Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE VICRYL 2-0 GS-24

Facility

$8.67

Hospital Charge Code	270671490
Hospital Revenue Code	272
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$4.33
Rate for Payer: Aetna Commercial	$3.29
Rate for Payer: Aetna Medicare Advantage	$2.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.21
Rate for Payer: Cigna Commercial	$4.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.25
Rate for Payer: Oxford Commercial	$1.73
Rate for Payer: Qualcare PPO/HMO/WC	$1.30
Rate for Payer: UnitedHealthcare Commercial	$1.73
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

SUTURE VICRYL 2-0 GS-24

Facility

$8.67

Hospital Charge Code	270671490
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$1.30
Rate for Payer: Qualcare PPO/HMO/WC	$1.30

SUTURE VICRYL 2-0 MO-4

Facility

$10.51

Hospital Charge Code	270671469
Hospital Revenue Code	272
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$1.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.58

SUTURE VICRYL 2-0 MO-4

Facility

$10.51

Hospital Charge Code	270671469
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$5.25
Rate for Payer: Aetna Commercial	$3.99
Rate for Payer: Aetna Medicare Advantage	$3.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.68
Rate for Payer: Cigna Commercial	$5.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$1.58
Rate for Payer: UnitedHealthcare Commercial	$2.10
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

SUTURE VICRYL 2-0 OS-6

Facility

$13.42

Hospital Charge Code	270672376
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	$4.03
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 VICRYL 2-0 OS-6

Facility

$13.42

Hospital Charge Code	270672376
Hospital Revenue Code	272
Min. Negotiated Rate	$2.01
Max. Negotiated Rate	$2.01
Rate for Payer: Qualcare PPO/HMO/WC	$2.01

SUTURE VICRYL 2-0 PLUS CT-1

Facility

$57.69

Hospital Charge Code	270691711
Hospital Revenue Code	272
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$8.65

SUTURE VICRYL 2-0 PLUS CT-1

Facility

$57.69

Hospital Charge Code	270691711
Hospital Revenue Code	272
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$28.84
Rate for Payer: Aetna Commercial	$21.92
Rate for Payer: Aetna Medicare Advantage	$17.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.71
Rate for Payer: Cigna Commercial	$28.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.00
Rate for Payer: Oxford Commercial	$11.54
Rate for Payer: Qualcare PPO/HMO/WC	$8.65
Rate for Payer: UnitedHealthcare Commercial	$11.54
Rate for Payer: UnitedHealthcare Community & State	$1.82
Rate for Payer: Wellpoint Medicaid Managed Care	$1.64

SUTURE VICRYL 2-0 REEL TIES

Facility

$9.91

Hospital Charge Code	270671449
Hospital Revenue Code	272
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$4.96
Rate for Payer: Aetna Commercial	$3.77
Rate for Payer: Aetna Medicare Advantage	$2.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.53
Rate for Payer: Cigna Commercial	$4.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.58
Rate for Payer: Oxford Commercial	$1.98
Rate for Payer: Qualcare PPO/HMO/WC	$1.49
Rate for Payer: UnitedHealthcare Commercial	$1.98
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

SUTURE VICRYL 2-0 REEL TIES

Facility

$9.91

Hospital Charge Code	270671449
Hospital Revenue Code	272
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$1.49
Rate for Payer: Qualcare PPO/HMO/WC	$1.49

SUTURE VICRYL 2-0 SH

Facility

$7.96

Hospital Charge Code	270672387
Hospital Revenue Code	272
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.19

SUTURE VICRYL 2-0 SH

Facility

$7.96

Hospital Charge Code	270672387
Hospital Revenue Code	272
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$3.98
Rate for Payer: Aetna Commercial	$3.02
Rate for Payer: Aetna Medicare Advantage	$2.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.03
Rate for Payer: Cigna Commercial	$3.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.07
Rate for Payer: Oxford Commercial	$1.59
Rate for Payer: Qualcare PPO/HMO/WC	$1.19
Rate for Payer: UnitedHealthcare Commercial	$1.59
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

SUTURE VICRYL 2-0 SH 27 IN

Facility

$7.96

Hospital Charge Code	270690134
Hospital Revenue Code	272
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.19

SUTURE VICRYL 2-0 SH 27 IN

Facility

$7.96

Hospital Charge Code	270690134
Hospital Revenue Code	272
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$3.98
Rate for Payer: Aetna Commercial	$3.02
Rate for Payer: Aetna Medicare Advantage	$2.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.03
Rate for Payer: Cigna Commercial	$3.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.07
Rate for Payer: Oxford Commercial	$1.59
Rate for Payer: Qualcare PPO/HMO/WC	$1.19
Rate for Payer: UnitedHealthcare Commercial	$1.59
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

