Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE SURGIGUT REEL 3-0

Facility

$7.26

Hospital Charge Code	270604482
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.63
Rate for Payer: Aetna Commercial	$2.76
Rate for Payer: Aetna Medicare Advantage	$2.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.18
Rate for Payer: Oxford Commercial	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$1.45
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE SURGIGUT REEL 4-0

Facility

$7.08

Hospital Charge Code	270604483
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	$2.12
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	$2.12
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 REEL 4-0

Facility

$7.08

Hospital Charge Code	270604483
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 SC11 4-0

Facility

$19.25

Hospital Charge Code	270604631
Hospital Revenue Code	272
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

SUTURE SURGIGUT SC11 4-0

Facility

$19.25

Hospital Charge Code	270604631
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.62
Rate for Payer: Aetna Commercial	$7.32
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.91
Rate for Payer: Cigna Commercial	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.78
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.89
Rate for Payer: UnitedHealthcare Commercial	$3.85
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

SUTURE SURGIGUT SHR 0 30 V20

Facility

$7.14

Hospital Charge Code	270651147
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.57
Rate for Payer: Aetna Commercial	$2.71
Rate for Payer: Aetna Medicare Advantage	$2.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.82
Rate for Payer: Cigna Commercial	$3.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.14
Rate for Payer: Oxford Commercial	$1.43
Rate for Payer: Qualcare PPO/HMO/WC	$1.07
Rate for Payer: UnitedHealthcare Commercial	$1.43
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE SURGIGUT SHR 0 30 V20

Facility

$7.14

Hospital Charge Code	270651147
Hospital Revenue Code	272
Min. Negotiated Rate	$1.07
Max. Negotiated Rate	$1.07
Rate for Payer: Qualcare PPO/HMO/WC	$1.07

SUTURE SURGIGUT TIE 2-0

Facility

$5.61

Hospital Charge Code	270604480
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.81
Rate for Payer: Aetna Commercial	$2.13
Rate for Payer: Aetna Medicare Advantage	$1.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.43
Rate for Payer: Cigna Commercial	$2.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.68
Rate for Payer: Oxford Commercial	$1.12
Rate for Payer: Qualcare PPO/HMO/WC	$0.84
Rate for Payer: UnitedHealthcare Commercial	$1.12
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

SUTURE SURGIGUT TIE 2-0

Facility

$5.61

Hospital Charge Code	270604480
Hospital Revenue Code	272
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$0.84
Rate for Payer: Qualcare PPO/HMO/WC	$0.84

SUTURE SURGIGUT TIE 3-0

Facility

$11.23

Hospital Charge Code	270604481
Hospital Revenue Code	272
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$1.68
Rate for Payer: Qualcare PPO/HMO/WC	$1.68

SUTURE SURGIGUT TIE 3-0

Facility

$11.23

Hospital Charge Code	270604481
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.27
Rate for Payer: Aetna Medicare Advantage	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.86
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.37
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.68
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

SUTURE SURGIGUT V20 0

Facility

$63.25

Hospital Charge Code	270600550
Hospital Revenue Code	272
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$31.62
Rate for Payer: Aetna Commercial	$24.04
Rate for Payer: Aetna Medicare Advantage	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.13
Rate for Payer: Cigna Commercial	$31.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.98
Rate for Payer: Oxford Commercial	$12.65
Rate for Payer: Qualcare PPO/HMO/WC	$9.49
Rate for Payer: UnitedHealthcare Commercial	$12.65
Rate for Payer: UnitedHealthcare Community & State	$1.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1.68

SUTURE SURGIGUT V20 0

Facility

$63.25

Hospital Charge Code	270600550
Hospital Revenue Code	272
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$9.49
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

SUTURE SURGIGUT V-20 4-0 30

Facility

$7.26

Hospital Charge Code	270651143
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.63
Rate for Payer: Aetna Commercial	$2.76
Rate for Payer: Aetna Medicare Advantage	$2.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.85
Rate for Payer: Cigna Commercial	$3.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.18
Rate for Payer: Oxford Commercial	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.09
Rate for Payer: UnitedHealthcare Commercial	$1.45
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE SURGIGUT V-20 4-0 30

Facility

$7.26

Hospital Charge Code	270651143
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

