Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE SURGITIE LIG LOOP W/

Facility

$453.15

Hospital Charge Code	270655608
Hospital Revenue Code	272
Min. Negotiated Rate	$67.97
Max. Negotiated Rate	$67.97
Rate for Payer: Qualcare PPO/HMO/WC	$67.97

SUTURE SURGITIE LOOP POLY 0

Facility

$112.71

Hospital Charge Code	270604729
Hospital Revenue Code	272
Min. Negotiated Rate	$16.91
Max. Negotiated Rate	$16.91
Rate for Payer: Qualcare PPO/HMO/WC	$16.91

SUTURE SURGITIE LOOP POLY 0

Facility

$112.71

Hospital Charge Code	270604729
Hospital Revenue Code	272
Min. Negotiated Rate	$2.72
Max. Negotiated Rate	$56.35
Rate for Payer: Aetna Commercial	$42.83
Rate for Payer: Aetna Medicare Advantage	$33.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.74
Rate for Payer: Cigna Commercial	$56.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.81
Rate for Payer: Oxford Commercial	$22.54
Rate for Payer: Qualcare PPO/HMO/WC	$16.91
Rate for Payer: UnitedHealthcare Commercial	$22.54
Rate for Payer: UnitedHealthcare Community & State	$2.72
Rate for Payer: Wellpoint Medicaid Managed Care	$2.99

SUTURE SURG STEEL 2-0 SS28G

Facility

$93.65

Hospital Charge Code	270608066
Hospital Revenue Code	272
Min. Negotiated Rate	$14.05
Max. Negotiated Rate	$14.05
Rate for Payer: Qualcare PPO/HMO/WC	$14.05

SUTURE SURG STEEL 2-0 SS28G

Facility

$93.65

Hospital Charge Code	270608066
Hospital Revenue Code	272
Min. Negotiated Rate	$2.26
Max. Negotiated Rate	$46.83
Rate for Payer: Aetna Commercial	$35.59
Rate for Payer: Aetna Medicare Advantage	$28.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.88
Rate for Payer: Cigna Commercial	$46.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.09
Rate for Payer: Oxford Commercial	$18.73
Rate for Payer: Qualcare PPO/HMO/WC	$14.05
Rate for Payer: UnitedHealthcare Commercial	$18.73
Rate for Payer: UnitedHealthcare Community & State	$2.26
Rate for Payer: Wellpoint Medicaid Managed Care	$2.48

SUTURE SURG STEEL 3-0

Facility

$91.25

Hospital Charge Code	270604721
Hospital Revenue Code	272
Min. Negotiated Rate	$2.20
Max. Negotiated Rate	$45.62
Rate for Payer: Aetna Commercial	$34.67
Rate for Payer: Aetna Medicare Advantage	$27.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.27
Rate for Payer: Cigna Commercial	$45.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.38
Rate for Payer: Oxford Commercial	$18.25
Rate for Payer: Qualcare PPO/HMO/WC	$13.69
Rate for Payer: UnitedHealthcare Commercial	$18.25
Rate for Payer: UnitedHealthcare Community & State	$2.20
Rate for Payer: Wellpoint Medicaid Managed Care	$2.42

SUTURE SURG STEEL 3-0

Facility

$91.25

Hospital Charge Code	270604721
Hospital Revenue Code	272
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$13.69
Rate for Payer: Qualcare PPO/HMO/WC	$13.69

SUTURE SURG STEEL M654G

Facility

$133.25

Hospital Charge Code	270634808
Hospital Revenue Code	272
Min. Negotiated Rate	$19.99
Max. Negotiated Rate	$19.99
Rate for Payer: Qualcare PPO/HMO/WC	$19.99

SUTURE SURG STEEL M654G

Facility

$133.25

Hospital Charge Code	270634808
Hospital Revenue Code	272
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$66.62
Rate for Payer: Aetna Commercial	$50.63
Rate for Payer: Aetna Medicare Advantage	$39.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.98
Rate for Payer: Cigna Commercial	$66.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.98
Rate for Payer: Oxford Commercial	$26.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.99
Rate for Payer: UnitedHealthcare Commercial	$26.65
Rate for Payer: UnitedHealthcare Community & State	$3.21
Rate for Payer: Wellpoint Medicaid Managed Care	$3.53

SUTURE SWANSON PASSER

Facility

$438.90

Hospital Charge Code	270657893
Hospital Revenue Code	272
Min. Negotiated Rate	$10.58
Max. Negotiated Rate	$219.45
Rate for Payer: Aetna Commercial	$166.78
Rate for Payer: Aetna Medicare Advantage	$131.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.92
Rate for Payer: Cigna Commercial	$219.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.67
Rate for Payer: Oxford Commercial	$87.78
Rate for Payer: Qualcare PPO/HMO/WC	$65.83
Rate for Payer: UnitedHealthcare Commercial	$87.78
Rate for Payer: UnitedHealthcare Community & State	$10.58
Rate for Payer: Wellpoint Medicaid Managed Care	$11.63

SUTURE SWANSON PASSER

Facility

$438.90

Hospital Charge Code	270657893
Hospital Revenue Code	272
Min. Negotiated Rate	$65.83
Max. Negotiated Rate	$65.83
Rate for Payer: Qualcare PPO/HMO/WC	$65.83

