Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE GORETEX CV6 6.0 6M10A

Facility

$122.92

Hospital Charge Code	270634709
Hospital Revenue Code	272
Min. Negotiated Rate	$18.44
Max. Negotiated Rate	$18.44
Rate for Payer: Qualcare PPO/HMO/WC	$18.44

SUTURE GORE-TEX CV-6 76CM TT13

Facility

$124.17

Hospital Charge Code	270650752
Hospital Revenue Code	272
Min. Negotiated Rate	$3.53
Max. Negotiated Rate	$62.09
Rate for Payer: Aetna Commercial	$47.18
Rate for Payer: Aetna Medicare Advantage	$37.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.66
Rate for Payer: Cigna Commercial	$62.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.28
Rate for Payer: Oxford Commercial	$24.83
Rate for Payer: Qualcare PPO/HMO/WC	$18.63
Rate for Payer: UnitedHealthcare Commercial	$24.83
Rate for Payer: UnitedHealthcare Community & State	$3.92
Rate for Payer: Wellpoint Medicaid Managed Care	$3.53

SUTURE GORE-TEX CV-6 76CM TT13

Facility

$124.17

Hospital Charge Code	270650752
Hospital Revenue Code	272
Min. Negotiated Rate	$18.63
Max. Negotiated Rate	$18.63
Rate for Payer: Qualcare PPO/HMO/WC	$18.63

SUTURE GORE-TEX CV-7 TT-13

Facility

$128.75

Hospital Charge Code	270650823S
Hospital Revenue Code	272
Min. Negotiated Rate	$19.31
Max. Negotiated Rate	$19.31
Rate for Payer: Qualcare PPO/HMO/WC	$19.31

SUTURE GORE-TEX CV-7 TT-13

Facility

$128.75

Hospital Charge Code	270650823N
Hospital Revenue Code	272
Min. Negotiated Rate	$19.31
Max. Negotiated Rate	$19.31
Rate for Payer: Qualcare PPO/HMO/WC	$19.31

SUTURE GORE-TEX CV-7 TT-13

Facility

$128.75

Hospital Charge Code	270650823
Hospital Revenue Code	272
Min. Negotiated Rate	$3.66
Max. Negotiated Rate	$64.38
Rate for Payer: Aetna Commercial	$48.92
Rate for Payer: Aetna Medicare Advantage	$38.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.83
Rate for Payer: Cigna Commercial	$64.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.48
Rate for Payer: Oxford Commercial	$25.75
Rate for Payer: Qualcare PPO/HMO/WC	$19.31
Rate for Payer: UnitedHealthcare Commercial	$25.75
Rate for Payer: UnitedHealthcare Community & State	$4.07
Rate for Payer: Wellpoint Medicaid Managed Care	$3.66

SUTURE GORE-TEX CV-7 TT-13

Facility

$128.75

Hospital Charge Code	270650823S
Hospital Revenue Code	272
Min. Negotiated Rate	$3.66
Max. Negotiated Rate	$64.38
Rate for Payer: Aetna Commercial	$48.92
Rate for Payer: Aetna Medicare Advantage	$38.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.83
Rate for Payer: Cigna Commercial	$64.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.48
Rate for Payer: Oxford Commercial	$25.75
Rate for Payer: Qualcare PPO/HMO/WC	$19.31
Rate for Payer: UnitedHealthcare Commercial	$25.75
Rate for Payer: UnitedHealthcare Community & State	$4.07
Rate for Payer: Wellpoint Medicaid Managed Care	$3.66

SUTURE GORE-TEX CV-7 TT-13

Facility

$128.75

Hospital Charge Code	270650823N
Hospital Revenue Code	272
Min. Negotiated Rate	$3.66
Max. Negotiated Rate	$64.38
Rate for Payer: Aetna Commercial	$48.92
Rate for Payer: Aetna Medicare Advantage	$38.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.83
Rate for Payer: Cigna Commercial	$64.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.48
Rate for Payer: Oxford Commercial	$25.75
Rate for Payer: Qualcare PPO/HMO/WC	$19.31
Rate for Payer: UnitedHealthcare Commercial	$25.75
Rate for Payer: UnitedHealthcare Community & State	$4.07
Rate for Payer: Wellpoint Medicaid Managed Care	$3.66

