Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE ETHILON 2-0 PS-2

Facility

$17.99

Hospital Charge Code	270671388
Hospital Revenue Code	272
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

SUTURE ETHILON 2-0 PS-2

Facility

$17.99

Hospital Charge Code	270671388
Hospital Revenue Code	272
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$8.99
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$8.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

SUTURE ETHILON 2 GS-18

Facility

$35.33

Hospital Charge Code	270672227
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$17.66
Rate for Payer: Aetna Commercial	$13.43
Rate for Payer: Aetna Medicare Advantage	$10.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.01
Rate for Payer: Cigna Commercial	$17.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.60
Rate for Payer: Oxford Commercial	$7.07
Rate for Payer: Qualcare PPO/HMO/WC	$5.30
Rate for Payer: UnitedHealthcare Commercial	$7.07
Rate for Payer: UnitedHealthcare Community & State	$0.85
Rate for Payer: Wellpoint Medicaid Managed Care	$0.94

SUTURE ETHILON 2 GS-18

Facility

$13.45

Hospital Charge Code	270604723
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$6.72
Rate for Payer: Aetna Commercial	$5.11
Rate for Payer: Aetna Medicare Advantage	$4.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.43
Rate for Payer: Cigna Commercial	$6.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.04
Rate for Payer: Oxford Commercial	$2.69
Rate for Payer: Qualcare PPO/HMO/WC	$2.02
Rate for Payer: UnitedHealthcare Commercial	$2.69
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

SUTURE ETHILON 2 GS-18

Facility

$13.45

Hospital Charge Code	270604723
Hospital Revenue Code	272
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$2.02
Rate for Payer: Qualcare PPO/HMO/WC	$2.02

SUTURE ETHILON 2 GS-18

Facility

$35.33

Hospital Charge Code	270672227
Hospital Revenue Code	272
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$5.30
Rate for Payer: Qualcare PPO/HMO/WC	$5.30

SUTURE ETHILON 3/0 4IN BLACK B

Facility

$71.61

Hospital Charge Code	270683447
Hospital Revenue Code	272
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$35.80
Rate for Payer: Aetna Commercial	$27.21
Rate for Payer: Aetna Medicare Advantage	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.26
Rate for Payer: Cigna Commercial	$35.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.48
Rate for Payer: Oxford Commercial	$14.32
Rate for Payer: Qualcare PPO/HMO/WC	$10.74
Rate for Payer: UnitedHealthcare Commercial	$14.32
Rate for Payer: UnitedHealthcare Community & State	$1.73
Rate for Payer: Wellpoint Medicaid Managed Care	$1.90

SUTURE ETHILON 3/0 4IN BLACK B

Facility

$71.61

Hospital Charge Code	270683447
Hospital Revenue Code	272
Min. Negotiated Rate	$10.74
Max. Negotiated Rate	$10.74
Rate for Payer: Qualcare PPO/HMO/WC	$10.74

SUTURE ETHILON 3-0 BLK PS-2

Facility

$18.06

Hospital Charge Code	270664322
Hospital Revenue Code	272
Min. Negotiated Rate	$2.71
Max. Negotiated Rate	$2.71
Rate for Payer: Qualcare PPO/HMO/WC	$2.71

SUTURE ETHILON 3-0 BLK PS-2

Facility

$18.06

Hospital Charge Code	270664322
Hospital Revenue Code	272
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$9.03
Rate for Payer: Aetna Commercial	$6.86
Rate for Payer: Aetna Medicare Advantage	$5.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.61
Rate for Payer: Cigna Commercial	$9.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.42
Rate for Payer: Oxford Commercial	$3.61
Rate for Payer: Qualcare PPO/HMO/WC	$2.71
Rate for Payer: UnitedHealthcare Commercial	$3.61
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

SUTURE ETHILON 3-0 FS-1

Facility

$9.18

Hospital Charge Code	270663643
Hospital Revenue Code	272
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.59
Rate for Payer: Aetna Commercial	$3.49
Rate for Payer: Aetna Medicare Advantage	$2.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.34
Rate for Payer: Cigna Commercial	$4.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.75
Rate for Payer: Oxford Commercial	$1.84
Rate for Payer: Qualcare PPO/HMO/WC	$1.38
Rate for Payer: UnitedHealthcare Commercial	$1.84
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

SUTURE ETHILON 3-0 FS-1

Facility

$9.18

Hospital Charge Code	270663643
Hospital Revenue Code	272
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$1.38
Rate for Payer: Qualcare PPO/HMO/WC	$1.38

