Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURETAK MINI BIOCOMP

Facility

$1,625.00

Hospital Charge Code	270655938
Hospital Revenue Code	272
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$243.75
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

SUTURETAK MINI DISP KIT

Facility

$875.00

Hospital Charge Code	270655939
Hospital Revenue Code	272
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

SUTURETAK MINI DISP KIT

Facility

$875.00

Hospital Charge Code	270655939
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SUTURE TAKS W TAPE

Facility

$2,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270692653
Hospital Revenue Code	278
Min. Negotiated Rate	$66.03
Max. Negotiated Rate	$1,162.50
Rate for Payer: Aetna Commercial	$883.50
Rate for Payer: Aetna Medicare Advantage	$697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.88
Rate for Payer: Cigna Commercial	$1,162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: Qualcare PPO/HMO/WC	$348.75
Rate for Payer: UnitedHealthcare Community & State	$73.47
Rate for Payer: Wellpoint Medicaid Managed Care	$66.03

SUTURE TAKS W TAPE

Facility

$2,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270692653
Hospital Revenue Code	278
Min. Negotiated Rate	$348.75
Max. Negotiated Rate	$562.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: Qualcare PPO/HMO/WC	$348.75

SUTURE TAPE 1.2M XBRAID BL. CO

Facility

$650.25

Hospital Charge Code	270677418
Hospital Revenue Code	272
Min. Negotiated Rate	$97.54
Max. Negotiated Rate	$97.54
Rate for Payer: Qualcare PPO/HMO/WC	$97.54

SUTURE TAPE 1.2M XBRAID BL. CO

Facility

$650.25

Hospital Charge Code	270677418
Hospital Revenue Code	272
Min. Negotiated Rate	$18.47
Max. Negotiated Rate	$325.12
Rate for Payer: Aetna Commercial	$247.09
Rate for Payer: Aetna Medicare Advantage	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.81
Rate for Payer: Cigna Commercial	$325.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.06
Rate for Payer: Oxford Commercial	$130.05
Rate for Payer: Qualcare PPO/HMO/WC	$97.54
Rate for Payer: UnitedHealthcare Commercial	$130.05
Rate for Payer: UnitedHealthcare Community & State	$20.55
Rate for Payer: Wellpoint Medicaid Managed Care	$18.47

SUTURE TAPE FIBER SUTURE .9MM

Facility

$475.00

Hospital Charge Code	270688452
Hospital Revenue Code	272
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.50
Rate for Payer: Oxford Commercial	$95.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Commercial	$95.00
Rate for Payer: UnitedHealthcare Community & State	$15.01
Rate for Payer: Wellpoint Medicaid Managed Care	$13.49

SUTURE TAPE FIBER SUTURE .9MM

Facility

$475.00

Hospital Charge Code	270688452
Hospital Revenue Code	272
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SUTURE TAPE TIGER LINK 1.3MM W

Facility

$425.00

Hospital Charge Code	270688455
Hospital Revenue Code	272
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

SUTURE TAPE TIGER LINK 1.3MM W

Facility

$425.00

Hospital Charge Code	270688455
Hospital Revenue Code	272
Min. Negotiated Rate	$12.07
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$85.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$85.00
Rate for Payer: UnitedHealthcare Community & State	$13.43
Rate for Payer: Wellpoint Medicaid Managed Care	$12.07

SUTURETAPE W/TAILS 1.3MM

Facility

$175.00

Hospital Charge Code	270677469
Hospital Revenue Code	272
Min. Negotiated Rate	$4.97
Max. Negotiated Rate	$87.50
Rate for Payer: Aetna Commercial	$66.50
Rate for Payer: Aetna Medicare Advantage	$52.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.62
Rate for Payer: Cigna Commercial	$87.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.50
Rate for Payer: Oxford Commercial	$35.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.25
Rate for Payer: UnitedHealthcare Commercial	$35.00
Rate for Payer: UnitedHealthcare Community & State	$5.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.97

