Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB 0 6x18 U/D

Facility

$17.19

Hospital Charge Code	270651109
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.60
Rate for Payer: Aetna Commercial	$6.53
Rate for Payer: Aetna Medicare Advantage	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.38
Rate for Payer: Cigna Commercial	$8.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.16
Rate for Payer: Oxford Commercial	$3.44
Rate for Payer: Qualcare PPO/HMO/WC	$2.58
Rate for Payer: UnitedHealthcare Commercial	$3.44
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.46

SUTURE POLYSORB 0 GS-21 U/D 36

Facility

$6.63

Hospital Charge Code	270651263
Hospital Revenue Code	272
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$0.99
Rate for Payer: Qualcare PPO/HMO/WC	$0.99

SUTURE POLYSORB 0 GS-21 U/D 36

Facility

$6.63

Hospital Charge Code	270651263
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.31
Rate for Payer: Aetna Commercial	$2.52
Rate for Payer: Aetna Medicare Advantage	$1.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.69
Rate for Payer: Cigna Commercial	$3.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.99
Rate for Payer: Oxford Commercial	$1.33
Rate for Payer: Qualcare PPO/HMO/WC	$0.99
Rate for Payer: UnitedHealthcare Commercial	$1.33
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE POLYSORB 0 R-205 UD TIE

Facility

$6.07

Hospital Charge Code	270656141
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$3.04
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.55
Rate for Payer: Cigna Commercial	$3.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.82
Rate for Payer: Oxford Commercial	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.91
Rate for Payer: UnitedHealthcare Commercial	$1.21
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

SUTURE POLYSORB 0 R-205 UD TIE

Facility

$6.07

Hospital Charge Code	270656141
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.91

SUTURE POLYSORB 1 18 PRECUT

Facility

$28.33

Hospital Charge Code	270651108
Hospital Revenue Code	272
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$14.16
Rate for Payer: Aetna Commercial	$10.77
Rate for Payer: Aetna Medicare Advantage	$8.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.22
Rate for Payer: Cigna Commercial	$14.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.50
Rate for Payer: Oxford Commercial	$5.67
Rate for Payer: Qualcare PPO/HMO/WC	$4.25
Rate for Payer: UnitedHealthcare Commercial	$5.67
Rate for Payer: UnitedHealthcare Community & State	$0.68
Rate for Payer: Wellpoint Medicaid Managed Care	$0.75

SUTURE POLYSORB 1 18 PRECUT

Facility

$28.33

Hospital Charge Code	270651108
Hospital Revenue Code	272
Min. Negotiated Rate	$4.25
Max. Negotiated Rate	$4.25
Rate for Payer: Qualcare PPO/HMO/WC	$4.25

SUTURE POLYSORB 1 30 CT1

Facility

$6.43

Hospital Charge Code	270604534
Hospital Revenue Code	272
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$0.96
Rate for Payer: Qualcare PPO/HMO/WC	$0.96

SUTURE POLYSORB 1 30 CT1

Facility

$6.43

Hospital Charge Code	270604534
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$3.21
Rate for Payer: Aetna Commercial	$2.44
Rate for Payer: Aetna Medicare Advantage	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.64
Rate for Payer: Cigna Commercial	$3.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.93
Rate for Payer: Oxford Commercial	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$0.96
Rate for Payer: UnitedHealthcare Commercial	$1.29
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

SUTURE POLYSORB 1 30IN VIOLET

Facility

$8.62

Hospital Charge Code	270604533
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 1 30IN VIOLET

Facility

$8.62

Hospital Charge Code	270604533
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 1 36 U/D GS21

Facility

$23.16

Hospital Charge Code	270651266
Hospital Revenue Code	272
Min. Negotiated Rate	$3.47
Max. Negotiated Rate	$3.47
Rate for Payer: Qualcare PPO/HMO/WC	$3.47

SUTURE POLYSORB 1 36 U/D GS21

Facility

$23.16

Hospital Charge Code	270651266
Hospital Revenue Code	272
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$11.58
Rate for Payer: Aetna Commercial	$8.80
Rate for Payer: Aetna Medicare Advantage	$6.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.91
Rate for Payer: Cigna Commercial	$11.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.95
Rate for Payer: Oxford Commercial	$4.63
Rate for Payer: Qualcare PPO/HMO/WC	$3.47
Rate for Payer: UnitedHealthcare Commercial	$4.63
Rate for Payer: UnitedHealthcare Community & State	$0.56
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

SUTURE POLYSORB 1 36 U/D GS24

Facility

$23.04

Hospital Charge Code	270651493
Hospital Revenue Code	272
Min. Negotiated Rate	$3.46
Max. Negotiated Rate	$3.46
Rate for Payer: Qualcare PPO/HMO/WC	$3.46

SUTURE POLYSORB 1 36 U/D GS24

Facility

$23.04

Hospital Charge Code	270651493
Hospital Revenue Code	272
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$11.52
Rate for Payer: Aetna Commercial	$8.76
Rate for Payer: Aetna Medicare Advantage	$6.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.88
Rate for Payer: Cigna Commercial	$11.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.91
Rate for Payer: Oxford Commercial	$4.61
Rate for Payer: Qualcare PPO/HMO/WC	$3.46
Rate for Payer: UnitedHealthcare Commercial	$4.61
Rate for Payer: UnitedHealthcare Community & State	$0.56
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

SUTURE POLYSORB 1 36 VIO GS26

Facility

$7.14

Hospital Charge Code	270604532
Hospital Revenue Code	272
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$1.07
Rate for Payer: Qualcare PPO/HMO/WC	$1.07

SUTURE POLYSORB 1 36 VIO GS26

Facility

$7.14

Hospital Charge Code	270604532
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.57
Rate for Payer: Aetna Commercial	$2.71
Rate for Payer: Aetna Medicare Advantage	$2.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.82
Rate for Payer: Cigna Commercial	$3.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.14
Rate for Payer: Oxford Commercial	$1.43
Rate for Payer: Qualcare PPO/HMO/WC	$1.07
Rate for Payer: UnitedHealthcare Commercial	$1.43
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE POLYSORB 1 36 VIOLET

Facility

$6.83

Hospital Charge Code	270651134
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 1 36 VIOLET

Facility

$6.83

Hospital Charge Code	270651134
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 1 5x30 VIOLET

Facility

$26.37

Hospital Charge Code	270656027
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 1 5x30 VIOLET

Facility

$26.37

Hospital Charge Code	270656027
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 1 60 U/D TIES

Facility

$6.07

Hospital Charge Code	270659484
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$3.04
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.55
Rate for Payer: Cigna Commercial	$3.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.82
Rate for Payer: Oxford Commercial	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.91
Rate for Payer: UnitedHealthcare Commercial	$1.21
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

SUTURE POLYSORB 1 60 U/D TIES

Facility

$6.07

Hospital Charge Code	270659484
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.91

SUTURE POLYSORB 1 GS-21 36 UD

Facility

$6.95

Hospital Charge Code	270656028
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.48
Rate for Payer: Aetna Commercial	$2.64
Rate for Payer: Aetna Medicare Advantage	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.77
Rate for Payer: Cigna Commercial	$3.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.08
Rate for Payer: Oxford Commercial	$1.39
Rate for Payer: Qualcare PPO/HMO/WC	$1.04
Rate for Payer: UnitedHealthcare Commercial	$1.39
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE POLYSORB 1 GS-21 36 UD

Facility

$6.95

Hospital Charge Code	270656028
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$1.04
Rate for Payer: Qualcare PPO/HMO/WC	$1.04

Know your out-of-pocket cost for care.

All Charges