Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE ANCHOR SWIVELLOCK TENDO

Facility

$2,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270680783
Hospital Revenue Code	278
Min. Negotiated Rate	$326.25
Max. Negotiated Rate	$526.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: Qualcare PPO/HMO/WC	$326.25

SUTURE ANCHOR SWIVELOCK 4.75MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270664799
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

SUTURE ANCHOR SWIVELOCK 4.75MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270664799
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

SUTURE ANCHOR TAPE 3MM 2L

Facility

$10,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270692725
Hospital Revenue Code	278
Min. Negotiated Rate	$1,593.75
Max. Negotiated Rate	$2,571.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,571.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.75

SUTURE ANCHOR TAPE 3MM 2L

Facility

$10,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270692725
Hospital Revenue Code	278
Min. Negotiated Rate	$301.75
Max. Negotiated Rate	$5,312.50
Rate for Payer: Aetna Commercial	$4,037.50
Rate for Payer: Aetna Medicare Advantage	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,709.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,709.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,709.38
Rate for Payer: Cigna Commercial	$5,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,571.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.75
Rate for Payer: UnitedHealthcare Community & State	$335.75
Rate for Payer: Wellpoint Medicaid Managed Care	$301.75

SUTURE ANCHOR TITANIUM 3.0X12M

Facility

$2,258.75

Service Code	HCPCS C1713
Hospital Charge Code	270701724
Hospital Revenue Code	278
Min. Negotiated Rate	$64.15
Max. Negotiated Rate	$1,129.38
Rate for Payer: Aetna Commercial	$858.33
Rate for Payer: Aetna Medicare Advantage	$677.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$575.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$575.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$575.98
Rate for Payer: Cigna Commercial	$1,129.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.62
Rate for Payer: Qualcare PPO/HMO/WC	$338.81
Rate for Payer: UnitedHealthcare Community & State	$71.38
Rate for Payer: Wellpoint Medicaid Managed Care	$64.15

SUTURE ANCHOR TITANIUM 3.0X12M

Facility

$2,258.75

Service Code	HCPCS C1713
Hospital Charge Code	270701724
Hospital Revenue Code	278
Min. Negotiated Rate	$338.81
Max. Negotiated Rate	$546.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.62
Rate for Payer: Qualcare PPO/HMO/WC	$338.81

SUTURE ANCHR FIBETAK DBL 1.3MM

Facility

$1,850.00

Hospital Charge Code	270683555
Hospital Revenue Code	272
Min. Negotiated Rate	$52.54
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$703.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$481.00
Rate for Payer: Oxford Commercial	$370.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Commercial	$370.00
Rate for Payer: UnitedHealthcare Community & State	$58.46
Rate for Payer: Wellpoint Medicaid Managed Care	$52.54

SUTURE ANCHR FIBETAK DBL 1.3MM

Facility

$1,850.00

Hospital Charge Code	270683555
Hospital Revenue Code	272
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$277.50
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

SUTURE ANCHR FORCEFIB SZ2BLU36

Facility

$1,152.00

Service Code	HCPCS C1713
Hospital Charge Code	270657935
Hospital Revenue Code	278
Min. Negotiated Rate	$172.80
Max. Negotiated Rate	$278.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.78
Rate for Payer: Qualcare PPO/HMO/WC	$172.80

SUTURE ANCHR FORCEFIB SZ2BLU36

Facility

$1,152.00

Service Code	HCPCS C1713
Hospital Charge Code	270657935
Hospital Revenue Code	278
Min. Negotiated Rate	$32.72
Max. Negotiated Rate	$576.00
Rate for Payer: Aetna Commercial	$437.76
Rate for Payer: Aetna Medicare Advantage	$345.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.76
Rate for Payer: Cigna Commercial	$576.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.78
Rate for Payer: Qualcare PPO/HMO/WC	$172.80
Rate for Payer: UnitedHealthcare Community & State	$36.40
Rate for Payer: Wellpoint Medicaid Managed Care	$32.72

SUTURE ASORB BARDED 3-0 GS21

Facility

$175.93

Hospital Charge Code	270671574
Hospital Revenue Code	272
Min. Negotiated Rate	$26.39
Max. Negotiated Rate	$26.39
Rate for Payer: Qualcare PPO/HMO/WC	$26.39

