Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB 4/0 30 U/D FS2

Facility

$16.12

Hospital Charge Code	270651171
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$8.06
Rate for Payer: Aetna Commercial	$6.13
Rate for Payer: Aetna Medicare Advantage	$4.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.11
Rate for Payer: Cigna Commercial	$8.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.19
Rate for Payer: Oxford Commercial	$3.22
Rate for Payer: Qualcare PPO/HMO/WC	$2.42
Rate for Payer: UnitedHealthcare Commercial	$3.22
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.46

SUTURE POLYSORB 4/0 30 U/D FS2

Facility

$16.12

Hospital Charge Code	270651171
Hospital Revenue Code	272
Min. Negotiated Rate	$2.42
Max. Negotiated Rate	$2.42
Rate for Payer: Qualcare PPO/HMO/WC	$2.42

SUTURE POLYSORB 4/0 30 U/D SC2

Facility

$6.27

Hospital Charge Code	270604581
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 4/0 30 U/D SC2

Facility

$6.27

Hospital Charge Code	270604581
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 4/0 30 UD V20

Facility

$6.43

Hospital Charge Code	270605816
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.21
Rate for Payer: Aetna Commercial	$2.44
Rate for Payer: Aetna Medicare Advantage	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.64
Rate for Payer: Cigna Commercial	$3.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.67
Rate for Payer: Oxford Commercial	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.96
Rate for Payer: UnitedHealthcare Commercial	$1.29
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE POLYSORB 4/0 30 UD V20

Facility

$6.43

Hospital Charge Code	270605816
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$0.96
Rate for Payer: Qualcare PPO/HMO/WC	$0.96

SUTURE POLYSORB 4/0 30 UNDYED

Facility

$6.43

Hospital Charge Code	270651237
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$0.96
Rate for Payer: Qualcare PPO/HMO/WC	$0.96

SUTURE POLYSORB 4/0 30 UNDYED

Facility

$6.43

Hospital Charge Code	270651237
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.21
Rate for Payer: Aetna Commercial	$2.44
Rate for Payer: Aetna Medicare Advantage	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.64
Rate for Payer: Cigna Commercial	$3.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.67
Rate for Payer: Oxford Commercial	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.96
Rate for Payer: UnitedHealthcare Commercial	$1.29
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE POLYSORB 4/0 60 U/D

Facility

$7.24

Hospital Charge Code	270668418
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 4/0 60 U/D

Facility

$7.24

Hospital Charge Code	270668418
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 4/0 60 VIO

Facility

$7.24

Hospital Charge Code	270604524
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 4/0 60 VIO

Facility

$7.24

Hospital Charge Code	270604524
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 5/0 18 U/D P12

Facility

$14.59

Hospital Charge Code	270604583
Hospital Revenue Code	272
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$2.19
Rate for Payer: Qualcare PPO/HMO/WC	$2.19

SUTURE POLYSORB 5/0 18 U/D P12

Facility

$14.59

Hospital Charge Code	270604583
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$7.29
Rate for Payer: Aetna Commercial	$5.54
Rate for Payer: Aetna Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.72
Rate for Payer: Cigna Commercial	$7.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.79
Rate for Payer: Oxford Commercial	$2.92
Rate for Payer: Qualcare PPO/HMO/WC	$2.19
Rate for Payer: UnitedHealthcare Commercial	$2.92
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

SUTURE POLYSORB 5/0 30 VIOLET

Facility

$6.43

Hospital Charge Code	270604585
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.21
Rate for Payer: Aetna Commercial	$2.44
Rate for Payer: Aetna Medicare Advantage	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.64
Rate for Payer: Cigna Commercial	$3.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.67
Rate for Payer: Oxford Commercial	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.96
Rate for Payer: UnitedHealthcare Commercial	$1.29
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE POLYSORB 5/0 30 VIOLET

Facility

$6.43

Hospital Charge Code	270604585
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$0.96
Rate for Payer: Qualcare PPO/HMO/WC	$0.96

SUTURE POLYSORB 5-0 UNDYED 18

Facility

$14.32

Hospital Charge Code	270651356
Hospital Revenue Code	272
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$2.15
Rate for Payer: Qualcare PPO/HMO/WC	$2.15

