Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE MONOCRYL 4-0 SH

Facility

$9.91

Hospital Charge Code	270671520
Hospital Revenue Code	272
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$4.96
Rate for Payer: Aetna Commercial	$3.77
Rate for Payer: Aetna Medicare Advantage	$2.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.53
Rate for Payer: Cigna Commercial	$4.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.58
Rate for Payer: Oxford Commercial	$1.98
Rate for Payer: Qualcare PPO/HMO/WC	$1.49
Rate for Payer: UnitedHealthcare Commercial	$1.98
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

SUTURE MONOCRYL 4-0 SH

Facility

$9.91

Hospital Charge Code	270671520
Hospital Revenue Code	272
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$1.49
Rate for Payer: Qualcare PPO/HMO/WC	$1.49

SUTURE MONOCRYL 4-0 V-20

Facility

$10.73

Hospital Charge Code	270672368
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$5.37
Rate for Payer: Aetna Commercial	$4.08
Rate for Payer: Aetna Medicare Advantage	$3.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.74
Rate for Payer: Cigna Commercial	$5.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.79
Rate for Payer: Oxford Commercial	$2.15
Rate for Payer: Qualcare PPO/HMO/WC	$1.61
Rate for Payer: UnitedHealthcare Commercial	$2.15
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

SUTURE MONOCRYL 4-0 V-20

Facility

$10.73

Hospital Charge Code	270672368
Hospital Revenue Code	272
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$1.61
Rate for Payer: Qualcare PPO/HMO/WC	$1.61

SUTURE MONOCRYL 5-0 P-3

Facility

$24.20

Hospital Charge Code	270671524
Hospital Revenue Code	272
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$12.10
Rate for Payer: Aetna Commercial	$9.20
Rate for Payer: Aetna Medicare Advantage	$7.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.17
Rate for Payer: Cigna Commercial	$12.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.29
Rate for Payer: Oxford Commercial	$4.84
Rate for Payer: Qualcare PPO/HMO/WC	$3.63
Rate for Payer: UnitedHealthcare Commercial	$4.84
Rate for Payer: UnitedHealthcare Community & State	$0.76
Rate for Payer: Wellpoint Medicaid Managed Care	$0.69

SUTURE MONOCRYL 5-0 P-3

Facility

$32.80

Hospital Charge Code	270660427
Hospital Revenue Code	272
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$16.40
Rate for Payer: Aetna Commercial	$12.46
Rate for Payer: Aetna Medicare Advantage	$9.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.36
Rate for Payer: Cigna Commercial	$16.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.53
Rate for Payer: Oxford Commercial	$6.56
Rate for Payer: Qualcare PPO/HMO/WC	$4.92
Rate for Payer: UnitedHealthcare Commercial	$6.56
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

SUTURE MONOCRYL 5-0 P-3

Facility

$32.80

Hospital Charge Code	270660427
Hospital Revenue Code	272
Min. Negotiated Rate	$4.92
Max. Negotiated Rate	$4.92
Rate for Payer: Qualcare PPO/HMO/WC	$4.92

SUTURE MONOCRYL 5-0 P-3

Facility

$24.20

Hospital Charge Code	270671524
Hospital Revenue Code	272
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$3.63
Rate for Payer: Qualcare PPO/HMO/WC	$3.63

SUTURE MONOCRYL 5-0 RB-1

Facility

$12.00

Hospital Charge Code	270672616
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

SUTURE MONOCRYL 5-0 RB-1

Facility

$12.00

Hospital Charge Code	270672616
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.12
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.38
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

SUTURE MONOCRYL 5-0 V-10

Facility

$26.18

Hospital Charge Code	270663587
Hospital Revenue Code	272
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$13.09
Rate for Payer: Aetna Commercial	$9.95
Rate for Payer: Aetna Medicare Advantage	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.68
Rate for Payer: Cigna Commercial	$13.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.81
Rate for Payer: Oxford Commercial	$5.24
Rate for Payer: Qualcare PPO/HMO/WC	$3.93
Rate for Payer: UnitedHealthcare Commercial	$5.24
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

SUTURE MONOCRYL 5-0 V-10

Facility

$26.18

Hospital Charge Code	270663587
Hospital Revenue Code	272
Min. Negotiated Rate	$3.93
Max. Negotiated Rate	$3.93
Rate for Payer: Qualcare PPO/HMO/WC	$3.93

SUTURE MONOCRYL 6-0 P-3

Facility

$41.66

Hospital Charge Code	270660431
Hospital Revenue Code	272
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$20.83
Rate for Payer: Aetna Commercial	$15.83
Rate for Payer: Aetna Medicare Advantage	$12.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.62
Rate for Payer: Cigna Commercial	$20.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.83
Rate for Payer: Oxford Commercial	$8.33
Rate for Payer: Qualcare PPO/HMO/WC	$6.25
Rate for Payer: UnitedHealthcare Commercial	$8.33
Rate for Payer: UnitedHealthcare Community & State	$1.32
Rate for Payer: Wellpoint Medicaid Managed Care	$1.18

