Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE MONOSOF 6/0 18 CLR P1

Facility

$13.77

Hospital Charge Code	270604518
Hospital Revenue Code	272
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$6.88
Rate for Payer: Aetna Commercial	$5.23
Rate for Payer: Aetna Medicare Advantage	$4.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.51
Rate for Payer: Cigna Commercial	$6.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.58
Rate for Payer: Oxford Commercial	$2.75
Rate for Payer: Qualcare PPO/HMO/WC	$2.07
Rate for Payer: UnitedHealthcare Commercial	$2.75
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.39

SUTURE MONOSOF 6/0 18 CLR P1

Facility

$13.77

Hospital Charge Code	270604518
Hospital Revenue Code	272
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$2.07
Rate for Payer: Qualcare PPO/HMO/WC	$2.07

SUTURE MONOSOF 9-0 BLACK

Facility

$102.71

Hospital Charge Code	270651163
Hospital Revenue Code	272
Min. Negotiated Rate	$15.41
Max. Negotiated Rate	$15.41
Rate for Payer: Qualcare PPO/HMO/WC	$15.41

SUTURE MONOSOF 9-0 BLACK

Facility

$102.71

Hospital Charge Code	270651163
Hospital Revenue Code	272
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$51.35
Rate for Payer: Aetna Commercial	$39.03
Rate for Payer: Aetna Medicare Advantage	$30.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.19
Rate for Payer: Cigna Commercial	$51.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.70
Rate for Payer: Oxford Commercial	$20.54
Rate for Payer: Qualcare PPO/HMO/WC	$15.41
Rate for Payer: UnitedHealthcare Commercial	$20.54
Rate for Payer: UnitedHealthcare Community & State	$3.25
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

SUTURE MONOSOF C-14 2-0 30

Facility

$5.82

Hospital Charge Code	270651173
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$2.91
Rate for Payer: Aetna Commercial	$2.21
Rate for Payer: Aetna Medicare Advantage	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.48
Rate for Payer: Cigna Commercial	$2.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.51
Rate for Payer: Oxford Commercial	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$0.87
Rate for Payer: UnitedHealthcare Commercial	$1.16
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

SUTURE MONOSOF C-14 2-0 30

Facility

$5.82

Hospital Charge Code	270651173
Hospital Revenue Code	272
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$0.87
Rate for Payer: Qualcare PPO/HMO/WC	$0.87

SUTURE MONOSOF C-15 2-0

Facility

$14.43

Hospital Charge Code	270604509
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$7.21
Rate for Payer: Aetna Commercial	$5.48
Rate for Payer: Aetna Medicare Advantage	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.68
Rate for Payer: Cigna Commercial	$7.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.75
Rate for Payer: Oxford Commercial	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.16
Rate for Payer: UnitedHealthcare Commercial	$2.89
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

SUTURE MONOSOF C-15 2-0

Facility

$14.43

Hospital Charge Code	270604509
Hospital Revenue Code	272
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.16
Rate for Payer: Qualcare PPO/HMO/WC	$2.16

SUTURE MONOSOF C-17 2-0 30

Facility

$6.03

Hospital Charge Code	270651174
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.02
Rate for Payer: Aetna Commercial	$2.29
Rate for Payer: Aetna Medicare Advantage	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.54
Rate for Payer: Cigna Commercial	$3.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.57
Rate for Payer: Oxford Commercial	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.21
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

SUTURE MONOSOF C-17 2-0 30

Facility

$6.03

Hospital Charge Code	270651174
Hospital Revenue Code	272
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

SUTURE MONOSOF MV1355 8-0

Facility

$49.12

Hospital Charge Code	270604515
Hospital Revenue Code	272
Min. Negotiated Rate	$7.37
Max. Negotiated Rate	$7.37
Rate for Payer: Qualcare PPO/HMO/WC	$7.37

SUTURE MONOSOF MV1355 8-0

Facility

$49.12

Hospital Charge Code	270604515
Hospital Revenue Code	272
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$24.56
Rate for Payer: Aetna Commercial	$18.67
Rate for Payer: Aetna Medicare Advantage	$14.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.53
Rate for Payer: Cigna Commercial	$24.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.77
Rate for Payer: Oxford Commercial	$9.82
Rate for Payer: Qualcare PPO/HMO/WC	$7.37
Rate for Payer: UnitedHealthcare Commercial	$9.82
Rate for Payer: UnitedHealthcare Community & State	$1.55
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

