Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE SURGIGUT CHR 5/0 30

Facility

$7.09

Hospital Charge Code	270604500
Hospital Revenue Code	272
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$1.06
Rate for Payer: Qualcare PPO/HMO/WC	$1.06

SUTURE SURGIGUT CHR 5/0 30

Facility

$7.09

Hospital Charge Code	270604500
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$3.54
Rate for Payer: Aetna Commercial	$2.69
Rate for Payer: Aetna Medicare Advantage	$2.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.81
Rate for Payer: Cigna Commercial	$3.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.84
Rate for Payer: Oxford Commercial	$1.42
Rate for Payer: Qualcare PPO/HMO/WC	$1.06
Rate for Payer: UnitedHealthcare Commercial	$1.42
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

SUTURE SURGIGUT CHROMIC 7/0 18

Facility

$100.11

Hospital Charge Code	270651146
Hospital Revenue Code	272
Min. Negotiated Rate	$15.02
Max. Negotiated Rate	$15.02
Rate for Payer: Qualcare PPO/HMO/WC	$15.02

SUTURE SURGIGUT CHROMIC 7/0 18

Facility

$100.11

Hospital Charge Code	270651146
Hospital Revenue Code	272
Min. Negotiated Rate	$2.84
Max. Negotiated Rate	$50.05
Rate for Payer: Aetna Commercial	$38.04
Rate for Payer: Aetna Medicare Advantage	$30.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.53
Rate for Payer: Cigna Commercial	$50.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.03
Rate for Payer: Oxford Commercial	$20.02
Rate for Payer: Qualcare PPO/HMO/WC	$15.02
Rate for Payer: UnitedHealthcare Commercial	$20.02
Rate for Payer: UnitedHealthcare Community & State	$3.16
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

SUTURE SURGIGUT GS11 0

Facility

$65.65

Hospital Charge Code	270600553
Hospital Revenue Code	272
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$32.83
Rate for Payer: Aetna Commercial	$24.95
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.07
Rate for Payer: Oxford Commercial	$13.13
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$13.13
Rate for Payer: UnitedHealthcare Community & State	$2.07
Rate for Payer: Wellpoint Medicaid Managed Care	$1.86

SUTURE SURGIGUT GS11 0

Facility

$65.65

Hospital Charge Code	270600553
Hospital Revenue Code	272
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

SUTURE SURGIGUT GS21 0

Facility

$7.05

Hospital Charge Code	270600552
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$3.52
Rate for Payer: Aetna Commercial	$2.68
Rate for Payer: Aetna Medicare Advantage	$2.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.80
Rate for Payer: Cigna Commercial	$3.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.83
Rate for Payer: Oxford Commercial	$1.41
Rate for Payer: Qualcare PPO/HMO/WC	$1.06
Rate for Payer: UnitedHealthcare Commercial	$1.41
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

SUTURE SURGIGUT GS21 0

Facility

$7.05

Hospital Charge Code	270600552
Hospital Revenue Code	272
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$1.06
Rate for Payer: Qualcare PPO/HMO/WC	$1.06

SUTURE SURGIGUT GS23 2-0

Facility

$6.40

Hospital Charge Code	270604491
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.20
Rate for Payer: Aetna Commercial	$2.43
Rate for Payer: Aetna Medicare Advantage	$1.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.63
Rate for Payer: Cigna Commercial	$3.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.66
Rate for Payer: Oxford Commercial	$1.28
Rate for Payer: Qualcare PPO/HMO/WC	$0.96
Rate for Payer: UnitedHealthcare Commercial	$1.28
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE SURGIGUT GS23 2-0

Facility

$6.40

Hospital Charge Code	270604491
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$0.96
Rate for Payer: Qualcare PPO/HMO/WC	$0.96

SUTURE SURGIGUT PL 3/0 30 V20

Facility

$6.83

Hospital Charge Code	270656133
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 SURGIGUT PL 3/0 30 V20

Facility

$6.83

Hospital Charge Code	270656133
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.02