SUTURE MONOCRYL 6-0 P-3

Facility

$41.66

Hospital Charge Code	270660431
Hospital Revenue Code	272
Min. Negotiated Rate	$6.25
Max. Negotiated Rate	$6.25
Rate for Payer: Qualcare PPO/HMO/WC	$6.25

SUTURE MONOCRYL 6-0 PS-6

Facility

$24.98

Hospital Charge Code	270661076
Hospital Revenue Code	272
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

SUTURE MONOCRYL 6-0 PS-6

Facility

$24.98

Hospital Charge Code	270661076
Hospital Revenue Code	272
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$12.49
Rate for Payer: Aetna Commercial	$9.49
Rate for Payer: Aetna Medicare Advantage	$7.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.37
Rate for Payer: Cigna Commercial	$12.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.49
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

SUTURE MONOCRYL CT-1 SIZE 2-0

Facility

$169.83

Hospital Charge Code	270667542
Hospital Revenue Code	272
Min. Negotiated Rate	$25.47
Max. Negotiated Rate	$25.47
Rate for Payer: Qualcare PPO/HMO/WC	$25.47

SUTURE MONOCRYL CT-1 SIZE 2-0

Facility

$169.83

Hospital Charge Code	270667542
Hospital Revenue Code	272
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$84.92
Rate for Payer: Aetna Commercial	$64.54
Rate for Payer: Aetna Medicare Advantage	$50.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.31
Rate for Payer: Cigna Commercial	$84.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.16
Rate for Payer: Oxford Commercial	$33.97
Rate for Payer: Qualcare PPO/HMO/WC	$25.47
Rate for Payer: UnitedHealthcare Commercial	$33.97
Rate for Payer: UnitedHealthcare Community & State	$5.37
Rate for Payer: Wellpoint Medicaid Managed Care	$4.82

SUTURE MONOCRYL PLUS 3-0 UR6

Facility

$17.31

Hospital Charge Code	270698084
Hospital Revenue Code	272
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.60

SUTURE MONOCRYL PLUS 3-0 UR6

Facility

$17.31

Hospital Charge Code	270698084
Hospital Revenue Code	272
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$8.65
Rate for Payer: Aetna Commercial	$6.58
Rate for Payer: Aetna Medicare Advantage	$5.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.41
Rate for Payer: Cigna Commercial	$8.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.50
Rate for Payer: Oxford Commercial	$3.46
Rate for Payer: Qualcare PPO/HMO/WC	$2.60
Rate for Payer: UnitedHealthcare Commercial	$3.46
Rate for Payer: UnitedHealthcare Community & State	$0.55
Rate for Payer: Wellpoint Medicaid Managed Care	$0.49

SUTURE MONOCRYL PLUS PS 2 3-0

Facility

$175.30

Hospital Charge Code	270692958
Hospital Revenue Code	272
Min. Negotiated Rate	$4.98
Max. Negotiated Rate	$87.65
Rate for Payer: Aetna Commercial	$66.61
Rate for Payer: Aetna Medicare Advantage	$52.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.70
Rate for Payer: Cigna Commercial	$87.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.58
Rate for Payer: Oxford Commercial	$35.06
Rate for Payer: Qualcare PPO/HMO/WC	$26.30
Rate for Payer: UnitedHealthcare Commercial	$35.06
Rate for Payer: UnitedHealthcare Community & State	$5.54
Rate for Payer: Wellpoint Medicaid Managed Care	$4.98

SUTURE MONOCRYL PLUS PS 2 3-0

Facility

$175.30

Hospital Charge Code	270692958
Hospital Revenue Code	272
Min. Negotiated Rate	$26.30
Max. Negotiated Rate	$26.30
Rate for Payer: Qualcare PPO/HMO/WC	$26.30

SUTURE MONOCRYL PLUS PS 2 3-0

Facility

$114.73

Hospital Charge Code	270692959
Hospital Revenue Code	272
Min. Negotiated Rate	$3.26
Max. Negotiated Rate	$57.37
Rate for Payer: Aetna Commercial	$43.60
Rate for Payer: Aetna Medicare Advantage	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.26
Rate for Payer: Cigna Commercial	$57.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.83
Rate for Payer: Oxford Commercial	$22.95
Rate for Payer: Qualcare PPO/HMO/WC	$17.21
Rate for Payer: UnitedHealthcare Commercial	$22.95
Rate for Payer: UnitedHealthcare Community & State	$3.63
Rate for Payer: Wellpoint Medicaid Managed Care	$3.26

SUTURE MONOCRYL PLUS PS 2 3-0

Facility

$114.73

Hospital Charge Code	270692959
Hospital Revenue Code	272
Min. Negotiated Rate	$17.21
Max. Negotiated Rate	$17.21
Rate for Payer: Qualcare PPO/HMO/WC	$17.21

SUTURE MONODERM 0 14x14CM

Facility

$71.20

Hospital Charge Code	270678169
Hospital Revenue Code	272
Min. Negotiated Rate	$10.68
Max. Negotiated Rate	$10.68
Rate for Payer: Qualcare PPO/HMO/WC	$10.68

Know your out-of-pocket cost for care.

All Charges