Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE PROLENE 5-0 CC-1

Facility

$81.78

Hospital Charge Code	270671420
Hospital Revenue Code	272
Min. Negotiated Rate	$12.27
Max. Negotiated Rate	$12.27
Rate for Payer: Qualcare PPO/HMO/WC	$12.27

SUTURE PROLENE 5-0 FS-2

Facility

$13.18

Hospital Charge Code	270671410
Hospital Revenue Code	272
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$1.98
Rate for Payer: Qualcare PPO/HMO/WC	$1.98

SUTURE PROLENE 5-0 FS-2

Facility

$13.18

Hospital Charge Code	270671410
Hospital Revenue Code	272
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$6.59
Rate for Payer: Aetna Commercial	$5.01
Rate for Payer: Aetna Medicare Advantage	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.36
Rate for Payer: Cigna Commercial	$6.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.43
Rate for Payer: Oxford Commercial	$2.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.98
Rate for Payer: UnitedHealthcare Commercial	$2.64
Rate for Payer: UnitedHealthcare Community & State	$0.42
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

SUTURE PROLENE 5-0 P-3

Facility

$23.00

Hospital Charge Code	270604660
Hospital Revenue Code	272
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$11.50
Rate for Payer: Aetna Commercial	$8.74
Rate for Payer: Aetna Medicare Advantage	$6.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.87
Rate for Payer: Cigna Commercial	$11.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.98
Rate for Payer: Oxford Commercial	$4.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.45
Rate for Payer: UnitedHealthcare Commercial	$4.60
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.65

SUTURE PROLENE 5-0 P-3

Facility

$26.51

Hospital Charge Code	270663644
Hospital Revenue Code	272
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$3.98
Rate for Payer: Qualcare PPO/HMO/WC	$3.98

SUTURE PROLENE 5-0 P-3

Facility

$23.00

Hospital Charge Code	270604660
Hospital Revenue Code	272
Min. Negotiated Rate	$3.45
Max. Negotiated Rate	$3.45
Rate for Payer: Qualcare PPO/HMO/WC	$3.45

SUTURE PROLENE 5-0 P-3

Facility

$26.51

Hospital Charge Code	270663644
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$13.26
Rate for Payer: Aetna Commercial	$10.07
Rate for Payer: Aetna Medicare Advantage	$7.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.76
Rate for Payer: Cigna Commercial	$13.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.89
Rate for Payer: Oxford Commercial	$5.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.98
Rate for Payer: UnitedHealthcare Commercial	$5.30
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.75

SUTURE PROLENE 5-0 PC-1

Facility

$25.56

Hospital Charge Code	270649099
Hospital Revenue Code	272
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$3.83
Rate for Payer: Qualcare PPO/HMO/WC	$3.83

SUTURE PROLENE 5-0 PC-1

Facility

$25.56

Hospital Charge Code	270649099
Hospital Revenue Code	272
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$12.78
Rate for Payer: Aetna Commercial	$9.71
Rate for Payer: Aetna Medicare Advantage	$7.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.52
Rate for Payer: Cigna Commercial	$12.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.65
Rate for Payer: Oxford Commercial	$5.11
Rate for Payer: Qualcare PPO/HMO/WC	$3.83
Rate for Payer: UnitedHealthcare Commercial	$5.11
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.73

SUTURE PROLENE 5-0 PC-3

Facility

$25.56

Hospital Charge Code	270661970
Hospital Revenue Code	272
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$3.83
Rate for Payer: Qualcare PPO/HMO/WC	$3.83

SUTURE PROLENE 5-0 PC-3

Facility

$25.56

Hospital Charge Code	270661970
Hospital Revenue Code	272
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$12.78
Rate for Payer: Aetna Commercial	$9.71
Rate for Payer: Aetna Medicare Advantage	$7.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.52
Rate for Payer: Cigna Commercial	$12.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.65
Rate for Payer: Oxford Commercial	$5.11
Rate for Payer: Qualcare PPO/HMO/WC	$3.83
Rate for Payer: UnitedHealthcare Commercial	$5.11
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.73

SUTURE PROLENE 5-0 PC 5

Facility

$25.56

Hospital Charge Code	270651497
Hospital Revenue Code	272
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$12.78
Rate for Payer: Aetna Commercial	$9.71
Rate for Payer: Aetna Medicare Advantage	$7.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.52
Rate for Payer: Cigna Commercial	$12.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.65
Rate for Payer: Oxford Commercial	$5.11
Rate for Payer: Qualcare PPO/HMO/WC	$3.83
Rate for Payer: UnitedHealthcare Commercial	$5.11
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.73

SUTURE PROLENE 5-0 PC 5

Facility

$25.56

Hospital Charge Code	270651497
Hospital Revenue Code	272
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$3.83
Rate for Payer: Qualcare PPO/HMO/WC	$3.83

SUTURE PROLENE 5-0 PS-2

Facility

$21.33

Hospital Charge Code	270672395
Hospital Revenue Code	272
Min. Negotiated Rate	$3.20
Max. Negotiated Rate	$3.20
Rate for Payer: Qualcare PPO/HMO/WC	$3.20

