Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE SOFSILK 3/0 5x18 V20

Facility

$20.30

Hospital Charge Code	270656137
Hospital Revenue Code	272
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$3.04
Rate for Payer: Qualcare PPO/HMO/WC	$3.04

SUTURE SOFSILK 3/0 5x30 V20

Facility

$19.89

Hospital Charge Code	270604602
Hospital Revenue Code	272
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$2.98
Rate for Payer: Qualcare PPO/HMO/WC	$2.98

SUTURE SOFSILK 3/0 5x30 V20

Facility

$19.89

Hospital Charge Code	270604602
Hospital Revenue Code	272
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$9.95
Rate for Payer: Aetna Commercial	$7.56
Rate for Payer: Aetna Medicare Advantage	$5.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.07
Rate for Payer: Cigna Commercial	$9.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.97
Rate for Payer: Oxford Commercial	$3.98
Rate for Payer: Qualcare PPO/HMO/WC	$2.98
Rate for Payer: UnitedHealthcare Commercial	$3.98
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

SUTURE SOFSILK 3-0 98 REEL

Facility

$4.28

Hospital Charge Code	270651161
Hospital Revenue Code	272
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$0.64
Rate for Payer: Qualcare PPO/HMO/WC	$0.64

SUTURE SOFSILK 3-0 98 REEL

Facility

$4.28

Hospital Charge Code	270651161
Hospital Revenue Code	272
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.14
Rate for Payer: Aetna Commercial	$1.63
Rate for Payer: Aetna Medicare Advantage	$1.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.09
Rate for Payer: Cigna Commercial	$2.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.28
Rate for Payer: Oxford Commercial	$0.86
Rate for Payer: Qualcare PPO/HMO/WC	$0.64
Rate for Payer: UnitedHealthcare Commercial	$0.86
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

SUTURE SOFSILK 3-0 BK 12x24

Facility

$6.03

Hospital Charge Code	270651110
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$3.02
Rate for Payer: Aetna Commercial	$2.29
Rate for Payer: Aetna Medicare Advantage	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.54
Rate for Payer: Cigna Commercial	$3.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.81
Rate for Payer: Oxford Commercial	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.21
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

SUTURE SOFSILK 3-0 BK 12x24

Facility

$6.03

Hospital Charge Code	270651110
Hospital Revenue Code	272
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

SUTURE SOFSILK 3.0 BLACK 18

Facility

$12.00

Hospital Charge Code	270656165
Hospital Revenue Code	272
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

SUTURE SOFSILK 3.0 BLACK 18

Facility

$12.00

Hospital Charge Code	270656165
Hospital Revenue Code	272
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

SUTURE SOFSILK 3-0 BLK 12X30

Facility

$4.79

Hospital Charge Code	270651121
Hospital Revenue Code	272
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$0.72
Rate for Payer: Qualcare PPO/HMO/WC	$0.72

SUTURE SOFSILK 3-0 BLK 12X30

Facility

$4.79

Hospital Charge Code	270651121
Hospital Revenue Code	272
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.40
Rate for Payer: Aetna Commercial	$1.82
Rate for Payer: Aetna Medicare Advantage	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.22
Rate for Payer: Cigna Commercial	$2.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.44
Rate for Payer: Oxford Commercial	$0.96
Rate for Payer: Qualcare PPO/HMO/WC	$0.72
Rate for Payer: UnitedHealthcare Commercial	$0.96
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

SUTURE SOFSILK 3-0 NDL SS684

Facility

$6.65

Hospital Charge Code	270634718
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.33
Rate for Payer: Aetna Commercial	$2.53
Rate for Payer: Aetna Medicare Advantage	$2.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.70
Rate for Payer: Cigna Commercial	$3.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.00
Rate for Payer: Oxford Commercial	$1.33
Rate for Payer: Qualcare PPO/HMO/WC	$1.00
Rate for Payer: UnitedHealthcare Commercial	$1.33
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE SOFSILK 3-0 NDL SS684

Facility

$6.65

Hospital Charge Code	270634718
Hospital Revenue Code	272
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.00

