Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE LASSO 25 DEG TR CURVE

Facility

$700.00

Hospital Charge Code	270660675
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 DEG TR CURVE

Facility

$700.00

Hospital Charge Code	270660675
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

SUTURELASSO 25* TIGHT CURVED

Facility

$1,000.00

Hospital Charge Code	660673
Hospital Revenue Code	272
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$500.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.00
Rate for Payer: Oxford Commercial	$200.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$200.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

SUTURELASSO 25* TIGHT CURVED

Facility

$1,000.00

Hospital Charge Code	660673
Hospital Revenue Code	272
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

SUTURE LASSO 45 DEG CVD LEFT

Facility

$700.00

Hospital Charge Code	270638448
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 45 DEG CVD LEFT

Facility

$700.00

Hospital Charge Code	270638448
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

SUTURE LASSO 90 AR-4065-90W

Facility

$1,016.85

Hospital Charge Code	270629673
Hospital Revenue Code	272
Min. Negotiated Rate	$152.53
Max. Negotiated Rate	$152.53
Rate for Payer: Qualcare PPO/HMO/WC	$152.53

SUTURE LASSO 90 AR-4065-90W

Facility

$1,016.85

Hospital Charge Code	270629673
Hospital Revenue Code	272
Min. Negotiated Rate	$24.51
Max. Negotiated Rate	$508.43
Rate for Payer: Aetna Commercial	$386.40
Rate for Payer: Aetna Medicare Advantage	$305.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$259.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$259.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$259.30
Rate for Payer: Cigna Commercial	$508.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$305.06
Rate for Payer: Oxford Commercial	$203.37
Rate for Payer: Qualcare PPO/HMO/WC	$152.53
Rate for Payer: UnitedHealthcare Commercial	$203.37
Rate for Payer: UnitedHealthcare Community & State	$24.51
Rate for Payer: Wellpoint Medicaid Managed Care	$26.95

SUTURELASSO CRESENT

Facility

$700.00

Hospital Charge Code	270676475
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

SUTURELASSO CRESENT

Facility

$700.00

Hospital Charge Code	270676475
Hospital Revenue Code	272
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

SUTURE LEVEL 1

Facility

$33.00

Hospital Charge Code	270334763
Hospital Revenue Code	272
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$12.54
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.90
Rate for Payer: Oxford Commercial	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$6.60
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

SUTURE LEVEL 1

Facility

$33.00

Hospital Charge Code	270334763
Hospital Revenue Code	272
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

SUTURE LEVEL 2

Facility

$63.00

Hospital Charge Code	270334764
Hospital Revenue Code	272
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna Commercial	$23.94
Rate for Payer: Aetna Medicare Advantage	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.07
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.90
Rate for Payer: Oxford Commercial	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$12.60
Rate for Payer: UnitedHealthcare Community & State	$1.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1.67

SUTURE LEVEL 2

Facility

$63.00

Hospital Charge Code	270334764
Hospital Revenue Code	272
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

SUTURE LEVEL 3

Facility

$92.00

Hospital Charge Code	270334765
Hospital Revenue Code	272
Min. Negotiated Rate	$2.22
Max. Negotiated Rate	$46.00
Rate for Payer: Aetna Commercial	$34.96
Rate for Payer: Aetna Medicare Advantage	$27.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.46
Rate for Payer: Cigna Commercial	$46.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.60
Rate for Payer: Oxford Commercial	$18.40
Rate for Payer: Qualcare PPO/HMO/WC	$13.80
Rate for Payer: UnitedHealthcare Commercial	$18.40
Rate for Payer: UnitedHealthcare Community & State	$2.22
Rate for Payer: Wellpoint Medicaid Managed Care	$2.44

SUTURE LEVEL 3

Facility

$92.00

Hospital Charge Code	270334765
Hospital Revenue Code	272
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.80

SUTURE LEVEL 4

Facility

$88.00

Hospital Charge Code	270334766
Hospital Revenue Code	272
Min. Negotiated Rate	$13.20
Max. Negotiated Rate	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$13.20

SUTURE LEVEL 4

Facility

$88.00

Hospital Charge Code	270334766
Hospital Revenue Code	272
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$44.00
Rate for Payer: Aetna Commercial	$33.44
Rate for Payer: Aetna Medicare Advantage	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.44
Rate for Payer: Cigna Commercial	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.40
Rate for Payer: Oxford Commercial	$17.60
Rate for Payer: Qualcare PPO/HMO/WC	$13.20
Rate for Payer: UnitedHealthcare Commercial	$17.60
Rate for Payer: UnitedHealthcare Community & State	$2.12
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

SUTURE LIGAMENT ANKLE,COLLAT

Facility

$45,892.50

Service Code	HCPCS 27695
Hospital Charge Code	16000213
Hospital Revenue Code	360
Min. Negotiated Rate	$6,883.88
Max. Negotiated Rate	$6,883.88
Rate for Payer: Qualcare PPO/HMO/WC	$6,883.88

SUTURE LIGAMENT ANKLE,COLLAT

Facility

$45,892.50

Service Code	HCPCS 27695
Hospital Charge Code	16000213
Hospital Revenue Code	360
Min. Negotiated Rate	$1,016.00
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,767.75
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,883.88
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$1,106.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,216.15

SUTURE LIGAMENT ANKLE,COLLAT

Facility

$45,892.50

Service Code	HCPCS 27695
Hospital Charge Code	160000218
Hospital Revenue Code	360
Min. Negotiated Rate	$1,016.00
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,767.75
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,883.88
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$1,106.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,216.15

SUTURE LIGAMENT ANKLE,COLLAT

Facility

$45,892.50

Service Code	HCPCS 27695
Hospital Charge Code	160000218
Hospital Revenue Code	360
Min. Negotiated Rate	$6,883.88
Max. Negotiated Rate	$6,883.88
Rate for Payer: Qualcare PPO/HMO/WC	$6,883.88

SUTURE LIN RETRIEVER MD 9893

Facility

$165.95

Hospital Charge Code	270611099
Hospital Revenue Code	272
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$82.97
Rate for Payer: Aetna Commercial	$63.06
Rate for Payer: Aetna Medicare Advantage	$49.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.32
Rate for Payer: Cigna Commercial	$82.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.78
Rate for Payer: Oxford Commercial	$33.19
Rate for Payer: Qualcare PPO/HMO/WC	$24.89
Rate for Payer: UnitedHealthcare Commercial	$33.19
Rate for Payer: UnitedHealthcare Community & State	$4.00
Rate for Payer: Wellpoint Medicaid Managed Care	$4.40

SUTURE LIN RETRIEVER MD 9893

Facility

$165.95

Hospital Charge Code	270611099
Hospital Revenue Code	272
Min. Negotiated Rate	$24.89
Max. Negotiated Rate	$24.89
Rate for Payer: Qualcare PPO/HMO/WC	$24.89

SUTURE MAX BRAID #2

Facility

$164.58

Hospital Charge Code	270656669
Hospital Revenue Code	272
Min. Negotiated Rate	$3.97
Max. Negotiated Rate	$82.29
Rate for Payer: Aetna Commercial	$62.54
Rate for Payer: Aetna Medicare Advantage	$49.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.97
Rate for Payer: Cigna Commercial	$82.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.37
Rate for Payer: Oxford Commercial	$32.92
Rate for Payer: Qualcare PPO/HMO/WC	$24.69
Rate for Payer: UnitedHealthcare Commercial	$32.92
Rate for Payer: UnitedHealthcare Community & State	$3.97
Rate for Payer: Wellpoint Medicaid Managed Care	$4.36

Know your out-of-pocket cost for care.

All Charges