Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE PDS II 0 CT-1

Facility

$20.26

Hospital Charge Code	270604719
Hospital Revenue Code	272
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$3.04
Rate for Payer: Qualcare PPO/HMO/WC	$3.04

SUTURE PDS II 0 CT-2

Facility

$12.60

Hospital Charge Code	270671535
Hospital Revenue Code	272
Min. Negotiated Rate	$1.89
Max. Negotiated Rate	$1.89
Rate for Payer: Qualcare PPO/HMO/WC	$1.89

SUTURE PDS II 0 CT-2

Facility

$12.60

Hospital Charge Code	270671535
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$6.30
Rate for Payer: Aetna Commercial	$4.79
Rate for Payer: Aetna Medicare Advantage	$3.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.21
Rate for Payer: Cigna Commercial	$6.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.78
Rate for Payer: Oxford Commercial	$2.52
Rate for Payer: Qualcare PPO/HMO/WC	$1.89
Rate for Payer: UnitedHealthcare Commercial	$2.52
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

SUTURE PDS II 0 CTX VIL MONO

Facility

$27.12

Hospital Charge Code	270671539
Hospital Revenue Code	272
Min. Negotiated Rate	$4.07
Max. Negotiated Rate	$4.07
Rate for Payer: Qualcare PPO/HMO/WC	$4.07

SUTURE PDS II 0 CTX VIL MONO

Facility

$27.12

Hospital Charge Code	270671539
Hospital Revenue Code	272
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$13.56
Rate for Payer: Aetna Commercial	$10.31
Rate for Payer: Aetna Medicare Advantage	$8.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.92
Rate for Payer: Cigna Commercial	$13.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.14
Rate for Payer: Oxford Commercial	$5.42
Rate for Payer: Qualcare PPO/HMO/WC	$4.07
Rate for Payer: UnitedHealthcare Commercial	$5.42
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.72

SUTURE PDS II 1-0 CT-1

Facility

$13.80

Hospital Charge Code	270677715
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.90
Rate for Payer: Aetna Commercial	$5.24
Rate for Payer: Aetna Medicare Advantage	$4.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.52
Rate for Payer: Cigna Commercial	$6.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.14
Rate for Payer: Oxford Commercial	$2.76
Rate for Payer: Qualcare PPO/HMO/WC	$2.07
Rate for Payer: UnitedHealthcare Commercial	$2.76
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

SUTURE PDS II 1-0 CT-1

Facility

$13.80

Hospital Charge Code	270677715
Hospital Revenue Code	272
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$2.07
Rate for Payer: Qualcare PPO/HMO/WC	$2.07

SUTURE PDS II 1 CTX

Facility

$13.90

Hospital Charge Code	270611611
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.95
Rate for Payer: Aetna Commercial	$5.28
Rate for Payer: Aetna Medicare Advantage	$4.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.54
Rate for Payer: Cigna Commercial	$6.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.17
Rate for Payer: Oxford Commercial	$2.78
Rate for Payer: Qualcare PPO/HMO/WC	$2.08
Rate for Payer: UnitedHealthcare Commercial	$2.78
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

SUTURE PDS II 1 CTX

Facility

$13.90

Hospital Charge Code	270611611
Hospital Revenue Code	272
Min. Negotiated Rate	$2.08
Max. Negotiated Rate	$2.08
Rate for Payer: Qualcare PPO/HMO/WC	$2.08

SUTURE PDS II 1 TP-1

Facility

$45.67

Hospital Charge Code	270621617
Hospital Revenue Code	272
Min. Negotiated Rate	$6.85
Max. Negotiated Rate	$6.85
Rate for Payer: Qualcare PPO/HMO/WC	$6.85

SUTURE PDS II 1 TP-1

Facility

$45.67

Hospital Charge Code	270621617
Hospital Revenue Code	272
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$22.84
Rate for Payer: Aetna Commercial	$17.35
Rate for Payer: Aetna Medicare Advantage	$13.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.65
Rate for Payer: Cigna Commercial	$22.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.70
Rate for Payer: Oxford Commercial	$9.13
Rate for Payer: Qualcare PPO/HMO/WC	$6.85
Rate for Payer: UnitedHealthcare Commercial	$9.13
Rate for Payer: UnitedHealthcare Community & State	$1.10
Rate for Payer: Wellpoint Medicaid Managed Care	$1.21

SUTURE PDS II 1 TP-1

Facility

$23.37

Hospital Charge Code	270608379
Hospital Revenue Code	272
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$11.69
Rate for Payer: Aetna Commercial	$8.88
Rate for Payer: Aetna Medicare Advantage	$7.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.96
Rate for Payer: Cigna Commercial	$11.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.01
Rate for Payer: Oxford Commercial	$4.67
Rate for Payer: Qualcare PPO/HMO/WC	$3.51
Rate for Payer: UnitedHealthcare Commercial	$4.67
Rate for Payer: UnitedHealthcare Community & State	$0.56
Rate for Payer: Wellpoint Medicaid Managed Care	$0.62

