Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE VICRYL 4-0 PS-1

Facility

$29.92

Hospital Charge Code	270671488
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$14.96
Rate for Payer: Aetna Commercial	$11.37
Rate for Payer: Aetna Medicare Advantage	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.63
Rate for Payer: Cigna Commercial	$14.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.78
Rate for Payer: Oxford Commercial	$5.98
Rate for Payer: Qualcare PPO/HMO/WC	$4.49
Rate for Payer: UnitedHealthcare Commercial	$5.98
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

SUTURE VICRYL 4-0 PS-1

Facility

$29.92

Hospital Charge Code	270671488
Hospital Revenue Code	272
Min. Negotiated Rate	$4.49
Max. Negotiated Rate	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$4.49

SUTURE VICRYL 4-0 PS-2

Facility

$19.96

Hospital Charge Code	270672392
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$9.98
Rate for Payer: Aetna Commercial	$7.58
Rate for Payer: Aetna Medicare Advantage	$5.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.09
Rate for Payer: Cigna Commercial	$9.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.19
Rate for Payer: Oxford Commercial	$3.99
Rate for Payer: Qualcare PPO/HMO/WC	$2.99
Rate for Payer: UnitedHealthcare Commercial	$3.99
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.57

SUTURE VICRYL 4-0 PS-2

Facility

$19.96

Hospital Charge Code	270672392
Hospital Revenue Code	272
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$2.99
Rate for Payer: Qualcare PPO/HMO/WC	$2.99

SUTURE VICRYL 4-0 PS-2

Facility

$18.23

Hospital Charge Code	270671467
Hospital Revenue Code	272
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$9.12
Rate for Payer: Aetna Commercial	$6.93
Rate for Payer: Aetna Medicare Advantage	$5.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.65
Rate for Payer: Cigna Commercial	$9.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.74
Rate for Payer: Oxford Commercial	$3.65
Rate for Payer: Qualcare PPO/HMO/WC	$2.73
Rate for Payer: UnitedHealthcare Commercial	$3.65
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.52

SUTURE VICRYL 4-0 PS-2

Facility

$18.48

Hospital Charge Code	270671477
Hospital Revenue Code	272
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$2.77
Rate for Payer: Qualcare PPO/HMO/WC	$2.77

SUTURE VICRYL 4-0 PS-2

Facility

$28.88

Hospital Charge Code	270673500
Hospital Revenue Code	272
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$14.44
Rate for Payer: Aetna Commercial	$10.97
Rate for Payer: Aetna Medicare Advantage	$8.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.36
Rate for Payer: Cigna Commercial	$14.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.51
Rate for Payer: Oxford Commercial	$5.78
Rate for Payer: Qualcare PPO/HMO/WC	$4.33
Rate for Payer: UnitedHealthcare Commercial	$5.78
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$0.82

SUTURE VICRYL 4-0 PS-2

Facility

$28.88

Hospital Charge Code	270673500
Hospital Revenue Code	272
Min. Negotiated Rate	$4.33
Max. Negotiated Rate	$4.33
Rate for Payer: Qualcare PPO/HMO/WC	$4.33

SUTURE VICRYL 4-0 PS-2

Facility

$18.23

Hospital Charge Code	270671467
Hospital Revenue Code	272
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.73

SUTURE VICRYL 4-0 PS-2

Facility

$18.48

Hospital Charge Code	270671477
Hospital Revenue Code	272
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$9.24
Rate for Payer: Aetna Commercial	$7.02
Rate for Payer: Aetna Medicare Advantage	$5.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.71
Rate for Payer: Cigna Commercial	$9.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.80
Rate for Payer: Oxford Commercial	$3.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.77
Rate for Payer: UnitedHealthcare Commercial	$3.70
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.52

SUTURE VICRYL 4-0 RB-1

Facility

$8.68

Hospital Charge Code	270672393
Hospital Revenue Code	272
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$4.34
Rate for Payer: Aetna Commercial	$3.30
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	$4.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.26
Rate for Payer: Oxford Commercial	$1.74
Rate for Payer: Qualcare PPO/HMO/WC	$1.30
Rate for Payer: UnitedHealthcare Commercial	$1.74
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

SUTURE VICRYL 4-0 RB-1

Facility

$8.68

Hospital Charge Code	270672393
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 4-0 REEL TIES

