Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE PROLENE 5-0 P-3

Facility

$26.51

Hospital Charge Code	270663644
Hospital Revenue Code	272
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$13.26
Rate for Payer: Aetna Commercial	$10.07
Rate for Payer: Aetna Medicare Advantage	$7.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.76
Rate for Payer: Cigna Commercial	$13.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.95
Rate for Payer: Oxford Commercial	$5.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.98
Rate for Payer: UnitedHealthcare Commercial	$5.30
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.70

SUTURE PROLENE 5-0 P-3

Facility

$26.51

Hospital Charge Code	270663644
Hospital Revenue Code	272
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$3.98
Rate for Payer: Qualcare PPO/HMO/WC	$3.98

SUTURE PROLENE 5-0 PC-1

Facility

$25.56

Hospital Charge Code	270649099
Hospital Revenue Code	272
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$12.78
Rate for Payer: Aetna Commercial	$9.71
Rate for Payer: Aetna Medicare Advantage	$7.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.52
Rate for Payer: Cigna Commercial	$12.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.67
Rate for Payer: Oxford Commercial	$5.11
Rate for Payer: Qualcare PPO/HMO/WC	$3.83
Rate for Payer: UnitedHealthcare Commercial	$5.11
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.68

SUTURE PROLENE 5-0 PC-1

Facility

$25.56

Hospital Charge Code	270649099
Hospital Revenue Code	272
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$3.83
Rate for Payer: Qualcare PPO/HMO/WC	$3.83

SUTURE PROLENE 5-0 PC-3

Facility

$25.56

Hospital Charge Code	270661970
Hospital Revenue Code	272
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$3.83
Rate for Payer: Qualcare PPO/HMO/WC	$3.83

SUTURE PROLENE 5-0 PC-3

Facility

$25.56

Hospital Charge Code	270661970
Hospital Revenue Code	272
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$12.78
Rate for Payer: Aetna Commercial	$9.71
Rate for Payer: Aetna Medicare Advantage	$7.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.52
Rate for Payer: Cigna Commercial	$12.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.67
Rate for Payer: Oxford Commercial	$5.11
Rate for Payer: Qualcare PPO/HMO/WC	$3.83
Rate for Payer: UnitedHealthcare Commercial	$5.11
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.68

SUTURE PROLENE 5-0 PC 5

Facility

$25.56

Hospital Charge Code	270651497
Hospital Revenue Code	272
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$3.83
Rate for Payer: Qualcare PPO/HMO/WC	$3.83

SUTURE PROLENE 5-0 PC 5

Facility

$25.56

Hospital Charge Code	270651497
Hospital Revenue Code	272
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$12.78
Rate for Payer: Aetna Commercial	$9.71
Rate for Payer: Aetna Medicare Advantage	$7.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.52
Rate for Payer: Cigna Commercial	$12.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.67
Rate for Payer: Oxford Commercial	$5.11
Rate for Payer: Qualcare PPO/HMO/WC	$3.83
Rate for Payer: UnitedHealthcare Commercial	$5.11
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.68

SUTURE PROLENE 5-0 PS-2

Facility

$21.33

Hospital Charge Code	270672395
Hospital Revenue Code	272
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$10.66
Rate for Payer: Aetna Commercial	$8.11
Rate for Payer: Aetna Medicare Advantage	$6.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.44
Rate for Payer: Cigna Commercial	$10.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.40
Rate for Payer: Oxford Commercial	$4.27
Rate for Payer: Qualcare PPO/HMO/WC	$3.20
Rate for Payer: UnitedHealthcare Commercial	$4.27
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.57

SUTURE PROLENE 5-0 PS-2

Facility

$21.33

Hospital Charge Code	270672395
Hospital Revenue Code	272
Min. Negotiated Rate	$3.20
Max. Negotiated Rate	$3.20
Rate for Payer: Qualcare PPO/HMO/WC	$3.20

SUTURE PROLENE 5-0 RB-1

Facility

$14.28

Hospital Charge Code	270671425
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$7.14
Rate for Payer: Aetna Commercial	$5.43
Rate for Payer: Aetna Medicare Advantage	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.64
Rate for Payer: Cigna Commercial	$7.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.28
Rate for Payer: Oxford Commercial	$2.86
Rate for Payer: Qualcare PPO/HMO/WC	$2.14
Rate for Payer: UnitedHealthcare Commercial	$2.86
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.38

SUTURE PROLENE 5-0 RB-1

Facility

$14.28

Hospital Charge Code	270671425
Hospital Revenue Code	272
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$2.14
Rate for Payer: Qualcare PPO/HMO/WC	$2.14

SUTURE PROLENE 5-0 RB-1

Facility

$26.78

Hospital Charge Code	270655741
Hospital Revenue Code	272
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$13.39
Rate for Payer: Aetna Commercial	$10.18
Rate for Payer: Aetna Medicare Advantage	$8.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.83
Rate for Payer: Cigna Commercial	$13.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.03
Rate for Payer: Oxford Commercial	$5.36
Rate for Payer: Qualcare PPO/HMO/WC	$4.02
Rate for Payer: UnitedHealthcare Commercial	$5.36
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

SUTURE PROLENE 5-0 RB-1

Facility

$26.78

Hospital Charge Code	270655741
Hospital Revenue Code	272
Min. Negotiated Rate	$4.02
Max. Negotiated Rate	$4.02
Rate for Payer: Qualcare PPO/HMO/WC	$4.02

