Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE PLAIN PC-1 6-0

Facility

$30.45

Hospital Charge Code	270604738
Hospital Revenue Code	272
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$4.57
Rate for Payer: Qualcare PPO/HMO/WC	$4.57

SUTURE PLAIN PC-1 6-0

Facility

$30.45

Hospital Charge Code	270604738
Hospital Revenue Code	272
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$15.22
Rate for Payer: Aetna Commercial	$11.57
Rate for Payer: Aetna Medicare Advantage	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.76
Rate for Payer: Cigna Commercial	$15.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.92
Rate for Payer: Oxford Commercial	$6.09
Rate for Payer: Qualcare PPO/HMO/WC	$4.57
Rate for Payer: UnitedHealthcare Commercial	$6.09
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$0.86

SUTURE PLN GUT 4-0 SC-1 18

Facility

$15.58

Hospital Charge Code	270671381
Hospital Revenue Code	272
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$2.34
Rate for Payer: Qualcare PPO/HMO/WC	$2.34

SUTURE PLN GUT 4-0 SC-1 18

Facility

$15.58

Hospital Charge Code	270671381
Hospital Revenue Code	272
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$7.79
Rate for Payer: Aetna Commercial	$5.92
Rate for Payer: Aetna Medicare Advantage	$4.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.97
Rate for Payer: Cigna Commercial	$7.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.05
Rate for Payer: Oxford Commercial	$3.12
Rate for Payer: Qualcare PPO/HMO/WC	$2.34
Rate for Payer: UnitedHealthcare Commercial	$3.12
Rate for Payer: UnitedHealthcare Community & State	$0.49
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

SUTURE POLYSORB 0 12x18 U/D

Facility

$26.93

Hospital Charge Code	270654266
Hospital Revenue Code	272
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$13.46
Rate for Payer: Aetna Commercial	$10.23
Rate for Payer: Aetna Medicare Advantage	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.87
Rate for Payer: Cigna Commercial	$13.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.00
Rate for Payer: Oxford Commercial	$5.39
Rate for Payer: Qualcare PPO/HMO/WC	$4.04
Rate for Payer: UnitedHealthcare Commercial	$5.39
Rate for Payer: UnitedHealthcare Community & State	$0.85
Rate for Payer: Wellpoint Medicaid Managed Care	$0.76

SUTURE POLYSORB 0 12x18 U/D

Facility

$26.93

Hospital Charge Code	270654266
Hospital Revenue Code	272
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$4.04
Rate for Payer: Qualcare PPO/HMO/WC	$4.04

SUTURE POLYSORB 0 18 VIOLET

Facility

$12.65

Hospital Charge Code	270665290
Hospital Revenue Code	272
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$1.90
Rate for Payer: Qualcare PPO/HMO/WC	$1.90

SUTURE POLYSORB 0 18 VIOLET

Facility

$12.65

Hospital Charge Code	270665290
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	$3.79
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 POLYSORB 0 30 CT2

Facility

$6.48

Hospital Charge Code	270604538
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.24
Rate for Payer: Aetna Commercial	$2.46
Rate for Payer: Aetna Medicare Advantage	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.65
Rate for Payer: Cigna Commercial	$3.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.68
Rate for Payer: Oxford Commercial	$1.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.97
Rate for Payer: UnitedHealthcare Commercial	$1.30
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE POLYSORB 0 30 CT2

Facility

$6.48

Hospital Charge Code	270604538
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.97

SUTURE POLYSORB 0 30IN CT1

Facility

$6.27

Hospital Charge Code	270604537
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$0.94
Rate for Payer: Qualcare PPO/HMO/WC	$0.94

SUTURE POLYSORB 0 30IN CT1

Facility

$6.27

Hospital Charge Code	270604537
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.13
Rate for Payer: Aetna Commercial	$2.38
Rate for Payer: Aetna Medicare Advantage	$1.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.60
Rate for Payer: Cigna Commercial	$3.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.63
Rate for Payer: Oxford Commercial	$1.25
Rate for Payer: Qualcare PPO/HMO/WC	$0.94
Rate for Payer: UnitedHealthcare Commercial	$1.25
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE POLYSORB 0 30 VIOLET