SUTURE POLYSORB 5-0 UNDYED 18

Facility

$14.32

Hospital Charge Code	270651356
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$7.16
Rate for Payer: Aetna Commercial	$5.44
Rate for Payer: Aetna Medicare Advantage	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.65
Rate for Payer: Cigna Commercial	$7.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.72
Rate for Payer: Oxford Commercial	$2.86
Rate for Payer: Qualcare PPO/HMO/WC	$2.15
Rate for Payer: UnitedHealthcare Commercial	$2.86
Rate for Payer: UnitedHealthcare Community & State	$0.45
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

SUTURE POLYSORB 6/0 18 UD P13

Facility

$37.32

Hospital Charge Code	270604586
Hospital Revenue Code	272
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$18.66
Rate for Payer: Aetna Commercial	$14.18
Rate for Payer: Aetna Medicare Advantage	$11.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.52
Rate for Payer: Cigna Commercial	$18.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.70
Rate for Payer: Oxford Commercial	$7.46
Rate for Payer: Qualcare PPO/HMO/WC	$5.60
Rate for Payer: UnitedHealthcare Commercial	$7.46
Rate for Payer: UnitedHealthcare Community & State	$1.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

SUTURE POLYSORB 6/0 18 UD P13

Facility

$37.32

Hospital Charge Code	270604586
Hospital Revenue Code	272
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.60

SUTURE POLYSORB 6-0 UNDYED

Facility

$54.59

Hospital Charge Code	270658909
Hospital Revenue Code	272
Min. Negotiated Rate	$1.55
Max. Negotiated Rate	$27.30
Rate for Payer: Aetna Commercial	$20.74
Rate for Payer: Aetna Medicare Advantage	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.92
Rate for Payer: Cigna Commercial	$27.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.19
Rate for Payer: Oxford Commercial	$10.92
Rate for Payer: Qualcare PPO/HMO/WC	$8.19
Rate for Payer: UnitedHealthcare Commercial	$10.92
Rate for Payer: UnitedHealthcare Community & State	$1.73
Rate for Payer: Wellpoint Medicaid Managed Care	$1.55

SUTURE POLYSORB 6-0 UNDYED

Facility

$54.59

Hospital Charge Code	270658909
Hospital Revenue Code	272
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$8.19
Rate for Payer: Qualcare PPO/HMO/WC	$8.19

SUTURE POLYSORB 8-0 8 VL

Facility

$1,151.35

Hospital Charge Code	270658910
Hospital Revenue Code	272
Min. Negotiated Rate	$172.70
Max. Negotiated Rate	$172.70
Rate for Payer: Qualcare PPO/HMO/WC	$172.70

SUTURE POLYSORB 8-0 8 VL

Facility

$1,151.35

Hospital Charge Code	270658910
Hospital Revenue Code	272
Min. Negotiated Rate	$32.70
Max. Negotiated Rate	$575.67
Rate for Payer: Aetna Commercial	$437.51
Rate for Payer: Aetna Medicare Advantage	$345.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.59
Rate for Payer: Cigna Commercial	$575.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$299.35
Rate for Payer: Oxford Commercial	$230.27
Rate for Payer: Qualcare PPO/HMO/WC	$172.70
Rate for Payer: UnitedHealthcare Commercial	$230.27
Rate for Payer: UnitedHealthcare Community & State	$36.38
Rate for Payer: Wellpoint Medicaid Managed Care	$32.70

SUTURE POLYSORB CVF-23 4-0 27

Facility

$20.95

Hospital Charge Code	2706501237
Hospital Revenue Code	272
Min. Negotiated Rate	$0.59
Max. Negotiated Rate	$10.47
Rate for Payer: Aetna Commercial	$7.96
Rate for Payer: Aetna Medicare Advantage	$6.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.34
Rate for Payer: Cigna Commercial	$10.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.45
Rate for Payer: Oxford Commercial	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$3.14
Rate for Payer: UnitedHealthcare Commercial	$4.19
Rate for Payer: UnitedHealthcare Community & State	$0.66
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

Know your out-of-pocket cost for care.

All Charges