Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE VELOSORB 2-0 GS21 36 UD

Facility

$23.51

Hospital Charge Code	270660435
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.76
Rate for Payer: Aetna Commercial	$8.93
Rate for Payer: Aetna Medicare Advantage	$7.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.00
Rate for Payer: Cigna Commercial	$11.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.05
Rate for Payer: Oxford Commercial	$4.70
Rate for Payer: Qualcare PPO/HMO/WC	$3.53
Rate for Payer: UnitedHealthcare Commercial	$4.70
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.62

SUTURE VELOSORB 2-0 GS21 36 UD

Facility

$23.51

Hospital Charge Code	270660435
Hospital Revenue Code	272
Min. Negotiated Rate	$3.53
Max. Negotiated Rate	$3.53
Rate for Payer: Qualcare PPO/HMO/WC	$3.53

SUTURE VELOSORB 2-0 UD 30 V-20

Facility

$284.90

Hospital Charge Code	270665888
Hospital Revenue Code	272
Min. Negotiated Rate	$6.87
Max. Negotiated Rate	$142.45
Rate for Payer: Aetna Commercial	$108.26
Rate for Payer: Aetna Medicare Advantage	$85.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.65
Rate for Payer: Cigna Commercial	$142.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.47
Rate for Payer: Oxford Commercial	$56.98
Rate for Payer: Qualcare PPO/HMO/WC	$42.73
Rate for Payer: UnitedHealthcare Commercial	$56.98
Rate for Payer: UnitedHealthcare Community & State	$6.87
Rate for Payer: Wellpoint Medicaid Managed Care	$7.55

SUTURE VELOSORB 2-0 UD 30 V-20

Facility

$23.51

Hospital Charge Code	270663828
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.76
Rate for Payer: Aetna Commercial	$8.93
Rate for Payer: Aetna Medicare Advantage	$7.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.00
Rate for Payer: Cigna Commercial	$11.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.05
Rate for Payer: Oxford Commercial	$4.70
Rate for Payer: Qualcare PPO/HMO/WC	$3.53
Rate for Payer: UnitedHealthcare Commercial	$4.70
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.62

SUTURE VELOSORB 2-0 UD 30 V-20

Facility

$23.51

Hospital Charge Code	270663828
Hospital Revenue Code	272
Min. Negotiated Rate	$3.53
Max. Negotiated Rate	$3.53
Rate for Payer: Qualcare PPO/HMO/WC	$3.53

SUTURE VELOSORB 2-0 UD 30 V-20

Facility

$284.90

Hospital Charge Code	270665888
Hospital Revenue Code	272
Min. Negotiated Rate	$42.73
Max. Negotiated Rate	$42.73
Rate for Payer: Qualcare PPO/HMO/WC	$42.73

SUTURE VELOSORB 3-0 UD 30 V-21

Facility

$23.51

Hospital Charge Code	270664584
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$11.76
Rate for Payer: Aetna Commercial	$8.93
Rate for Payer: Aetna Medicare Advantage	$7.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.00
Rate for Payer: Cigna Commercial	$11.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.05
Rate for Payer: Oxford Commercial	$4.70
Rate for Payer: Qualcare PPO/HMO/WC	$3.53
Rate for Payer: UnitedHealthcare Commercial	$4.70
Rate for Payer: UnitedHealthcare Community & State	$0.57
Rate for Payer: Wellpoint Medicaid Managed Care	$0.62

SUTURE VELOSORB 3-0 UD 30 V-21

Facility

$23.51

Hospital Charge Code	270664584
Hospital Revenue Code	272
Min. Negotiated Rate	$3.53
Max. Negotiated Rate	$3.53
Rate for Payer: Qualcare PPO/HMO/WC	$3.53

SUTURE VELOSORB FAST BRAIDED A

Facility

$854.70

Hospital Charge Code	270665889
Hospital Revenue Code	272
Min. Negotiated Rate	$20.60
Max. Negotiated Rate	$427.35
Rate for Payer: Aetna Commercial	$324.79
Rate for Payer: Aetna Medicare Advantage	$256.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.95
Rate for Payer: Cigna Commercial	$427.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.41
Rate for Payer: Oxford Commercial	$170.94
Rate for Payer: Qualcare PPO/HMO/WC	$128.21
Rate for Payer: UnitedHealthcare Commercial	$170.94
Rate for Payer: UnitedHealthcare Community & State	$20.60
Rate for Payer: Wellpoint Medicaid Managed Care	$22.65

