Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE PDS II 4-0 RB-1

Facility

$12.14

Hospital Charge Code	270671533
Hospital Revenue Code	272
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.07
Rate for Payer: Aetna Commercial	$4.61
Rate for Payer: Aetna Medicare Advantage	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.10
Rate for Payer: Cigna Commercial	$6.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$2.43
Rate for Payer: Qualcare PPO/HMO/WC	$1.82
Rate for Payer: UnitedHealthcare Commercial	$2.43
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

SUTURE PDS II 4-0 RB-1

Facility

$12.14

Hospital Charge Code	270671533
Hospital Revenue Code	272
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$1.82
Rate for Payer: Qualcare PPO/HMO/WC	$1.82

SUTURE PDS II 5-0 RB-1

Facility

$20.46

Hospital Charge Code	270671532
Hospital Revenue Code	272
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$10.23
Rate for Payer: Aetna Commercial	$7.77
Rate for Payer: Aetna Medicare Advantage	$6.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.22
Rate for Payer: Cigna Commercial	$10.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.14
Rate for Payer: Oxford Commercial	$4.09
Rate for Payer: Qualcare PPO/HMO/WC	$3.07
Rate for Payer: UnitedHealthcare Commercial	$4.09
Rate for Payer: UnitedHealthcare Community & State	$0.49
Rate for Payer: Wellpoint Medicaid Managed Care	$0.54

SUTURE PDS II 5-0 RB-1

Facility

$20.46

Hospital Charge Code	270671532
Hospital Revenue Code	272
Min. Negotiated Rate	$3.07
Max. Negotiated Rate	$3.07
Rate for Payer: Qualcare PPO/HMO/WC	$3.07

SUTURE PDS II 6-0 TF

Facility

$15.49

Hospital Charge Code	270671537
Hospital Revenue Code	272
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$2.32
Rate for Payer: Qualcare PPO/HMO/WC	$2.32

SUTURE PDS II 6-0 TF

Facility

$15.49

Hospital Charge Code	270671537
Hospital Revenue Code	272
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$7.75
Rate for Payer: Aetna Commercial	$5.89
Rate for Payer: Aetna Medicare Advantage	$4.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.95
Rate for Payer: Cigna Commercial	$7.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.65
Rate for Payer: Oxford Commercial	$3.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.32
Rate for Payer: UnitedHealthcare Commercial	$3.10
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

SUTURE PDS II 7-0 BV-1

Facility

$74.19

Hospital Charge Code	270671531
Hospital Revenue Code	272
Min. Negotiated Rate	$1.79
Max. Negotiated Rate	$37.09
Rate for Payer: Aetna Commercial	$28.19
Rate for Payer: Aetna Medicare Advantage	$22.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.92
Rate for Payer: Cigna Commercial	$37.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.26
Rate for Payer: Oxford Commercial	$14.84
Rate for Payer: Qualcare PPO/HMO/WC	$11.13
Rate for Payer: UnitedHealthcare Commercial	$14.84
Rate for Payer: UnitedHealthcare Community & State	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.97

SUTURE PDS II 7-0 BV-1

Facility

$74.19

Hospital Charge Code	270671531
Hospital Revenue Code	272
Min. Negotiated Rate	$11.13
Max. Negotiated Rate	$11.13
Rate for Payer: Qualcare PPO/HMO/WC	$11.13

SUTURE PDS PLUS 1 CTX

Facility

$14.73

Hospital Charge Code	270672369
Hospital Revenue Code	272
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$2.21
Rate for Payer: Qualcare PPO/HMO/WC	$2.21

SUTURE PDS PLUS 1 CTX

Facility

$14.73

Hospital Charge Code	270672369
Hospital Revenue Code	272
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$7.37
Rate for Payer: Aetna Commercial	$5.60
Rate for Payer: Aetna Medicare Advantage	$4.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.76
Rate for Payer: Cigna Commercial	$7.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.42
Rate for Payer: Oxford Commercial	$2.95
Rate for Payer: Qualcare PPO/HMO/WC	$2.21
Rate for Payer: UnitedHealthcare Commercial	$2.95
Rate for Payer: UnitedHealthcare Community & State	$0.35
Rate for Payer: Wellpoint Medicaid Managed Care	$0.39

SUTURE PDS PLUS 2-0 CT-2

Facility

$14.03

Hospital Charge Code	270683593
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$7.01
Rate for Payer: Aetna Commercial	$5.33
Rate for Payer: Aetna Medicare Advantage	$4.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.58
Rate for Payer: Cigna Commercial	$7.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.21
Rate for Payer: Oxford Commercial	$2.81
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$2.81
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

SUTURE PDS PLUS 2-0 CT-2

Facility

$14.03

Hospital Charge Code	270683593
Hospital Revenue Code	272
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

SUTURE PDS PLUS 3/0 27 IN SH

Facility

$13.48

Hospital Charge Code	270683604
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$6.74
Rate for Payer: Aetna Commercial	$5.12
Rate for Payer: Aetna Medicare Advantage	$4.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.44
Rate for Payer: Cigna Commercial	$6.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.04
Rate for Payer: Oxford Commercial	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.02
Rate for Payer: UnitedHealthcare Commercial	$2.70
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

