Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE ETHILON 1 GS-25

Facility

$8.09

Hospital Charge Code	270676700
Hospital Revenue Code	272
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$1.21

SUTURE ETHILON 1 GS-25

Facility

$8.09

Hospital Charge Code	270676700
Hospital Revenue Code	272
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.04
Rate for Payer: Aetna Commercial	$3.07
Rate for Payer: Aetna Medicare Advantage	$2.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.06
Rate for Payer: Cigna Commercial	$4.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$1.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.21
Rate for Payer: UnitedHealthcare Commercial	$1.62
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

SUTURE ETHILON 2-0 C-15

Facility

$9.00

Hospital Charge Code	270675342
Hospital Revenue Code	272
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

SUTURE ETHILON 2-0 C-15

Facility

$9.00

Hospital Charge Code	270675342
Hospital Revenue Code	272
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

SUTURE ETHILON 2-0 FS C-15

Facility

$317.10

Hospital Charge Code	270673637
Hospital Revenue Code	272
Min. Negotiated Rate	$9.01
Max. Negotiated Rate	$158.55
Rate for Payer: Aetna Commercial	$120.50
Rate for Payer: Aetna Medicare Advantage	$95.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.86
Rate for Payer: Cigna Commercial	$158.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.45
Rate for Payer: Oxford Commercial	$63.42
Rate for Payer: Qualcare PPO/HMO/WC	$47.56
Rate for Payer: UnitedHealthcare Commercial	$63.42
Rate for Payer: UnitedHealthcare Community & State	$10.02
Rate for Payer: Wellpoint Medicaid Managed Care	$9.01

SUTURE ETHILON 2-0 FS C-15

Facility

$317.10

Hospital Charge Code	270673637
Hospital Revenue Code	272
Min. Negotiated Rate	$47.56
Max. Negotiated Rate	$47.56
Rate for Payer: Qualcare PPO/HMO/WC	$47.56

SUTURE ETHILON 2-0 KS

Facility

$12.99

Hospital Charge Code	270655804
Hospital Revenue Code	272
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

SUTURE ETHILON 2-0 KS

Facility

$12.99

Hospital Charge Code	270655804
Hospital Revenue Code	272
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.38
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

SUTURE ETHILON 2-0 PS

Facility

$29.01

Hospital Charge Code	270667333
Hospital Revenue Code	272
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$4.35
Rate for Payer: Qualcare PPO/HMO/WC	$4.35

SUTURE ETHILON 2-0 PS

Facility

$29.01

Hospital Charge Code	270667333
Hospital Revenue Code	272
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$14.51
Rate for Payer: Aetna Commercial	$11.02
Rate for Payer: Aetna Medicare Advantage	$8.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.40
Rate for Payer: Cigna Commercial	$14.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.54
Rate for Payer: Oxford Commercial	$5.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.35
Rate for Payer: UnitedHealthcare Commercial	$5.80
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$0.82

SUTURE ETHILON 2-0 PS-2

Facility

$17.99

Hospital Charge Code	270671388
Hospital Revenue Code	272
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$8.99
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$8.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.68
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

SUTURE ETHILON 2-0 PS-2

Facility

$17.99

Hospital Charge Code	270671388
Hospital Revenue Code	272
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

SUTURE ETHILON 2 GS-18

Facility

$13.45

Hospital Charge Code	270604723
Hospital Revenue Code	272
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$6.72
Rate for Payer: Aetna Commercial	$5.11
Rate for Payer: Aetna Medicare Advantage	$4.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.43
Rate for Payer: Cigna Commercial	$6.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.50
Rate for Payer: Oxford Commercial	$2.69
Rate for Payer: Qualcare PPO/HMO/WC	$2.02
Rate for Payer: UnitedHealthcare Commercial	$2.69
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.38

SUTURE ETHILON 2 GS-18

Facility

$35.33

Hospital Charge Code	270672227
Hospital Revenue Code	272
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$17.66
Rate for Payer: Aetna Commercial	$13.43
Rate for Payer: Aetna Medicare Advantage	$10.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.01
Rate for Payer: Cigna Commercial	$17.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.19
Rate for Payer: Oxford Commercial	$7.07
Rate for Payer: Qualcare PPO/HMO/WC	$5.30
Rate for Payer: UnitedHealthcare Commercial	$7.07
Rate for Payer: UnitedHealthcare Community & State	$1.12
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