SUTURE GORE-TEX CV-7 TT-13

Facility

$128.75

Hospital Charge Code	270650823
Hospital Revenue Code	272
Min. Negotiated Rate	$19.31
Max. Negotiated Rate	$19.31
Rate for Payer: Qualcare PPO/HMO/WC	$19.31

Suture Gore-Tex TT 9 6-0

Facility

$140.42

Hospital Charge Code	270606765
Hospital Revenue Code	272
Min. Negotiated Rate	$21.06
Max. Negotiated Rate	$21.06
Rate for Payer: Qualcare PPO/HMO/WC	$21.06

Suture Gore-Tex TT 9 6-0

Facility

$140.42

Hospital Charge Code	270606765
Hospital Revenue Code	272
Min. Negotiated Rate	$3.99
Max. Negotiated Rate	$70.21
Rate for Payer: Aetna Commercial	$53.36
Rate for Payer: Aetna Medicare Advantage	$42.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.81
Rate for Payer: Cigna Commercial	$70.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.51
Rate for Payer: Oxford Commercial	$28.08
Rate for Payer: Qualcare PPO/HMO/WC	$21.06
Rate for Payer: UnitedHealthcare Commercial	$28.08
Rate for Payer: UnitedHealthcare Community & State	$4.44
Rate for Payer: Wellpoint Medicaid Managed Care	$3.99

SUTURE GORETX TT13 CV6 6-0

Facility

$103.75

Hospital Charge Code	270604731
Hospital Revenue Code	272
Min. Negotiated Rate	$15.56
Max. Negotiated Rate	$15.56
Rate for Payer: Qualcare PPO/HMO/WC	$15.56

SUTURE GORETX TT13 CV6 6-0

Facility

$103.75

Hospital Charge Code	270604731
Hospital Revenue Code	272
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$51.88
Rate for Payer: Aetna Commercial	$39.42
Rate for Payer: Aetna Medicare Advantage	$31.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.46
Rate for Payer: Cigna Commercial	$51.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.98
Rate for Payer: Oxford Commercial	$20.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.56
Rate for Payer: UnitedHealthcare Commercial	$20.75
Rate for Payer: UnitedHealthcare Community & State	$3.28
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

SUTURE GORETX TT13 CV7 7-0

Facility

$109.58

Hospital Charge Code	270604732
Hospital Revenue Code	272
Min. Negotiated Rate	$16.44
Max. Negotiated Rate	$16.44
Rate for Payer: Qualcare PPO/HMO/WC	$16.44

SUTURE GORETX TT13 CV7 7-0

Facility

$109.58

Hospital Charge Code	270604732
Hospital Revenue Code	272
Min. Negotiated Rate	$3.11
Max. Negotiated Rate	$54.79
Rate for Payer: Aetna Commercial	$41.64
Rate for Payer: Aetna Medicare Advantage	$32.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.94
Rate for Payer: Cigna Commercial	$54.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.49
Rate for Payer: Oxford Commercial	$21.92
Rate for Payer: Qualcare PPO/HMO/WC	$16.44
Rate for Payer: UnitedHealthcare Commercial	$21.92
Rate for Payer: UnitedHealthcare Community & State	$3.46
Rate for Payer: Wellpoint Medicaid Managed Care	$3.11

SUTURE GORTEX 2-0 W/SH NEEDLE

Facility

$122.08

Hospital Charge Code	270673725
Hospital Revenue Code	272
Min. Negotiated Rate	$18.31
Max. Negotiated Rate	$18.31
Rate for Payer: Qualcare PPO/HMO/WC	$18.31

