Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE TICRON 4/0 30 BLUE C12

Facility

$5.30

Hospital Charge Code	270604647
Hospital Revenue Code	272
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.80

SUTURE TICRON 4/0 30 BLUE C12

Facility

$5.30

Hospital Charge Code	270604647
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$2.65
Rate for Payer: Aetna Commercial	$2.01
Rate for Payer: Aetna Medicare Advantage	$1.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.35
Rate for Payer: Cigna Commercial	$2.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.38
Rate for Payer: Oxford Commercial	$1.06
Rate for Payer: Qualcare PPO/HMO/WC	$0.80
Rate for Payer: UnitedHealthcare Commercial	$1.06
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

SUTURE TICRON 5 30 BLUE GS18

Facility

$13.41

Hospital Charge Code	270661495
Hospital Revenue Code	272
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$6.71
Rate for Payer: Aetna Commercial	$5.10
Rate for Payer: Aetna Medicare Advantage	$4.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.42
Rate for Payer: Cigna Commercial	$6.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.49
Rate for Payer: Oxford Commercial	$2.68
Rate for Payer: Qualcare PPO/HMO/WC	$2.01
Rate for Payer: UnitedHealthcare Commercial	$2.68
Rate for Payer: UnitedHealthcare Community & State	$0.42
Rate for Payer: Wellpoint Medicaid Managed Care	$0.38

SUTURE TICRON 5 30 BLUE GS18

Facility

$13.41

Hospital Charge Code	270661495
Hospital Revenue Code	272
Min. Negotiated Rate	$2.01
Max. Negotiated Rate	$2.01
Rate for Payer: Qualcare PPO/HMO/WC	$2.01

SUTURE TICRON 5 BLUE 30 T-56

Facility

$10.30

Hospital Charge Code	270665643
Hospital Revenue Code	272
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$5.15
Rate for Payer: Aetna Commercial	$3.91
Rate for Payer: Aetna Medicare Advantage	$3.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.63
Rate for Payer: Cigna Commercial	$5.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.68
Rate for Payer: Oxford Commercial	$2.06
Rate for Payer: Qualcare PPO/HMO/WC	$1.54
Rate for Payer: UnitedHealthcare Commercial	$2.06
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

SUTURE TICRON 5 BLUE 30 T-56

Facility

$10.30

Hospital Charge Code	270665643
Hospital Revenue Code	272
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.54

SUTURE TICRON COATED BRAIDED

Facility

$12.55

Hospital Charge Code	270651247
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$6.28
Rate for Payer: Aetna Commercial	$4.77
Rate for Payer: Aetna Medicare Advantage	$3.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.20
Rate for Payer: Cigna Commercial	$6.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.26
Rate for Payer: Oxford Commercial	$2.51
Rate for Payer: Qualcare PPO/HMO/WC	$1.88
Rate for Payer: UnitedHealthcare Commercial	$2.51
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

SUTURE TICRON COATED BRAIDED

Facility

$12.55

Hospital Charge Code	270651247
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

SUTURE TICRON COATED BRAIDED

Facility

$7.26

Hospital Charge Code	270651243
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

SUTURE TICRON COATED BRAIDED

Facility

$7.26

Hospital Charge Code	270651243
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 TICRON CT1 GS21 2/0 BLU

Facility

$7.19

Hospital Charge Code	270656044
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 CT1 GS21 2/0 BLU

Facility

$7.19

Hospital Charge Code	270656044
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 II BLUE GC-21

Facility

$14.73

Hospital Charge Code	270646028
Hospital Revenue Code	272
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$7.37
Rate for Payer: Aetna Commercial	$5.60
Rate for Payer: Aetna Medicare Advantage	$4.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.76
Rate for Payer: Cigna Commercial	$7.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.83
Rate for Payer: Oxford Commercial	$2.95
Rate for Payer: Qualcare PPO/HMO/WC	$2.21
Rate for Payer: UnitedHealthcare Commercial	$2.95
Rate for Payer: UnitedHealthcare Community & State	$0.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

SUTURE TICRON II BLUE GC-21

Facility

$14.73

Hospital Charge Code	270646028
Hospital Revenue Code	272
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$2.21
Rate for Payer: Qualcare PPO/HMO/WC	$2.21

