Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

$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 C-1

Facility

$85.00

Hospital Charge Code	270677256
Hospital Revenue Code	272
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

SUTURE PROLENE 6-0 C-1

Facility

$201.09

Hospital Charge Code	270676671
Hospital Revenue Code	272
Min. Negotiated Rate	$30.16
Max. Negotiated Rate	$30.16
Rate for Payer: Qualcare PPO/HMO/WC	$30.16

SUTURE PROLENE 6-0 C-1

Facility

$201.09

Hospital Charge Code	270676671
Hospital Revenue Code	272
Min. Negotiated Rate	$4.85
Max. Negotiated Rate	$100.55
Rate for Payer: Aetna Commercial	$76.41
Rate for Payer: Aetna Medicare Advantage	$60.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.28
Rate for Payer: Cigna Commercial	$100.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.33
Rate for Payer: Oxford Commercial	$40.22
Rate for Payer: Qualcare PPO/HMO/WC	$30.16
Rate for Payer: UnitedHealthcare Commercial	$40.22
Rate for Payer: UnitedHealthcare Community & State	$4.85
Rate for Payer: Wellpoint Medicaid Managed Care	$5.33

SUTURE PROLENE 6-0 C-1

Facility

$85.00

Hospital Charge Code	270677256
Hospital Revenue Code	272
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$42.50
Rate for Payer: Aetna Commercial	$32.30
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.50
Rate for Payer: Oxford Commercial	$17.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
Rate for Payer: UnitedHealthcare Commercial	$17.00
Rate for Payer: UnitedHealthcare Community & State	$2.05
Rate for Payer: Wellpoint Medicaid Managed Care	$2.25

SUTURE PROLENE 6-0 C1

Facility

$73.31

Hospital Charge Code	270677065
Hospital Revenue Code	272
Min. Negotiated Rate	$11.00
Max. Negotiated Rate	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.00

SUTURE PROLENE 6-0 C1

Facility

$73.31

Hospital Charge Code	270677065
Hospital Revenue Code	272
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$36.66
Rate for Payer: Aetna Commercial	$27.86
Rate for Payer: Aetna Medicare Advantage	$21.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.69
Rate for Payer: Cigna Commercial	$36.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.99
Rate for Payer: Oxford Commercial	$14.66
Rate for Payer: Qualcare PPO/HMO/WC	$11.00
Rate for Payer: UnitedHealthcare Commercial	$14.66
Rate for Payer: UnitedHealthcare Community & State	$1.77
Rate for Payer: Wellpoint Medicaid Managed Care	$1.94

SUTURE PROLENE 6-0 C-1/CV-11

Facility

$80.04

Hospital Charge Code	270655738
Hospital Revenue Code	272
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$40.02
Rate for Payer: Aetna Commercial	$30.42
Rate for Payer: Aetna Medicare Advantage	$24.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.41
Rate for Payer: Cigna Commercial	$40.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.01
Rate for Payer: Oxford Commercial	$16.01
Rate for Payer: Qualcare PPO/HMO/WC	$12.01
Rate for Payer: UnitedHealthcare Commercial	$16.01
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

SUTURE PROLENE 6-0 C-1/CV-11

Facility

$80.04

Hospital Charge Code	270655738
Hospital Revenue Code	272
Min. Negotiated Rate	$12.01
Max. Negotiated Rate	$12.01
Rate for Payer: Qualcare PPO/HMO/WC	$12.01

SUTURE PROLENE 6-0 CC-1

Facility

$231.78

Hospital Charge Code	270655694
Hospital Revenue Code	272
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$115.89
Rate for Payer: Aetna Commercial	$88.08
Rate for Payer: Aetna Medicare Advantage	$69.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.10
Rate for Payer: Cigna Commercial	$115.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.53
Rate for Payer: Oxford Commercial	$46.36
Rate for Payer: Qualcare PPO/HMO/WC	$34.77
Rate for Payer: UnitedHealthcare Commercial	$46.36
Rate for Payer: UnitedHealthcare Community & State	$5.59
Rate for Payer: Wellpoint Medicaid Managed Care	$6.14

SUTURE PROLENE 6-0 CC-1

Facility

$231.78

Hospital Charge Code	270655694
Hospital Revenue Code	272
Min. Negotiated Rate	$34.77
Max. Negotiated Rate	$34.77
Rate for Payer: Qualcare PPO/HMO/WC	$34.77

SUTURE PROLENE 6-0 CC-1

Facility

$85.36

Hospital Charge Code	270671415
Hospital Revenue Code	272
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$42.68
Rate for Payer: Aetna Commercial	$32.44
Rate for Payer: Aetna Medicare Advantage	$25.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.77
Rate for Payer: Cigna Commercial	$42.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.61
Rate for Payer: Oxford Commercial	$17.07
Rate for Payer: Qualcare PPO/HMO/WC	$12.80
Rate for Payer: UnitedHealthcare Commercial	$17.07
Rate for Payer: UnitedHealthcare Community & State	$2.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.26

