Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE POLYSORB GS-24 0 UNDYED

Facility

$6.90

Hospital Charge Code	270651137
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.45
Rate for Payer: Aetna Commercial	$2.62
Rate for Payer: Aetna Medicare Advantage	$2.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.76
Rate for Payer: Cigna Commercial	$3.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.07
Rate for Payer: Oxford Commercial	$1.38
Rate for Payer: Qualcare PPO/HMO/WC	$1.03
Rate for Payer: UnitedHealthcare Commercial	$1.38
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE POLYSORB GS24 2-0

Facility

$16.85

Hospital Charge Code	270600571
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 GS24 2-0

Facility

$16.85

Hospital Charge Code	270600571
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 GS26 1

Facility

$14.35

Hospital Charge Code	270604531
Hospital Revenue Code	272
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$7.17
Rate for Payer: Aetna Commercial	$5.45
Rate for Payer: Aetna Medicare Advantage	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.66
Rate for Payer: Cigna Commercial	$7.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.30
Rate for Payer: Oxford Commercial	$2.87
Rate for Payer: Qualcare PPO/HMO/WC	$2.15
Rate for Payer: UnitedHealthcare Commercial	$2.87
Rate for Payer: UnitedHealthcare Community & State	$0.35
Rate for Payer: Wellpoint Medicaid Managed Care	$0.38

SUTURE POLYSORB GS26 1

Facility

$14.35

Hospital Charge Code	270604531
Hospital Revenue Code	272
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$2.15
Rate for Payer: Qualcare PPO/HMO/WC	$2.15

SUTURE POLYSORB HOS-11 1 30

Facility

$10.04

Hospital Charge Code	270651129
Hospital Revenue Code	272
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$5.02
Rate for Payer: Aetna Commercial	$3.82
Rate for Payer: Aetna Medicare Advantage	$3.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.56
Rate for Payer: Cigna Commercial	$5.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.01
Rate for Payer: Oxford Commercial	$2.01
Rate for Payer: Qualcare PPO/HMO/WC	$1.51
Rate for Payer: UnitedHealthcare Commercial	$2.01
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

SUTURE POLYSORB HOS-11 1 30

Facility

$10.04

Hospital Charge Code	270651129
Hospital Revenue Code	272
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$1.51
Rate for Payer: Qualcare PPO/HMO/WC	$1.51

SUTURE POLYSORB HOS12 0

Facility

$18.64

Hospital Charge Code	270612404
Hospital Revenue Code	272
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$9.32
Rate for Payer: Aetna Commercial	$7.08
Rate for Payer: Aetna Medicare Advantage	$5.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.75
Rate for Payer: Cigna Commercial	$9.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.59
Rate for Payer: Oxford Commercial	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.80
Rate for Payer: UnitedHealthcare Commercial	$3.73
Rate for Payer: UnitedHealthcare Community & State	$0.45
Rate for Payer: Wellpoint Medicaid Managed Care	$0.49

SUTURE POLYSORB HOS12 0

Facility

$18.64

Hospital Charge Code	270612404
Hospital Revenue Code	272
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$2.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.80

SUTURE POLYSORB HOS12 0

Facility

$136.85

Hospital Charge Code	270604529
Hospital Revenue Code	272
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$68.42
Rate for Payer: Aetna Commercial	$52.00
Rate for Payer: Aetna Medicare Advantage	$41.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.90
Rate for Payer: Cigna Commercial	$68.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.05
Rate for Payer: Oxford Commercial	$27.37
Rate for Payer: Qualcare PPO/HMO/WC	$20.53
Rate for Payer: UnitedHealthcare Commercial	$27.37
Rate for Payer: UnitedHealthcare Community & State	$3.30
Rate for Payer: Wellpoint Medicaid Managed Care	$3.63

SUTURE POLYSORB HOS12 0

Facility

$136.85

Hospital Charge Code	270604529
Hospital Revenue Code	272
Min. Negotiated Rate	$20.53
Max. Negotiated Rate	$20.53
Rate for Payer: Qualcare PPO/HMO/WC	$20.53

