Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE SURGIGUT HGS21 0

Facility

$77.65

Hospital Charge Code	270604489
Hospital Revenue Code	272
Min. Negotiated Rate	$1.87
Max. Negotiated Rate	$38.83
Rate for Payer: Aetna Commercial	$29.51
Rate for Payer: Aetna Medicare Advantage	$23.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.80
Rate for Payer: Cigna Commercial	$38.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.30
Rate for Payer: Oxford Commercial	$15.53
Rate for Payer: Qualcare PPO/HMO/WC	$11.65
Rate for Payer: UnitedHealthcare Commercial	$15.53
Rate for Payer: UnitedHealthcare Community & State	$1.87
Rate for Payer: Wellpoint Medicaid Managed Care	$2.06

SUTURE SURGIGUT HGS21 0

Facility

$77.65

Hospital Charge Code	270604489
Hospital Revenue Code	272
Min. Negotiated Rate	$11.65
Max. Negotiated Rate	$11.65
Rate for Payer: Qualcare PPO/HMO/WC	$11.65

SUTURE SURGIGUT HGS21 1

Facility

$933.65

Hospital Charge Code	270609915
Hospital Revenue Code	272
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$466.82
Rate for Payer: Aetna Commercial	$354.79
Rate for Payer: Aetna Medicare Advantage	$280.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.08
Rate for Payer: Cigna Commercial	$466.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$280.10
Rate for Payer: Oxford Commercial	$186.73
Rate for Payer: Qualcare PPO/HMO/WC	$140.05
Rate for Payer: UnitedHealthcare Commercial	$186.73
Rate for Payer: UnitedHealthcare Community & State	$22.50
Rate for Payer: Wellpoint Medicaid Managed Care	$24.74

SUTURE SURGIGUT HGS21 1

Facility

$933.65

Hospital Charge Code	270609914
Hospital Revenue Code	272
Min. Negotiated Rate	$140.05
Max. Negotiated Rate	$140.05
Rate for Payer: Qualcare PPO/HMO/WC	$140.05

SUTURE SURGIGUT HGS21 1

Facility

$933.65

Hospital Charge Code	270609915
Hospital Revenue Code	272
Min. Negotiated Rate	$140.05
Max. Negotiated Rate	$140.05
Rate for Payer: Qualcare PPO/HMO/WC	$140.05

SUTURE SURGIGUT HGS21 1

Facility

$933.65

Hospital Charge Code	270609914
Hospital Revenue Code	272
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$466.82
Rate for Payer: Aetna Commercial	$354.79
Rate for Payer: Aetna Medicare Advantage	$280.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.08
Rate for Payer: Cigna Commercial	$466.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$280.10
Rate for Payer: Oxford Commercial	$186.73
Rate for Payer: Qualcare PPO/HMO/WC	$140.05
Rate for Payer: UnitedHealthcare Commercial	$186.73
Rate for Payer: UnitedHealthcare Community & State	$22.50
Rate for Payer: Wellpoint Medicaid Managed Care	$24.74

SUTURE SURGIGUT HOS10 2-0

Facility

$80.00

Hospital Charge Code	270604490
Hospital Revenue Code	272
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$30.40
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.00
Rate for Payer: Oxford Commercial	$16.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Commercial	$16.00
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

SUTURE SURGIGUT HOS10 2-0

Facility

$80.00

Hospital Charge Code	270604490
Hospital Revenue Code	272
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

SUTURE SURGIGUT P11 5-0

Facility

$43.25

Hospital Charge Code	270604634
Hospital Revenue Code	272
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

SUTURE SURGIGUT P11 5-0

Facility

$43.25

Hospital Charge Code	270604634
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.62
Rate for Payer: Aetna Commercial	$16.43
Rate for Payer: Aetna Medicare Advantage	$12.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.03
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.97
Rate for Payer: Oxford Commercial	$8.65
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$8.65
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

SUTURE SURGIGUT P11 6-0

Facility

$32.00

Hospital Charge Code	270600786
Hospital Revenue Code	272
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$6.40
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