SUTURE PROLENE 6-0 CC-1

Facility

$85.36

Hospital Charge Code	270671415
Hospital Revenue Code	272
Min. Negotiated Rate	$12.80
Max. Negotiated Rate	$12.80
Rate for Payer: Qualcare PPO/HMO/WC	$12.80

SUTURE PROLENE 6-0 P-1

Facility

$28.41

Hospital Charge Code	270671414
Hospital Revenue Code	272
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$14.21
Rate for Payer: Aetna Commercial	$10.80
Rate for Payer: Aetna Medicare Advantage	$8.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.24
Rate for Payer: Cigna Commercial	$14.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.52
Rate for Payer: Oxford Commercial	$5.68
Rate for Payer: Qualcare PPO/HMO/WC	$4.26
Rate for Payer: UnitedHealthcare Commercial	$5.68
Rate for Payer: UnitedHealthcare Community & State	$0.68
Rate for Payer: Wellpoint Medicaid Managed Care	$0.75

SUTURE PROLENE 6-0 P-1

Facility

$28.41

Hospital Charge Code	270671414
Hospital Revenue Code	272
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$4.26
Rate for Payer: Qualcare PPO/HMO/WC	$4.26

SUTURE PROLENE 6-0 P-1/P-10

Facility

$24.82

Hospital Charge Code	270671409
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.41
Rate for Payer: Aetna Commercial	$9.43
Rate for Payer: Aetna Medicare Advantage	$7.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.33
Rate for Payer: Cigna Commercial	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.45
Rate for Payer: Oxford Commercial	$4.96
Rate for Payer: Qualcare PPO/HMO/WC	$3.72
Rate for Payer: UnitedHealthcare Commercial	$4.96
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

SUTURE PROLENE 6-0 P-1/P-10

Facility

$24.82

Hospital Charge Code	270671409
Hospital Revenue Code	272
Min. Negotiated Rate	$3.72
Max. Negotiated Rate	$3.72
Rate for Payer: Qualcare PPO/HMO/WC	$3.72

SUTURE PROLENE 6-0 PC-1

Facility

$29.06

Hospital Charge Code	270664551
Hospital Revenue Code	272
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$14.53
Rate for Payer: Aetna Commercial	$11.04
Rate for Payer: Aetna Medicare Advantage	$8.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.41
Rate for Payer: Cigna Commercial	$14.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.72
Rate for Payer: Oxford Commercial	$5.81
Rate for Payer: Qualcare PPO/HMO/WC	$4.36
Rate for Payer: UnitedHealthcare Commercial	$5.81
Rate for Payer: UnitedHealthcare Community & State	$0.70
Rate for Payer: Wellpoint Medicaid Managed Care	$0.77

SUTURE PROLENE 6-0 PC-1

Facility

$29.06

Hospital Charge Code	270664551
Hospital Revenue Code	272
Min. Negotiated Rate	$4.36
Max. Negotiated Rate	$4.36
Rate for Payer: Qualcare PPO/HMO/WC	$4.36

SUTURE PROLENE 6-0 PC-3

Facility

$29.06

Hospital Charge Code	270661971
Hospital Revenue Code	272
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$14.53
Rate for Payer: Aetna Commercial	$11.04
Rate for Payer: Aetna Medicare Advantage	$8.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.41
Rate for Payer: Cigna Commercial	$14.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.72
Rate for Payer: Oxford Commercial	$5.81
Rate for Payer: Qualcare PPO/HMO/WC	$4.36
Rate for Payer: UnitedHealthcare Commercial	$5.81
Rate for Payer: UnitedHealthcare Community & State	$0.70
Rate for Payer: Wellpoint Medicaid Managed Care	$0.77

SUTURE PROLENE 6-0 PC-3

Facility

$29.06

Hospital Charge Code	270661971
Hospital Revenue Code	272
Min. Negotiated Rate	$4.36
Max. Negotiated Rate	$4.36
Rate for Payer: Qualcare PPO/HMO/WC	$4.36

SUTURE PROLENE 6-0 PS-3/P-11

Facility

$23.70

Hospital Charge Code	270677826
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.85
Rate for Payer: Aetna Commercial	$9.01
Rate for Payer: Aetna Medicare Advantage	$7.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.04
Rate for Payer: Cigna Commercial	$11.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.11
Rate for Payer: Oxford Commercial	$4.74
Rate for Payer: Qualcare PPO/HMO/WC	$3.56
Rate for Payer: UnitedHealthcare Commercial	$4.74
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.63

SUTURE PROLENE 6-0 PS-3/P-11

Facility

$23.70

Hospital Charge Code	270677826
Hospital Revenue Code	272
Min. Negotiated Rate	$3.56
Max. Negotiated Rate	$3.56
Rate for Payer: Qualcare PPO/HMO/WC	$3.56

Know your out-of-pocket cost for care.

All Charges