SUTURE MONOSOF P-10 7-0 BLK

Facility

$13.57

Hospital Charge Code	270649088
Hospital Revenue Code	272
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$2.04
Rate for Payer: Qualcare PPO/HMO/WC	$2.04

SUTURE MONOSOF P-10 7-0 BLK

Facility

$13.57

Hospital Charge Code	270649088
Hospital Revenue Code	272
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$6.79
Rate for Payer: Aetna Commercial	$5.16
Rate for Payer: Aetna Medicare Advantage	$4.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.46
Rate for Payer: Cigna Commercial	$6.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.53
Rate for Payer: Oxford Commercial	$2.71
Rate for Payer: Qualcare PPO/HMO/WC	$2.04
Rate for Payer: UnitedHealthcare Commercial	$2.71
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.39

SUTURE MONOSOF P-12 5-0 18

Facility

$12.90

Hospital Charge Code	270651305
Hospital Revenue Code	272
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$6.45
Rate for Payer: Aetna Commercial	$4.90
Rate for Payer: Aetna Medicare Advantage	$3.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.29
Rate for Payer: Cigna Commercial	$6.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.35
Rate for Payer: Oxford Commercial	$2.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.94
Rate for Payer: UnitedHealthcare Commercial	$2.58
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

SUTURE MONOSOF P-12 5-0 18

Facility

$12.90

Hospital Charge Code	270651305
Hospital Revenue Code	272
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$1.94
Rate for Payer: Qualcare PPO/HMO/WC	$1.94

SUTURE MONOSOF P13 4-0 SN5691

Facility

$12.67

Hospital Charge Code	270633023
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$6.33
Rate for Payer: Aetna Commercial	$4.81
Rate for Payer: Aetna Medicare Advantage	$3.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.23
Rate for Payer: Cigna Commercial	$6.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.29
Rate for Payer: Oxford Commercial	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$1.90
Rate for Payer: UnitedHealthcare Commercial	$2.53
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

SUTURE MONOSOF P13 4-0 SN5691

Facility

$12.67

Hospital Charge Code	270633023
Hospital Revenue Code	272
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$1.90
Rate for Payer: Qualcare PPO/HMO/WC	$1.90

SUTURE MONOSOF P13 6-0

Facility

$12.51

Hospital Charge Code	270604514
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$6.25
Rate for Payer: Aetna Commercial	$4.75
Rate for Payer: Aetna Medicare Advantage	$3.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.19
Rate for Payer: Cigna Commercial	$6.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.25
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.88
Rate for Payer: UnitedHealthcare Commercial	$2.50
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

SUTURE MONOSOF P13 6-0

Facility

$12.51

Hospital Charge Code	270604514
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

SUTURE MONOSOF P16 7-0

Facility

$29.65

Hospital Charge Code	270600772
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$14.82
Rate for Payer: Aetna Commercial	$11.27
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.56
Rate for Payer: Cigna Commercial	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.71
Rate for Payer: Oxford Commercial	$5.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.45
Rate for Payer: UnitedHealthcare Commercial	$5.93
Rate for Payer: UnitedHealthcare Community & State	$0.94
Rate for Payer: Wellpoint Medicaid Managed Care	$0.84

SUTURE MONOSOF P16 7-0

Facility

$29.65

Hospital Charge Code	270600772
Hospital Revenue Code	272
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$4.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.45

SUTURE MONOSOF PC-11 5-0

Facility

$16.68

Hospital Charge Code	270600777
Hospital Revenue Code	272
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$8.34
Rate for Payer: Aetna Commercial	$6.34
Rate for Payer: Aetna Medicare Advantage	$5.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.25
Rate for Payer: Cigna Commercial	$8.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.34
Rate for Payer: Oxford Commercial	$3.34
Rate for Payer: Qualcare PPO/HMO/WC	$2.50
Rate for Payer: UnitedHealthcare Commercial	$3.34
Rate for Payer: UnitedHealthcare Community & State	$0.53
Rate for Payer: Wellpoint Medicaid Managed Care	$0.47

SUTURE MONOSOF PC-11 5-0

Facility

$16.68

Hospital Charge Code	270600777
Hospital Revenue Code	272
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$2.50

SUTURE MONOSOFT 2-0 BLACK 18

Facility

$39.61

Hospital Charge Code	270651309
Hospital Revenue Code	272
Min. Negotiated Rate	$5.94
Max. Negotiated Rate	$5.94
Rate for Payer: Qualcare PPO/HMO/WC	$5.94

Know your out-of-pocket cost for care.

All Charges