Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE ANCHOR PUSH 3.5X19.5MM

Facility

$2,000.00

Hospital Charge Code	270663909
Hospital Revenue Code	272
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

SUTURE ANCHOR PUSH 3.5X19.5MM

Facility

$2,000.00

Hospital Charge Code	270663909
Hospital Revenue Code	272
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Commercial	$400.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

SUTURE ANCHOR PUSH LOCK 2.9

Facility

$2,000.00

Hospital Charge Code	270667608
Hospital Revenue Code	272
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.00
Rate for Payer: Oxford Commercial	$400.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Commercial	$400.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

SUTURE ANCHOR PUSH LOCK 2.9

Facility

$2,000.00

Hospital Charge Code	270667608
Hospital Revenue Code	272
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

SUTURE ANCHOR QFIX MINI 1.8MM

Facility

$3,575.00

Service Code	HCPCS A4649
Hospital Charge Code	270687358
Hospital Revenue Code	278
Min. Negotiated Rate	$86.16
Max. Negotiated Rate	$1,787.50
Rate for Payer: Aetna Commercial	$1,358.50
Rate for Payer: Aetna Medicare Advantage	$1,072.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$911.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$911.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$715.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$911.62
Rate for Payer: Cigna Commercial	$1,787.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$865.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$536.25
Rate for Payer: UnitedHealthcare Community & State	$86.16
Rate for Payer: Wellpoint Medicaid Managed Care	$94.74

SUTURE ANCHOR QFIX MINI 1.8MM

Facility

$3,575.00

Service Code	HCPCS A4649
Hospital Charge Code	270687358
Hospital Revenue Code	278
Min. Negotiated Rate	$536.25
Max. Negotiated Rate	$865.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$715.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$865.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$536.25

SUTURE ANCHOR SUPER REVO 5MM

Facility

$968.20

Hospital Charge Code	270678104
Hospital Revenue Code	272
Min. Negotiated Rate	$23.33
Max. Negotiated Rate	$484.10
Rate for Payer: Aetna Commercial	$367.92
Rate for Payer: Aetna Medicare Advantage	$290.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$246.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$246.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$246.89
Rate for Payer: Cigna Commercial	$484.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.46
Rate for Payer: Oxford Commercial	$193.64
Rate for Payer: Qualcare PPO/HMO/WC	$145.23
Rate for Payer: UnitedHealthcare Commercial	$193.64
Rate for Payer: UnitedHealthcare Community & State	$23.33
Rate for Payer: Wellpoint Medicaid Managed Care	$25.66

SUTURE ANCHOR SUPER REVO 5MM

Facility

$968.20

Hospital Charge Code	270678104
Hospital Revenue Code	272
Min. Negotiated Rate	$145.23
Max. Negotiated Rate	$145.23
Rate for Payer: Qualcare PPO/HMO/WC	$145.23

SUTURE ANCHOR SWIVELLOCK TENDO

Facility

$2,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270680783
Hospital Revenue Code	278
Min. Negotiated Rate	$326.25
Max. Negotiated Rate	$526.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$478.50
Rate for Payer: Qualcare PPO/HMO/WC	$326.25

SUTURE ANCHOR SWIVELLOCK TENDO

Facility

$2,175.00

Service Code	HCPCS C1713
Hospital Charge Code	270680783
Hospital Revenue Code	278
Min. Negotiated Rate	$52.42
Max. Negotiated Rate	$1,087.50
Rate for Payer: Aetna Commercial	$826.50
Rate for Payer: Aetna Medicare Advantage	$652.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$554.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$554.62
Rate for Payer: Cigna Commercial	$1,087.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$526.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$478.50
Rate for Payer: Qualcare PPO/HMO/WC	$326.25
Rate for Payer: UnitedHealthcare Community & State	$52.42
Rate for Payer: Wellpoint Medicaid Managed Care	$57.64

SUTURE ANCHOR SWIVELOCK 4.75MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270664799
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

SUTURE ANCHOR SWIVELOCK 4.75MM

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270664799
Hospital Revenue Code	278
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

SUTURE ANCHOR TAPE 3MM 2L

Facility

$10,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270692725
Hospital Revenue Code	278
Min. Negotiated Rate	$1,593.75
Max. Negotiated Rate	$2,571.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,571.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,337.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.75

SUTURE ANCHOR TAPE 3MM 2L

Facility

$10,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270692725
Hospital Revenue Code	278
Min. Negotiated Rate	$256.06
Max. Negotiated Rate	$5,312.50
Rate for Payer: Aetna Commercial	$4,037.50
Rate for Payer: Aetna Medicare Advantage	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,709.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,709.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,709.38
Rate for Payer: Cigna Commercial	$5,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,571.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,337.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.75
Rate for Payer: UnitedHealthcare Community & State	$256.06
Rate for Payer: Wellpoint Medicaid Managed Care	$281.56

