Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

Suture Gore-Tex TT 9 6-0

Facility

$140.42

Hospital Charge Code	270606765
Hospital Revenue Code	272
Min. Negotiated Rate	$21.06
Max. Negotiated Rate	$21.06
Rate for Payer: Qualcare PPO/HMO/WC	$21.06

SUTURE GORETX TT13 CV5 5-0

Facility

$160.85

Hospital Charge Code	270604730
Hospital Revenue Code	272
Min. Negotiated Rate	$24.13
Max. Negotiated Rate	$24.13
Rate for Payer: Qualcare PPO/HMO/WC	$24.13

SUTURE GORETX TT13 CV5 5-0

Facility

$160.85

Hospital Charge Code	270604730
Hospital Revenue Code	272
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$80.42
Rate for Payer: Aetna Commercial	$61.12
Rate for Payer: Aetna Medicare Advantage	$48.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.02
Rate for Payer: Cigna Commercial	$80.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.26
Rate for Payer: Oxford Commercial	$32.17
Rate for Payer: Qualcare PPO/HMO/WC	$24.13
Rate for Payer: UnitedHealthcare Commercial	$32.17
Rate for Payer: UnitedHealthcare Community & State	$3.88
Rate for Payer: Wellpoint Medicaid Managed Care	$4.26

SUTURE GORETX TT13 CV6 6-0

Facility

$103.75

Hospital Charge Code	270604731
Hospital Revenue Code	272
Min. Negotiated Rate	$15.56
Max. Negotiated Rate	$15.56
Rate for Payer: Qualcare PPO/HMO/WC	$15.56

SUTURE GORETX TT13 CV6 6-0

Facility

$103.75

Hospital Charge Code	270604731
Hospital Revenue Code	272
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$51.88
Rate for Payer: Aetna Commercial	$39.42
Rate for Payer: Aetna Medicare Advantage	$31.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.46
Rate for Payer: Cigna Commercial	$51.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.12
Rate for Payer: Oxford Commercial	$20.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.56
Rate for Payer: UnitedHealthcare Commercial	$20.75
Rate for Payer: UnitedHealthcare Community & State	$2.50
Rate for Payer: Wellpoint Medicaid Managed Care	$2.75

SUTURE GORETX TT13 CV7 7-0

Facility

$109.58

Hospital Charge Code	270604732
Hospital Revenue Code	272
Min. Negotiated Rate	$16.44
Max. Negotiated Rate	$16.44
Rate for Payer: Qualcare PPO/HMO/WC	$16.44

SUTURE GORETX TT13 CV7 7-0

Facility

$109.58

Hospital Charge Code	270604732
Hospital Revenue Code	272
Min. Negotiated Rate	$2.64
Max. Negotiated Rate	$54.79
Rate for Payer: Aetna Commercial	$41.64
Rate for Payer: Aetna Medicare Advantage	$32.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.94
Rate for Payer: Cigna Commercial	$54.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.87
Rate for Payer: Oxford Commercial	$21.92
Rate for Payer: Qualcare PPO/HMO/WC	$16.44
Rate for Payer: UnitedHealthcare Commercial	$21.92
Rate for Payer: UnitedHealthcare Community & State	$2.64
Rate for Payer: Wellpoint Medicaid Managed Care	$2.90

SUTURE GORTEX 2-0 W/SH NEEDLE

Facility

$122.08

Hospital Charge Code	270673725
Hospital Revenue Code	272
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$61.04
Rate for Payer: Aetna Commercial	$46.39
Rate for Payer: Aetna Medicare Advantage	$36.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.13
Rate for Payer: Cigna Commercial	$61.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.62
Rate for Payer: Oxford Commercial	$24.42
Rate for Payer: Qualcare PPO/HMO/WC	$18.31
Rate for Payer: UnitedHealthcare Commercial	$24.42
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

SUTURE GORTEX 2-0 W/SH NEEDLE

Facility

$122.08

Hospital Charge Code	270673725
Hospital Revenue Code	272
Min. Negotiated Rate	$18.31
Max. Negotiated Rate	$18.31
Rate for Payer: Qualcare PPO/HMO/WC	$18.31

SUTURE GRAVITY SYNCHFIX #5

Facility

$7,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270695344
Hospital Revenue Code	278
Min. Negotiated Rate	$1,192.50
Max. Negotiated Rate	$1,923.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,923.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,749.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.50

SUTURE GRAVITY SYNCHFIX #5

Facility

$7,950.00

Service Code	HCPCS C1713
Hospital Charge Code	270695344
Hospital Revenue Code	278
Min. Negotiated Rate	$191.59
Max. Negotiated Rate	$3,975.00
Rate for Payer: Aetna Commercial	$3,021.00
Rate for Payer: Aetna Medicare Advantage	$2,385.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,027.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,027.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,590.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,027.25
Rate for Payer: Cigna Commercial	$3,975.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,923.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,749.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,192.50
Rate for Payer: UnitedHealthcare Community & State	$191.59
Rate for Payer: Wellpoint Medicaid Managed Care	$210.68

