Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE SURGIPRO 6/0 18 BLU PC3

Facility

$17.85

Hospital Charge Code	270651316
Hospital Revenue Code	272
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$8.93
Rate for Payer: Aetna Commercial	$6.78
Rate for Payer: Aetna Medicare Advantage	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.55
Rate for Payer: Cigna Commercial	$8.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.36
Rate for Payer: Oxford Commercial	$3.57
Rate for Payer: Qualcare PPO/HMO/WC	$2.68
Rate for Payer: UnitedHealthcare Commercial	$3.57
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.47

SUTURE SURGIPRO 6/0 18 BLU PC3

Facility

$17.85

Hospital Charge Code	270651316
Hospital Revenue Code	272
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$2.68
Rate for Payer: Qualcare PPO/HMO/WC	$2.68

SUTURE SURGIPRO 6/0 18 CLEAR

Facility

$16.47

Hospital Charge Code	270604663
Hospital Revenue Code	272
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$8.23
Rate for Payer: Aetna Commercial	$6.26
Rate for Payer: Aetna Medicare Advantage	$4.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.20
Rate for Payer: Cigna Commercial	$8.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.94
Rate for Payer: Oxford Commercial	$3.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.47
Rate for Payer: UnitedHealthcare Commercial	$3.29
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

SUTURE SURGIPRO 6/0 18 CLEAR

Facility

$16.47

Hospital Charge Code	270604663
Hospital Revenue Code	272
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$2.47
Rate for Payer: Qualcare PPO/HMO/WC	$2.47

SUTURE SURGIPRO 6-0 NDL P-10

Facility

$15.16

Hospital Charge Code	270646966
Hospital Revenue Code	272
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$7.58
Rate for Payer: Aetna Commercial	$5.76
Rate for Payer: Aetna Medicare Advantage	$4.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.87
Rate for Payer: Cigna Commercial	$7.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.55
Rate for Payer: Oxford Commercial	$3.03
Rate for Payer: Qualcare PPO/HMO/WC	$2.27
Rate for Payer: UnitedHealthcare Commercial	$3.03
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

SUTURE SURGIPRO 6-0 NDL P-10

Facility

$15.16

Hospital Charge Code	270646966
Hospital Revenue Code	272
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$2.27
Rate for Payer: Qualcare PPO/HMO/WC	$2.27

SUTURE SURGIPRO 6-0 NDL P-10

Facility

$15.16

Hospital Charge Code	270646966C
Hospital Revenue Code	272
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$2.27
Rate for Payer: Qualcare PPO/HMO/WC	$2.27

SUTURE SURGIPRO 6-0 NDL P-10

Facility

$15.16

Hospital Charge Code	270646966C
Hospital Revenue Code	272
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$7.58
Rate for Payer: Aetna Commercial	$5.76
Rate for Payer: Aetna Medicare Advantage	$4.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.87
Rate for Payer: Cigna Commercial	$7.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.55
Rate for Payer: Oxford Commercial	$3.03
Rate for Payer: Qualcare PPO/HMO/WC	$2.27
Rate for Payer: UnitedHealthcare Commercial	$3.03
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

SUTURE SURGIPRO C13 3-0

Facility

$16.85

Hospital Charge Code	270600785
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

SUTURE SURGIPRO C13 3-0

Facility

$16.85

Hospital Charge Code	270600785
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

SUTURE SURGIPRO C13 5-0

Facility

$16.85

Hospital Charge Code	270600783
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

SUTURE SURGIPRO C13 5-0

Facility

$16.85

Hospital Charge Code	270600783
Hospital Revenue Code	272
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

SUTURE SURGIPRO C15 2-0

Facility

$7.26

Hospital Charge Code	270604670
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 SURGIPRO C15 2-0

Facility

$7.26

Hospital Charge Code	270604670
Hospital Revenue Code	272
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$1.09

SUTURE SURGIPRO CV-11 6-0

Facility

$84.45

Hospital Charge Code	270617469
Hospital Revenue Code	272
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$42.23
Rate for Payer: Aetna Commercial	$32.09
Rate for Payer: Aetna Medicare Advantage	$25.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.53
Rate for Payer: Cigna Commercial	$42.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.34
Rate for Payer: Oxford Commercial	$16.89
Rate for Payer: Qualcare PPO/HMO/WC	$12.67
Rate for Payer: UnitedHealthcare Commercial	$16.89
Rate for Payer: UnitedHealthcare Community & State	$2.04
Rate for Payer: Wellpoint Medicaid Managed Care	$2.24