SUTURE ANCHOR TITANIUM 3.0X12M

Facility

$2,258.75

Service Code	HCPCS C1713
Hospital Charge Code	270701724
Hospital Revenue Code	278
Min. Negotiated Rate	$54.44
Max. Negotiated Rate	$1,129.38
Rate for Payer: Aetna Commercial	$858.33
Rate for Payer: Aetna Medicare Advantage	$677.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$575.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$575.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$575.98
Rate for Payer: Cigna Commercial	$1,129.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.93
Rate for Payer: Qualcare PPO/HMO/WC	$338.81
Rate for Payer: UnitedHealthcare Community & State	$54.44
Rate for Payer: Wellpoint Medicaid Managed Care	$59.86

SUTURE ANCHOR TITANIUM 3.0X12M

Facility

$2,258.75

Service Code	HCPCS C1713
Hospital Charge Code	270701724
Hospital Revenue Code	278
Min. Negotiated Rate	$338.81
Max. Negotiated Rate	$546.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$451.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$496.93
Rate for Payer: Qualcare PPO/HMO/WC	$338.81

SUTURE ANCHR FIBETAK DBL 1.3MM

Facility

$1,850.00

Hospital Charge Code	270683555
Hospital Revenue Code	272
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$277.50
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

SUTURE ANCHR FIBETAK DBL 1.3MM

Facility

$1,850.00

Hospital Charge Code	270683555
Hospital Revenue Code	272
Min. Negotiated Rate	$44.59
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$703.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$555.00
Rate for Payer: Oxford Commercial	$370.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Commercial	$370.00
Rate for Payer: UnitedHealthcare Community & State	$44.59
Rate for Payer: Wellpoint Medicaid Managed Care	$49.02

SUTURE ANCHR FORCEFIB SZ2BLU36

Facility

$1,152.00

Service Code	HCPCS C1713
Hospital Charge Code	270657935
Hospital Revenue Code	278
Min. Negotiated Rate	$27.76
Max. Negotiated Rate	$576.00
Rate for Payer: Aetna Commercial	$437.76
Rate for Payer: Aetna Medicare Advantage	$345.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$293.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$293.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$293.76
Rate for Payer: Cigna Commercial	$576.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.44
Rate for Payer: Qualcare PPO/HMO/WC	$172.80
Rate for Payer: UnitedHealthcare Community & State	$27.76
Rate for Payer: Wellpoint Medicaid Managed Care	$30.53

SUTURE ANCHR FORCEFIB SZ2BLU36

Facility

$1,152.00

Service Code	HCPCS C1713
Hospital Charge Code	270657935
Hospital Revenue Code	278
Min. Negotiated Rate	$172.80
Max. Negotiated Rate	$278.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$230.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$278.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$253.44
Rate for Payer: Qualcare PPO/HMO/WC	$172.80

SUTURE ASORB BARDED 3-0 GS21

Facility

$175.93

Hospital Charge Code	270671574
Hospital Revenue Code	272
Min. Negotiated Rate	$26.39
Max. Negotiated Rate	$26.39
Rate for Payer: Qualcare PPO/HMO/WC	$26.39

SUTURE ASORB BARDED 3-0 GS21

Facility

$175.93

Hospital Charge Code	270671574
Hospital Revenue Code	272
Min. Negotiated Rate	$4.24
Max. Negotiated Rate	$87.97
Rate for Payer: Aetna Commercial	$66.85
Rate for Payer: Aetna Medicare Advantage	$52.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.86
Rate for Payer: Cigna Commercial	$87.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.78
Rate for Payer: Oxford Commercial	$35.19
Rate for Payer: Qualcare PPO/HMO/WC	$26.39
Rate for Payer: UnitedHealthcare Commercial	$35.19
Rate for Payer: UnitedHealthcare Community & State	$4.24
Rate for Payer: Wellpoint Medicaid Managed Care	$4.66

SUTURE BEADED BLUE #2

Facility

$212.50

Hospital Charge Code	270672173
Hospital Revenue Code	272
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$106.25
Rate for Payer: Aetna Commercial	$80.75
Rate for Payer: Aetna Medicare Advantage	$63.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.19
Rate for Payer: Cigna Commercial	$106.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.75
Rate for Payer: Oxford Commercial	$42.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.88
Rate for Payer: UnitedHealthcare Commercial	$42.50
Rate for Payer: UnitedHealthcare Community & State	$5.12
Rate for Payer: Wellpoint Medicaid Managed Care	$5.63

SUTURE BEADED BLUE #2

Facility

$212.50

Hospital Charge Code	270672173
Hospital Revenue Code	272
Min. Negotiated Rate	$31.88
Max. Negotiated Rate	$31.88
Rate for Payer: Qualcare PPO/HMO/WC	$31.88

SUTURE BEALON CV23 4-0

Facility

$71.25

Hospital Charge Code	270605413
Hospital Revenue Code	272
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$35.62
Rate for Payer: Aetna Commercial	$27.07
Rate for Payer: Aetna Medicare Advantage	$21.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.17
Rate for Payer: Cigna Commercial	$35.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.38
Rate for Payer: Oxford Commercial	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$10.69
Rate for Payer: UnitedHealthcare Commercial	$14.25
Rate for Payer: UnitedHealthcare Community & State	$1.72
Rate for Payer: Wellpoint Medicaid Managed Care	$1.89

Know your out-of-pocket cost for care.

All Charges