SUTURE TAK GUIDE CL OF AR1934G

Facility

$719.25

Hospital Charge Code	270633583
Hospital Revenue Code	272
Min. Negotiated Rate	$17.33
Max. Negotiated Rate	$359.62
Rate for Payer: Aetna Commercial	$273.31
Rate for Payer: Aetna Medicare Advantage	$215.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.41
Rate for Payer: Cigna Commercial	$359.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.78
Rate for Payer: Oxford Commercial	$143.85
Rate for Payer: Qualcare PPO/HMO/WC	$107.89
Rate for Payer: UnitedHealthcare Commercial	$143.85
Rate for Payer: UnitedHealthcare Community & State	$17.33
Rate for Payer: Wellpoint Medicaid Managed Care	$19.06

SUTURE TAK GUIDE CL OF AR1934G

Facility

$719.25

Hospital Charge Code	270633583
Hospital Revenue Code	272
Min. Negotiated Rate	$107.89
Max. Negotiated Rate	$107.89
Rate for Payer: Qualcare PPO/HMO/WC	$107.89

SUTURETAK MINI BIOCOMP

Facility

$1,625.00

Hospital Charge Code	270655938
Hospital Revenue Code	272
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$243.75
Rate for Payer: Qualcare PPO/HMO/WC	$243.75

SUTURETAK MINI BIOCOMP

Facility

$1,625.00

Hospital Charge Code	270655938
Hospital Revenue Code	272
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$812.50
Rate for Payer: Aetna Commercial	$617.50
Rate for Payer: Aetna Medicare Advantage	$487.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.38
Rate for Payer: Cigna Commercial	$812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$487.50
Rate for Payer: Oxford Commercial	$325.00
Rate for Payer: Qualcare PPO/HMO/WC	$243.75
Rate for Payer: UnitedHealthcare Commercial	$325.00
Rate for Payer: UnitedHealthcare Community & State	$39.16
Rate for Payer: Wellpoint Medicaid Managed Care	$43.06

SUTURETAK MINI DISP KIT

Facility

$875.00

Hospital Charge Code	270655939
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

SUTURETAK MINI DISP KIT

Facility

$875.00

Hospital Charge Code	270655939
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

SUTURE TAKS W TAPE

Facility

$2,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270692653
Hospital Revenue Code	278
Min. Negotiated Rate	$348.75
Max. Negotiated Rate	$562.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$511.50
Rate for Payer: Qualcare PPO/HMO/WC	$348.75

SUTURE TAKS W TAPE

Facility

$2,325.00

Service Code	HCPCS C1713
Hospital Charge Code	270692653
Hospital Revenue Code	278
Min. Negotiated Rate	$56.03
Max. Negotiated Rate	$1,162.50
Rate for Payer: Aetna Commercial	$883.50
Rate for Payer: Aetna Medicare Advantage	$697.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$592.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$592.88
Rate for Payer: Cigna Commercial	$1,162.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$511.50
Rate for Payer: Qualcare PPO/HMO/WC	$348.75
Rate for Payer: UnitedHealthcare Community & State	$56.03
Rate for Payer: Wellpoint Medicaid Managed Care	$61.61

SUTURE TAPE 1.2M XBRAID BL. CO

Facility

$650.25

Hospital Charge Code	270677418
Hospital Revenue Code	272
Min. Negotiated Rate	$97.54
Max. Negotiated Rate	$97.54
Rate for Payer: Qualcare PPO/HMO/WC	$97.54

SUTURE TAPE 1.2M XBRAID BL. CO

Facility

$650.25

Hospital Charge Code	270677418
Hospital Revenue Code	272
Min. Negotiated Rate	$15.67
Max. Negotiated Rate	$325.12
Rate for Payer: Aetna Commercial	$247.09
Rate for Payer: Aetna Medicare Advantage	$195.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.81
Rate for Payer: Cigna Commercial	$325.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.07
Rate for Payer: Oxford Commercial	$130.05
Rate for Payer: Qualcare PPO/HMO/WC	$97.54
Rate for Payer: UnitedHealthcare Commercial	$130.05
Rate for Payer: UnitedHealthcare Community & State	$15.67
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

SUTURE TAPE FIBER SUTURE .9MM

Facility

$475.00

Hospital Charge Code	270688452
Hospital Revenue Code	272
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.50
Rate for Payer: Oxford Commercial	$95.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Commercial	$95.00
Rate for Payer: UnitedHealthcare Community & State	$11.45
Rate for Payer: Wellpoint Medicaid Managed Care	$12.59

SUTURE TAPE FIBER SUTURE .9MM

Facility

$475.00

Hospital Charge Code	270688452
Hospital Revenue Code	272
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Qualcare PPO/HMO/WC	$71.25

SUTURE TAPE TIGER LINK 1.3MM W

Facility

$425.00

Hospital Charge Code	270688455
Hospital Revenue Code	272
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.50
Rate for Payer: Oxford Commercial	$85.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$85.00
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

SUTURE TAPE TIGER LINK 1.3MM W

Facility

$425.00

Hospital Charge Code	270688455
Hospital Revenue Code	272
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

Know your out-of-pocket cost for care.

All Charges