Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE ETHIBOND 5-0 V-37

Facility

$79.58

Hospital Charge Code	270672367
Hospital Revenue Code	272
Min. Negotiated Rate	$11.94
Max. Negotiated Rate	$11.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.94

SUTURE ETHIBOND 5 GS-18

Facility

$13.82

Hospital Charge Code	270671436
Hospital Revenue Code	272
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$2.07
Rate for Payer: Qualcare PPO/HMO/WC	$2.07

SUTURE ETHIBOND 5 GS-18

Facility

$13.82

Hospital Charge Code	270671436
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.91
Rate for Payer: Aetna Commercial	$5.25
Rate for Payer: Aetna Medicare Advantage	$4.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.52
Rate for Payer: Cigna Commercial	$6.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.15
Rate for Payer: Oxford Commercial	$2.76
Rate for Payer: Qualcare PPO/HMO/WC	$2.07
Rate for Payer: UnitedHealthcare Commercial	$2.76
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

SUTURE ETHIBOND EXTRA 5-0 V-37

Facility

$79.58

Hospital Charge Code	270628893
Hospital Revenue Code	272
Min. Negotiated Rate	$11.94
Max. Negotiated Rate	$11.94
Rate for Payer: Qualcare PPO/HMO/WC	$11.94

SUTURE ETHIBOND EXTRA 5-0 V-37

Facility

$79.58

Hospital Charge Code	270628893
Hospital Revenue Code	272
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$39.79
Rate for Payer: Aetna Commercial	$30.24
Rate for Payer: Aetna Medicare Advantage	$23.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.29
Rate for Payer: Cigna Commercial	$39.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.87
Rate for Payer: Oxford Commercial	$15.92
Rate for Payer: Qualcare PPO/HMO/WC	$11.94
Rate for Payer: UnitedHealthcare Commercial	$15.92
Rate for Payer: UnitedHealthcare Community & State	$1.92
Rate for Payer: Wellpoint Medicaid Managed Care	$2.11

SUTURE ETHIBON EXCEL 5 30IN

Facility

$131.61

Hospital Charge Code	270678399
Hospital Revenue Code	272
Min. Negotiated Rate	$19.74
Max. Negotiated Rate	$19.74
Rate for Payer: Qualcare PPO/HMO/WC	$19.74

SUTURE ETHIBON EXCEL 5 30IN

Facility

$131.61

Hospital Charge Code	270678399
Hospital Revenue Code	272
Min. Negotiated Rate	$3.17
Max. Negotiated Rate	$65.81
Rate for Payer: Aetna Commercial	$50.01
Rate for Payer: Aetna Medicare Advantage	$39.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.56
Rate for Payer: Cigna Commercial	$65.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.48
Rate for Payer: Oxford Commercial	$26.32
Rate for Payer: Qualcare PPO/HMO/WC	$19.74
Rate for Payer: UnitedHealthcare Commercial	$26.32
Rate for Payer: UnitedHealthcare Community & State	$3.17
Rate for Payer: Wellpoint Medicaid Managed Care	$3.49

SUTURE ETHIL. 8-0 5IN BV130-3

Facility

$73.26

Hospital Charge Code	270684520
Hospital Revenue Code	272
Min. Negotiated Rate	$10.99
Max. Negotiated Rate	$10.99
Rate for Payer: Qualcare PPO/HMO/WC	$10.99

SUTURE ETHIL. 8-0 5IN BV130-3

Facility

$73.26

Hospital Charge Code	270684520
Hospital Revenue Code	272
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$36.63
Rate for Payer: Aetna Commercial	$27.84
Rate for Payer: Aetna Medicare Advantage	$21.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.68
Rate for Payer: Cigna Commercial	$36.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.98
Rate for Payer: Oxford Commercial	$14.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.99
Rate for Payer: UnitedHealthcare Commercial	$14.65
Rate for Payer: UnitedHealthcare Community & State	$1.77
Rate for Payer: Wellpoint Medicaid Managed Care	$1.94

SUTURE ETHILON 10-0 BV100-4

Facility

$99.58

Hospital Charge Code	270671752
Hospital Revenue Code	272
Min. Negotiated Rate	$14.94
Max. Negotiated Rate	$14.94
Rate for Payer: Qualcare PPO/HMO/WC	$14.94

SUTURE ETHILON 10-0 BV100-4

Facility

$99.58

Hospital Charge Code	270671752
Hospital Revenue Code	272
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$49.79
Rate for Payer: Aetna Commercial	$37.84
Rate for Payer: Aetna Medicare Advantage	$29.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.39
Rate for Payer: Cigna Commercial	$49.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.87
Rate for Payer: Oxford Commercial	$19.92
Rate for Payer: Qualcare PPO/HMO/WC	$14.94
Rate for Payer: UnitedHealthcare Commercial	$19.92
Rate for Payer: UnitedHealthcare Community & State	$2.40
Rate for Payer: Wellpoint Medicaid Managed Care	$2.64