Facility

$9.71

Hospital Charge Code	270671447
Hospital Revenue Code	272
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$1.46
Rate for Payer: Qualcare PPO/HMO/WC	$1.46

SUTURE VICRYL 4-0 REEL TIES

Facility

$9.71

Hospital Charge Code	270671447
Hospital Revenue Code	272
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$4.86
Rate for Payer: Aetna Commercial	$3.69
Rate for Payer: Aetna Medicare Advantage	$2.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.48
Rate for Payer: Cigna Commercial	$4.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.52
Rate for Payer: Oxford Commercial	$1.94
Rate for Payer: Qualcare PPO/HMO/WC	$1.46
Rate for Payer: UnitedHealthcare Commercial	$1.94
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

SUTURE VICRYL 4-0 SC-2

Facility

$9.64

Hospital Charge Code	270655696
Hospital Revenue Code	272
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

SUTURE VICRYL 4-0 SC-2

Facility

$9.64

Hospital Charge Code	270655696
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$4.82
Rate for Payer: Aetna Commercial	$3.66
Rate for Payer: Aetna Medicare Advantage	$2.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.51
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$1.93
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

SUTURE VICRYL 4-0 SH

Facility

$8.81

Hospital Charge Code	270672305
Hospital Revenue Code	272
Min. Negotiated Rate	$1.32
Max. Negotiated Rate	$1.32
Rate for Payer: Qualcare PPO/HMO/WC	$1.32

SUTURE VICRYL 4-0 SH

Facility

$8.81

Hospital Charge Code	270672305
Hospital Revenue Code	272
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$4.41
Rate for Payer: Aetna Commercial	$3.35
Rate for Payer: Aetna Medicare Advantage	$2.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.25
Rate for Payer: Cigna Commercial	$4.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.29
Rate for Payer: Oxford Commercial	$1.76
Rate for Payer: Qualcare PPO/HMO/WC	$1.32
Rate for Payer: UnitedHealthcare Commercial	$1.76
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

SUTURE VICRYL 4-0 TIES

Facility

$42.33

Hospital Charge Code	270672394
Hospital Revenue Code	272
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$21.16
Rate for Payer: Aetna Commercial	$16.09
Rate for Payer: Aetna Medicare Advantage	$12.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.79
Rate for Payer: Cigna Commercial	$21.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.01
Rate for Payer: Oxford Commercial	$8.47
Rate for Payer: Qualcare PPO/HMO/WC	$6.35
Rate for Payer: UnitedHealthcare Commercial	$8.47
Rate for Payer: UnitedHealthcare Community & State	$1.34
Rate for Payer: Wellpoint Medicaid Managed Care	$1.20

SUTURE VICRYL 4-0 TIES

Facility

$42.33

Hospital Charge Code	270672394
Hospital Revenue Code	272
Min. Negotiated Rate	$6.35
Max. Negotiated Rate	$6.35
Rate for Payer: Qualcare PPO/HMO/WC	$6.35

SUTURE VICRYL 4-0 V-20

Facility

$7.13

Hospital Charge Code	270671464
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$3.56
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	$3.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.85
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 VICRYL 4-0 V-20

Facility

$7.13

Hospital Charge Code	270671464
Hospital Revenue Code	272
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$1.07
Rate for Payer: Qualcare PPO/HMO/WC	$1.07

SUTURE VICRYL 5-0 P-1

Facility

$18.74

Hospital Charge Code	270676736
Hospital Revenue Code	272
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$2.81
Rate for Payer: Qualcare PPO/HMO/WC	$2.81

SUTURE VICRYL 5-0 P-1

Facility

$18.74

Hospital Charge Code	270676736
Hospital Revenue Code	272
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$9.37
Rate for Payer: Aetna Commercial	$7.12
Rate for Payer: Aetna Medicare Advantage	$5.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.78
Rate for Payer: Cigna Commercial	$9.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.87
Rate for Payer: Oxford Commercial	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$2.81
Rate for Payer: UnitedHealthcare Commercial	$3.75
Rate for Payer: UnitedHealthcare Community & State	$0.59
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

SUTURE VICRYL 5-0 P-3

Facility

$20.30

Hospital Charge Code	270671473
Hospital Revenue Code	272
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$3.04
Rate for Payer: Qualcare PPO/HMO/WC	$3.04

Know your out-of-pocket cost for care.

All Charges