SUTURE SURGIPRO CV-11 6-0

Facility

$84.45

Hospital Charge Code	270617469
Hospital Revenue Code	272
Min. Negotiated Rate	$12.67
Max. Negotiated Rate	$12.67
Rate for Payer: Qualcare PPO/HMO/WC	$12.67

SUTURE SURGIPRO CV-14 4-0 36

Facility

$18.85

Hospital Charge Code	270651335
Hospital Revenue Code	272
Min. Negotiated Rate	$2.83
Max. Negotiated Rate	$2.83
Rate for Payer: Qualcare PPO/HMO/WC	$2.83

SUTURE SURGIPRO CV-14 4-0 36

Facility

$18.85

Hospital Charge Code	270651335
Hospital Revenue Code	272
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$9.43
Rate for Payer: Aetna Commercial	$7.16
Rate for Payer: Aetna Medicare Advantage	$5.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.81
Rate for Payer: Cigna Commercial	$9.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.66
Rate for Payer: Oxford Commercial	$3.77
Rate for Payer: Qualcare PPO/HMO/WC	$2.83
Rate for Payer: UnitedHealthcare Commercial	$3.77
Rate for Payer: UnitedHealthcare Community & State	$0.45
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

SUTURE SURGIPRO CV-1 6-0 24

Facility

$43.21

Hospital Charge Code	270651239
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.61
Rate for Payer: Aetna Commercial	$16.42
Rate for Payer: Aetna Medicare Advantage	$12.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.02
Rate for Payer: Cigna Commercial	$21.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.96
Rate for Payer: Oxford Commercial	$8.64
Rate for Payer: Qualcare PPO/HMO/WC	$6.48
Rate for Payer: UnitedHealthcare Commercial	$8.64
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

SUTURE SURGIPRO CV-1 6-0 24

Facility

$43.21

Hospital Charge Code	270651239
Hospital Revenue Code	272
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$6.48
Rate for Payer: Qualcare PPO/HMO/WC	$6.48

SUTURE SURGIPRO CV-1 7-0 VP702

Facility

$96.85

Hospital Charge Code	270608723
Hospital Revenue Code	272
Min. Negotiated Rate	$14.53
Max. Negotiated Rate	$14.53
Rate for Payer: Qualcare PPO/HMO/WC	$14.53

SUTURE SURGIPRO CV-1 7-0 VP702

Facility

$96.85

Hospital Charge Code	270608723
Hospital Revenue Code	272
Min. Negotiated Rate	$2.33
Max. Negotiated Rate	$48.42
Rate for Payer: Aetna Commercial	$36.80
Rate for Payer: Aetna Medicare Advantage	$29.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.70
Rate for Payer: Cigna Commercial	$48.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.05
Rate for Payer: Oxford Commercial	$19.37
Rate for Payer: Qualcare PPO/HMO/WC	$14.53
Rate for Payer: UnitedHealthcare Commercial	$19.37
Rate for Payer: UnitedHealthcare Community & State	$2.33
Rate for Payer: Wellpoint Medicaid Managed Care	$2.57

SUTURE SURGIPRO CV-20 7-0

Facility

$105.65

Hospital Charge Code	270607499
Hospital Revenue Code	272
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$52.83
Rate for Payer: Aetna Commercial	$40.15
Rate for Payer: Aetna Medicare Advantage	$31.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.94
Rate for Payer: Cigna Commercial	$52.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.70
Rate for Payer: Oxford Commercial	$21.13
Rate for Payer: Qualcare PPO/HMO/WC	$15.85
Rate for Payer: UnitedHealthcare Commercial	$21.13
Rate for Payer: UnitedHealthcare Community & State	$2.55
Rate for Payer: Wellpoint Medicaid Managed Care	$2.80

SUTURE SURGIPRO CV-20 7-0

Facility

$105.65

Hospital Charge Code	270607499
Hospital Revenue Code	272
Min. Negotiated Rate	$15.85
Max. Negotiated Rate	$15.85
Rate for Payer: Qualcare PPO/HMO/WC	$15.85

SUTURE SURGIPRO CV22 6-0

Facility

$15.05

Hospital Charge Code	270604684
Hospital Revenue Code	272
Min. Negotiated Rate	$2.26
Max. Negotiated Rate	$2.26
Rate for Payer: Qualcare PPO/HMO/WC	$2.26

Know your out-of-pocket cost for care.

All Charges