Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB 3/0 30 UD V20

Facility

$6.07

Hospital Charge Code	270651281S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.04
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.55
Rate for Payer: Cigna Commercial	$3.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.58
Rate for Payer: Oxford Commercial	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.91
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 POLYSORB 3/0 30 UD V20

Facility

$6.07

Hospital Charge Code	270651281N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.91

SUTURE POLYSORB 3/0 30 UD V20

Facility

$6.07

Hospital Charge Code	270604578
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.04
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.55
Rate for Payer: Cigna Commercial	$3.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.58
Rate for Payer: Oxford Commercial	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.91
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 POLYSORB 3/0 30 UD V20

Facility

$6.07

Hospital Charge Code	270651281S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.91

SUTURE POLYSORB 3/0 30 UD V20

Facility

$6.07

Hospital Charge Code	270604578
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.91

SUTURE POLYSORB 3/0 3x18 VIO

Facility

$7.34

Hospital Charge Code	270670966
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 3/0 3x18 VIO

Facility

$7.34

Hospital Charge Code	270670966
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 3/0 3x30 VIO

Facility

$7.24

Hospital Charge Code	270604527
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 3/0 3x30 VIO

Facility

$7.24

Hospital Charge Code	270604527
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 3/0 60 U/D

Facility

$7.29

Hospital Charge Code	270651155
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 3/0 60 U/D

Facility

$7.29

Hospital Charge Code	270651155
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$3.65
Rate for Payer: Aetna Commercial	$2.77
Rate for Payer: Aetna Medicare Advantage	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.86
Rate for Payer: Cigna Commercial	$3.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.90
Rate for Payer: Oxford Commercial	$1.46
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$1.46
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SUTURE POLYSORB 3/0 60 VIO

Facility

$7.34

Hospital Charge Code	270604523
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 3/0 60 VIO

Facility

$7.34

Hospital Charge Code	270604523
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 3/0 V-20 30 UD

Facility

$5.80

Hospital Charge Code	270656032
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 3/0 V-20 30 UD

Facility

$5.80

Hospital Charge Code	270656032
Hospital Revenue Code	272
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$0.87
Rate for Payer: Qualcare PPO/HMO/WC	$0.87

SUTURE POLYSORB 4/0 18 U/D P12

Facility

$14.08

Hospital Charge Code	270651676
Hospital Revenue Code	272
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$2.11
Rate for Payer: Qualcare PPO/HMO/WC	$2.11

SUTURE POLYSORB 4/0 18 U/D P12

Facility

$14.08

Hospital Charge Code	270651676
Hospital Revenue Code	272
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$7.04
Rate for Payer: Aetna Commercial	$5.35
Rate for Payer: Aetna Medicare Advantage	$4.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.59
Rate for Payer: Cigna Commercial	$7.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.66
Rate for Payer: Oxford Commercial	$2.82
Rate for Payer: Qualcare PPO/HMO/WC	$2.11
Rate for Payer: UnitedHealthcare Commercial	$2.82
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

SUTURE POLYSORB 4/0 18 U/D P13

Facility

$35.98

Hospital Charge Code	270649102
Hospital Revenue Code	272
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

SUTURE POLYSORB 4/0 18 U/D P13

Facility

$15.10

Hospital Charge Code	270600795
Hospital Revenue Code	272
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$2.27
Rate for Payer: Qualcare PPO/HMO/WC	$2.27

SUTURE POLYSORB 4/0 18 U/D P13

Facility

$35.98

Hospital Charge Code	270649102
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$17.99
Rate for Payer: Aetna Commercial	$13.67
Rate for Payer: Aetna Medicare Advantage	$10.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.17
Rate for Payer: Cigna Commercial	$17.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.35
Rate for Payer: Oxford Commercial	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$5.40
Rate for Payer: UnitedHealthcare Commercial	$7.20
Rate for Payer: UnitedHealthcare Community & State	$1.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.02

SUTURE POLYSORB 4/0 18 U/D P13

Facility

$15.10

Hospital Charge Code	270600795
Hospital Revenue Code	272
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$7.55
Rate for Payer: Aetna Commercial	$5.74
Rate for Payer: Aetna Medicare Advantage	$4.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.85
Rate for Payer: Cigna Commercial	$7.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.93
Rate for Payer: Oxford Commercial	$3.02
Rate for Payer: Qualcare PPO/HMO/WC	$2.27
Rate for Payer: UnitedHealthcare Commercial	$3.02
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

SUTURE POLYSORB 4/0 18 U/D P21

Facility

$13.77

Hospital Charge Code	270651289
Hospital Revenue Code	272
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$2.07
Rate for Payer: Qualcare PPO/HMO/WC	$2.07

SUTURE POLYSORB 4/0 18 U/D P21

Facility

$13.77

Hospital Charge Code	270651289
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 POLYSORB 4/0 18 UNDYED

Facility

$13.40

Hospital Charge Code	270656152
Hospital Revenue Code	272
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$6.70
Rate for Payer: Aetna Commercial	$5.09
Rate for Payer: Aetna Medicare Advantage	$4.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.42
Rate for Payer: Cigna Commercial	$6.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.48
Rate for Payer: Oxford Commercial	$2.68
Rate for Payer: Qualcare PPO/HMO/WC	$2.01
Rate for Payer: UnitedHealthcare Commercial	$2.68
Rate for Payer: UnitedHealthcare Community & State	$0.42
Rate for Payer: Wellpoint Medicaid Managed Care	$0.38

SUTURE POLYSORB 4/0 18 UNDYED

Facility

$13.40

Hospital Charge Code	270656152
Hospital Revenue Code	272
Min. Negotiated Rate	$2.01
Max. Negotiated Rate	$2.01
Rate for Payer: Qualcare PPO/HMO/WC	$2.01

Know your out-of-pocket cost for care.

All Charges