SUTURE ETHILON 10-0 TG140-8

Facility

$71.19

Hospital Charge Code	270654999
Hospital Revenue Code	272
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$35.59
Rate for Payer: Aetna Commercial	$27.05
Rate for Payer: Aetna Medicare Advantage	$21.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.15
Rate for Payer: Cigna Commercial	$35.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.36
Rate for Payer: Oxford Commercial	$14.24
Rate for Payer: Qualcare PPO/HMO/WC	$10.68
Rate for Payer: UnitedHealthcare Commercial	$14.24
Rate for Payer: UnitedHealthcare Community & State	$1.72
Rate for Payer: Wellpoint Medicaid Managed Care	$1.89

SUTURE ETHILON 10-0 TG140-8

Facility

$71.19

Hospital Charge Code	270654999
Hospital Revenue Code	272
Min. Negotiated Rate	$10.68
Max. Negotiated Rate	$10.68
Rate for Payer: Qualcare PPO/HMO/WC	$10.68

SUTURE ETHILON 10-0 TG160-6

Facility

$132.03

Hospital Charge Code	270660118
Hospital Revenue Code	272
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$19.80
Rate for Payer: Qualcare PPO/HMO/WC	$19.80

SUTURE ETHILON 10-0 TG160-6

Facility

$132.03

Hospital Charge Code	270660118
Hospital Revenue Code	272
Min. Negotiated Rate	$3.18
Max. Negotiated Rate	$66.02
Rate for Payer: Aetna Commercial	$50.17
Rate for Payer: Aetna Medicare Advantage	$39.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.67
Rate for Payer: Cigna Commercial	$66.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.61
Rate for Payer: Oxford Commercial	$26.41
Rate for Payer: Qualcare PPO/HMO/WC	$19.80
Rate for Payer: UnitedHealthcare Commercial	$26.41
Rate for Payer: UnitedHealthcare Community & State	$3.18
Rate for Payer: Wellpoint Medicaid Managed Care	$3.50

SUTURE ETHILON 1 GS-25

Facility

$8.09

Hospital Charge Code	270676700
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$4.04
Rate for Payer: Aetna Commercial	$3.07
Rate for Payer: Aetna Medicare Advantage	$2.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.06
Rate for Payer: Cigna Commercial	$4.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.43
Rate for Payer: Oxford Commercial	$1.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.21
Rate for Payer: UnitedHealthcare Commercial	$1.62
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SUTURE ETHILON 1 GS-25

Facility

$8.09

Hospital Charge Code	270676700
Hospital Revenue Code	272
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$1.21

SUTURE ETHILON 2-0 C-15

Facility

$9.00

Hospital Charge Code	270675342
Hospital Revenue Code	272
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

SUTURE ETHILON 2-0 C-15

Facility

$9.00

Hospital Charge Code	270675342
Hospital Revenue Code	272
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

SUTURE ETHILON 2-0 FS C-15

Facility

$317.10

Hospital Charge Code	270673637
Hospital Revenue Code	272
Min. Negotiated Rate	$7.64
Max. Negotiated Rate	$158.55
Rate for Payer: Aetna Commercial	$120.50
Rate for Payer: Aetna Medicare Advantage	$95.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.86
Rate for Payer: Cigna Commercial	$158.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.13
Rate for Payer: Oxford Commercial	$63.42
Rate for Payer: Qualcare PPO/HMO/WC	$47.56
Rate for Payer: UnitedHealthcare Commercial	$63.42
Rate for Payer: UnitedHealthcare Community & State	$7.64
Rate for Payer: Wellpoint Medicaid Managed Care	$8.40

SUTURE ETHILON 2-0 FS C-15

Facility

$317.10

Hospital Charge Code	270673637
Hospital Revenue Code	272
Min. Negotiated Rate	$47.56
Max. Negotiated Rate	$47.56
Rate for Payer: Qualcare PPO/HMO/WC	$47.56

SUTURE ETHILON 2-0 KS

Facility

$12.99

Hospital Charge Code	270655804
Hospital Revenue Code	272
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

SUTURE ETHILON 2-0 KS

Facility

$12.99

Hospital Charge Code	270655804
Hospital Revenue Code	272
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

SUTURE ETHILON 2-0 PS

Facility

$29.01

Hospital Charge Code	270667333
Hospital Revenue Code	272
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$14.51
Rate for Payer: Aetna Commercial	$11.02
Rate for Payer: Aetna Medicare Advantage	$8.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.40
Rate for Payer: Cigna Commercial	$14.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.70
Rate for Payer: Oxford Commercial	$5.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.35
Rate for Payer: UnitedHealthcare Commercial	$5.80
Rate for Payer: UnitedHealthcare Community & State	$0.70
Rate for Payer: Wellpoint Medicaid Managed Care	$0.77

SUTURE ETHILON 2-0 PS

Facility

$29.01

Hospital Charge Code	270667333
Hospital Revenue Code	272
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$4.35
Rate for Payer: Qualcare PPO/HMO/WC	$4.35

Know your out-of-pocket cost for care.

All Charges