Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE PROLENE 3/0 30 SH 8832H

Facility

$13.59

Hospital Charge Code	270655616
Hospital Revenue Code	272
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$2.04
Rate for Payer: Qualcare PPO/HMO/WC	$2.04

SUTURE PROLENE 3/0 30 SH 8832H

Facility

$13.59

Hospital Charge Code	270655616
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.79
Rate for Payer: Aetna Commercial	$5.16
Rate for Payer: Aetna Medicare Advantage	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.47
Rate for Payer: Cigna Commercial	$6.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.08
Rate for Payer: Oxford Commercial	$2.72
Rate for Payer: Qualcare PPO/HMO/WC	$2.04
Rate for Payer: UnitedHealthcare Commercial	$2.72
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

SUTURE PROLENE 3-0 CT-2

Facility

$12.17

Hospital Charge Code	270661976
Hospital Revenue Code	272
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$1.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.83

SUTURE PROLENE 3-0 CT-2

Facility

$12.17

Hospital Charge Code	270661976
Hospital Revenue Code	272
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.08
Rate for Payer: Aetna Commercial	$4.62
Rate for Payer: Aetna Medicare Advantage	$3.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.10
Rate for Payer: Cigna Commercial	$6.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.65
Rate for Payer: Oxford Commercial	$2.43
Rate for Payer: Qualcare PPO/HMO/WC	$1.83
Rate for Payer: UnitedHealthcare Commercial	$2.43
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

SUTURE PROLENE 3-0 FS-1

Facility

$14.95

Hospital Charge Code	270661974
Hospital Revenue Code	272
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$2.24
Rate for Payer: Qualcare PPO/HMO/WC	$2.24

SUTURE PROLENE 3-0 FS-1

Facility

$14.95

Hospital Charge Code	270661974
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.47
Rate for Payer: Aetna Commercial	$5.68
Rate for Payer: Aetna Medicare Advantage	$4.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.81
Rate for Payer: Cigna Commercial	$7.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.49
Rate for Payer: Oxford Commercial	$2.99
Rate for Payer: Qualcare PPO/HMO/WC	$2.24
Rate for Payer: UnitedHealthcare Commercial	$2.99
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

SUTURE PROLENE 3-0 KS

Facility

$15.07

Hospital Charge Code	270659088
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.54
Rate for Payer: Aetna Commercial	$5.73
Rate for Payer: Aetna Medicare Advantage	$4.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.84
Rate for Payer: Cigna Commercial	$7.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.52
Rate for Payer: Oxford Commercial	$3.01
Rate for Payer: Qualcare PPO/HMO/WC	$2.26
Rate for Payer: UnitedHealthcare Commercial	$3.01
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

SUTURE PROLENE 3-0 KS

Facility

$15.07

Hospital Charge Code	270659088
Hospital Revenue Code	272
Min. Negotiated Rate	$2.26
Max. Negotiated Rate	$2.26
Rate for Payer: Qualcare PPO/HMO/WC	$2.26

SUTURE PROLENE 3-0 PC-5

Facility

$40.15

Hospital Charge Code	270661973
Hospital Revenue Code	272
Min. Negotiated Rate	$6.02
Max. Negotiated Rate	$6.02
Rate for Payer: Qualcare PPO/HMO/WC	$6.02

SUTURE PROLENE 3-0 PC-5

Facility

$40.15

Hospital Charge Code	270661973
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$20.07
Rate for Payer: Aetna Commercial	$15.26
Rate for Payer: Aetna Medicare Advantage	$12.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.24
Rate for Payer: Cigna Commercial	$20.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.04
Rate for Payer: Oxford Commercial	$8.03
Rate for Payer: Qualcare PPO/HMO/WC	$6.02
Rate for Payer: UnitedHealthcare Commercial	$8.03
Rate for Payer: UnitedHealthcare Community & State	$0.97
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

SUTURE PROLENE 3-0 PS-1/PS-14

Facility

$34.22

Hospital Charge Code	270633105
Hospital Revenue Code	272
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$17.11
Rate for Payer: Aetna Commercial	$13.00
Rate for Payer: Aetna Medicare Advantage	$10.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.73
Rate for Payer: Cigna Commercial	$17.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.27
Rate for Payer: Oxford Commercial	$6.84
Rate for Payer: Qualcare PPO/HMO/WC	$5.13
Rate for Payer: UnitedHealthcare Commercial	$6.84
Rate for Payer: UnitedHealthcare Community & State	$0.82
Rate for Payer: Wellpoint Medicaid Managed Care	$0.91

SUTURE PROLENE 3-0 PS-1/PS-14

Facility

$34.22

Hospital Charge Code	270633105
Hospital Revenue Code	272
Min. Negotiated Rate	$5.13
Max. Negotiated Rate	$5.13
Rate for Payer: Qualcare PPO/HMO/WC	$5.13