SUTURE PDS II 1 TP-1

Facility

$23.37

Hospital Charge Code	270608379
Hospital Revenue Code	272
Min. Negotiated Rate	$3.51
Max. Negotiated Rate	$3.51
Rate for Payer: Qualcare PPO/HMO/WC	$3.51

SUTURE PDS II 2-0 CT-2

Facility

$12.99

Hospital Charge Code	270604720
Hospital Revenue Code	272
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

SUTURE PDS II 2-0 CT-2

Facility

$12.99

Hospital Charge Code	270604720
Hospital Revenue Code	272
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

SUTURE PDS II 2-0 SH

Facility

$91.63

Hospital Charge Code	270671538
Hospital Revenue Code	272
Min. Negotiated Rate	$13.74
Max. Negotiated Rate	$13.74
Rate for Payer: Qualcare PPO/HMO/WC	$13.74

SUTURE PDS II 2-0 SH

Facility

$12.20

Hospital Charge Code	270671534
Hospital Revenue Code	272
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.10
Rate for Payer: Aetna Commercial	$4.64
Rate for Payer: Aetna Medicare Advantage	$3.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.11
Rate for Payer: Cigna Commercial	$6.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.66
Rate for Payer: Oxford Commercial	$2.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.83
Rate for Payer: UnitedHealthcare Commercial	$2.44
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

SUTURE PDS II 2-0 SH

Facility

$12.20

Hospital Charge Code	270671534
Hospital Revenue Code	272
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$1.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.83

SUTURE PDS II 2-0 SH

Facility

$91.63

Hospital Charge Code	270671538
Hospital Revenue Code	272
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$45.81
Rate for Payer: Aetna Commercial	$34.82
Rate for Payer: Aetna Medicare Advantage	$27.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.37
Rate for Payer: Cigna Commercial	$45.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.49
Rate for Payer: Oxford Commercial	$18.33
Rate for Payer: Qualcare PPO/HMO/WC	$13.74
Rate for Payer: UnitedHealthcare Commercial	$18.33
Rate for Payer: UnitedHealthcare Community & State	$2.21
Rate for Payer: Wellpoint Medicaid Managed Care	$2.43

SUTURE PDS II 3-0 SH

Facility

$12.25

Hospital Charge Code	270677550
Hospital Revenue Code	272
Min. Negotiated Rate	$1.84
Max. Negotiated Rate	$1.84
Rate for Payer: Qualcare PPO/HMO/WC	$1.84

SUTURE PDS II 3-0 SH

Facility

$12.25

Hospital Charge Code	270677550
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$6.12
Rate for Payer: Aetna Commercial	$4.66
Rate for Payer: Aetna Medicare Advantage	$3.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.12
Rate for Payer: Cigna Commercial	$6.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.67
Rate for Payer: Oxford Commercial	$2.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.84
Rate for Payer: UnitedHealthcare Commercial	$2.45
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

SUTURE PDS II 3-0 SH 27 NEEDLE

Facility

$23.72

Hospital Charge Code	270639272
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.86
Rate for Payer: Aetna Commercial	$9.01
Rate for Payer: Aetna Medicare Advantage	$7.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.05
Rate for Payer: Cigna Commercial	$11.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.12
Rate for Payer: Oxford Commercial	$4.74
Rate for Payer: Qualcare PPO/HMO/WC	$3.56
Rate for Payer: UnitedHealthcare Commercial	$4.74
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.63

SUTURE PDS II 3-0 SH 27 NEEDLE

Facility

$23.72

Hospital Charge Code	270639272
Hospital Revenue Code	272
Min. Negotiated Rate	$3.56
Max. Negotiated Rate	$3.56
Rate for Payer: Qualcare PPO/HMO/WC	$3.56

SUTURE PDS II 4-0 PS-2

Facility

$23.70

Hospital Charge Code	270677556
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.85
Rate for Payer: Aetna Commercial	$9.01
Rate for Payer: Aetna Medicare Advantage	$7.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.04
Rate for Payer: Cigna Commercial	$11.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.11
Rate for Payer: Oxford Commercial	$4.74
Rate for Payer: Qualcare PPO/HMO/WC	$3.56
Rate for Payer: UnitedHealthcare Commercial	$4.74
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.63

SUTURE PDS II 4-0 PS-2

Facility

$23.70

Hospital Charge Code	270677556
Hospital Revenue Code	272
Min. Negotiated Rate	$3.56
Max. Negotiated Rate	$3.56
Rate for Payer: Qualcare PPO/HMO/WC	$3.56

Know your out-of-pocket cost for care.

All Charges