SUTURE SURGIGUT P11 6-0

Facility

$32.00

Hospital Charge Code	270600786
Hospital Revenue Code	272
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

SUTURE SURGIGUT P12 3-0

Facility

$29.65

Hospital Charge Code	270600789
Hospital Revenue Code	272
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$14.82
Rate for Payer: Aetna Commercial	$11.27
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.56
Rate for Payer: Cigna Commercial	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.89
Rate for Payer: Oxford Commercial	$5.93
Rate for Payer: Qualcare PPO/HMO/WC	$4.45
Rate for Payer: UnitedHealthcare Commercial	$5.93
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

SUTURE SURGIGUT P12 3-0

Facility

$29.65

Hospital Charge Code	270600789
Hospital Revenue Code	272
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$4.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.45

SUTURE SURGIGUT P24 4-0

Facility

$39.25

Hospital Charge Code	270604496
Hospital Revenue Code	272
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.62
Rate for Payer: Aetna Commercial	$14.91
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.78
Rate for Payer: Oxford Commercial	$7.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Commercial	$7.85
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

SUTURE SURGIGUT P24 4-0

Facility

$39.25

Hospital Charge Code	270604496
Hospital Revenue Code	272
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$5.89
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

SUTURE SURGIGUT P24 4-0 SG1633

Facility

$1,492.00

Hospital Charge Code	270611060
Hospital Revenue Code	272
Min. Negotiated Rate	$35.96
Max. Negotiated Rate	$746.00
Rate for Payer: Aetna Commercial	$566.96
Rate for Payer: Aetna Medicare Advantage	$447.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$380.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$380.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$380.46
Rate for Payer: Cigna Commercial	$746.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$447.60
Rate for Payer: Oxford Commercial	$298.40
Rate for Payer: Qualcare PPO/HMO/WC	$223.80
Rate for Payer: UnitedHealthcare Commercial	$298.40
Rate for Payer: UnitedHealthcare Community & State	$35.96
Rate for Payer: Wellpoint Medicaid Managed Care	$39.54

SUTURE SURGIGUT P24 4-0 SG1633

Facility

$1,492.00

Hospital Charge Code	270611060
Hospital Revenue Code	272
Min. Negotiated Rate	$223.80
Max. Negotiated Rate	$223.80
Rate for Payer: Qualcare PPO/HMO/WC	$223.80

SUTURE SURGIGUT P24 5-0

Facility

$39.25

Hospital Charge Code	270604499
Hospital Revenue Code	272
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.62
Rate for Payer: Aetna Commercial	$14.91
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.78
Rate for Payer: Oxford Commercial	$7.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Commercial	$7.85
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

SUTURE SURGIGUT P24 5-0

Facility

$39.25

Hospital Charge Code	270604499
Hospital Revenue Code	272
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$5.89
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

SUTURE SURGIGUT PC12 4-0

Facility

$39.25

Hospital Charge Code	270604494
Hospital Revenue Code	272
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.62
Rate for Payer: Aetna Commercial	$14.91
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.78
Rate for Payer: Oxford Commercial	$7.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Commercial	$7.85
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

SUTURE SURGIGUT PC12 4-0

Facility

$39.25

Hospital Charge Code	270604494
Hospital Revenue Code	272
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$5.89
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

SUTURE SURGIGUT PL 3/0 30 V20

Facility

$6.83

Hospital Charge Code	270656133
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$1.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.02

SUTURE SURGIGUT PL 3/0 30 V20

Facility

$6.83

Hospital Charge Code	270656133
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$3.42
Rate for Payer: Aetna Commercial	$2.60
Rate for Payer: Aetna Medicare Advantage	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.74
Rate for Payer: Cigna Commercial	$3.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.05
Rate for Payer: Oxford Commercial	$1.37
Rate for Payer: Qualcare PPO/HMO/WC	$1.02
Rate for Payer: UnitedHealthcare Commercial	$1.37
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE SURGIGUT REEL 3-0

Facility

$7.26

Hospital Charge Code	270604482
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

Know your out-of-pocket cost for care.

All Charges