Payer: UnitedHealthcare Commercial	$11.91
Rate for Payer: UnitedHealthcare Community & State	$1.88
Rate for Payer: Wellpoint Medicaid Managed Care	$1.69

Know your out-of-pocket cost for care.

All Charges