Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE PLAINGUT GS24 2-0

Facility

$19.25

Hospital Charge Code	270604632
Hospital Revenue Code	272
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

SUTURE PLAIN GUT GS-24 2-0 30

Facility

$6.85

Hospital Charge Code	270651125
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.42
Rate for Payer: Aetna Commercial	$2.60
Rate for Payer: Aetna Medicare Advantage	$2.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.75
Rate for Payer: Cigna Commercial	$3.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.06
Rate for Payer: Oxford Commercial	$1.37
Rate for Payer: Qualcare PPO/HMO/WC	$1.03
Rate for Payer: UnitedHealthcare Commercial	$1.37
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE PLAIN GUT GS-24 2-0 30

Facility

$6.85

Hospital Charge Code	270651125
Hospital Revenue Code	272
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$1.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.03

SUTURE PLAIN GUT PS-2 4-1 18

Facility

$92.14

Hospital Charge Code	270651288
Hospital Revenue Code	272
Min. Negotiated Rate	$2.22
Max. Negotiated Rate	$46.07
Rate for Payer: Aetna Commercial	$35.01
Rate for Payer: Aetna Medicare Advantage	$27.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.50
Rate for Payer: Cigna Commercial	$46.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.64
Rate for Payer: Oxford Commercial	$18.43
Rate for Payer: Qualcare PPO/HMO/WC	$13.82
Rate for Payer: UnitedHealthcare Commercial	$18.43
Rate for Payer: UnitedHealthcare Community & State	$2.22
Rate for Payer: Wellpoint Medicaid Managed Care	$2.44

SUTURE PLAIN GUT PS-2 4-1 18

Facility

$92.14

Hospital Charge Code	270651288
Hospital Revenue Code	272
Min. Negotiated Rate	$13.82
Max. Negotiated Rate	$13.82
Rate for Payer: Qualcare PPO/HMO/WC	$13.82

SUTURE PLAIN GUT PS-4 4-0 18

Facility

$30.10

Hospital Charge Code	270661963
Hospital Revenue Code	272
Min. Negotiated Rate	$4.51
Max. Negotiated Rate	$4.51
Rate for Payer: Qualcare PPO/HMO/WC	$4.51

SUTURE PLAIN GUT PS-4 4-0 18

Facility

$30.10

Hospital Charge Code	270661963
Hospital Revenue Code	272
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$15.05
Rate for Payer: Aetna Commercial	$11.44
Rate for Payer: Aetna Medicare Advantage	$9.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.68
Rate for Payer: Cigna Commercial	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.03
Rate for Payer: Oxford Commercial	$6.02
Rate for Payer: Qualcare PPO/HMO/WC	$4.51
Rate for Payer: UnitedHealthcare Commercial	$6.02
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

SUTURE PLAIN GUT SS-145-0 12

Facility

$75.86

Hospital Charge Code	270651145
Hospital Revenue Code	272
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$37.93
Rate for Payer: Aetna Commercial	$28.83
Rate for Payer: Aetna Medicare Advantage	$22.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.34
Rate for Payer: Cigna Commercial	$37.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.76
Rate for Payer: Oxford Commercial	$15.17
Rate for Payer: Qualcare PPO/HMO/WC	$11.38
Rate for Payer: UnitedHealthcare Commercial	$15.17
Rate for Payer: UnitedHealthcare Community & State	$1.83
Rate for Payer: Wellpoint Medicaid Managed Care	$2.01

SUTURE PLAIN GUT SS-145-0 12

Facility

$75.86

Hospital Charge Code	270651145
Hospital Revenue Code	272
Min. Negotiated Rate	$11.38
Max. Negotiated Rate	$11.38
Rate for Payer: Qualcare PPO/HMO/WC	$11.38

SUTURE PLAIN PC-1 6-0

Facility

$30.45

Hospital Charge Code	270604738
Hospital Revenue Code	272
Min. Negotiated Rate	$4.57
Max. Negotiated Rate	$4.57
Rate for Payer: Qualcare PPO/HMO/WC	$4.57

SUTURE PLAIN PC-1 6-0

Facility

$30.45

Hospital Charge Code	270604738
Hospital Revenue Code	272
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$15.22
Rate for Payer: Aetna Commercial	$11.57
Rate for Payer: Aetna Medicare Advantage	$9.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.76
Rate for Payer: Cigna Commercial	$15.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.13
Rate for Payer: Oxford Commercial	$6.09
Rate for Payer: Qualcare PPO/HMO/WC	$4.57
Rate for Payer: UnitedHealthcare Commercial	$6.09
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

SUTURE PLAIN TIE 2-0

Facility

$19.25

Hospital Charge Code	270604629
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.62
Rate for Payer: Aetna Commercial	$7.32
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.91
Rate for Payer: Cigna Commercial	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.78
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.89
Rate for Payer: UnitedHealthcare Commercial	$3.85
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

