Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE SURGIGUT CH 3/0 30 V26

Facility

$7.09

Hospital Charge Code	270651800
Hospital Revenue Code	272
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$1.06
Rate for Payer: Qualcare PPO/HMO/WC	$1.06

SUTURE SURGIGUT CH 3/0 30 V26

Facility

$7.09

Hospital Charge Code	270651800
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.54
Rate for Payer: Aetna Commercial	$2.69
Rate for Payer: Aetna Medicare Advantage	$2.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.81
Rate for Payer: Cigna Commercial	$3.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.13
Rate for Payer: Oxford Commercial	$1.42
Rate for Payer: Qualcare PPO/HMO/WC	$1.06
Rate for Payer: UnitedHealthcare Commercial	$1.42
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE SURGIGUT CH 4/0 30 V20

Facility

$7.19

Hospital Charge Code	270604493
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$1.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.08

SUTURE SURGIGUT CH 4/0 30 V20

Facility

$7.19

Hospital Charge Code	270604493
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.60
Rate for Payer: Aetna Commercial	$2.73
Rate for Payer: Aetna Medicare Advantage	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.83
Rate for Payer: Cigna Commercial	$3.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.16
Rate for Payer: Oxford Commercial	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.08
Rate for Payer: UnitedHealthcare Commercial	$1.44
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE SURGIGUT CHR 0 60 TIES

Facility

$6.07

Hospital Charge Code	270604478
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$3.04
Rate for Payer: Aetna Commercial	$2.31
Rate for Payer: Aetna Medicare Advantage	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.55
Rate for Payer: Cigna Commercial	$3.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.82
Rate for Payer: Oxford Commercial	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.91
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 SURGIGUT CHR 0 60 TIES

Facility

$6.07

Hospital Charge Code	270604478
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.91

SUTURE SURGIGUT CHR 1 60 TIES

Facility

$6.27

Hospital Charge Code	270604479
Hospital Revenue Code	272
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$0.94
Rate for Payer: Qualcare PPO/HMO/WC	$0.94

SUTURE SURGIGUT CHR 1 60 TIES

Facility

$6.27

Hospital Charge Code	270604479
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$3.13
Rate for Payer: Aetna Commercial	$2.38
Rate for Payer: Aetna Medicare Advantage	$1.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.60
Rate for Payer: Cigna Commercial	$3.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.88
Rate for Payer: Oxford Commercial	$1.25
Rate for Payer: Qualcare PPO/HMO/WC	$0.94
Rate for Payer: UnitedHealthcare Commercial	$1.25
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

SUTURE SURGIGUT CHR 1 6X18IN

Facility

$14.08

Hospital Charge Code	270659480
Hospital Revenue Code	272
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$2.11
Rate for Payer: Qualcare PPO/HMO/WC	$2.11

SUTURE SURGIGUT CHR 1 6X18IN

Facility

$14.08

Hospital Charge Code	270659480
Hospital Revenue Code	272
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$7.04
Rate for Payer: Aetna Commercial	$5.35
Rate for Payer: Aetna Medicare Advantage	$4.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.59
Rate for Payer: Cigna Commercial	$7.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.22
Rate for Payer: Oxford Commercial	$2.82
Rate for Payer: Qualcare PPO/HMO/WC	$2.11
Rate for Payer: UnitedHealthcare Commercial	$2.82
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

SUTURE SURGIGUT CHR 3/0 30

Facility

$7.19

Hospital Charge Code	270604492
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.60
Rate for Payer: Aetna Commercial	$2.73
Rate for Payer: Aetna Medicare Advantage	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.83
Rate for Payer: Cigna Commercial	$3.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.16
Rate for Payer: Oxford Commercial	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.08
Rate for Payer: UnitedHealthcare Commercial	$1.44
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE SURGIGUT CHR 3/0 30

Facility

$7.19

Hospital Charge Code	270604492
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$1.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.08

SUTURE SURGIGUT CHR 4/0 30

Facility

$7.19

Hospital Charge Code	270604497
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$1.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.08