SUTURE PROLENE 3-0 PS-2

Facility

$25.76

Hospital Charge Code	270672611
Hospital Revenue Code	272
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$12.88
Rate for Payer: Aetna Commercial	$9.79
Rate for Payer: Aetna Medicare Advantage	$7.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.57
Rate for Payer: Cigna Commercial	$12.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.73
Rate for Payer: Oxford Commercial	$5.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.86
Rate for Payer: UnitedHealthcare Commercial	$5.15
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.68

SUTURE PROLENE 3-0 PS-2

Facility

$25.76

Hospital Charge Code	270672611
Hospital Revenue Code	272
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$3.86
Rate for Payer: Qualcare PPO/HMO/WC	$3.86

SUTURE PROLENE 3-0 SH-1

Facility

$25.74

Hospital Charge Code	270671421
Hospital Revenue Code	272
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$3.86
Rate for Payer: Qualcare PPO/HMO/WC	$3.86

SUTURE PROLENE 3-0 SH-1

Facility

$25.74

Hospital Charge Code	270671421
Hospital Revenue Code	272
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$12.87
Rate for Payer: Aetna Commercial	$9.78
Rate for Payer: Aetna Medicare Advantage	$7.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.56
Rate for Payer: Cigna Commercial	$12.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.72
Rate for Payer: Oxford Commercial	$5.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.86
Rate for Payer: UnitedHealthcare Commercial	$5.15
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.68

SUTURE PROLENE 3-0 SH V-20

Facility

$26.21

Hospital Charge Code	270671407
Hospital Revenue Code	272
Min. Negotiated Rate	$3.93
Max. Negotiated Rate	$3.93
Rate for Payer: Qualcare PPO/HMO/WC	$3.93

SUTURE PROLENE 3-0 SH V-20

Facility

$26.21

Hospital Charge Code	270671407
Hospital Revenue Code	272
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$13.11
Rate for Payer: Aetna Commercial	$9.96
Rate for Payer: Aetna Medicare Advantage	$7.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.68
Rate for Payer: Cigna Commercial	$13.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.86
Rate for Payer: Oxford Commercial	$5.24
Rate for Payer: Qualcare PPO/HMO/WC	$3.93
Rate for Payer: UnitedHealthcare Commercial	$5.24
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.69

SUTURE PROLENE 3-0 V-7

Facility

$35.21

Hospital Charge Code	270671428
Hospital Revenue Code	272
Min. Negotiated Rate	$5.28
Max. Negotiated Rate	$5.28
Rate for Payer: Qualcare PPO/HMO/WC	$5.28

SUTURE PROLENE 3-0 V-7

Facility

$35.21

Hospital Charge Code	270671428
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$17.61
Rate for Payer: Aetna Commercial	$13.38
Rate for Payer: Aetna Medicare Advantage	$10.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.98
Rate for Payer: Cigna Commercial	$17.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.56
Rate for Payer: Oxford Commercial	$7.04
Rate for Payer: Qualcare PPO/HMO/WC	$5.28
Rate for Payer: UnitedHealthcare Commercial	$7.04
Rate for Payer: UnitedHealthcare Community & State	$0.85
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

SUTURE PROLENE 4/0

Facility

$600.00

Hospital Charge Code	270659089
Hospital Revenue Code	272
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.00
Rate for Payer: Oxford Commercial	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Commercial	$120.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

SUTURE PROLENE 4/0

Facility

$600.00

Hospital Charge Code	270659089
Hospital Revenue Code	272
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

SUTURE PROLENE 4-0 FS-1

Facility

$15.90

Hospital Charge Code	270661975
Hospital Revenue Code	272
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$2.38
Rate for Payer: Qualcare PPO/HMO/WC	$2.38

SUTURE PROLENE 4-0 FS-1

Facility

$15.90

Hospital Charge Code	270661975
Hospital Revenue Code	272
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$7.95
Rate for Payer: Aetna Commercial	$6.04
Rate for Payer: Aetna Medicare Advantage	$4.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.05
Rate for Payer: Cigna Commercial	$7.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.77
Rate for Payer: Oxford Commercial	$3.18
Rate for Payer: Qualcare PPO/HMO/WC	$2.38
Rate for Payer: UnitedHealthcare Commercial	$3.18
Rate for Payer: UnitedHealthcare Community & State	$0.38
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

SUTURE PROLENE 4-0 FS-2

Facility

$12.98

Hospital Charge Code	270671412
Hospital Revenue Code	272
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.49
Rate for Payer: Aetna Commercial	$4.93
Rate for Payer: Aetna Medicare Advantage	$3.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.89
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

Know your out-of-pocket cost for care.

All Charges