Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB BGS-21 3-0 36

Facility

$6.75

Hospital Charge Code	270651136
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.38
Rate for Payer: Aetna Commercial	$2.56
Rate for Payer: Aetna Medicare Advantage	$2.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.72
Rate for Payer: Cigna Commercial	$3.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.02
Rate for Payer: Oxford Commercial	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.01
Rate for Payer: UnitedHealthcare Commercial	$1.35
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE POLYSORB CV-23 3.0

Facility

$5.77

Hospital Charge Code	270648137
Hospital Revenue Code	272
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$0.87
Rate for Payer: Qualcare PPO/HMO/WC	$0.87

SUTURE POLYSORB CV-23 3.0

Facility

$5.77

Hospital Charge Code	270648137
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.88
Rate for Payer: Aetna Commercial	$2.19
Rate for Payer: Aetna Medicare Advantage	$1.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.47
Rate for Payer: Cigna Commercial	$2.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.73
Rate for Payer: Oxford Commercial	$1.15
Rate for Payer: Qualcare PPO/HMO/WC	$0.87
Rate for Payer: UnitedHealthcare Commercial	$1.15
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

SUTURE POLYSORB CVF-23 4-0 27

Facility

$20.95

Hospital Charge Code	2706501237
Hospital Revenue Code	272
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$3.14
Rate for Payer: Qualcare PPO/HMO/WC	$3.14

SUTURE POLYSORB CVF-23 4-0 27

Facility

$20.95

Hospital Charge Code	2706501237
Hospital Revenue Code	272
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$10.47
Rate for Payer: Aetna Commercial	$7.96
Rate for Payer: Aetna Medicare Advantage	$6.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.34
Rate for Payer: Cigna Commercial	$10.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.29
Rate for Payer: Oxford Commercial	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$3.14
Rate for Payer: UnitedHealthcare Commercial	$4.19
Rate for Payer: UnitedHealthcare Community & State	$0.50
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

SUTURE POLYSORB ENDOSTI ES9

Facility

$228.85

Hospital Charge Code	270604727
Hospital Revenue Code	272
Min. Negotiated Rate	$5.52
Max. Negotiated Rate	$114.42
Rate for Payer: Aetna Commercial	$86.96
Rate for Payer: Aetna Medicare Advantage	$68.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.36
Rate for Payer: Cigna Commercial	$114.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.66
Rate for Payer: Oxford Commercial	$45.77
Rate for Payer: Qualcare PPO/HMO/WC	$34.33
Rate for Payer: UnitedHealthcare Commercial	$45.77
Rate for Payer: UnitedHealthcare Community & State	$5.52
Rate for Payer: Wellpoint Medicaid Managed Care	$6.06

SUTURE POLYSORB ENDOSTI ES9

Facility

$228.85

Hospital Charge Code	270604727
Hospital Revenue Code	272
Min. Negotiated Rate	$34.33
Max. Negotiated Rate	$34.33
Rate for Payer: Qualcare PPO/HMO/WC	$34.33

SUTURE POLYSORB ENDOSTITCH 2-0

Facility

$115.90

Hospital Charge Code	270658690
Hospital Revenue Code	272
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$17.39
Rate for Payer: Qualcare PPO/HMO/WC	$17.39

SUTURE POLYSORB ENDOSTITCH 2-0

Facility

$115.90

Hospital Charge Code	270658690
Hospital Revenue Code	272
Min. Negotiated Rate	$2.79
Max. Negotiated Rate	$57.95
Rate for Payer: Aetna Commercial	$44.04
Rate for Payer: Aetna Medicare Advantage	$34.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.55
Rate for Payer: Cigna Commercial	$57.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.77
Rate for Payer: Oxford Commercial	$23.18
Rate for Payer: Qualcare PPO/HMO/WC	$17.39
Rate for Payer: UnitedHealthcare Commercial	$23.18
Rate for Payer: UnitedHealthcare Community & State	$2.79
Rate for Payer: Wellpoint Medicaid Managed Care	$3.07