SUTURE SURGIGUT CHR 4/0 30

Facility

$7.19

Hospital Charge Code	270604497
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.60
Rate for Payer: Aetna Commercial	$2.73
Rate for Payer: Aetna Medicare Advantage	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.83
Rate for Payer: Cigna Commercial	$3.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.16
Rate for Payer: Oxford Commercial	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.08
Rate for Payer: UnitedHealthcare Commercial	$1.44
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE SURGIGUT CHR 5/0 30

Facility

$7.09

Hospital Charge Code	270604500
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.54
Rate for Payer: Aetna Commercial	$2.69
Rate for Payer: Aetna Medicare Advantage	$2.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.81
Rate for Payer: Cigna Commercial	$3.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.13
Rate for Payer: Oxford Commercial	$1.42
Rate for Payer: Qualcare PPO/HMO/WC	$1.06
Rate for Payer: UnitedHealthcare Commercial	$1.42
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE SURGIGUT CHR 5/0 30

Facility

$7.09

Hospital Charge Code	270604500
Hospital Revenue Code	272
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$1.06
Rate for Payer: Qualcare PPO/HMO/WC	$1.06

SUTURE SURGIGUT CHROMIC 7/0 18

Facility

$100.11

Hospital Charge Code	270651146
Hospital Revenue Code	272
Min. Negotiated Rate	$15.02
Max. Negotiated Rate	$15.02
Rate for Payer: Qualcare PPO/HMO/WC	$15.02

SUTURE SURGIGUT CHROMIC 7/0 18

Facility

$100.11

Hospital Charge Code	270651146
Hospital Revenue Code	272
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$50.05
Rate for Payer: Aetna Commercial	$38.04
Rate for Payer: Aetna Medicare Advantage	$30.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.53
Rate for Payer: Cigna Commercial	$50.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.03
Rate for Payer: Oxford Commercial	$20.02
Rate for Payer: Qualcare PPO/HMO/WC	$15.02
Rate for Payer: UnitedHealthcare Commercial	$20.02
Rate for Payer: UnitedHealthcare Community & State	$2.41
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

SUTURE SURGIGUT CV23 4-0 30

Facility

$635.25

Hospital Charge Code	270610212
Hospital Revenue Code	272
Min. Negotiated Rate	$15.31
Max. Negotiated Rate	$317.62
Rate for Payer: Aetna Commercial	$241.40
Rate for Payer: Aetna Medicare Advantage	$190.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.99
Rate for Payer: Cigna Commercial	$317.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.57
Rate for Payer: Oxford Commercial	$127.05
Rate for Payer: Qualcare PPO/HMO/WC	$95.29
Rate for Payer: UnitedHealthcare Commercial	$127.05
Rate for Payer: UnitedHealthcare Community & State	$15.31
Rate for Payer: Wellpoint Medicaid Managed Care	$16.83

SUTURE SURGIGUT CV23 4-0 30

Facility

$635.25

Hospital Charge Code	270610212
Hospital Revenue Code	272
Min. Negotiated Rate	$95.29
Max. Negotiated Rate	$95.29
Rate for Payer: Qualcare PPO/HMO/WC	$95.29

SUTURE SURGIGUT GS11 0

Facility

$65.65

Hospital Charge Code	270600553
Hospital Revenue Code	272
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$32.83
Rate for Payer: Aetna Commercial	$24.95
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.70
Rate for Payer: Oxford Commercial	$13.13
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$13.13
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.74

SUTURE SURGIGUT GS11 0

Facility

$65.65

Hospital Charge Code	270600553
Hospital Revenue Code	272
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

SUTURE SURGIGUT GS11 2-0

Facility

$65.65

Hospital Charge Code	270600554
Hospital Revenue Code	272
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$32.83
Rate for Payer: Aetna Commercial	$24.95
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.70
Rate for Payer: Oxford Commercial	$13.13
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$13.13
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.74

SUTURE SURGIGUT GS11 2-0

Facility

$65.65

Hospital Charge Code	270600554
Hospital Revenue Code	272
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

SUTURE SURGIGUT GS11 3-0

Facility

$16.85

Hospital Charge Code	270600562
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.43
Rate for Payer: Aetna Commercial	$6.40
Rate for Payer: Aetna Medicare Advantage	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.05
Rate for Payer: Oxford Commercial	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$3.37
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

Know your out-of-pocket cost for care.

All Charges