Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB V-20 2-0 30

Facility

$6.13

Hospital Charge Code	270651149
Hospital Revenue Code	272
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$0.92
Rate for Payer: Qualcare PPO/HMO/WC	$0.92

SUTURE POLYSORB V-20 2/0 30

Facility

$6.07

Hospital Charge Code	270656135N
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 V-20 2/0 30

Facility

$6.07

Hospital Charge Code	270656135N
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 V-20 2/0 30

Facility

$6.07

Hospital Charge Code	270656135S
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 V-20 2/0 30

Facility

$6.07

Hospital Charge Code	270656135S
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 V-20 2/0 30

Facility

$6.07

Hospital Charge Code	270656135
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 V-20 2/0 30

Facility

$6.07

Hospital Charge Code	270656135
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 V-20 2-0 U/D

Facility

$5.67

Hospital Charge Code	270651670
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

SUTURE POLYSORB V-20 2-0 U/D

Facility

$5.67

Hospital Charge Code	270651670
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$2.83
Rate for Payer: Aetna Commercial	$2.15
Rate for Payer: Aetna Medicare Advantage	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.45
Rate for Payer: Cigna Commercial	$2.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.47
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.85
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

SUTURE POLYSORB V-20 3-0

Facility

$6.13

Hospital Charge Code	270651148
Hospital Revenue Code	272
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$0.92
Rate for Payer: Qualcare PPO/HMO/WC	$0.92

SUTURE POLYSORB V-20 3-0

Facility

$6.13

Hospital Charge Code	270651148
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.06
Rate for Payer: Aetna Commercial	$2.33
Rate for Payer: Aetna Medicare Advantage	$1.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.56
Rate for Payer: Cigna Commercial	$3.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.59
Rate for Payer: Oxford Commercial	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$0.92
Rate for Payer: UnitedHealthcare Commercial	$1.23
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

SUTURE POLYSORB V-20 3-0 18

Facility

$26.11

Hospital Charge Code	270651276
Hospital Revenue Code	272
Min. Negotiated Rate	$3.92
Max. Negotiated Rate	$3.92
Rate for Payer: Qualcare PPO/HMO/WC	$3.92

SUTURE POLYSORB V-20 3-0 18

Facility

$26.11

Hospital Charge Code	270651276
Hospital Revenue Code	272
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$13.05
Rate for Payer: Aetna Commercial	$9.92
Rate for Payer: Aetna Medicare Advantage	$7.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.66
Rate for Payer: Cigna Commercial	$13.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.79
Rate for Payer: Oxford Commercial	$5.22
Rate for Payer: Qualcare PPO/HMO/WC	$3.92
Rate for Payer: UnitedHealthcare Commercial	$5.22
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

SUTURE POLYSORB V-20 4-0

Facility

$6.49

Hospital Charge Code	270651279S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.25
Rate for Payer: Aetna Commercial	$2.47
Rate for Payer: Aetna Medicare Advantage	$1.95
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	$3.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
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	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE POLYSORB V-20 4-0

Facility

$6.49

Hospital Charge Code	270651279
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 V-20 4-0

Facility

$6.49

Hospital Charge Code	270651279
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.25
Rate for Payer: Aetna Commercial	$2.47
Rate for Payer: Aetna Medicare Advantage	$1.95
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	$3.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
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	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE POLYSORB V-20 4-0

Facility

$6.49

Hospital Charge Code	270651279S
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 V-20 4-0

Facility

$1.26

Hospital Charge Code	270651279N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$0.19
Rate for Payer: Qualcare PPO/HMO/WC	$0.19

SUTURE POLYSORB V-20 4-0

Facility

$1.26

Hospital Charge Code	270651279N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.63
Rate for Payer: Aetna Commercial	$0.48
Rate for Payer: Aetna Medicare Advantage	$0.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.32
Rate for Payer: Cigna Commercial	$0.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.33
Rate for Payer: Oxford Commercial	$0.25
Rate for Payer: Qualcare PPO/HMO/WC	$0.19
Rate for Payer: UnitedHealthcare Commercial	$0.25
Rate for Payer: UnitedHealthcare Community & State	$0.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.04

SUTURE POLYSSORB 2-0 GS-21

Facility

$25.23

Hospital Charge Code	270669983
Hospital Revenue Code	272
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$12.62
Rate for Payer: Aetna Commercial	$9.59
Rate for Payer: Aetna Medicare Advantage	$7.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.43
Rate for Payer: Cigna Commercial	$12.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.56
Rate for Payer: Oxford Commercial	$5.05
Rate for Payer: Qualcare PPO/HMO/WC	$3.78
Rate for Payer: UnitedHealthcare Commercial	$5.05
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.72

SUTURE POLYSSORB 2-0 GS-21

Facility

$25.23

Hospital Charge Code	270669983
Hospital Revenue Code	272
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$3.78
Rate for Payer: Qualcare PPO/HMO/WC	$3.78

SUTURE PROL BL 1X18 8714H

Facility

$35.51

Hospital Charge Code	270698082
Hospital Revenue Code	272
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$17.75
Rate for Payer: Aetna Commercial	$13.49
Rate for Payer: Aetna Medicare Advantage	$10.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.06
Rate for Payer: Cigna Commercial	$17.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.23
Rate for Payer: Oxford Commercial	$7.10
Rate for Payer: Qualcare PPO/HMO/WC	$5.33
Rate for Payer: UnitedHealthcare Commercial	$7.10
Rate for Payer: UnitedHealthcare Community & State	$1.12
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

SUTURE PROL BL 1X18 8714H

Facility

$35.51

Hospital Charge Code	270698082
Hospital Revenue Code	272
Min. Negotiated Rate	$5.33
Max. Negotiated Rate	$5.33
Rate for Payer: Qualcare PPO/HMO/WC	$5.33

SUTURE PROLENE 0 CT-1 GS-21

Facility

$18.65

Hospital Charge Code	270659090
Hospital Revenue Code	272
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$2.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.80

SUTURE PROLENE 0 CT-1 GS-21

Facility

$18.65

Hospital Charge Code	270659090
Hospital Revenue Code	272
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$9.32
Rate for Payer: Aetna Commercial	$7.09
Rate for Payer: Aetna Medicare Advantage	$5.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.76
Rate for Payer: Cigna Commercial	$9.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.85
Rate for Payer: Oxford Commercial	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.80
Rate for Payer: UnitedHealthcare Commercial	$3.73
Rate for Payer: UnitedHealthcare Community & State	$0.59
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

Know your out-of-pocket cost for care.

All Charges