Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE PROLENE SZ 0 UR 6 30

Facility

$173.45

Hospital Charge Code	270680623
Hospital Revenue Code	272
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$86.72
Rate for Payer: Aetna Commercial	$65.91
Rate for Payer: Aetna Medicare Advantage	$52.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.23
Rate for Payer: Cigna Commercial	$86.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.03
Rate for Payer: Oxford Commercial	$34.69
Rate for Payer: Qualcare PPO/HMO/WC	$26.02
Rate for Payer: UnitedHealthcare Commercial	$34.69
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: Wellpoint Medicaid Managed Care	$4.60

SUTURE QUAD/HAMSTNG MSCL RUPT

Facility

$30,595.00

Service Code	HCPCS 27385
Hospital Charge Code	16000398
Hospital Revenue Code	360
Min. Negotiated Rate	$737.34
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,178.50
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$737.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$810.77

SUTURE QUAD/HAMSTNG MSCL RUPT

Facility

$30,595.00

Service Code	HCPCS 27385
Hospital Charge Code	16000398
Hospital Revenue Code	360
Min. Negotiated Rate	$4,589.25
Max. Negotiated Rate	$4,589.25
Rate for Payer: Qualcare PPO/HMO/WC	$4,589.25

SUTURE QUILL #2

Facility

$97.14

Hospital Charge Code	270655973
Hospital Revenue Code	272
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$48.57
Rate for Payer: Aetna Commercial	$36.91
Rate for Payer: Aetna Medicare Advantage	$29.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.77
Rate for Payer: Cigna Commercial	$48.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.14
Rate for Payer: Oxford Commercial	$19.43
Rate for Payer: Qualcare PPO/HMO/WC	$14.57
Rate for Payer: UnitedHealthcare Commercial	$19.43
Rate for Payer: UnitedHealthcare Community & State	$2.34
Rate for Payer: Wellpoint Medicaid Managed Care	$2.57

SUTURE QUILL #2

Facility

$97.14

Hospital Charge Code	270655973
Hospital Revenue Code	272
Min. Negotiated Rate	$14.57
Max. Negotiated Rate	$14.57
Rate for Payer: Qualcare PPO/HMO/WC	$14.57

SUTURE QUILL PDO 2-1 20CM 1/2

Facility

$56.44

Hospital Charge Code	270686781
Hospital Revenue Code	272
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$28.22
Rate for Payer: Aetna Commercial	$21.45
Rate for Payer: Aetna Medicare Advantage	$16.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.39
Rate for Payer: Cigna Commercial	$28.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.93
Rate for Payer: Oxford Commercial	$11.29
Rate for Payer: Qualcare PPO/HMO/WC	$8.47
Rate for Payer: UnitedHealthcare Commercial	$11.29
Rate for Payer: UnitedHealthcare Community & State	$1.36
Rate for Payer: Wellpoint Medicaid Managed Care	$1.50

SUTURE QUILL PDO 2-1 20CM 1/2

Facility

$56.44

Hospital Charge Code	270686781
Hospital Revenue Code	272
Min. Negotiated Rate	$8.47
Max. Negotiated Rate	$8.47
Rate for Payer: Qualcare PPO/HMO/WC	$8.47

SUTURE QUILL PDO 2 UNI 20CM

Facility

$58.91

Hospital Charge Code	270686783
Hospital Revenue Code	272
Min. Negotiated Rate	$8.84
Max. Negotiated Rate	$8.84
Rate for Payer: Qualcare PPO/HMO/WC	$8.84

SUTURE QUILL PDO 2 UNI 20CM

Facility

$58.91

Hospital Charge Code	270686783
Hospital Revenue Code	272
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$29.45
Rate for Payer: Aetna Commercial	$22.39
Rate for Payer: Aetna Medicare Advantage	$17.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.02
Rate for Payer: Cigna Commercial	$29.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.67
Rate for Payer: Oxford Commercial	$11.78
Rate for Payer: Qualcare PPO/HMO/WC	$8.84
Rate for Payer: UnitedHealthcare Commercial	$11.78
Rate for Payer: UnitedHealthcare Community & State	$1.42
Rate for Payer: Wellpoint Medicaid Managed Care	$1.56

SUTURE QUILL PDO VIOLET 15 CM

Facility

$56.44

Hospital Charge Code	270688662
Hospital Revenue Code	272
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$28.22
Rate for Payer: Aetna Commercial	$21.45
Rate for Payer: Aetna Medicare Advantage	$16.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.39
Rate for Payer: Cigna Commercial	$28.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.93
Rate for Payer: Oxford Commercial	$11.29
Rate for Payer: Qualcare PPO/HMO/WC	$8.47
Rate for Payer: UnitedHealthcare Commercial	$11.29
Rate for Payer: UnitedHealthcare Community & State	$1.36
Rate for Payer: Wellpoint Medicaid Managed Care	$1.50

SUTURE QUILL PDO VIOLET 15 CM

Facility

$56.44

Hospital Charge Code	270688662
Hospital Revenue Code	272
Min. Negotiated Rate	$8.47
Max. Negotiated Rate	$8.47
Rate for Payer: Qualcare PPO/HMO/WC	$8.47