SUTURE PROLENE 5-0 RB-2

Facility

$40.78

Hospital Charge Code	270671416
Hospital Revenue Code	272
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$20.39
Rate for Payer: Aetna Commercial	$15.50
Rate for Payer: Aetna Medicare Advantage	$12.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.40
Rate for Payer: Cigna Commercial	$20.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.23
Rate for Payer: Oxford Commercial	$8.16
Rate for Payer: Qualcare PPO/HMO/WC	$6.12
Rate for Payer: UnitedHealthcare Commercial	$8.16
Rate for Payer: UnitedHealthcare Community & State	$0.98
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

SUTURE PROLENE 5-0 RB-2

Facility

$40.78

Hospital Charge Code	270671416
Hospital Revenue Code	272
Min. Negotiated Rate	$6.12
Max. Negotiated Rate	$6.12
Rate for Payer: Qualcare PPO/HMO/WC	$6.12

SUTURE PROLENE 5-0 RB-2

Facility

$25.39

Hospital Charge Code	270672396
Hospital Revenue Code	272
Min. Negotiated Rate	$3.81
Max. Negotiated Rate	$3.81
Rate for Payer: Qualcare PPO/HMO/WC	$3.81

SUTURE PROLENE 5-0 RB-2

Facility

$25.39

Hospital Charge Code	270672396
Hospital Revenue Code	272
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$12.70
Rate for Payer: Aetna Commercial	$9.65
Rate for Payer: Aetna Medicare Advantage	$7.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.47
Rate for Payer: Cigna Commercial	$12.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.62
Rate for Payer: Oxford Commercial	$5.08
Rate for Payer: Qualcare PPO/HMO/WC	$3.81
Rate for Payer: UnitedHealthcare Commercial	$5.08
Rate for Payer: UnitedHealthcare Community & State	$0.61
Rate for Payer: Wellpoint Medicaid Managed Care	$0.67

SUTURE PROLENE 6-0 30 BV-1 BV1

Facility

$91.00

Hospital Charge Code	270636869
Hospital Revenue Code	272
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$13.65
Rate for Payer: Qualcare PPO/HMO/WC	$13.65

SUTURE PROLENE 6-0 30 BV-1 BV1

Facility

$91.00

Hospital Charge Code	270636869
Hospital Revenue Code	272
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$45.50
Rate for Payer: Aetna Commercial	$34.58
Rate for Payer: Aetna Medicare Advantage	$27.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.20
Rate for Payer: Cigna Commercial	$45.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.30
Rate for Payer: Oxford Commercial	$18.20
Rate for Payer: Qualcare PPO/HMO/WC	$13.65
Rate for Payer: UnitedHealthcare Commercial	$18.20
Rate for Payer: UnitedHealthcare Community & State	$2.19
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

SUTURE PROLENE 6-0 BV-1

Facility

$63.15

Hospital Charge Code	270655714
Hospital Revenue Code	272
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$31.57
Rate for Payer: Aetna Commercial	$24.00
Rate for Payer: Aetna Medicare Advantage	$18.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.10
Rate for Payer: Cigna Commercial	$31.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.95
Rate for Payer: Oxford Commercial	$12.63
Rate for Payer: Qualcare PPO/HMO/WC	$9.47
Rate for Payer: UnitedHealthcare Commercial	$12.63
Rate for Payer: UnitedHealthcare Community & State	$1.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1.67

SUTURE PROLENE 6-0 BV-1

Facility

$41.53

Hospital Charge Code	270688285
Hospital Revenue Code	272
Min. Negotiated Rate	$6.23
Max. Negotiated Rate	$6.23
Rate for Payer: Qualcare PPO/HMO/WC	$6.23

SUTURE PROLENE 6-0 BV-1

Facility

$242.77

Hospital Charge Code	270676672
Hospital Revenue Code	272
Min. Negotiated Rate	$36.42
Max. Negotiated Rate	$36.42
Rate for Payer: Qualcare PPO/HMO/WC	$36.42

SUTURE PROLENE 6-0 BV-1

Facility

$41.53

Hospital Charge Code	270688285
Hospital Revenue Code	272
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$20.77
Rate for Payer: Aetna Commercial	$15.78
Rate for Payer: Aetna Medicare Advantage	$12.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.59
Rate for Payer: Cigna Commercial	$20.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.46
Rate for Payer: Oxford Commercial	$8.31
Rate for Payer: Qualcare PPO/HMO/WC	$6.23
Rate for Payer: UnitedHealthcare Commercial	$8.31
Rate for Payer: UnitedHealthcare Community & State	$1.00
Rate for Payer: Wellpoint Medicaid Managed Care	$1.10

SUTURE PROLENE 6-0 BV-1

Facility

$242.77

Hospital Charge Code	270676672
Hospital Revenue Code	272
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$121.39
Rate for Payer: Aetna Commercial	$92.25
Rate for Payer: Aetna Medicare Advantage	$72.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.91
Rate for Payer: Cigna Commercial	$121.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.83
Rate for Payer: Oxford Commercial	$48.55
Rate for Payer: Qualcare PPO/HMO/WC	$36.42
Rate for Payer: UnitedHealthcare Commercial	$48.55
Rate for Payer: UnitedHealthcare Community & State	$5.85
Rate for Payer: Wellpoint Medicaid Managed Care	$6.43

Know your out-of-pocket cost for care.

All Charges