Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB 2/0 30 UD V20

Facility

$2.24

Hospital Charge Code	270605250
Hospital Revenue Code	272
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.12
Rate for Payer: Aetna Commercial	$0.85
Rate for Payer: Aetna Medicare Advantage	$0.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.57
Rate for Payer: Cigna Commercial	$1.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.58
Rate for Payer: Oxford Commercial	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.34
Rate for Payer: UnitedHealthcare Commercial	$0.45
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

SUTURE POLYSORB 2/0 30 VIOLET

Facility

$7.96

Hospital Charge Code	270604543
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 2/0 30 VIOLET

Facility

$7.96

Hospital Charge Code	270604543
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 2/0 30 VIOLET

Facility

$8.82

Hospital Charge Code	270604548
Hospital Revenue Code	272
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$4.41
Rate for Payer: Aetna Commercial	$3.35
Rate for Payer: Aetna Medicare Advantage	$2.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.25
Rate for Payer: Cigna Commercial	$4.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.29
Rate for Payer: Oxford Commercial	$1.76
Rate for Payer: Qualcare PPO/HMO/WC	$1.32
Rate for Payer: UnitedHealthcare Commercial	$1.76
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

SUTURE POLYSORB 2/0 30 VIOLET

Facility

$8.82

Hospital Charge Code	270604548
Hospital Revenue Code	272
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$1.32
Rate for Payer: Qualcare PPO/HMO/WC	$1.32

SUTURE POLYSORB 2/0 36 U/D CT

Facility

$6.83

Hospital Charge Code	270651346
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 2/0 36 U/D CT

Facility

$6.83

Hospital Charge Code	270651346
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 2/0 3x18 VIO

Facility

$7.34

Hospital Charge Code	270670965
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 2/0 3x18 VIO

Facility

$7.34

Hospital Charge Code	270670965
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 2/0 3x27 VIO

Facility

$7.24

Hospital Charge Code	270604526
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 2/0 3x27 VIO

Facility

$7.24

Hospital Charge Code	270604526
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	$1.88
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 2/0 60 U/D

Facility

$7.40

Hospital Charge Code	270651156
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$3.70
Rate for Payer: Aetna Commercial	$2.81
Rate for Payer: Aetna Medicare Advantage	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.89
Rate for Payer: Cigna Commercial	$3.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.92
Rate for Payer: Oxford Commercial	$1.48
Rate for Payer: Qualcare PPO/HMO/WC	$1.11
Rate for Payer: UnitedHealthcare Commercial	$1.48
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SUTURE POLYSORB 2/0 60 U/D

Facility

$7.40

Hospital Charge Code	270651156
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$1.11
Rate for Payer: Qualcare PPO/HMO/WC	$1.11

SUTURE POLYSORB 2/0 60 UNDYED

Facility

$5.97

Hospital Charge Code	270656138
Hospital Revenue Code	272
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

SUTURE POLYSORB 2/0 60 UNDYED

Facility

$5.97

Hospital Charge Code	270656138
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$2.98
Rate for Payer: Aetna Commercial	$2.27
Rate for Payer: Aetna Medicare Advantage	$1.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.52
Rate for Payer: Cigna Commercial	$2.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.55
Rate for Payer: Oxford Commercial	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.19
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

SUTURE POLYSORB 2/0 60 VIO

Facility

$7.40

Hospital Charge Code	270604522
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$3.70
Rate for Payer: Aetna Commercial	$2.81
Rate for Payer: Aetna Medicare Advantage	$2.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.89
Rate for Payer: Cigna Commercial	$3.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.92
Rate for Payer: Oxford Commercial	$1.48
Rate for Payer: Qualcare PPO/HMO/WC	$1.11
Rate for Payer: UnitedHealthcare Commercial	$1.48
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SUTURE POLYSORB 2/0 60 VIO

Facility

$7.40

Hospital Charge Code	270604522
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$1.11
Rate for Payer: Qualcare PPO/HMO/WC	$1.11

SUTURE POLYSORB 2 0 GS21

Facility

$6.81

Hospital Charge Code	270662049S
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 2 0 GS21

Facility

$6.81

Hospital Charge Code	270662049S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.40
Rate for Payer: Aetna Commercial	$2.59
Rate for Payer: Aetna Medicare Advantage	$2.04
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	$3.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.77
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	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE POLYSORB 2 0 GS21

Facility

$6.81

Hospital Charge Code	270662049N
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 2 0 GS21

Facility

$6.81

Hospital Charge Code	270662049N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.40
Rate for Payer: Aetna Commercial	$2.59
Rate for Payer: Aetna Medicare Advantage	$2.04
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	$3.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.77
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	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE POLYSORB 2 0 GS21

Facility

$6.81

Hospital Charge Code	270662049
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 2 0 GS21

Facility

$6.81

Hospital Charge Code	270662049
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.40
Rate for Payer: Aetna Commercial	$2.59
Rate for Payer: Aetna Medicare Advantage	$2.04
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	$3.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.77
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	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE POLYSORB 2-0 VL 60 PCT

Facility

$5.80

Hospital Charge Code	270656143
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$2.90
Rate for Payer: Aetna Commercial	$2.20
Rate for Payer: Aetna Medicare Advantage	$1.74
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	$2.90
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	$0.16

SUTURE POLYSORB 2-0 VL 60 PCT

Facility

$5.80

Hospital Charge Code	270656143
Hospital Revenue Code	272
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$0.87
Rate for Payer: Qualcare PPO/HMO/WC	$0.87

Know your out-of-pocket cost for care.

All Charges