SUTURE SURGILENE 6-0 P-13

Facility

$28.60

Hospital Charge Code	270655913
Hospital Revenue Code	272
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$14.30
Rate for Payer: Aetna Commercial	$10.87
Rate for Payer: Aetna Medicare Advantage	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.29
Rate for Payer: Cigna Commercial	$14.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.58
Rate for Payer: Oxford Commercial	$5.72
Rate for Payer: Qualcare PPO/HMO/WC	$4.29
Rate for Payer: UnitedHealthcare Commercial	$5.72
Rate for Payer: UnitedHealthcare Community & State	$0.69
Rate for Payer: Wellpoint Medicaid Managed Care	$0.76

SUTURE SURGILENE 6-0 P-13

Facility

$28.60

Hospital Charge Code	270655913
Hospital Revenue Code	272
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$4.29
Rate for Payer: Qualcare PPO/HMO/WC	$4.29

SUTURE SURGILON 3/0 30 BK C14

Facility

$19.71

Hospital Charge Code	270618236
Hospital Revenue Code	272
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$9.86
Rate for Payer: Aetna Commercial	$7.49
Rate for Payer: Aetna Medicare Advantage	$5.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.03
Rate for Payer: Cigna Commercial	$9.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.91
Rate for Payer: Oxford Commercial	$3.94
Rate for Payer: Qualcare PPO/HMO/WC	$2.96
Rate for Payer: UnitedHealthcare Commercial	$3.94
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.52

SUTURE SURGILON 3/0 30 BK C14

Facility

$19.71

Hospital Charge Code	270618236
Hospital Revenue Code	272
Min. Negotiated Rate	$2.96
Max. Negotiated Rate	$2.96
Rate for Payer: Qualcare PPO/HMO/WC	$2.96

SUTURE SURGILON 4-0 TF CVF-21

Facility

$125.40

Hospital Charge Code	270658811
Hospital Revenue Code	272
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$62.70
Rate for Payer: Aetna Commercial	$47.65
Rate for Payer: Aetna Medicare Advantage	$37.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.98
Rate for Payer: Cigna Commercial	$62.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.62
Rate for Payer: Oxford Commercial	$25.08
Rate for Payer: Qualcare PPO/HMO/WC	$18.81
Rate for Payer: UnitedHealthcare Commercial	$25.08
Rate for Payer: UnitedHealthcare Community & State	$3.02
Rate for Payer: Wellpoint Medicaid Managed Care	$3.32

SUTURE SURGILON 4-0 TF CVF-21

Facility

$125.40

Hospital Charge Code	270658811
Hospital Revenue Code	272
Min. Negotiated Rate	$18.81
Max. Negotiated Rate	$18.81
Rate for Payer: Qualcare PPO/HMO/WC	$18.81

SUTURE SURGILON C-14 2/0 BLK

Facility

$35.36

Hospital Charge Code	270618237
Hospital Revenue Code	272
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$5.30
Rate for Payer: Qualcare PPO/HMO/WC	$5.30

SUTURE SURGILON C-14 2/0 BLK

Facility

$35.36

Hospital Charge Code	270618237
Hospital Revenue Code	272
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$17.68
Rate for Payer: Aetna Commercial	$13.44
Rate for Payer: Aetna Medicare Advantage	$10.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.02
Rate for Payer: Cigna Commercial	$17.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.61
Rate for Payer: Oxford Commercial	$7.07
Rate for Payer: Qualcare PPO/HMO/WC	$5.30
Rate for Payer: UnitedHealthcare Commercial	$7.07
Rate for Payer: UnitedHealthcare Community & State	$0.85
Rate for Payer: Wellpoint Medicaid Managed Care	$0.94

SUTURE SURGIPRO 0 30 BLUE CT1

Facility

$8.11

Hospital Charge Code	270604668
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$4.05
Rate for Payer: Aetna Commercial	$3.08
Rate for Payer: Aetna Medicare Advantage	$2.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.07
Rate for Payer: Cigna Commercial	$4.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.43
Rate for Payer: Oxford Commercial	$1.62
Rate for Payer: Qualcare PPO/HMO/WC	$1.22
Rate for Payer: UnitedHealthcare Commercial	$1.62
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SUTURE SURGIPRO 0 30 BLUE CT1

Facility

$8.11

Hospital Charge Code	270604668
Hospital Revenue Code	272
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$1.22
Rate for Payer: Qualcare PPO/HMO/WC	$1.22

Know your out-of-pocket cost for care.

All Charges