SUTURE ETHILON 2 GS-18

Facility

$13.45

Hospital Charge Code	270604723
Hospital Revenue Code	272
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$2.02
Rate for Payer: Qualcare PPO/HMO/WC	$2.02

SUTURE ETHILON 2 GS-18

Facility

$35.33

Hospital Charge Code	270672227
Hospital Revenue Code	272
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$5.30
Rate for Payer: Qualcare PPO/HMO/WC	$5.30

SUTURE ETHILON 3/0 4IN BLACK B

Facility

$71.61

Hospital Charge Code	270683447
Hospital Revenue Code	272
Min. Negotiated Rate	$10.74
Max. Negotiated Rate	$10.74
Rate for Payer: Qualcare PPO/HMO/WC	$10.74

SUTURE ETHILON 3/0 4IN BLACK B

Facility

$71.61

Hospital Charge Code	270683447
Hospital Revenue Code	272
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$35.80
Rate for Payer: Aetna Commercial	$27.21
Rate for Payer: Aetna Medicare Advantage	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.26
Rate for Payer: Cigna Commercial	$35.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.62
Rate for Payer: Oxford Commercial	$14.32
Rate for Payer: Qualcare PPO/HMO/WC	$10.74
Rate for Payer: UnitedHealthcare Commercial	$14.32
Rate for Payer: UnitedHealthcare Community & State	$2.26
Rate for Payer: Wellpoint Medicaid Managed Care	$2.03

SUTURE ETHILON 3-0 BLK PS-2

Facility

$18.06

Hospital Charge Code	270664322
Hospital Revenue Code	272
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$9.03
Rate for Payer: Aetna Commercial	$6.86
Rate for Payer: Aetna Medicare Advantage	$5.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.61
Rate for Payer: Cigna Commercial	$9.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.70
Rate for Payer: Oxford Commercial	$3.61
Rate for Payer: Qualcare PPO/HMO/WC	$2.71
Rate for Payer: UnitedHealthcare Commercial	$3.61
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

SUTURE ETHILON 3-0 BLK PS-2

Facility

$18.06

Hospital Charge Code	270664322
Hospital Revenue Code	272
Min. Negotiated Rate	$2.71
Max. Negotiated Rate	$2.71
Rate for Payer: Qualcare PPO/HMO/WC	$2.71

SUTURE ETHILON 3-0 FS-1

Facility

$9.18

Hospital Charge Code	270663643
Hospital Revenue Code	272
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$4.59
Rate for Payer: Aetna Commercial	$3.49
Rate for Payer: Aetna Medicare Advantage	$2.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.34
Rate for Payer: Cigna Commercial	$4.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.39
Rate for Payer: Oxford Commercial	$1.84
Rate for Payer: Qualcare PPO/HMO/WC	$1.38
Rate for Payer: UnitedHealthcare Commercial	$1.84
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

SUTURE ETHILON 3-0 FS-1

Facility

$9.18

Hospital Charge Code	270663643
Hospital Revenue Code	272
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$1.38
Rate for Payer: Qualcare PPO/HMO/WC	$1.38

SUTURE ETHILON 3-0 KS CUTTING

Facility

$9.51

Hospital Charge Code	270672358
Hospital Revenue Code	272
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$1.43
Rate for Payer: Qualcare PPO/HMO/WC	$1.43

SUTURE ETHILON 3-0 KS CUTTING

Facility

$9.51

Hospital Charge Code	270672358
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$4.75
Rate for Payer: Aetna Commercial	$3.61
Rate for Payer: Aetna Medicare Advantage	$2.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.43
Rate for Payer: Cigna Commercial	$4.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.47
Rate for Payer: Oxford Commercial	$1.90
Rate for Payer: Qualcare PPO/HMO/WC	$1.43
Rate for Payer: UnitedHealthcare Commercial	$1.90
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

SUTURE ETHILON 4-0 FS-2

Facility

$8.30

Hospital Charge Code	270677492
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$1.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.25

Know your out-of-pocket cost for care.

All Charges