SUTURE ETHILON 3-0 KS CUTTING

Facility

$9.51

Hospital Charge Code	270672358
Hospital Revenue Code	272
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.75
Rate for Payer: Aetna Commercial	$3.61
Rate for Payer: Aetna Medicare Advantage	$2.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.43
Rate for Payer: Cigna Commercial	$4.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.85
Rate for Payer: Oxford Commercial	$1.90
Rate for Payer: Qualcare PPO/HMO/WC	$1.43
Rate for Payer: UnitedHealthcare Commercial	$1.90
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

SUTURE ETHILON 3-0 KS CUTTING

Facility

$9.51

Hospital Charge Code	270672358
Hospital Revenue Code	272
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$1.43
Rate for Payer: Qualcare PPO/HMO/WC	$1.43

SUTURE ETHILON 4-0 FS-2

Facility

$8.30

Hospital Charge Code	270677492
Hospital Revenue Code	272
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$1.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.25

SUTURE ETHILON 4-0 FS-2

Facility

$8.30

Hospital Charge Code	270677492
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$4.15
Rate for Payer: Aetna Commercial	$3.15
Rate for Payer: Aetna Medicare Advantage	$2.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.12
Rate for Payer: Cigna Commercial	$4.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.49
Rate for Payer: Oxford Commercial	$1.66
Rate for Payer: Qualcare PPO/HMO/WC	$1.25
Rate for Payer: UnitedHealthcare Commercial	$1.66
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

SUTURE ETHILON 4-0 P-3

Facility

$27.92

Hospital Charge Code	270671397
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$13.96
Rate for Payer: Aetna Commercial	$10.61
Rate for Payer: Aetna Medicare Advantage	$8.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.12
Rate for Payer: Cigna Commercial	$13.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.38
Rate for Payer: Oxford Commercial	$5.58
Rate for Payer: Qualcare PPO/HMO/WC	$4.19
Rate for Payer: UnitedHealthcare Commercial	$5.58
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

SUTURE ETHILON 4-0 P-3

Facility

$27.92

Hospital Charge Code	270671397
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.19

SUTURE ETHILON 4-0 P-3

Facility

$19.24

Hospital Charge Code	270671399
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.62
Rate for Payer: Aetna Commercial	$7.31
Rate for Payer: Aetna Medicare Advantage	$5.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.91
Rate for Payer: Cigna Commercial	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.77
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.89
Rate for Payer: UnitedHealthcare Commercial	$3.85
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

SUTURE ETHILON 4-0 P-3

Facility

$19.24

Hospital Charge Code	270671399
Hospital Revenue Code	272
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

SUTURE ETHILON 4-0 PC-3

Facility

$20.10

Hospital Charge Code	270671384
Hospital Revenue Code	272
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$10.05
Rate for Payer: Aetna Commercial	$7.64
Rate for Payer: Aetna Medicare Advantage	$6.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.13
Rate for Payer: Cigna Commercial	$10.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.03
Rate for Payer: Oxford Commercial	$4.02
Rate for Payer: Qualcare PPO/HMO/WC	$3.02
Rate for Payer: UnitedHealthcare Commercial	$4.02
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

SUTURE ETHILON 4-0 PC-3

Facility

$20.10

Hospital Charge Code	270671384
Hospital Revenue Code	272
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$3.02
Rate for Payer: Qualcare PPO/HMO/WC	$3.02

SUTURE ETHILON 4-0 PC-5

Facility

$20.43

Hospital Charge Code	270651496
Hospital Revenue Code	272
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$3.06
Rate for Payer: Qualcare PPO/HMO/WC	$3.06

SUTURE ETHILON 4-0 PC-5

Facility

$20.43

Hospital Charge Code	270651496
Hospital Revenue Code	272
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$10.21
Rate for Payer: Aetna Commercial	$7.76
Rate for Payer: Aetna Medicare Advantage	$6.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.21
Rate for Payer: Cigna Commercial	$10.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.13
Rate for Payer: Oxford Commercial	$4.09
Rate for Payer: Qualcare PPO/HMO/WC	$3.06
Rate for Payer: UnitedHealthcare Commercial	$4.09
Rate for Payer: UnitedHealthcare Community & State	$0.49
Rate for Payer: Wellpoint Medicaid Managed Care	$0.54

SUTURE ETHILON 4-0 PS-2

Facility

$18.30

Hospital Charge Code	270678102
Hospital Revenue Code	272
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$2.75
Rate for Payer: Qualcare PPO/HMO/WC	$2.75

Know your out-of-pocket cost for care.

All Charges