Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE MONOCRYL 5-0 V-10

Facility

$26.18

Hospital Charge Code	270663587
Hospital Revenue Code	272
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$13.09
Rate for Payer: Aetna Commercial	$9.95
Rate for Payer: Aetna Medicare Advantage	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.68
Rate for Payer: Cigna Commercial	$13.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.85
Rate for Payer: Oxford Commercial	$5.24
Rate for Payer: Qualcare PPO/HMO/WC	$3.93
Rate for Payer: UnitedHealthcare Commercial	$5.24
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.69

SUTURE MONOCRYL 6-0 P-3

Facility

$41.66

Hospital Charge Code	270660431
Hospital Revenue Code	272
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$20.83
Rate for Payer: Aetna Commercial	$15.83
Rate for Payer: Aetna Medicare Advantage	$12.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.62
Rate for Payer: Cigna Commercial	$20.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.50
Rate for Payer: Oxford Commercial	$8.33
Rate for Payer: Qualcare PPO/HMO/WC	$6.25
Rate for Payer: UnitedHealthcare Commercial	$8.33
Rate for Payer: UnitedHealthcare Community & State	$1.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1.10

SUTURE MONOCRYL 6-0 P-3

Facility

$41.66

Hospital Charge Code	270660431
Hospital Revenue Code	272
Min. Negotiated Rate	$6.25
Max. Negotiated Rate	$6.25
Rate for Payer: Qualcare PPO/HMO/WC	$6.25

SUTURE MONOCRYL 6-0 PS-6

Facility

$24.98

Hospital Charge Code	270661076
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.49
Rate for Payer: Aetna Commercial	$9.49
Rate for Payer: Aetna Medicare Advantage	$7.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.37
Rate for Payer: Cigna Commercial	$12.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.49
Rate for Payer: Oxford Commercial	$5.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.75
Rate for Payer: UnitedHealthcare Commercial	$5.00
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

SUTURE MONOCRYL 6-0 PS-6

Facility

$24.98

Hospital Charge Code	270661076
Hospital Revenue Code	272
Min. Negotiated Rate	$3.75
Max. Negotiated Rate	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$3.75

SUTURE MONOCRYL CT-1 SIZE 0 X

Facility

$112.65

Hospital Charge Code	270667541
Hospital Revenue Code	272
Min. Negotiated Rate	$16.90
Max. Negotiated Rate	$16.90
Rate for Payer: Qualcare PPO/HMO/WC	$16.90

SUTURE MONOCRYL CT-1 SIZE 0 X

Facility

$112.65

Hospital Charge Code	270667541
Hospital Revenue Code	272
Min. Negotiated Rate	$2.71
Max. Negotiated Rate	$56.33
Rate for Payer: Aetna Commercial	$42.81
Rate for Payer: Aetna Medicare Advantage	$33.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.73
Rate for Payer: Cigna Commercial	$56.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.80
Rate for Payer: Oxford Commercial	$22.53
Rate for Payer: Qualcare PPO/HMO/WC	$16.90
Rate for Payer: UnitedHealthcare Commercial	$22.53
Rate for Payer: UnitedHealthcare Community & State	$2.71
Rate for Payer: Wellpoint Medicaid Managed Care	$2.99

SUTURE MONOCRYL CT-1 SIZE 2-0

Facility

$169.83

Hospital Charge Code	270667542
Hospital Revenue Code	272
Min. Negotiated Rate	$25.47
Max. Negotiated Rate	$25.47
Rate for Payer: Qualcare PPO/HMO/WC	$25.47

SUTURE MONOCRYL CT-1 SIZE 2-0

Facility

$169.83

Hospital Charge Code	270667542
Hospital Revenue Code	272
Min. Negotiated Rate	$4.09
Max. Negotiated Rate	$84.92
Rate for Payer: Aetna Commercial	$64.54
Rate for Payer: Aetna Medicare Advantage	$50.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.31
Rate for Payer: Cigna Commercial	$84.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.95
Rate for Payer: Oxford Commercial	$33.97
Rate for Payer: Qualcare PPO/HMO/WC	$25.47
Rate for Payer: UnitedHealthcare Commercial	$33.97
Rate for Payer: UnitedHealthcare Community & State	$4.09
Rate for Payer: Wellpoint Medicaid Managed Care	$4.50

SUTURE MONOCRYL PLUS 3-0 UR6

Facility

$17.31

Hospital Charge Code	270698084
Hospital Revenue Code	272
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.60

SUTURE MONOCRYL PLUS 3-0 UR6

Facility

$17.31

Hospital Charge Code	270698084
Hospital Revenue Code	272
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$8.65
Rate for Payer: Aetna Commercial	$6.58
Rate for Payer: Aetna Medicare Advantage	$5.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.41
Rate for Payer: Cigna Commercial	$8.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.19
Rate for Payer: Oxford Commercial	$3.46
Rate for Payer: Qualcare PPO/HMO/WC	$2.60
Rate for Payer: UnitedHealthcare Commercial	$3.46
Rate for Payer: UnitedHealthcare Community & State	$0.42
Rate for Payer: Wellpoint Medicaid Managed Care	$0.46

SUTURE MONOCRYL PLUS PS 2 3-0

Facility

$114.73

Hospital Charge Code	270692959
Hospital Revenue Code	272
Min. Negotiated Rate	$2.76
Max. Negotiated Rate	$57.37
Rate for Payer: Aetna Commercial	$43.60
Rate for Payer: Aetna Medicare Advantage	$34.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.26
Rate for Payer: Cigna Commercial	$57.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.42
Rate for Payer: Oxford Commercial	$22.95
Rate for Payer: Qualcare PPO/HMO/WC	$17.21
Rate for Payer: UnitedHealthcare Commercial	$22.95
Rate for Payer: UnitedHealthcare Community & State	$2.76
Rate for Payer: Wellpoint Medicaid Managed Care	$3.04

