Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE BLACK W/NEEDLE

Facility

$230.00

Hospital Charge Code	270672216
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 BLACK W/NEEDLE

Facility

$230.00

Hospital Charge Code	270672216
Hospital Revenue Code	272
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

SUTURE BLUE W/NEEDLE

Facility

$230.00

Hospital Charge Code	270672215
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 BLUE W/NEEDLE

Facility

$230.00

Hospital Charge Code	270672215
Hospital Revenue Code	272
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

SUTURE BOLSTERS RETENTION

Facility

$25.13

Hospital Charge Code	270651256
Hospital Revenue Code	272
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$12.56
Rate for Payer: Aetna Commercial	$9.55
Rate for Payer: Aetna Medicare Advantage	$7.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.41
Rate for Payer: Cigna Commercial	$12.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.53
Rate for Payer: Oxford Commercial	$5.03
Rate for Payer: Qualcare PPO/HMO/WC	$3.77
Rate for Payer: UnitedHealthcare Commercial	$5.03
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

SUTURE BOLSTERS RETENTION

Facility

$25.13

Hospital Charge Code	270651256
Hospital Revenue Code	272
Min. Negotiated Rate	$3.77
Max. Negotiated Rate	$3.77
Rate for Payer: Qualcare PPO/HMO/WC	$3.77

SUTURE BOOTIES STERION AID

Facility

$52.20

Hospital Charge Code	270663758
Hospital Revenue Code	270
Min. Negotiated Rate	$7.83
Max. Negotiated Rate	$7.83
Rate for Payer: Qualcare PPO/HMO/WC	$7.83

SUTURE BOOTIES STERION AID

Facility

$52.20

Hospital Charge Code	270663758
Hospital Revenue Code	270
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$26.10
Rate for Payer: Aetna Commercial	$19.84
Rate for Payer: Aetna Medicare Advantage	$15.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.31
Rate for Payer: Cigna Commercial	$26.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.57
Rate for Payer: Oxford Commercial	$10.44
Rate for Payer: Qualcare PPO/HMO/WC	$7.83
Rate for Payer: UnitedHealthcare Commercial	$10.44
Rate for Payer: UnitedHealthcare Community & State	$1.65
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

SUTURE BRD BLACK NONABS 4X30IN

Facility

$104.17

Service Code	HCPCS A4649
Hospital Charge Code	270699896
Hospital Revenue Code	272
Min. Negotiated Rate	$2.96
Max. Negotiated Rate	$52.09
Rate for Payer: Aetna Commercial	$39.58
Rate for Payer: Aetna Medicare Advantage	$31.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.56
Rate for Payer: Cigna Commercial	$52.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.08
Rate for Payer: Oxford Commercial	$20.83
Rate for Payer: Qualcare PPO/HMO/WC	$15.63
Rate for Payer: UnitedHealthcare Commercial	$20.83
Rate for Payer: UnitedHealthcare Community & State	$3.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2.96

SUTURE BRD BLACK NONABS 4X30IN

Facility

$104.17

Service Code	HCPCS A4649
Hospital Charge Code	270699896
Hospital Revenue Code	272
Min. Negotiated Rate	$15.63
Max. Negotiated Rate	$15.63
Rate for Payer: Qualcare PPO/HMO/WC	$15.63

SUTURE CAPIO ETHIBOND 1/2 TAPE

Facility

$216.75

Hospital Charge Code	270683969
Hospital Revenue Code	272
Min. Negotiated Rate	$6.16
Max. Negotiated Rate	$108.38
Rate for Payer: Aetna Commercial	$82.36
Rate for Payer: Aetna Medicare Advantage	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.27
Rate for Payer: Cigna Commercial	$108.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.35
Rate for Payer: Oxford Commercial	$43.35
Rate for Payer: Qualcare PPO/HMO/WC	$32.51
Rate for Payer: UnitedHealthcare Commercial	$43.35
Rate for Payer: UnitedHealthcare Community & State	$6.85
Rate for Payer: Wellpoint Medicaid Managed Care	$6.16

SUTURE CAPIO ETHIBOND 1/2 TAPE

Facility

$216.75

Hospital Charge Code	270683969
Hospital Revenue Code	272
Min. Negotiated Rate	$32.51
Max. Negotiated Rate	$32.51
Rate for Payer: Qualcare PPO/HMO/WC	$32.51

SUTURE CAPIO PDS SZ 0

Facility

$199.56

Hospital Charge Code	270678356
Hospital Revenue Code	272
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$99.78
Rate for Payer: Aetna Commercial	$75.83
Rate for Payer: Aetna Medicare Advantage	$59.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.89
Rate for Payer: Cigna Commercial	$99.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.89
Rate for Payer: Oxford Commercial	$39.91
Rate for Payer: Qualcare PPO/HMO/WC	$29.93
Rate for Payer: UnitedHealthcare Commercial	$39.91
Rate for Payer: UnitedHealthcare Community & State	$6.31
Rate for Payer: Wellpoint Medicaid Managed Care	$5.67