SUTURE SURGIGUT REEL 3-0

Facility

$7.26

Hospital Charge Code	270604482
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

SUTURE SURGIGUT REEL 3-0

Facility

$7.26

Hospital Charge Code	270604482
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$3.63
Rate for Payer: Aetna Commercial	$2.76
Rate for Payer: Aetna Medicare Advantage	$2.18
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	$3.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.89
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 SURGIGUT REEL 4-0

Facility

$7.08

Hospital Charge Code	270604483
Hospital Revenue Code	272
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$1.06
Rate for Payer: Qualcare PPO/HMO/WC	$1.06

SUTURE SURGIGUT REEL 4-0

Facility

$7.08

Hospital Charge Code	270604483
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$3.54
Rate for Payer: Aetna Commercial	$2.69
Rate for Payer: Aetna Medicare Advantage	$2.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.81
Rate for Payer: Cigna Commercial	$3.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.84
Rate for Payer: Oxford Commercial	$1.42
Rate for Payer: Qualcare PPO/HMO/WC	$1.06
Rate for Payer: UnitedHealthcare Commercial	$1.42
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

SUTURE SURGIGUT SHR 0 30 V20

Facility

$7.14

Hospital Charge Code	270651147
Hospital Revenue Code	272
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$1.07
Rate for Payer: Qualcare PPO/HMO/WC	$1.07

SUTURE SURGIGUT SHR 0 30 V20

Facility

$7.14

Hospital Charge Code	270651147
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$3.57
Rate for Payer: Aetna Commercial	$2.71
Rate for Payer: Aetna Medicare Advantage	$2.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.82
Rate for Payer: Cigna Commercial	$3.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.86
Rate for Payer: Oxford Commercial	$1.43
Rate for Payer: Qualcare PPO/HMO/WC	$1.07
Rate for Payer: UnitedHealthcare Commercial	$1.43
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

SUTURE SURGIGUT TIE 2-0

Facility

$5.61

Hospital Charge Code	270604480
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$2.81
Rate for Payer: Aetna Commercial	$2.13
Rate for Payer: Aetna Medicare Advantage	$1.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.43
Rate for Payer: Cigna Commercial	$2.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$1.12
Rate for Payer: Qualcare PPO/HMO/WC	$0.84
Rate for Payer: UnitedHealthcare Commercial	$1.12
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

SUTURE SURGIGUT TIE 2-0

Facility

$5.61

Hospital Charge Code	270604480
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$0.84
Rate for Payer: Qualcare PPO/HMO/WC	$0.84

SUTURE SURGIGUT TIE 3-0

Facility

$11.23

Hospital Charge Code	270604481
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.27
Rate for Payer: Aetna Medicare Advantage	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.86
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.68
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.35
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

SUTURE SURGIGUT TIE 3-0

Facility

$11.23

Hospital Charge Code	270604481
Hospital Revenue Code	272
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$1.68
Rate for Payer: Qualcare PPO/HMO/WC	$1.68

SUTURE SURGILENE 6-0 P-13

Facility

$28.60

Hospital Charge Code	270655913
Hospital Revenue Code	272
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$14.30
Rate for Payer: Aetna Commercial	$10.87
Rate for Payer: Aetna Medicare Advantage	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.29
Rate for Payer: Cigna Commercial	$14.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.44
Rate for Payer: Oxford Commercial	$5.72
Rate for Payer: Qualcare PPO/HMO/WC	$4.29
Rate for Payer: UnitedHealthcare Commercial	$5.72
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

SUTURE SURGILENE 6-0 P-13

Facility

$28.60

Hospital Charge Code	270655913
Hospital Revenue Code	272
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$4.29
Rate for Payer: Qualcare PPO/HMO/WC	$4.29

SUTURE SURGILON 3/0 30 BK C14

Facility

$19.71

Hospital Charge Code	270618236
Hospital Revenue Code	272
Min. Negotiated Rate	$2.96
Max. Negotiated Rate	$2.96
Rate for Payer: Qualcare PPO/HMO/WC	$2.96

Know your out-of-pocket cost for care.

All Charges