SUTURE MONOCRYL PLUS PS 2 3-0

Facility

$175.30

Hospital Charge Code	270692958
Hospital Revenue Code	272
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$87.65
Rate for Payer: Aetna Commercial	$66.61
Rate for Payer: Aetna Medicare Advantage	$52.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.70
Rate for Payer: Cigna Commercial	$87.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.59
Rate for Payer: Oxford Commercial	$35.06
Rate for Payer: Qualcare PPO/HMO/WC	$26.30
Rate for Payer: UnitedHealthcare Commercial	$35.06
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$4.65

SUTURE MONOCRYL PLUS PS 2 3-0

Facility

$175.30

Hospital Charge Code	270692958
Hospital Revenue Code	272
Min. Negotiated Rate	$26.30
Max. Negotiated Rate	$26.30
Rate for Payer: Qualcare PPO/HMO/WC	$26.30

SUTURE MONOCRYL PLUS PS 2 3-0

Facility

$114.73

Hospital Charge Code	270692959
Hospital Revenue Code	272
Min. Negotiated Rate	$17.21
Max. Negotiated Rate	$17.21
Rate for Payer: Qualcare PPO/HMO/WC	$17.21

SUTURE MONOCRYL SH SIZE 0 X 27

Facility

$30.95

Hospital Charge Code	270667543
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$15.47
Rate for Payer: Aetna Commercial	$11.76
Rate for Payer: Aetna Medicare Advantage	$9.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.89
Rate for Payer: Cigna Commercial	$15.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.29
Rate for Payer: Oxford Commercial	$6.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.64
Rate for Payer: UnitedHealthcare Commercial	$6.19
Rate for Payer: UnitedHealthcare Community & State	$0.75
Rate for Payer: Wellpoint Medicaid Managed Care	$0.82

SUTURE MONOCRYL SH SIZE 0 X 27

Facility

$30.95

Hospital Charge Code	270667543
Hospital Revenue Code	272
Min. Negotiated Rate	$4.64
Max. Negotiated Rate	$4.64
Rate for Payer: Qualcare PPO/HMO/WC	$4.64

SUTURE MONOCRYL SH SIZE 2-0 X

Facility

$29.60

Hospital Charge Code	270667544
Hospital Revenue Code	272
Min. Negotiated Rate	$4.44
Max. Negotiated Rate	$4.44
Rate for Payer: Qualcare PPO/HMO/WC	$4.44

SUTURE MONOCRYL SH SIZE 2-0 X

Facility

$29.60

Hospital Charge Code	270667544
Hospital Revenue Code	272
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$14.80
Rate for Payer: Aetna Commercial	$11.25
Rate for Payer: Aetna Medicare Advantage	$8.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.55
Rate for Payer: Cigna Commercial	$14.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: Oxford Commercial	$5.92
Rate for Payer: Qualcare PPO/HMO/WC	$4.44
Rate for Payer: UnitedHealthcare Commercial	$5.92
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.78

SUTURE MONODERM 0 14x14CM

Facility

$71.20

Hospital Charge Code	270678169
Hospital Revenue Code	272
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$35.60
Rate for Payer: Aetna Commercial	$27.06
Rate for Payer: Aetna Medicare Advantage	$21.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.16
Rate for Payer: Cigna Commercial	$35.60
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 MONODERM 0 14x14CM

Facility

$71.20

Hospital Charge Code	270678169
Hospital Revenue Code	272
Min. Negotiated Rate	$10.68
Max. Negotiated Rate	$10.68
Rate for Payer: Qualcare PPO/HMO/WC	$10.68

SUTURE MONODERM 0 36CMX36CM

Facility

$113.33

Hospital Charge Code	270668404
Hospital Revenue Code	272
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$56.66
Rate for Payer: Aetna Commercial	$43.07
Rate for Payer: Aetna Medicare Advantage	$34.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.90
Rate for Payer: Cigna Commercial	$56.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.00
Rate for Payer: Oxford Commercial	$22.67
Rate for Payer: Qualcare PPO/HMO/WC	$17.00
Rate for Payer: UnitedHealthcare Commercial	$22.67
Rate for Payer: UnitedHealthcare Community & State	$2.73
Rate for Payer: Wellpoint Medicaid Managed Care	$3.00

SUTURE MONODERM 0 36CMX36CM

Facility

$113.33

Hospital Charge Code	270668404
Hospital Revenue Code	272
Min. Negotiated Rate	$17.00
Max. Negotiated Rate	$17.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.00

SUTURE MONODERM 2-0 14CMX14CM

Facility

$71.20

Hospital Charge Code	270668403
Hospital Revenue Code	272
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$35.60
Rate for Payer: Aetna Commercial	$27.06
Rate for Payer: Aetna Medicare Advantage	$21.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.16
Rate for Payer: Cigna Commercial	$35.60
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 MONODERM 2-0 14CMX14CM

Facility

$71.20

Hospital Charge Code	270668403
Hospital Revenue Code	272
Min. Negotiated Rate	$10.68
Max. Negotiated Rate	$10.68
Rate for Payer: Qualcare PPO/HMO/WC	$10.68

Know your out-of-pocket cost for care.

All Charges