SUTURE ULTRABRAID #2 WHT

Facility

$98.50

Hospital Charge Code	270676714
Hospital Revenue Code	272
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$49.25
Rate for Payer: Aetna Commercial	$37.43
Rate for Payer: Aetna Medicare Advantage	$29.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.12
Rate for Payer: Cigna Commercial	$49.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.61
Rate for Payer: Oxford Commercial	$19.70
Rate for Payer: Qualcare PPO/HMO/WC	$14.78
Rate for Payer: UnitedHealthcare Commercial	$19.70
Rate for Payer: UnitedHealthcare Community & State	$3.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.80

SUTURE ULTRABRAID #2 WHT

Facility

$107.10

Hospital Charge Code	270686304
Hospital Revenue Code	272
Min. Negotiated Rate	$16.07
Max. Negotiated Rate	$16.07
Rate for Payer: Qualcare PPO/HMO/WC	$16.07

SUTURE ULTRABRAID #2 WHT

Facility

$107.10

Hospital Charge Code	270686304
Hospital Revenue Code	272
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$53.55
Rate for Payer: Aetna Commercial	$40.70
Rate for Payer: Aetna Medicare Advantage	$32.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.31
Rate for Payer: Cigna Commercial	$53.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.85
Rate for Payer: Oxford Commercial	$21.42
Rate for Payer: Qualcare PPO/HMO/WC	$16.07
Rate for Payer: UnitedHealthcare Commercial	$21.42
Rate for Payer: UnitedHealthcare Community & State	$3.38
Rate for Payer: Wellpoint Medicaid Managed Care	$3.04

SUTURE ULTRABRAID #2 WHT

Facility

$98.50

Hospital Charge Code	270676714
Hospital Revenue Code	272
Min. Negotiated Rate	$14.78
Max. Negotiated Rate	$14.78
Rate for Payer: Qualcare PPO/HMO/WC	$14.78

SUTURE ULTRATAPE 2MM BLUE

Facility

$667.50

Hospital Charge Code	270676715
Hospital Revenue Code	272
Min. Negotiated Rate	$100.12
Max. Negotiated Rate	$100.12
Rate for Payer: Qualcare PPO/HMO/WC	$100.12

SUTURE ULTRATAPE 2MM BLUE

Facility

$667.50

Hospital Charge Code	270676715
Hospital Revenue Code	272
Min. Negotiated Rate	$18.96
Max. Negotiated Rate	$333.75
Rate for Payer: Aetna Commercial	$253.65
Rate for Payer: Aetna Medicare Advantage	$200.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.21
Rate for Payer: Cigna Commercial	$333.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.55
Rate for Payer: Oxford Commercial	$133.50
Rate for Payer: Qualcare PPO/HMO/WC	$100.12
Rate for Payer: UnitedHealthcare Commercial	$133.50
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

SUTURE UMBILICAL TAPE

Facility

$6.60

Hospital Charge Code	270604718
Hospital Revenue Code	272
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$0.99
Rate for Payer: Qualcare PPO/HMO/WC	$0.99

SUTURE UMBILICAL TAPE

Facility

$6.60

Hospital Charge Code	270604718
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.30
Rate for Payer: Aetna Commercial	$2.51
Rate for Payer: Aetna Medicare Advantage	$1.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.68
Rate for Payer: Cigna Commercial	$3.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.72
Rate for Payer: Oxford Commercial	$1.32
Rate for Payer: Qualcare PPO/HMO/WC	$0.99
Rate for Payer: UnitedHealthcare Commercial	$1.32
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE VCL PLUS 27 IN 2-0

Facility

$21.07

Hospital Charge Code	270690892
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$10.54
Rate for Payer: Aetna Commercial	$8.01
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	$10.54
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

SUTURE VCL PLUS 27 IN 2-0

Facility

$21.07

Hospital Charge Code	270690892
Hospital Revenue Code	272
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$3.16
Rate for Payer: Qualcare PPO/HMO/WC	$3.16

SUTURE VCL PLUS 8X18 IN 2-0 CR

Facility

$79.57

Hospital Charge Code	270690889
Hospital Revenue Code	272
Min. Negotiated Rate	$11.94
Max. Negotiated Rate	$11.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.94

Know your out-of-pocket cost for care.

All Charges