SUTURE PDS PLUS 3/0 27 IN SH

Facility

$13.48

Hospital Charge Code	270683604
Hospital Revenue Code	272
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$2.02
Rate for Payer: Qualcare PPO/HMO/WC	$2.02

SUTURE PDS PLUS 6-0 RB-2

Facility

$33.89

Hospital Charge Code	270672372
Hospital Revenue Code	272
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$16.95
Rate for Payer: Aetna Commercial	$12.88
Rate for Payer: Aetna Medicare Advantage	$10.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.64
Rate for Payer: Cigna Commercial	$16.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.17
Rate for Payer: Oxford Commercial	$6.78
Rate for Payer: Qualcare PPO/HMO/WC	$5.08
Rate for Payer: UnitedHealthcare Commercial	$6.78
Rate for Payer: UnitedHealthcare Community & State	$0.82
Rate for Payer: Wellpoint Medicaid Managed Care	$0.90

SUTURE PDS PLUS 6-0 RB-2

Facility

$33.89

Hospital Charge Code	270672372
Hospital Revenue Code	272
Min. Negotiated Rate	$5.08
Max. Negotiated Rate	$5.08
Rate for Payer: Qualcare PPO/HMO/WC	$5.08

SUTURE PDS PLUS CT-1

Facility

$13.03

Hospital Charge Code	270663649
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 PLUS CT-1

Facility

$13.03

Hospital Charge Code	270663649
Hospital Revenue Code	272
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.51
Rate for Payer: Aetna Commercial	$4.95
Rate for Payer: Aetna Medicare Advantage	$3.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.32
Rate for Payer: Cigna Commercial	$6.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.91
Rate for Payer: Oxford Commercial	$2.61
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.61
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.35

SUTURE PDS PLUS CTX 0

Facility

$21.68

Hospital Charge Code	270663650
Hospital Revenue Code	272
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$3.25
Rate for Payer: Qualcare PPO/HMO/WC	$3.25

SUTURE PDS PLUS CTX 0

Facility

$21.68

Hospital Charge Code	270663650
Hospital Revenue Code	272
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$10.84
Rate for Payer: Aetna Commercial	$8.24
Rate for Payer: Aetna Medicare Advantage	$6.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.53
Rate for Payer: Cigna Commercial	$10.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.50
Rate for Payer: Oxford Commercial	$4.34
Rate for Payer: Qualcare PPO/HMO/WC	$3.25
Rate for Payer: UnitedHealthcare Commercial	$4.34
Rate for Payer: UnitedHealthcare Community & State	$0.52
Rate for Payer: Wellpoint Medicaid Managed Care	$0.57

SUTURE PDS PLUS XLH 96 IN

Facility

$29.02

Hospital Charge Code	270692378
Hospital Revenue Code	272
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$14.51
Rate for Payer: Aetna Commercial	$11.03
Rate for Payer: Aetna Medicare Advantage	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.40
Rate for Payer: Cigna Commercial	$14.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.71
Rate for Payer: Oxford Commercial	$5.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.35
Rate for Payer: UnitedHealthcare Commercial	$5.80
Rate for Payer: UnitedHealthcare Community & State	$0.70
Rate for Payer: Wellpoint Medicaid Managed Care	$0.77

SUTURE PDS PLUS XLH 96 IN

Facility

$29.02

Hospital Charge Code	270692378
Hospital Revenue Code	272
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$4.35
Rate for Payer: Qualcare PPO/HMO/WC	$4.35

SUTURE PDS SFX UNI 6IN S/A

Facility

$185.85

Hospital Charge Code	270697557
Hospital Revenue Code	272
Min. Negotiated Rate	$4.48
Max. Negotiated Rate	$92.92
Rate for Payer: Aetna Commercial	$70.62
Rate for Payer: Aetna Medicare Advantage	$55.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.39
Rate for Payer: Cigna Commercial	$92.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.76
Rate for Payer: Oxford Commercial	$37.17
Rate for Payer: Qualcare PPO/HMO/WC	$27.88
Rate for Payer: UnitedHealthcare Commercial	$37.17
Rate for Payer: UnitedHealthcare Community & State	$4.48
Rate for Payer: Wellpoint Medicaid Managed Care	$4.93

SUTURE PDS SFX UNI 6IN S/A

Facility

$185.85

Hospital Charge Code	270697557
Hospital Revenue Code	272
Min. Negotiated Rate	$27.88
Max. Negotiated Rate	$27.88
Rate for Payer: Qualcare PPO/HMO/WC	$27.88

SUTURE PDS STRATAFIX 0 30 CT-2

Facility

$124.15

Hospital Charge Code	270681813
Hospital Revenue Code	272
Min. Negotiated Rate	$18.62
Max. Negotiated Rate	$18.62
Rate for Payer: Qualcare PPO/HMO/WC	$18.62

Know your out-of-pocket cost for care.

All Charges