Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB 3/0 18IN UNDYE

Facility

$13.13

Hospital Charge Code	270661668S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$6.57
Rate for Payer: Aetna Commercial	$4.99
Rate for Payer: Aetna Medicare Advantage	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.35
Rate for Payer: Cigna Commercial	$6.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.94
Rate for Payer: Oxford Commercial	$2.63
Rate for Payer: Qualcare PPO/HMO/WC	$1.97
Rate for Payer: UnitedHealthcare Commercial	$2.63
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.35

SUTURE POLYSORB 3/0 18IN UNDYE

Facility

$12.83

Hospital Charge Code	2709007228
Hospital Revenue Code	272
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.92

SUTURE POLYSORB 3/0 18 U/D P12

Facility

$14.08

Hospital Charge Code	270656154S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$7.04
Rate for Payer: Aetna Commercial	$5.35
Rate for Payer: Aetna Medicare Advantage	$4.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.59
Rate for Payer: Cigna Commercial	$7.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.22
Rate for Payer: Oxford Commercial	$2.82
Rate for Payer: Qualcare PPO/HMO/WC	$2.11
Rate for Payer: UnitedHealthcare Commercial	$2.82
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

SUTURE POLYSORB 3/0 18 U/D P12

Facility

$14.08

Hospital Charge Code	270656154
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$7.04
Rate for Payer: Aetna Commercial	$5.35
Rate for Payer: Aetna Medicare Advantage	$4.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.59
Rate for Payer: Cigna Commercial	$7.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.22
Rate for Payer: Oxford Commercial	$2.82
Rate for Payer: Qualcare PPO/HMO/WC	$2.11
Rate for Payer: UnitedHealthcare Commercial	$2.82
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

SUTURE POLYSORB 3/0 18 U/D P12

Facility

$14.08

Hospital Charge Code	270656154
Hospital Revenue Code	272
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$2.11
Rate for Payer: Qualcare PPO/HMO/WC	$2.11

SUTURE POLYSORB 3/0 18 U/D P12

Facility

$14.08

Hospital Charge Code	270656154N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$7.04
Rate for Payer: Aetna Commercial	$5.35
Rate for Payer: Aetna Medicare Advantage	$4.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.59
Rate for Payer: Cigna Commercial	$7.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.22
Rate for Payer: Oxford Commercial	$2.82
Rate for Payer: Qualcare PPO/HMO/WC	$2.11
Rate for Payer: UnitedHealthcare Commercial	$2.82
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

SUTURE POLYSORB 3/0 18 U/D P12

Facility

$14.08

Hospital Charge Code	270656154S
Hospital Revenue Code	272
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$2.11
Rate for Payer: Qualcare PPO/HMO/WC	$2.11

SUTURE POLYSORB 3/0 18 U/D P12

Facility

$14.08

Hospital Charge Code	270656154N
Hospital Revenue Code	272
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$2.11
Rate for Payer: Qualcare PPO/HMO/WC	$2.11

SUTURE POLYSORB 3/0 30 CT1

Facility

$6.07

Hospital Charge Code	270604550
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 3/0 30 CT1

Facility

$6.07

Hospital Charge Code	270604550
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 3/0 30 GS10

Facility

$6.78

Hospital Charge Code	270651130
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 3/0 30 GS10

Facility

$6.78

Hospital Charge Code	270651130
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 3/0 30 U/D P12

Facility

$13.92

Hospital Charge Code	270604577
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$6.96
Rate for Payer: Aetna Commercial	$5.29
Rate for Payer: Aetna Medicare Advantage	$4.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.55
Rate for Payer: Cigna Commercial	$6.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.18
Rate for Payer: Oxford Commercial	$2.78
Rate for Payer: Qualcare PPO/HMO/WC	$2.09
Rate for Payer: UnitedHealthcare Commercial	$2.78
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

SUTURE POLYSORB 3/0 30 U/D P12

Facility

$13.92

Hospital Charge Code	270604577
Hospital Revenue Code	272
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$2.09
Rate for Payer: Qualcare PPO/HMO/WC	$2.09

SUTURE POLYSORB 3/0 30 UD V20

Facility

$6.07

Hospital Charge Code	270604578
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 3/0 30 UD V20

Facility

$6.07

Hospital Charge Code	270651281N
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 3/0 30 UD V20

Facility

$6.07

Hospital Charge Code	270651281S
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 3/0 30 UD V20

Facility

$6.07

Hospital Charge Code	270604578
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 3/0 30 UD V20

Facility

$6.07

Hospital Charge Code	270651281
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 3/0 30 UD V20

Facility

$6.07

Hospital Charge Code	270651281
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 3/0 30 UD V20

Facility

$6.07

Hospital Charge Code	270651281N
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 3/0 30 UD V20

Facility

$6.07

Hospital Charge Code	270651281S
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 3/0 3x18 VIO

Facility

$7.34

Hospital Charge Code	270670966
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 3/0 3x18 VIO

Facility

$7.34

Hospital Charge Code	270670966
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 3/0 3x30 VIO

Facility

$7.24

Hospital Charge Code	270604527
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

Know your out-of-pocket cost for care.

All Charges