SUTURE PROLENE 5-0 PS-2

Facility

$21.33

Hospital Charge Code	270672395
Hospital Revenue Code	272
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$10.66
Rate for Payer: Aetna Commercial	$8.11
Rate for Payer: Aetna Medicare Advantage	$6.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.44
Rate for Payer: Cigna Commercial	$10.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.55
Rate for Payer: Oxford Commercial	$4.27
Rate for Payer: Qualcare PPO/HMO/WC	$3.20
Rate for Payer: UnitedHealthcare Commercial	$4.27
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

SUTURE PROLENE 5-0 RB-1

Facility

$14.28

Hospital Charge Code	270671425
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$7.14
Rate for Payer: Aetna Commercial	$5.43
Rate for Payer: Aetna Medicare Advantage	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.64
Rate for Payer: Cigna Commercial	$7.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.71
Rate for Payer: Oxford Commercial	$2.86
Rate for Payer: Qualcare PPO/HMO/WC	$2.14
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 PROLENE 5-0 RB-1

Facility

$26.78

Hospital Charge Code	270655741
Hospital Revenue Code	272
Min. Negotiated Rate	$4.02
Max. Negotiated Rate	$4.02
Rate for Payer: Qualcare PPO/HMO/WC	$4.02

SUTURE PROLENE 5-0 RB-1

Facility

$26.78

Hospital Charge Code	270655741
Hospital Revenue Code	272
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$13.39
Rate for Payer: Aetna Commercial	$10.18
Rate for Payer: Aetna Medicare Advantage	$8.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.83
Rate for Payer: Cigna Commercial	$13.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.96
Rate for Payer: Oxford Commercial	$5.36
Rate for Payer: Qualcare PPO/HMO/WC	$4.02
Rate for Payer: UnitedHealthcare Commercial	$5.36
Rate for Payer: UnitedHealthcare Community & State	$0.85
Rate for Payer: Wellpoint Medicaid Managed Care	$0.76

SUTURE PROLENE 5-0 RB-1

Facility

$14.28

Hospital Charge Code	270671425
Hospital Revenue Code	272
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$2.14
Rate for Payer: Qualcare PPO/HMO/WC	$2.14

SUTURE PROLENE 5-0 RB-2

Facility

$40.78

Hospital Charge Code	270671416
Hospital Revenue Code	272
Min. Negotiated Rate	$6.12
Max. Negotiated Rate	$6.12
Rate for Payer: Qualcare PPO/HMO/WC	$6.12

SUTURE PROLENE 5-0 RB-2

Facility

$25.39

Hospital Charge Code	270672396
Hospital Revenue Code	272
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$12.70
Rate for Payer: Aetna Commercial	$9.65
Rate for Payer: Aetna Medicare Advantage	$7.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.47
Rate for Payer: Cigna Commercial	$12.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.60
Rate for Payer: Oxford Commercial	$5.08
Rate for Payer: Qualcare PPO/HMO/WC	$3.81
Rate for Payer: UnitedHealthcare Commercial	$5.08
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.72

SUTURE PROLENE 5-0 RB-2

Facility

$40.78

Hospital Charge Code	270671416
Hospital Revenue Code	272
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$20.39
Rate for Payer: Aetna Commercial	$15.50
Rate for Payer: Aetna Medicare Advantage	$12.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.40
Rate for Payer: Cigna Commercial	$20.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.60
Rate for Payer: Oxford Commercial	$8.16
Rate for Payer: Qualcare PPO/HMO/WC	$6.12
Rate for Payer: UnitedHealthcare Commercial	$8.16
Rate for Payer: UnitedHealthcare Community & State	$1.29
Rate for Payer: Wellpoint Medicaid Managed Care	$1.16

SUTURE PROLENE 5-0 RB-2

Facility

$25.39

Hospital Charge Code	270672396
Hospital Revenue Code	272
Min. Negotiated Rate	$3.81
Max. Negotiated Rate	$3.81
Rate for Payer: Qualcare PPO/HMO/WC	$3.81

SUTURE PROLENE 6-0 BV-1

Facility

$242.77

Hospital Charge Code	270676672
Hospital Revenue Code	272
Min. Negotiated Rate	$6.89
Max. Negotiated Rate	$121.39
Rate for Payer: Aetna Commercial	$92.25
Rate for Payer: Aetna Medicare Advantage	$72.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.91
Rate for Payer: Cigna Commercial	$121.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.12
Rate for Payer: Oxford Commercial	$48.55
Rate for Payer: Qualcare PPO/HMO/WC	$36.42
Rate for Payer: UnitedHealthcare Commercial	$48.55
Rate for Payer: UnitedHealthcare Community & State	$7.67
Rate for Payer: Wellpoint Medicaid Managed Care	$6.89

SUTURE PROLENE 6-0 BV-1

Facility

$63.15

Hospital Charge Code	270655714
Hospital Revenue Code	272
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$31.57
Rate for Payer: Aetna Commercial	$24.00
Rate for Payer: Aetna Medicare Advantage	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.10
Rate for Payer: Cigna Commercial	$31.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.42
Rate for Payer: Oxford Commercial	$12.63
Rate for Payer: Qualcare PPO/HMO/WC	$9.47
Rate for Payer: UnitedHealthcare Commercial	$12.63
Rate for Payer: UnitedHealthcare Community & State	$2.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1.79

Know your out-of-pocket cost for care.

All Charges