SUTURE CAPIO PDS SZ 0

Facility

$199.56

Hospital Charge Code	270678356
Hospital Revenue Code	272
Min. Negotiated Rate	$29.93
Max. Negotiated Rate	$29.93
Rate for Payer: Qualcare PPO/HMO/WC	$29.93

SUTURE CAPIO PROLENE 1/2 CIRCL

Facility

$200.00

Hospital Charge Code	270616241
Hospital Revenue Code	272
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00

SUTURE CAPIO PROLENE 1/2 CIRCL

Facility

$200.00

Hospital Charge Code	270616241
Hospital Revenue Code	272
Min. Negotiated Rate	$5.68
Max. Negotiated Rate	$100.00
Rate for Payer: Aetna Commercial	$76.00
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.00
Rate for Payer: Cigna Commercial	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.00
Rate for Payer: Oxford Commercial	$40.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.00
Rate for Payer: UnitedHealthcare Commercial	$40.00
Rate for Payer: UnitedHealthcare Community & State	$6.32
Rate for Payer: Wellpoint Medicaid Managed Care	$5.68

SUTURE CAPIO PROLENE SZ 0 48

Facility

$199.56

Hospital Charge Code	270621604
Hospital Revenue Code	272
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$99.78
Rate for Payer: Aetna Commercial	$75.83
Rate for Payer: Aetna Medicare Advantage	$59.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.89
Rate for Payer: Cigna Commercial	$99.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.89
Rate for Payer: Oxford Commercial	$39.91
Rate for Payer: Qualcare PPO/HMO/WC	$29.93
Rate for Payer: UnitedHealthcare Commercial	$39.91
Rate for Payer: UnitedHealthcare Community & State	$6.31
Rate for Payer: Wellpoint Medicaid Managed Care	$5.67

SUTURE CAPIO PROLENE SZ 0 48

Facility

$199.56

Hospital Charge Code	270621604
Hospital Revenue Code	272
Min. Negotiated Rate	$29.93
Max. Negotiated Rate	$29.93
Rate for Payer: Qualcare PPO/HMO/WC	$29.93

SUTURE CAPIO PROLENT TC 36 IN

Facility

$216.75

Hospital Charge Code	270683968
Hospital Revenue Code	272
Min. Negotiated Rate	$6.16
Max. Negotiated Rate	$108.38
Rate for Payer: Aetna Commercial	$82.36
Rate for Payer: Aetna Medicare Advantage	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.27
Rate for Payer: Cigna Commercial	$108.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.35
Rate for Payer: Oxford Commercial	$43.35
Rate for Payer: Qualcare PPO/HMO/WC	$32.51
Rate for Payer: UnitedHealthcare Commercial	$43.35
Rate for Payer: UnitedHealthcare Community & State	$6.85
Rate for Payer: Wellpoint Medicaid Managed Care	$6.16

SUTURE CAPIO PROLENT TC 36 IN

Facility

$216.75

Hospital Charge Code	270683968
Hospital Revenue Code	272
Min. Negotiated Rate	$32.51
Max. Negotiated Rate	$32.51
Rate for Payer: Qualcare PPO/HMO/WC	$32.51

SUTURE CAPROSYN 1 36 KV34

Facility

$10.30

Hospital Charge Code	270675606
Hospital Revenue Code	272
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.54

SUTURE CAPROSYN 1 36 KV34

Facility

$10.30

Hospital Charge Code	270675606
Hospital Revenue Code	272
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$5.15
Rate for Payer: Aetna Commercial	$3.91
Rate for Payer: Aetna Medicare Advantage	$3.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.63
Rate for Payer: Cigna Commercial	$5.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.68
Rate for Payer: Oxford Commercial	$2.06
Rate for Payer: Qualcare PPO/HMO/WC	$1.54
Rate for Payer: UnitedHealthcare Commercial	$2.06
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

SUTURE CAPROSYN 3/0 36 GS21

Facility

$7.29

Hospital Charge Code	270605820
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$3.65
Rate for Payer: Aetna Commercial	$2.77
Rate for Payer: Aetna Medicare Advantage	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.86
Rate for Payer: Cigna Commercial	$3.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.90
Rate for Payer: Oxford Commercial	$1.46
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$1.46
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SUTURE CAPROSYN 3/0 36 GS21

Facility

$7.29

Hospital Charge Code	270605820
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

SUTURE CAPROSYN 4-0 UNDYED 30

Facility

$36.10

Hospital Charge Code	270671790
Hospital Revenue Code	272
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$18.05
Rate for Payer: Aetna Commercial	$13.72
Rate for Payer: Aetna Medicare Advantage	$10.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.21
Rate for Payer: Cigna Commercial	$18.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.39
Rate for Payer: Oxford Commercial	$7.22
Rate for Payer: Qualcare PPO/HMO/WC	$5.42
Rate for Payer: UnitedHealthcare Commercial	$7.22
Rate for Payer: UnitedHealthcare Community & State	$1.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.03

Know your out-of-pocket cost for care.

All Charges