SUTURE GUT PLAIN 6-0 18

Facility

$69.00

Hospital Charge Code	270334603
Hospital Revenue Code	272
Min. Negotiated Rate	$10.35
Max. Negotiated Rate	$10.35
Rate for Payer: Qualcare PPO/HMO/WC	$10.35

SUTURE GUT PLAIN 6-0 18

Facility

$69.00

Hospital Charge Code	270334603
Hospital Revenue Code	272
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$34.50
Rate for Payer: Aetna Commercial	$26.22
Rate for Payer: Aetna Medicare Advantage	$20.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.59
Rate for Payer: Cigna Commercial	$34.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.70
Rate for Payer: Oxford Commercial	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.35
Rate for Payer: UnitedHealthcare Commercial	$13.80
Rate for Payer: UnitedHealthcare Community & State	$1.66
Rate for Payer: Wellpoint Medicaid Managed Care	$1.83

SUTURE HERCULINE H5000

Facility

$124.00

Hospital Charge Code	270633957
Hospital Revenue Code	272
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

SUTURE HERCULINE H5000

Facility

$124.00

Hospital Charge Code	270633957
Hospital Revenue Code	272
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$62.00
Rate for Payer: Aetna Commercial	$47.12
Rate for Payer: Aetna Medicare Advantage	$37.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.62
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.20
Rate for Payer: Oxford Commercial	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$24.80
Rate for Payer: UnitedHealthcare Community & State	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

SUTURE HI-FI #2 SNGL 40 BLUE

Facility

$240.00

Hospital Charge Code	270676308
Hospital Revenue Code	272
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

SUTURE HI-FI #2 SNGL 40 BLUE

Facility

$240.00

Hospital Charge Code	270676308
Hospital Revenue Code	272
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$120.00
Rate for Payer: Aetna Commercial	$91.20
Rate for Payer: Aetna Medicare Advantage	$72.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.20
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.00
Rate for Payer: Oxford Commercial	$48.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$48.00
Rate for Payer: UnitedHealthcare Community & State	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$6.36

SUTURE II SURGIPRO 4-0 36 BLUE

Facility

$65.82

Hospital Charge Code	270651343
Hospital Revenue Code	272
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$32.91
Rate for Payer: Aetna Commercial	$25.01
Rate for Payer: Aetna Medicare Advantage	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.78
Rate for Payer: Cigna Commercial	$32.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.75
Rate for Payer: Oxford Commercial	$13.16
Rate for Payer: Qualcare PPO/HMO/WC	$9.87
Rate for Payer: UnitedHealthcare Commercial	$13.16
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.74

SUTURE II SURGIPRO 4-0 36 BLUE

Facility

$65.82

Hospital Charge Code	270651343
Hospital Revenue Code	272
Min. Negotiated Rate	$9.87
Max. Negotiated Rate	$9.87
Rate for Payer: Qualcare PPO/HMO/WC	$9.87

SUTURE KIT D-SPECIAL 5-0

Facility

$163.30

Hospital Charge Code	270676568
Hospital Revenue Code	272
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$24.50
Rate for Payer: Qualcare PPO/HMO/WC	$24.50

SUTURE KIT D-SPECIAL 5-0

Facility

$163.30

Hospital Charge Code	270676568
Hospital Revenue Code	272
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$81.65
Rate for Payer: Aetna Commercial	$62.05
Rate for Payer: Aetna Medicare Advantage	$48.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.64
Rate for Payer: Cigna Commercial	$81.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.99
Rate for Payer: Oxford Commercial	$32.66
Rate for Payer: Qualcare PPO/HMO/WC	$24.50
Rate for Payer: UnitedHealthcare Commercial	$32.66
Rate for Payer: UnitedHealthcare Community & State	$3.94
Rate for Payer: Wellpoint Medicaid Managed Care	$4.33

SUTURE LAPAROSCOPIC RETRIEVAL

Facility

$270.00

Hospital Charge Code	270657795
Hospital Revenue Code	272
Min. Negotiated Rate	$6.51
Max. Negotiated Rate	$135.00
Rate for Payer: Aetna Commercial	$102.60
Rate for Payer: Aetna Medicare Advantage	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.85
Rate for Payer: Cigna Commercial	$135.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.00
Rate for Payer: Oxford Commercial	$54.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.50
Rate for Payer: UnitedHealthcare Commercial	$54.00
Rate for Payer: UnitedHealthcare Community & State	$6.51
Rate for Payer: Wellpoint Medicaid Managed Care	$7.16

SUTURE LAPAROSCOPIC RETRIEVAL

Facility

$270.00

Hospital Charge Code	270657795
Hospital Revenue Code	272
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Qualcare PPO/HMO/WC	$40.50

suture LASSO 25 degr tight crv

Facility

$700.00

Hospital Charge Code	270660673
Hospital Revenue Code	272
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

suture LASSO 25 degr tight crv

Facility

$700.00

Hospital Charge Code	270660673
Hospital Revenue Code	272
Min. Negotiated Rate	$16.87
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.00
Rate for Payer: Oxford Commercial	$140.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Commercial	$140.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$18.55

Know your out-of-pocket cost for care.

All Charges