SUTURE VICRYL 2-0 SH UNDYED CR

Facility

$456.12

Hospital Charge Code	270693822
Hospital Revenue Code	272
Min. Negotiated Rate	$68.42
Max. Negotiated Rate	$68.42
Rate for Payer: Qualcare PPO/HMO/WC	$68.42

SUTURE VICRYL 2-0 SH UNDYED CR

Facility

$456.12

Hospital Charge Code	270693822
Hospital Revenue Code	272
Min. Negotiated Rate	$12.95
Max. Negotiated Rate	$228.06
Rate for Payer: Aetna Commercial	$173.33
Rate for Payer: Aetna Medicare Advantage	$136.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.31
Rate for Payer: Cigna Commercial	$228.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.59
Rate for Payer: Oxford Commercial	$91.22
Rate for Payer: Qualcare PPO/HMO/WC	$68.42
Rate for Payer: UnitedHealthcare Commercial	$91.22
Rate for Payer: UnitedHealthcare Community & State	$14.41
Rate for Payer: Wellpoint Medicaid Managed Care	$12.95

SUTURE VICRYL 2-0 TIES

Facility

$8.73

Hospital Charge Code	270655687
Hospital Revenue Code	272
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$4.37
Rate for Payer: Aetna Commercial	$3.32
Rate for Payer: Aetna Medicare Advantage	$2.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.23
Rate for Payer: Cigna Commercial	$4.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.27
Rate for Payer: Oxford Commercial	$1.75
Rate for Payer: Qualcare PPO/HMO/WC	$1.31
Rate for Payer: UnitedHealthcare Commercial	$1.75
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

SUTURE VICRYL 2-0 TIES

Facility

$8.73

Hospital Charge Code	270655687
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$1.31

SUTURE VICRYL 2-0 TIES

Facility

$38.58

Hospital Charge Code	270671445
Hospital Revenue Code	272
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$19.29
Rate for Payer: Aetna Commercial	$14.66
Rate for Payer: Aetna Medicare Advantage	$11.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.84
Rate for Payer: Cigna Commercial	$19.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.03
Rate for Payer: Oxford Commercial	$7.72
Rate for Payer: Qualcare PPO/HMO/WC	$5.79
Rate for Payer: UnitedHealthcare Commercial	$7.72
Rate for Payer: UnitedHealthcare Community & State	$1.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1.10

SUTURE VICRYL 2-0 TIES

Facility

$38.58

Hospital Charge Code	270671445
Hospital Revenue Code	272
Min. Negotiated Rate	$5.79
Max. Negotiated Rate	$5.79
Rate for Payer: Qualcare PPO/HMO/WC	$5.79

SUTURE VICRYL 2-0 TIES 18

Facility

$41.84

Hospital Charge Code	270672389
Hospital Revenue Code	272
Min. Negotiated Rate	$6.28
Max. Negotiated Rate	$6.28
Rate for Payer: Qualcare PPO/HMO/WC	$6.28

SUTURE VICRYL 2-0 TIES 18

Facility

$41.84

Hospital Charge Code	270672389
Hospital Revenue Code	272
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$20.92
Rate for Payer: Aetna Commercial	$15.90
Rate for Payer: Aetna Medicare Advantage	$12.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.67
Rate for Payer: Cigna Commercial	$20.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.88
Rate for Payer: Oxford Commercial	$8.37
Rate for Payer: Qualcare PPO/HMO/WC	$6.28
Rate for Payer: UnitedHealthcare Commercial	$8.37
Rate for Payer: UnitedHealthcare Community & State	$1.32
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

SUTURE VICRYL 2-0 TIES 54

Facility

$9.41

Hospital Charge Code	270672388
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$4.71
Rate for Payer: Aetna Commercial	$3.58
Rate for Payer: Aetna Medicare Advantage	$2.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.40
Rate for Payer: Cigna Commercial	$4.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.45
Rate for Payer: Oxford Commercial	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.41
Rate for Payer: UnitedHealthcare Commercial	$1.88
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

SUTURE VICRYL 2-0 TIES 54

Facility

$9.41

Hospital Charge Code	270672388
Hospital Revenue Code	272
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$1.41
Rate for Payer: Qualcare PPO/HMO/WC	$1.41

SUTURE VICRYL 2-0 TIES UNDYED

Facility

$9.78

Hospital Charge Code	270671456
Hospital Revenue Code	272
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$1.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.47

Know your out-of-pocket cost for care.

All Charges