SUTURETAPE W/TAILS 1.3MM

Facility

$175.00

Hospital Charge Code	270677469
Hospital Revenue Code	272
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Qualcare PPO/HMO/WC	$26.25

SUTURE TENSIONER CUTTER FOR

Facility

$875.00

Hospital Charge Code	270690984
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SUTURE TENSIONER CUTTER FOR

Facility

$875.00

Hospital Charge Code	270690984
Hospital Revenue Code	272
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$27.65
Rate for Payer: Wellpoint Medicaid Managed Care	$24.85

SUTURE TICRON 1 30 BLUE CT1

Facility

$7.19

Hospital Charge Code	270651244
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$1.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.08

SUTURE TICRON 1 30 BLUE CT1

Facility

$7.19

Hospital Charge Code	270651244
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$3.60
Rate for Payer: Aetna Commercial	$2.73
Rate for Payer: Aetna Medicare Advantage	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.83
Rate for Payer: Cigna Commercial	$3.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.87
Rate for Payer: Oxford Commercial	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.08
Rate for Payer: UnitedHealthcare Commercial	$1.44
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

SUTURE TICRON 2/0 30 BLUE C15

Facility

$5.66

Hospital Charge Code	270604638
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	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
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 TICRON 2/0 30 BLUE C15

Facility

$5.66

Hospital Charge Code	270604638
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$0.85
Rate for Payer: Qualcare PPO/HMO/WC	$0.85

SUTURE TICRON 2-0 V-20 NDL

Facility

$4.69

Hospital Charge Code	270644589
Hospital Revenue Code	272
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$0.70
Rate for Payer: Qualcare PPO/HMO/WC	$0.70

SUTURE TICRON 2-0 V-20 NDL

Facility

$4.69

Hospital Charge Code	270644589
Hospital Revenue Code	272
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.35
Rate for Payer: Aetna Commercial	$1.78
Rate for Payer: Aetna Medicare Advantage	$1.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.20
Rate for Payer: Cigna Commercial	$2.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.22
Rate for Payer: Oxford Commercial	$0.94
Rate for Payer: Qualcare PPO/HMO/WC	$0.70
Rate for Payer: UnitedHealthcare Commercial	$0.94
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

SUTURE TICRON 2 30 BLUE HOS10

Facility

$10.05

Hospital Charge Code	270656049
Hospital Revenue Code	272
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$1.51
Rate for Payer: Qualcare PPO/HMO/WC	$1.51

SUTURE TICRON 2 30 BLUE HOS10

Facility

$10.05

Hospital Charge Code	270656049
Hospital Revenue Code	272
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$5.03
Rate for Payer: Aetna Commercial	$3.82
Rate for Payer: Aetna Medicare Advantage	$3.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.56
Rate for Payer: Cigna Commercial	$5.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.61
Rate for Payer: Oxford Commercial	$2.01
Rate for Payer: Qualcare PPO/HMO/WC	$1.51
Rate for Payer: UnitedHealthcare Commercial	$2.01
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

SUTURE TICRON 3/0 36 BLU CV3

Facility

$21.06

Hospital Charge Code	270651248
Hospital Revenue Code	272
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$3.16
Rate for Payer: Qualcare PPO/HMO/WC	$3.16

SUTURE TICRON 3/0 36 BLU CV3

Facility

$21.06

Hospital Charge Code	270651248
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$10.53
Rate for Payer: Aetna Commercial	$8.00
Rate for Payer: Aetna Medicare Advantage	$6.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.37
Rate for Payer: Cigna Commercial	$10.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.48
Rate for Payer: Oxford Commercial	$4.21
Rate for Payer: Qualcare PPO/HMO/WC	$3.16
Rate for Payer: UnitedHealthcare Commercial	$4.21
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.60

Know your out-of-pocket cost for care.

All Charges