SUTURE GORTEX 2-0 W/SH NEEDLE

Facility

$122.08

Hospital Charge Code	270673725
Hospital Revenue Code	272
Min. Negotiated Rate	$3.47
Max. Negotiated Rate	$61.04
Rate for Payer: Aetna Commercial	$46.39
Rate for Payer: Aetna Medicare Advantage	$36.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.13
Rate for Payer: Cigna Commercial	$61.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.74
Rate for Payer: Oxford Commercial	$24.42
Rate for Payer: Qualcare PPO/HMO/WC	$18.31
Rate for Payer: UnitedHealthcare Commercial	$24.42
Rate for Payer: UnitedHealthcare Community & State	$3.86
Rate for Payer: Wellpoint Medicaid Managed Care	$3.47

SUTURE GRAVITY SYNCHFIX #5

Facility

$7,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270695344
Hospital Revenue Code	278
Min. Negotiated Rate	$1,192.50
Max. Negotiated Rate	$1,923.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,923.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.50

SUTURE GRAVITY SYNCHFIX #5

Facility

$7,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270695344
Hospital Revenue Code	278
Min. Negotiated Rate	$225.78
Max. Negotiated Rate	$3,975.00
Rate for Payer: Aetna Commercial	$3,021.00
Rate for Payer: Aetna Medicare Advantage	$2,385.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,027.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,027.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,027.25
Rate for Payer: Cigna Commercial	$3,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,923.90
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.50
Rate for Payer: UnitedHealthcare Community & State	$251.22
Rate for Payer: Wellpoint Medicaid Managed Care	$225.78

SUTURE GUT PLAIN 6-0 18

Facility

$69.00

Hospital Charge Code	270334603
Hospital Revenue Code	272
Min. Negotiated Rate	$1.96
Max. Negotiated Rate	$34.50
Rate for Payer: Aetna Commercial	$26.22
Rate for Payer: Aetna Medicare Advantage	$20.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.59
Rate for Payer: Cigna Commercial	$34.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Oxford Commercial	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.35
Rate for Payer: UnitedHealthcare Commercial	$13.80
Rate for Payer: UnitedHealthcare Community & State	$2.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.96

SUTURE GUT PLAIN 6-0 18

Facility

$69.00

Hospital Charge Code	270334603
Hospital Revenue Code	272
Min. Negotiated Rate	$10.35
Max. Negotiated Rate	$10.35
Rate for Payer: Qualcare PPO/HMO/WC	$10.35

SUTURE HI-FI #2 SNGL 40 BLUE

Facility

$240.00

Hospital Charge Code	270676308
Hospital Revenue Code	272
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

SUTURE HI-FI #2 SNGL 40 BLUE

Facility

$240.00

Hospital Charge Code	270676308
Hospital Revenue Code	272
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.40
Rate for Payer: Oxford Commercial	$48.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$48.00
Rate for Payer: UnitedHealthcare Community & State	$7.58
Rate for Payer: Wellpoint Medicaid Managed Care	$6.82

SUTURE KIT D-SPECIAL 5-0

Facility

$163.30

Hospital Charge Code	270676568
Hospital Revenue Code	272
Min. Negotiated Rate	$4.64
Max. Negotiated Rate	$81.65
Rate for Payer: Aetna Commercial	$62.05
Rate for Payer: Aetna Medicare Advantage	$48.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.64
Rate for Payer: Cigna Commercial	$81.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.46
Rate for Payer: Oxford Commercial	$32.66
Rate for Payer: Qualcare PPO/HMO/WC	$24.50
Rate for Payer: UnitedHealthcare Commercial	$32.66
Rate for Payer: UnitedHealthcare Community & State	$5.16
Rate for Payer: Wellpoint Medicaid Managed Care	$4.64

SUTURE KIT D-SPECIAL 5-0

Facility

$163.30

Hospital Charge Code	270676568
Hospital Revenue Code	272
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$24.50
Rate for Payer: Qualcare PPO/HMO/WC	$24.50

Know your out-of-pocket cost for care.

All Charges