SUTURE POLYSORB EV20 0

Facility

$178.45

Hospital Charge Code	270604736
Hospital Revenue Code	272
Min. Negotiated Rate	$4.30
Max. Negotiated Rate	$89.22
Rate for Payer: Aetna Commercial	$67.81
Rate for Payer: Aetna Medicare Advantage	$53.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.50
Rate for Payer: Cigna Commercial	$89.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.53
Rate for Payer: Oxford Commercial	$35.69
Rate for Payer: Qualcare PPO/HMO/WC	$26.77
Rate for Payer: UnitedHealthcare Commercial	$35.69
Rate for Payer: UnitedHealthcare Community & State	$4.30
Rate for Payer: Wellpoint Medicaid Managed Care	$4.73

SUTURE POLYSORB EV20 0

Facility

$178.45

Hospital Charge Code	270604736
Hospital Revenue Code	272
Min. Negotiated Rate	$26.77
Max. Negotiated Rate	$26.77
Rate for Payer: Qualcare PPO/HMO/WC	$26.77

SUTURE POLYSORB EV20 2-0

Facility

$178.45

Hospital Charge Code	270604737
Hospital Revenue Code	272
Min. Negotiated Rate	$4.30
Max. Negotiated Rate	$89.22
Rate for Payer: Aetna Commercial	$67.81
Rate for Payer: Aetna Medicare Advantage	$53.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.50
Rate for Payer: Cigna Commercial	$89.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.53
Rate for Payer: Oxford Commercial	$35.69
Rate for Payer: Qualcare PPO/HMO/WC	$26.77
Rate for Payer: UnitedHealthcare Commercial	$35.69
Rate for Payer: UnitedHealthcare Community & State	$4.30
Rate for Payer: Wellpoint Medicaid Managed Care	$4.73

SUTURE POLYSORB EV20 2-0

Facility

$178.45

Hospital Charge Code	270604737
Hospital Revenue Code	272
Min. Negotiated Rate	$26.77
Max. Negotiated Rate	$26.77
Rate for Payer: Qualcare PPO/HMO/WC	$26.77

SUTURE POLYSORB EV23 3-0

Facility

$88.00

Hospital Charge Code	270604579
Hospital Revenue Code	272
Min. Negotiated Rate	$13.20
Max. Negotiated Rate	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$13.20

SUTURE POLYSORB EV23 3-0

Facility

$88.00

Hospital Charge Code	270604579
Hospital Revenue Code	272
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$44.00
Rate for Payer: Aetna Commercial	$33.44
Rate for Payer: Aetna Medicare Advantage	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.44
Rate for Payer: Cigna Commercial	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.40
Rate for Payer: Oxford Commercial	$17.60
Rate for Payer: Qualcare PPO/HMO/WC	$13.20
Rate for Payer: UnitedHealthcare Commercial	$17.60
Rate for Payer: UnitedHealthcare Community & State	$2.12
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

SUTURE POLYSORB FS-2 C13 UD 30

Facility

$6.94

Hospital Charge Code	270656157
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.47
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	$3.47
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 FS-2 C13 UD 30

Facility

$6.94

Hospital Charge Code	270656157
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$1.04
Rate for Payer: Qualcare PPO/HMO/WC	$1.04

SUTURE POLYSORB GS-10 3-0

Facility

$26.37

Hospital Charge Code	270623469
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 GS-10 3-0

Facility

$26.37

Hospital Charge Code	270623469
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 GS11 0

Facility

$6.83

Hospital Charge Code	270604541
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 GS11 0

Facility

$16.85

Hospital Charge Code	270600572
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

SUTURE POLYSORB GS11 0

Facility

$6.83

Hospital Charge Code	270604541
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 GS11 0

Facility

$16.85

Hospital Charge Code	270600572
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$6.40
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.05
Rate for Payer: Oxford Commercial	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$3.37
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

SUTURE POLYSORB GS11 1

Facility

$22.45

Hospital Charge Code	270604535
Hospital Revenue Code	272
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

SUTURE POLYSORB GS11 1

Facility

$22.45

Hospital Charge Code	270604535
Hospital Revenue Code	272
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$8.53
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.74
Rate for Payer: Oxford Commercial	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$4.49
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

Know your out-of-pocket cost for care.

All Charges