Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB 0 30 VIOLET

Facility

$8.62

Hospital Charge Code	270604536
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.31
Rate for Payer: Aetna Commercial	$3.28
Rate for Payer: Aetna Medicare Advantage	$2.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.20
Rate for Payer: Cigna Commercial	$4.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.59
Rate for Payer: Oxford Commercial	$1.72
Rate for Payer: Qualcare PPO/HMO/WC	$1.29
Rate for Payer: UnitedHealthcare Commercial	$1.72
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

SUTURE POLYSORB 0 30 VIOLET

Facility

$8.62

Hospital Charge Code	270604536
Hospital Revenue Code	272
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$1.29

SUTURE POLYSORB 0 30 VIOLET

Facility

$7.60

Hospital Charge Code	270651238
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.80
Rate for Payer: Aetna Commercial	$2.89
Rate for Payer: Aetna Medicare Advantage	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.94
Rate for Payer: Cigna Commercial	$3.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.28
Rate for Payer: Oxford Commercial	$1.52
Rate for Payer: Qualcare PPO/HMO/WC	$1.14
Rate for Payer: UnitedHealthcare Commercial	$1.52
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

SUTURE POLYSORB 0 30 VIOLET

Facility

$7.60

Hospital Charge Code	270651238
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$1.14
Rate for Payer: Qualcare PPO/HMO/WC	$1.14

SUTURE POLYSORB 0 30 VIOLET

Facility

$7.96

Hospital Charge Code	270604542
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.98
Rate for Payer: Aetna Commercial	$3.02
Rate for Payer: Aetna Medicare Advantage	$2.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.03
Rate for Payer: Cigna Commercial	$3.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.39
Rate for Payer: Oxford Commercial	$1.59
Rate for Payer: Qualcare PPO/HMO/WC	$1.19
Rate for Payer: UnitedHealthcare Commercial	$1.59
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SUTURE POLYSORB 0 30 VIOLET

Facility

$7.96

Hospital Charge Code	270604542
Hospital Revenue Code	272
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.19

SUTURE POLYSORB 0 30 VIOLET

Facility

$7.25

Hospital Charge Code	270656167
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.75
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.17
Rate for Payer: Oxford Commercial	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$1.45
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE POLYSORB 0 30 VIOLET

Facility

$7.25

Hospital Charge Code	270656167
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

SUTURE POLYSORB 0 36 U/D CT1

Facility

$7.34

Hospital Charge Code	270600564
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.67
Rate for Payer: Aetna Commercial	$2.79
Rate for Payer: Aetna Medicare Advantage	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.87
Rate for Payer: Cigna Commercial	$3.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.20
Rate for Payer: Oxford Commercial	$1.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.10
Rate for Payer: UnitedHealthcare Commercial	$1.47
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE POLYSORB 0 36 U/D CT1

Facility

$7.34

Hospital Charge Code	270600564
Hospital Revenue Code	272
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$1.10
Rate for Payer: Qualcare PPO/HMO/WC	$1.10

SUTURE POLYSORB 0 36U/D GS24

Facility

$6.83

Hospital Charge Code	270651133
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.42
Rate for Payer: Aetna Commercial	$2.60
Rate for Payer: Aetna Medicare Advantage	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.74
Rate for Payer: Cigna Commercial	$3.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.05
Rate for Payer: Oxford Commercial	$1.37
Rate for Payer: Qualcare PPO/HMO/WC	$1.02
Rate for Payer: UnitedHealthcare Commercial	$1.37
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE POLYSORB 0 36U/D GS24

Facility

$6.83

Hospital Charge Code	270651133
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.02

SUTURE POLYSORB 0 36 VIO GS24

Facility

$6.78

Hospital Charge Code	270656125
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.39
Rate for Payer: Aetna Commercial	$2.58
Rate for Payer: Aetna Medicare Advantage	$2.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.73
Rate for Payer: Cigna Commercial	$3.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.03
Rate for Payer: Oxford Commercial	$1.36
Rate for Payer: Qualcare PPO/HMO/WC	$1.02
Rate for Payer: UnitedHealthcare Commercial	$1.36
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE POLYSORB 0 36 VIO GS24

Facility

$6.78

Hospital Charge Code	270656125
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.02

SUTURE POLYSORB 0 36 VIOLET

Facility

$8.11

Hospital Charge Code	270604716
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$4.05
Rate for Payer: Aetna Commercial	$3.08
Rate for Payer: Aetna Medicare Advantage	$2.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.07
Rate for Payer: Cigna Commercial	$4.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.43
Rate for Payer: Oxford Commercial	$1.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.22
Rate for Payer: UnitedHealthcare Commercial	$1.62
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SUTURE POLYSORB 0 36 VIOLET

Facility

$8.11

Hospital Charge Code	270604716
Hospital Revenue Code	272
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$1.22
Rate for Payer: Qualcare PPO/HMO/WC	$1.22

SUTURE POLYSORB 0 3x27 VIOLET

Facility

$7.24

Hospital Charge Code	270604525
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.75
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.17
Rate for Payer: Oxford Commercial	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$1.45
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE POLYSORB 0 3x27 VIOLET

Facility

$7.24

Hospital Charge Code	270604525
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

SUTURE POLYSORB 0 5x30 GS21

Facility

$26.37

Hospital Charge Code	270651128
Hospital Revenue Code	272
Min. Negotiated Rate	$3.96
Max. Negotiated Rate	$3.96
Rate for Payer: Qualcare PPO/HMO/WC	$3.96

SUTURE POLYSORB 0 5x30 GS21

Facility

$26.37

Hospital Charge Code	270651128
Hospital Revenue Code	272
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$13.19
Rate for Payer: Aetna Commercial	$10.02
Rate for Payer: Aetna Medicare Advantage	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.72
Rate for Payer: Cigna Commercial	$13.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.91
Rate for Payer: Oxford Commercial	$5.27
Rate for Payer: Qualcare PPO/HMO/WC	$3.96
Rate for Payer: UnitedHealthcare Commercial	$5.27
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

SUTURE POLYSORB 0 60 REEL

Facility

$7.31

Hospital Charge Code	270651159
Hospital Revenue Code	272
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$1.10
Rate for Payer: Qualcare PPO/HMO/WC	$1.10

SUTURE POLYSORB 0 60 REEL

Facility

$7.31

Hospital Charge Code	270651159
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.65
Rate for Payer: Aetna Commercial	$2.78
Rate for Payer: Aetna Medicare Advantage	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.86
Rate for Payer: Cigna Commercial	$3.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.19
Rate for Payer: Oxford Commercial	$1.46
Rate for Payer: Qualcare PPO/HMO/WC	$1.10
Rate for Payer: UnitedHealthcare Commercial	$1.46
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE POLYSORB 0 60 VIO REEL

Facility

$7.24

Hospital Charge Code	270604521
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.62
Rate for Payer: Aetna Commercial	$2.75
Rate for Payer: Aetna Medicare Advantage	$2.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.17
Rate for Payer: Oxford Commercial	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$1.45
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE POLYSORB 0 60 VIO REEL

Facility

$7.24

Hospital Charge Code	270604521
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

SUTURE POLYSORB 0 6x18 U/D

Facility

$17.19

Hospital Charge Code	270651109
Hospital Revenue Code	272
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$2.58
Rate for Payer: Qualcare PPO/HMO/WC	$2.58

Know your out-of-pocket cost for care.

All Charges