SUTURE PLAIN TIE 2-0

Facility

$19.25

Hospital Charge Code	270604629
Hospital Revenue Code	272
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

SUTURE PLN GUT 4-0 SC-1 18

Facility

$15.58

Hospital Charge Code	270671381
Hospital Revenue Code	272
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$7.79
Rate for Payer: Aetna Commercial	$5.92
Rate for Payer: Aetna Medicare Advantage	$4.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.97
Rate for Payer: Cigna Commercial	$7.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.67
Rate for Payer: Oxford Commercial	$3.12
Rate for Payer: Qualcare PPO/HMO/WC	$2.34
Rate for Payer: UnitedHealthcare Commercial	$3.12
Rate for Payer: UnitedHealthcare Community & State	$0.38
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

SUTURE PLN GUT 4-0 SC-1 18

Facility

$15.58

Hospital Charge Code	270671381
Hospital Revenue Code	272
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$2.34
Rate for Payer: Qualcare PPO/HMO/WC	$2.34

SUTURE POLYPRO 10-0

Facility

$425.65

Hospital Charge Code	270608747
Hospital Revenue Code	272
Min. Negotiated Rate	$63.85
Max. Negotiated Rate	$63.85
Rate for Payer: Qualcare PPO/HMO/WC	$63.85

SUTURE POLYPRO 10-0

Facility

$425.65

Hospital Charge Code	270608747
Hospital Revenue Code	272
Min. Negotiated Rate	$10.26
Max. Negotiated Rate	$212.82
Rate for Payer: Aetna Commercial	$161.75
Rate for Payer: Aetna Medicare Advantage	$127.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.54
Rate for Payer: Cigna Commercial	$212.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.69
Rate for Payer: Oxford Commercial	$85.13
Rate for Payer: Qualcare PPO/HMO/WC	$63.85
Rate for Payer: UnitedHealthcare Commercial	$85.13
Rate for Payer: UnitedHealthcare Community & State	$10.26
Rate for Payer: Wellpoint Medicaid Managed Care	$11.28

SUTURE POLYSORB 0 12x18 U/D

Facility

$26.93

Hospital Charge Code	270654266
Hospital Revenue Code	272
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$4.04
Rate for Payer: Qualcare PPO/HMO/WC	$4.04

SUTURE POLYSORB 0 12x18 U/D

Facility

$26.93

Hospital Charge Code	270654266
Hospital Revenue Code	272
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$13.46
Rate for Payer: Aetna Commercial	$10.23
Rate for Payer: Aetna Medicare Advantage	$8.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.87
Rate for Payer: Cigna Commercial	$13.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.08
Rate for Payer: Oxford Commercial	$5.39
Rate for Payer: Qualcare PPO/HMO/WC	$4.04
Rate for Payer: UnitedHealthcare Commercial	$5.39
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

SUTURE POLYSORB 0 18 VIOLET

Facility

$12.65

Hospital Charge Code	270665290
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$6.33
Rate for Payer: Aetna Commercial	$4.81
Rate for Payer: Aetna Medicare Advantage	$3.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.23
Rate for Payer: Cigna Commercial	$6.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.79
Rate for Payer: Oxford Commercial	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$1.90
Rate for Payer: UnitedHealthcare Commercial	$2.53
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

SUTURE POLYSORB 0 18 VIOLET

Facility

$12.65

Hospital Charge Code	270665290
Hospital Revenue Code	272
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$1.90
Rate for Payer: Qualcare PPO/HMO/WC	$1.90

SUTURE POLYSORB 0 30 CT2

Facility

$6.48

Hospital Charge Code	270604538
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.97

SUTURE POLYSORB 0 30 CT2

Facility

$6.48

Hospital Charge Code	270604538
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.24
Rate for Payer: Aetna Commercial	$2.46
Rate for Payer: Aetna Medicare Advantage	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.65
Rate for Payer: Cigna Commercial	$3.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.94
Rate for Payer: Oxford Commercial	$1.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.97
Rate for Payer: UnitedHealthcare Commercial	$1.30
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

SUTURE POLYSORB 0 30IN CT1

Facility

$6.27

Hospital Charge Code	270604537
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$3.13
Rate for Payer: Aetna Commercial	$2.38
Rate for Payer: Aetna Medicare Advantage	$1.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.60
Rate for Payer: Cigna Commercial	$3.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.88
Rate for Payer: Oxford Commercial	$1.25
Rate for Payer: Qualcare PPO/HMO/WC	$0.94
Rate for Payer: UnitedHealthcare Commercial	$1.25
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

SUTURE POLYSORB 0 30IN CT1

Facility

$6.27

Hospital Charge Code	270604537
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$0.94
Rate for Payer: Qualcare PPO/HMO/WC	$0.94

Know your out-of-pocket cost for care.

All Charges