Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE PALIN GUT GS-21 3-0 30

Facility

$6.73

Hospital Charge Code	270651124
Hospital Revenue Code	272
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$1.01
Rate for Payer: Qualcare PPO/HMO/WC	$1.01

SUTURE PALIN GUT GS-21 3-0 30

Facility

$6.73

Hospital Charge Code	270651124
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.37
Rate for Payer: Aetna Commercial	$2.56
Rate for Payer: Aetna Medicare Advantage	$2.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.72
Rate for Payer: Cigna Commercial	$3.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.02
Rate for Payer: Oxford Commercial	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.01
Rate for Payer: UnitedHealthcare Commercial	$1.35
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTUREPASSERFIRSTPASSMINIRT

Facility

$2,475.00

Hospital Charge Code	270686254
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

SUTUREPASSERFIRSTPASSMINIRT

Facility

$2,475.00

Hospital Charge Code	270686254
Hospital Revenue Code	272
Min. Negotiated Rate	$59.65
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$742.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$59.65
Rate for Payer: Wellpoint Medicaid Managed Care	$65.59

SUTURE PASSER HIP SWITSTITCH

Facility

$1,200.00

Hospital Charge Code	270687986
Hospital Revenue Code	272
Min. Negotiated Rate	$28.92
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$456.00
Rate for Payer: Aetna Medicare Advantage	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.00
Rate for Payer: Cigna Commercial	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$360.00
Rate for Payer: Oxford Commercial	$240.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.00
Rate for Payer: UnitedHealthcare Commercial	$240.00
Rate for Payer: UnitedHealthcare Community & State	$28.92
Rate for Payer: Wellpoint Medicaid Managed Care	$31.80

SUTURE PASSER HIP SWITSTITCH

Facility

$1,200.00

Hospital Charge Code	270687986
Hospital Revenue Code	272
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.00

SUTURE PASSING WIRE

Facility

$225.00

Hospital Charge Code	270335618
Hospital Revenue Code	272
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$112.50
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.50
Rate for Payer: Oxford Commercial	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$45.00
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

SUTURE PASSING WIRE

Facility

$540.00

Hospital Charge Code	270667981
Hospital Revenue Code	272
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$81.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.00

SUTURE PASSING WIRE

Facility

$540.00

Hospital Charge Code	270667981
Hospital Revenue Code	272
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$270.00
Rate for Payer: Aetna Commercial	$205.20
Rate for Payer: Aetna Medicare Advantage	$162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$137.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$137.70
Rate for Payer: Cigna Commercial	$270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.00
Rate for Payer: Oxford Commercial	$108.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.00
Rate for Payer: UnitedHealthcare Commercial	$108.00
Rate for Payer: UnitedHealthcare Community & State	$13.01
Rate for Payer: Wellpoint Medicaid Managed Care	$14.31

SUTURE PASSING WIRE

Facility

$225.00

Hospital Charge Code	270335618
Hospital Revenue Code	272
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

SUTURE PDO 30CM VIOLET 1/2 C

Facility

$59.06

Hospital Charge Code	270686782
Hospital Revenue Code	272
Min. Negotiated Rate	$8.86
Max. Negotiated Rate	$8.86
Rate for Payer: Qualcare PPO/HMO/WC	$8.86

SUTURE PDO 30CM VIOLET 1/2 C

Facility

$59.06

Hospital Charge Code	270686782
Hospital Revenue Code	272
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$29.53
Rate for Payer: Aetna Commercial	$22.44
Rate for Payer: Aetna Medicare Advantage	$17.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.06
Rate for Payer: Cigna Commercial	$29.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.72
Rate for Payer: Oxford Commercial	$11.81
Rate for Payer: Qualcare PPO/HMO/WC	$8.86
Rate for Payer: UnitedHealthcare Commercial	$11.81
Rate for Payer: UnitedHealthcare Community & State	$1.42
Rate for Payer: Wellpoint Medicaid Managed Care	$1.57

SUTURE PDO SZ0 36MM 1/2 CIRCLE

Facility

$103.44

Hospital Charge Code	270675899
Hospital Revenue Code	272
Min. Negotiated Rate	$15.52
Max. Negotiated Rate	$15.52
Rate for Payer: Qualcare PPO/HMO/WC	$15.52