SUTURE POLYSORB KV-34 2-0 36

Facility

$10.56

Hospital Charge Code	270651135
Hospital Revenue Code	272
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.28
Rate for Payer: Aetna Commercial	$4.01
Rate for Payer: Aetna Medicare Advantage	$3.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.69
Rate for Payer: Cigna Commercial	$5.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.17
Rate for Payer: Oxford Commercial	$2.11
Rate for Payer: Qualcare PPO/HMO/WC	$1.58
Rate for Payer: UnitedHealthcare Commercial	$2.11
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

SUTURE POLYSORB KV-34 2-0 36

Facility

$10.56

Hospital Charge Code	270651135
Hospital Revenue Code	272
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$1.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.58

SUTURE POLYSORB OGS-22 30 UD

Facility

$6.15

Hospital Charge Code	270655779
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$3.08
Rate for Payer: Aetna Commercial	$2.34
Rate for Payer: Aetna Medicare Advantage	$1.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.57
Rate for Payer: Cigna Commercial	$3.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.84
Rate for Payer: Oxford Commercial	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$0.92
Rate for Payer: UnitedHealthcare Commercial	$1.23
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

SUTURE POLYSORB OGS-22 30 UD

Facility

$6.15

Hospital Charge Code	270655779
Hospital Revenue Code	272
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$0.92
Rate for Payer: Qualcare PPO/HMO/WC	$0.92

SUTURE POLYSORB P10 5-0

Facility

$32.00

Hospital Charge Code	270600793
Hospital Revenue Code	272
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

SUTURE POLYSORB P10 5-0

Facility

$32.00

Hospital Charge Code	270600793
Hospital Revenue Code	272
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$6.40
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

SUTURE POLYSORB P10 6-0

Facility

$32.00

Hospital Charge Code	270600797
Hospital Revenue Code	272
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

SUTURE POLYSORB P10 6-0

Facility

$32.00

Hospital Charge Code	270600797
Hospital Revenue Code	272
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$6.40
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

SUTURE POLYSORB P11 4-0

Facility

$33.65

Hospital Charge Code	270600794
Hospital Revenue Code	272
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$16.82
Rate for Payer: Aetna Commercial	$12.79
Rate for Payer: Aetna Medicare Advantage	$10.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.58
Rate for Payer: Cigna Commercial	$16.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.10
Rate for Payer: Oxford Commercial	$6.73
Rate for Payer: Qualcare PPO/HMO/WC	$5.05
Rate for Payer: UnitedHealthcare Commercial	$6.73
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.89

SUTURE POLYSORB P11 4-0

Facility

$33.65

Hospital Charge Code	270600794
Hospital Revenue Code	272
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$5.05
Rate for Payer: Qualcare PPO/HMO/WC	$5.05

SUTURE POLYSORB P12 3-0

Facility

$29.65

Hospital Charge Code	270600798
Hospital Revenue Code	272
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$14.82
Rate for Payer: Aetna Commercial	$11.27
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.56
Rate for Payer: Cigna Commercial	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.89
Rate for Payer: Oxford Commercial	$5.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.45
Rate for Payer: UnitedHealthcare Commercial	$5.93
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

SUTURE POLYSORB P12 3-0

Facility

$29.65

Hospital Charge Code	270600798
Hospital Revenue Code	272
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$4.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.45

SUTURE POLYSORB P-12 5-0

Facility

$13.96

Hospital Charge Code	270651291
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 P-12 5-0

Facility

$13.96

Hospital Charge Code	270651291
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$6.98
Rate for Payer: Aetna Commercial	$5.30
Rate for Payer: Aetna Medicare Advantage	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.56
Rate for Payer: Cigna Commercial	$6.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.19
Rate for Payer: Oxford Commercial	$2.79
Rate for Payer: Qualcare PPO/HMO/WC	$2.09
Rate for Payer: UnitedHealthcare Commercial	$2.79
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

Know your out-of-pocket cost for care.

All Charges