SUTURE REELS/TIES

Facility

$24.85

Hospital Charge Code	270999001
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

SUTURE REELS/TIES

Facility

$24.85

Hospital Charge Code	270999001
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$9.44
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.46
Rate for Payer: Oxford Commercial	$4.97
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$4.97
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

SUTURE REMOVAL KIT LITTAUER

Facility

$3.86

Hospital Charge Code	270653259
Hospital Revenue Code	272
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.47
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.16
Rate for Payer: Oxford Commercial	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$0.77
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

SUTURE REMOVAL KIT LITTAUER

Facility

$3.86

Hospital Charge Code	270653259
Hospital Revenue Code	272
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

SUTURE RETRIVER

Facility

$2,926.40

Hospital Charge Code	270655803
Hospital Revenue Code	272
Min. Negotiated Rate	$438.96
Max. Negotiated Rate	$438.96
Rate for Payer: Qualcare PPO/HMO/WC	$438.96

SUTURE RETRIVER

Facility

$2,926.40

Hospital Charge Code	270655803
Hospital Revenue Code	272
Min. Negotiated Rate	$70.53
Max. Negotiated Rate	$1,463.20
Rate for Payer: Aetna Commercial	$1,112.03
Rate for Payer: Aetna Medicare Advantage	$877.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$746.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$746.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$746.23
Rate for Payer: Cigna Commercial	$1,463.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$877.92
Rate for Payer: Oxford Commercial	$585.28
Rate for Payer: Qualcare PPO/HMO/WC	$438.96
Rate for Payer: UnitedHealthcare Commercial	$585.28
Rate for Payer: UnitedHealthcare Community & State	$70.53
Rate for Payer: Wellpoint Medicaid Managed Care	$77.55

SUTURES****

Facility

$44.00

Hospital Charge Code	1800267
Hospital Revenue Code	279
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.20
Rate for Payer: Oxford Commercial	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$8.80
Rate for Payer: UnitedHealthcare Community & State	$1.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

SUTURES****

Facility

$44.00

Hospital Charge Code	1800267
Hospital Revenue Code	279
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

SUTURE SH PROLENE 3-0

Facility

$573.45

Hospital Charge Code	207657434
Hospital Revenue Code	272
Min. Negotiated Rate	$13.82
Max. Negotiated Rate	$286.73
Rate for Payer: Aetna Commercial	$217.91
Rate for Payer: Aetna Medicare Advantage	$172.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.23
Rate for Payer: Cigna Commercial	$286.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.03
Rate for Payer: Oxford Commercial	$114.69
Rate for Payer: Qualcare PPO/HMO/WC	$86.02
Rate for Payer: UnitedHealthcare Commercial	$114.69
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: Wellpoint Medicaid Managed Care	$15.20

SUTURE SH PROLENE 3-0

Facility

$573.45

Hospital Charge Code	207657434
Hospital Revenue Code	272
Min. Negotiated Rate	$86.02
Max. Negotiated Rate	$86.02
Rate for Payer: Qualcare PPO/HMO/WC	$86.02

SUTURE SH PROLENE 3-0

Facility

$373.35

Hospital Charge Code	270657435
Hospital Revenue Code	272
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$186.68
Rate for Payer: Aetna Commercial	$141.87
Rate for Payer: Aetna Medicare Advantage	$112.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.20
Rate for Payer: Cigna Commercial	$186.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.00
Rate for Payer: Oxford Commercial	$74.67
Rate for Payer: Qualcare PPO/HMO/WC	$56.00
Rate for Payer: UnitedHealthcare Commercial	$74.67
Rate for Payer: UnitedHealthcare Community & State	$9.00
Rate for Payer: Wellpoint Medicaid Managed Care	$9.89

SUTURE SH PROLENE 3-0

Facility

$373.35

Hospital Charge Code	270657435
Hospital Revenue Code	272
Min. Negotiated Rate	$56.00
Max. Negotiated Rate	$56.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.00

SUTURE SH UNDYED VICRYL 3-0

Facility

$58.85

Hospital Charge Code	270657438
Hospital Revenue Code	272
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$29.43
Rate for Payer: Aetna Commercial	$22.36
Rate for Payer: Aetna Medicare Advantage	$17.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.01
Rate for Payer: Cigna Commercial	$29.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.66
Rate for Payer: Oxford Commercial	$11.77
Rate for Payer: Qualcare PPO/HMO/WC	$8.83
Rate for Payer: UnitedHealthcare Commercial	$11.77
Rate for Payer: UnitedHealthcare Community & State	$1.42
Rate for Payer: Wellpoint Medicaid Managed Care	$1.56

SUTURE SH UNDYED VICRYL 3-0

Facility

$58.85

Hospital Charge Code	270657438
Hospital Revenue Code	272
Min. Negotiated Rate	$8.83
Max. Negotiated Rate	$8.83
Rate for Payer: Qualcare PPO/HMO/WC	$8.83

Know your out-of-pocket cost for care.

All Charges