SUTURE SOFSILK 4/0 12x24 BLK

Facility

$5.97

Hospital Charge Code	270604595
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.98
Rate for Payer: Aetna Commercial	$2.27
Rate for Payer: Aetna Medicare Advantage	$1.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.52
Rate for Payer: Cigna Commercial	$2.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.79
Rate for Payer: Oxford Commercial	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.19
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

SUTURE SOFSILK 4/0 12x24 BLK

Facility

$5.97

Hospital Charge Code	270604595
Hospital Revenue Code	272
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

SUTURE SOFSILK 4/0 12x30 BLK

Facility

$7.80

Hospital Charge Code	270608847
Hospital Revenue Code	272
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$1.17
Rate for Payer: Qualcare PPO/HMO/WC	$1.17

SUTURE SOFSILK 4/0 12x30 BLK

Facility

$7.80

Hospital Charge Code	270608847
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.90
Rate for Payer: Aetna Commercial	$2.96
Rate for Payer: Aetna Medicare Advantage	$2.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.99
Rate for Payer: Cigna Commercial	$3.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Oxford Commercial	$1.56
Rate for Payer: Qualcare PPO/HMO/WC	$1.17
Rate for Payer: UnitedHealthcare Commercial	$1.56
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SUTURE SOFSILK 4/0 18 BLACK

Facility

$13.46

Hospital Charge Code	270604606
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$6.73
Rate for Payer: Aetna Commercial	$5.11
Rate for Payer: Aetna Medicare Advantage	$4.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.43
Rate for Payer: Cigna Commercial	$6.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.04
Rate for Payer: Oxford Commercial	$2.69
Rate for Payer: Qualcare PPO/HMO/WC	$2.02
Rate for Payer: UnitedHealthcare Commercial	$2.69
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

SUTURE SOFSILK 4/0 18 BLACK

Facility

$13.46

Hospital Charge Code	270604606
Hospital Revenue Code	272
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$2.02
Rate for Payer: Qualcare PPO/HMO/WC	$2.02

SUTURE SOFSILK 4/0 30 BLK V20

Facility

$5.10

Hospital Charge Code	270604605
Hospital Revenue Code	272
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.55
Rate for Payer: Aetna Commercial	$1.94
Rate for Payer: Aetna Medicare Advantage	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.30
Rate for Payer: Cigna Commercial	$2.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.53
Rate for Payer: Oxford Commercial	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$0.77
Rate for Payer: UnitedHealthcare Commercial	$1.02
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

SUTURE SOFSILK 4/0 30 BLK V20

Facility

$5.10

Hospital Charge Code	270604605
Hospital Revenue Code	272
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.77

SUTURE SOFSILK 4-0 BLACK 18

Facility

$13.60

Hospital Charge Code	270651330
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.80
Rate for Payer: Aetna Commercial	$5.17
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	$6.80
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 SOFSILK 4-0 BLACK 18

Facility

$13.60

Hospital Charge Code	270651330
Hospital Revenue Code	272
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$2.04
Rate for Payer: Qualcare PPO/HMO/WC	$2.04

SUTURE SOFSILK 5/0 18 BLACK

Facility

$46.88

Hospital Charge Code	270600791
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$23.44
Rate for Payer: Aetna Commercial	$17.81
Rate for Payer: Aetna Medicare Advantage	$14.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.95
Rate for Payer: Cigna Commercial	$23.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.06
Rate for Payer: Oxford Commercial	$9.38
Rate for Payer: Qualcare PPO/HMO/WC	$7.03
Rate for Payer: UnitedHealthcare Commercial	$9.38
Rate for Payer: UnitedHealthcare Community & State	$1.13
Rate for Payer: Wellpoint Medicaid Managed Care	$1.24

SUTURE SOFSILK 5/0 18 BLACK

Facility

$46.88

Hospital Charge Code	270600791
Hospital Revenue Code	272
Min. Negotiated Rate	$7.03
Max. Negotiated Rate	$7.03
Rate for Payer: Qualcare PPO/HMO/WC	$7.03

Know your out-of-pocket cost for care.

All Charges