Facility

$7.60

Hospital Charge Code	270651238
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$1.14
Rate for Payer: Qualcare PPO/HMO/WC	$1.14

SUTURE POLYSORB 0 30 VIOLET

Facility

$7.60

Hospital Charge Code	270651238
Hospital Revenue Code	272
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$3.80
Rate for Payer: Aetna Commercial	$2.89
Rate for Payer: Aetna Medicare Advantage	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.94
Rate for Payer: Cigna Commercial	$3.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.98
Rate for Payer: Oxford Commercial	$1.52
Rate for Payer: Qualcare PPO/HMO/WC	$1.14
Rate for Payer: UnitedHealthcare Commercial	$1.52
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

SUTURE POLYSORB 0 30 VIOLET

Facility

$7.25

Hospital Charge Code	270656167
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

SUTURE POLYSORB 0 30 VIOLET

Facility

$8.62

Hospital Charge Code	270604536
Hospital Revenue Code	272
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$1.29

SUTURE POLYSORB 0 30 VIOLET

Facility

$8.62

Hospital Charge Code	270604536
Hospital Revenue Code	272
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$4.31
Rate for Payer: Aetna Commercial	$3.28
Rate for Payer: Aetna Medicare Advantage	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.20
Rate for Payer: Cigna Commercial	$4.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.24
Rate for Payer: Oxford Commercial	$1.72
Rate for Payer: Qualcare PPO/HMO/WC	$1.29
Rate for Payer: UnitedHealthcare Commercial	$1.72
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

SUTURE POLYSORB 0 30 VIOLET

Facility

$7.96

Hospital Charge Code	270604542
Hospital Revenue Code	272
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$3.98
Rate for Payer: Aetna Commercial	$3.02
Rate for Payer: Aetna Medicare Advantage	$2.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.03
Rate for Payer: Cigna Commercial	$3.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.07
Rate for Payer: Oxford Commercial	$1.59
Rate for Payer: Qualcare PPO/HMO/WC	$1.19
Rate for Payer: UnitedHealthcare Commercial	$1.59
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

SUTURE POLYSORB 0 30 VIOLET

Facility

$7.25

Hospital Charge Code	270656167
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.75
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.89
Rate for Payer: Oxford Commercial	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$1.45
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SUTURE POLYSORB 0 30 VIOLET

Facility

$7.96

Hospital Charge Code	270604542
Hospital Revenue Code	272
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.19

SUTURE POLYSORB 0 36 U/D CT1

Facility

$7.34

Hospital Charge Code	270600564
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$3.67
Rate for Payer: Aetna Commercial	$2.79
Rate for Payer: Aetna Medicare Advantage	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.87
Rate for Payer: Cigna Commercial	$3.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.91
Rate for Payer: Oxford Commercial	$1.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.10
Rate for Payer: UnitedHealthcare Commercial	$1.47
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SUTURE POLYSORB 0 36 U/D CT1

Facility

$7.34

Hospital Charge Code	270600564
Hospital Revenue Code	272
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$1.10
Rate for Payer: Qualcare PPO/HMO/WC	$1.10

SUTURE POLYSORB 0 36U/D GS24

Facility

$6.83

Hospital Charge Code	270651133
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.42
Rate for Payer: Aetna Commercial	$2.60
Rate for Payer: Aetna Medicare Advantage	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.74
Rate for Payer: Cigna Commercial	$3.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.78
Rate for Payer: Oxford Commercial	$1.37
Rate for Payer: Qualcare PPO/HMO/WC	$1.02
Rate for Payer: UnitedHealthcare Commercial	$1.37
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE POLYSORB 0 36U/D GS24

Facility

$6.83

Hospital Charge Code	270651133
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.02

SUTURE POLYSORB 0 36 VIO GS24

Facility

$6.78

Hospital Charge Code	270656125
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.39
Rate for Payer: Aetna Commercial	$2.58
Rate for Payer: Aetna Medicare Advantage	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.73
Rate for Payer: Cigna Commercial	$3.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.76
Rate for Payer: Oxford Commercial	$1.36
Rate for Payer: Qualcare PPO/HMO/WC	$1.02
Rate for Payer: UnitedHealthcare Commercial	$1.36
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

Know your out-of-pocket cost for care.

All Charges