SUTURE ASORB BARDED 3-0 GS21

Facility

$175.93

Hospital Charge Code	270671574
Hospital Revenue Code	272
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$87.97
Rate for Payer: Aetna Commercial	$66.85
Rate for Payer: Aetna Medicare Advantage	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.86
Rate for Payer: Cigna Commercial	$87.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.74
Rate for Payer: Oxford Commercial	$35.19
Rate for Payer: Qualcare PPO/HMO/WC	$26.39
Rate for Payer: UnitedHealthcare Commercial	$35.19
Rate for Payer: UnitedHealthcare Community & State	$5.56
Rate for Payer: Wellpoint Medicaid Managed Care	$5.00

SUTURE BEADED BLUE #2

Facility

$212.50

Hospital Charge Code	270672173
Hospital Revenue Code	272
Min. Negotiated Rate	$31.88
Max. Negotiated Rate	$31.88
Rate for Payer: Qualcare PPO/HMO/WC	$31.88

SUTURE BEADED BLUE #2

Facility

$212.50

Hospital Charge Code	270672173
Hospital Revenue Code	272
Min. Negotiated Rate	$6.04
Max. Negotiated Rate	$106.25
Rate for Payer: Aetna Commercial	$80.75
Rate for Payer: Aetna Medicare Advantage	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.19
Rate for Payer: Cigna Commercial	$106.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.25
Rate for Payer: Oxford Commercial	$42.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.88
Rate for Payer: UnitedHealthcare Commercial	$42.50
Rate for Payer: UnitedHealthcare Community & State	$6.71
Rate for Payer: Wellpoint Medicaid Managed Care	$6.04

SUTURE BIOSYN 0 36 U/D CT1

Facility

$7.19

Hospital Charge Code	270607969
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$1.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.08

SUTURE BIOSYN 0 36 U/D CT1

Facility

$7.19

Hospital Charge Code	270607969
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$3.60
Rate for Payer: Aetna Commercial	$2.73
Rate for Payer: Aetna Medicare Advantage	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.83
Rate for Payer: Cigna Commercial	$3.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.87
Rate for Payer: Oxford Commercial	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.08
Rate for Payer: UnitedHealthcare Commercial	$1.44
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

SUTURE BIOSYN 2/0 27 U/D CT1

Facility

$6.78

Hospital Charge Code	270659478
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.02

SUTURE BIOSYN 2/0 27 U/D CT1

Facility

$6.78

Hospital Charge Code	270659478
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.39
Rate for Payer: Aetna Commercial	$2.58
Rate for Payer: Aetna Medicare Advantage	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.73
Rate for Payer: Cigna Commercial	$3.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.76
Rate for Payer: Oxford Commercial	$1.36
Rate for Payer: Qualcare PPO/HMO/WC	$1.02
Rate for Payer: UnitedHealthcare Commercial	$1.36
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE BIOSYN 2/0 30 U/D V20

Facility

$6.78

Hospital Charge Code	270604706
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.39
Rate for Payer: Aetna Commercial	$2.58
Rate for Payer: Aetna Medicare Advantage	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.73
Rate for Payer: Cigna Commercial	$3.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.76
Rate for Payer: Oxford Commercial	$1.36
Rate for Payer: Qualcare PPO/HMO/WC	$1.02
Rate for Payer: UnitedHealthcare Commercial	$1.36
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE BIOSYN 2/0 30 U/D V20

Facility

$6.78

Hospital Charge Code	270604706
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.02

SUTURE BIOSYN 2/0 30 UNDYED

Facility

$7.91

Hospital Charge Code	270606792
Hospital Revenue Code	272
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$3.96
Rate for Payer: Aetna Commercial	$3.01
Rate for Payer: Aetna Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.02
Rate for Payer: Cigna Commercial	$3.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.06
Rate for Payer: Oxford Commercial	$1.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.19
Rate for Payer: UnitedHealthcare Commercial	$1.58
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

SUTURE BIOSYN 2/0 30 UNDYED

Facility

$7.91

Hospital Charge Code	270606792
Hospital Revenue Code	272
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.19

SUTURE BIOSYN 2/0 30 VIO GS22

Facility

$6.78

Hospital Charge Code	270675603
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.39
Rate for Payer: Aetna Commercial	$2.58
Rate for Payer: Aetna Medicare Advantage	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.73
Rate for Payer: Cigna Commercial	$3.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.76
Rate for Payer: Oxford Commercial	$1.36
Rate for Payer: Qualcare PPO/HMO/WC	$1.02
Rate for Payer: UnitedHealthcare Commercial	$1.36
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE BIOSYN 2/0 30 VIO GS22

Facility

$6.78

Hospital Charge Code	270675603
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.02

Know your out-of-pocket cost for care.

All Charges