SUTURE PDO SZ0 36MM 1/2 CIRCLE

Facility

$103.44

Hospital Charge Code	270675899
Hospital Revenue Code	272
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$51.72
Rate for Payer: Aetna Commercial	$39.31
Rate for Payer: Aetna Medicare Advantage	$31.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.38
Rate for Payer: Cigna Commercial	$51.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.03
Rate for Payer: Oxford Commercial	$20.69
Rate for Payer: Qualcare PPO/HMO/WC	$15.52
Rate for Payer: UnitedHealthcare Commercial	$20.69
Rate for Payer: UnitedHealthcare Community & State	$2.49
Rate for Payer: Wellpoint Medicaid Managed Care	$2.74

SUTURE PDS 2-0 CT1 27 IN

Facility

$12.02

Hospital Charge Code	270681804
Hospital Revenue Code	272
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.01
Rate for Payer: Aetna Commercial	$4.57
Rate for Payer: Aetna Medicare Advantage	$3.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.07
Rate for Payer: Cigna Commercial	$6.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.61
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

SUTURE PDS 2-0 CT1 27 IN

Facility

$12.02

Hospital Charge Code	270681804
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

SUTURE PDS 5-0 RB1 DOUBLE ARM

Facility

$49.70

Hospital Charge Code	270685432
Hospital Revenue Code	272
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$24.85
Rate for Payer: Aetna Commercial	$18.89
Rate for Payer: Aetna Medicare Advantage	$14.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.67
Rate for Payer: Cigna Commercial	$24.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.91
Rate for Payer: Oxford Commercial	$9.94
Rate for Payer: Qualcare PPO/HMO/WC	$7.46
Rate for Payer: UnitedHealthcare Commercial	$9.94
Rate for Payer: UnitedHealthcare Community & State	$1.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

SUTURE PDS 5-0 RB1 DOUBLE ARM

Facility

$49.70

Hospital Charge Code	270685432
Hospital Revenue Code	272
Min. Negotiated Rate	$7.46
Max. Negotiated Rate	$7.46
Rate for Payer: Qualcare PPO/HMO/WC	$7.46

SUTURE PDS CT 0

Facility

$12.73

Hospital Charge Code	270600574
Hospital Revenue Code	272
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$1.91
Rate for Payer: Qualcare PPO/HMO/WC	$1.91

SUTURE PDS CT 0

Facility

$12.73

Hospital Charge Code	270600574
Hospital Revenue Code	272
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.37
Rate for Payer: Aetna Commercial	$4.84
Rate for Payer: Aetna Medicare Advantage	$3.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.25
Rate for Payer: Cigna Commercial	$6.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.82
Rate for Payer: Oxford Commercial	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$1.91
Rate for Payer: UnitedHealthcare Commercial	$2.55
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

SUTURE PDS II 0 CP-1

Facility

$12.75

Hospital Charge Code	270673259
Hospital Revenue Code	272
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.38
Rate for Payer: Aetna Commercial	$4.84
Rate for Payer: Aetna Medicare Advantage	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.25
Rate for Payer: Cigna Commercial	$6.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.83
Rate for Payer: Oxford Commercial	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$1.91
Rate for Payer: UnitedHealthcare Commercial	$2.55
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

SUTURE PDS II 0 CP-1

Facility

$12.75

Hospital Charge Code	270673259
Hospital Revenue Code	272
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$1.91
Rate for Payer: Qualcare PPO/HMO/WC	$1.91

SUTURE PDS II 0 CT-1

Facility

$12.06

Hospital Charge Code	270671536
Hospital Revenue Code	272
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$1.81
Rate for Payer: Qualcare PPO/HMO/WC	$1.81

SUTURE PDS II 0 CT-1

Facility

$12.06

Hospital Charge Code	270671536
Hospital Revenue Code	272
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.03
Rate for Payer: Aetna Commercial	$4.58
Rate for Payer: Aetna Medicare Advantage	$3.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.08
Rate for Payer: Cigna Commercial	$6.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.62
Rate for Payer: Oxford Commercial	$2.41
Rate for Payer: Qualcare PPO/HMO/WC	$1.81
Rate for Payer: UnitedHealthcare Commercial	$2.41
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

SUTURE PDS II 0 CT-1

Facility

$20.26

Hospital Charge Code	270604719
Hospital Revenue Code	272
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$10.13
Rate for Payer: Aetna Commercial	$7.70
Rate for Payer: Aetna Medicare Advantage	$6.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.17
Rate for Payer: Cigna Commercial	$10.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.08
Rate for Payer: Oxford Commercial	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$3.04
Rate for Payer: UnitedHealthcare Commercial	$4.05
Rate for Payer: UnitedHealthcare Community & State	$0.49
Rate for Payer: Wellpoint Medicaid Managed Care	$0.54

Know your out-of-pocket cost for care.

All Charges