SUTURE VELOSORB FAST BRAIDED A

Facility

$854.70

Hospital Charge Code	270665889
Hospital Revenue Code	272
Min. Negotiated Rate	$128.21
Max. Negotiated Rate	$128.21
Rate for Payer: Qualcare PPO/HMO/WC	$128.21

SUTURE VICRLY CT-1 2-0 J339H

Facility

$8.86

Hospital Charge Code	270698083
Hospital Revenue Code	272
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$1.33
Rate for Payer: Qualcare PPO/HMO/WC	$1.33

SUTURE VICRLY CT-1 2-0 J339H

Facility

$8.86

Hospital Charge Code	270698083
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.43
Rate for Payer: Aetna Commercial	$3.37
Rate for Payer: Aetna Medicare Advantage	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.26
Rate for Payer: Cigna Commercial	$4.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.66
Rate for Payer: Oxford Commercial	$1.77
Rate for Payer: Qualcare PPO/HMO/WC	$1.33
Rate for Payer: UnitedHealthcare Commercial	$1.77
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

SUTURE VICRYL 0 CP

Facility

$28.19

Hospital Charge Code	270672858
Hospital Revenue Code	272
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$14.10
Rate for Payer: Aetna Commercial	$10.71
Rate for Payer: Aetna Medicare Advantage	$8.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.19
Rate for Payer: Cigna Commercial	$14.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.46
Rate for Payer: Oxford Commercial	$5.64
Rate for Payer: Qualcare PPO/HMO/WC	$4.23
Rate for Payer: UnitedHealthcare Commercial	$5.64
Rate for Payer: UnitedHealthcare Community & State	$0.68
Rate for Payer: Wellpoint Medicaid Managed Care	$0.75

SUTURE VICRYL 0 CP

Facility

$28.19

Hospital Charge Code	270672858
Hospital Revenue Code	272
Min. Negotiated Rate	$4.23
Max. Negotiated Rate	$4.23
Rate for Payer: Qualcare PPO/HMO/WC	$4.23

SUTURE VICRYL 0 CT

Facility

$9.10

Hospital Charge Code	270672384
Hospital Revenue Code	272
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$1.36
Rate for Payer: Qualcare PPO/HMO/WC	$1.36

SUTURE VICRYL 0 CT

Facility

$9.10

Hospital Charge Code	270672384
Hospital Revenue Code	272
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.55
Rate for Payer: Aetna Commercial	$3.46
Rate for Payer: Aetna Medicare Advantage	$2.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.32
Rate for Payer: Cigna Commercial	$4.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$1.82
Rate for Payer: Qualcare PPO/HMO/WC	$1.36
Rate for Payer: UnitedHealthcare Commercial	$1.82
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

SUTURE VICRYL 0 CT-1

Facility

$53.99

Hospital Charge Code	270671484
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$27.00
Rate for Payer: Aetna Commercial	$20.52
Rate for Payer: Aetna Medicare Advantage	$16.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.77
Rate for Payer: Cigna Commercial	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.20
Rate for Payer: Oxford Commercial	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$8.10
Rate for Payer: UnitedHealthcare Commercial	$10.80
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

SUTURE VICRYL 0 CT-1

Facility

$53.99

Hospital Charge Code	270671484
Hospital Revenue Code	272
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$8.10
Rate for Payer: Qualcare PPO/HMO/WC	$8.10

SUTURE VICRYL 0 CT-1

Facility

$7.31

Hospital Charge Code	270655915
Hospital Revenue Code	272
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$1.10
Rate for Payer: Qualcare PPO/HMO/WC	$1.10

SUTURE VICRYL 0 CT-1

Facility

$7.31

Hospital Charge Code	270655915
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.65
Rate for Payer: Aetna Commercial	$2.78
Rate for Payer: Aetna Medicare Advantage	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.86
Rate for Payer: Cigna Commercial	$3.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.19
Rate for Payer: Oxford Commercial	$1.46
Rate for Payer: Qualcare PPO/HMO/WC	$1.10
Rate for Payer: UnitedHealthcare Commercial	$1.46
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE VICRYL 0 CT-1

Facility

$7.80

Hospital Charge Code	270671453
Hospital Revenue Code	272
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$1.17
Rate for Payer: Qualcare PPO/HMO/WC	$1.17

SUTURE VICRYL 0 CT-1

Facility

$7.80

Hospital Charge Code	270671453
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.90
Rate for Payer: Aetna Commercial	$2.96
Rate for Payer: Aetna Medicare Advantage	$2.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.99
Rate for Payer: Cigna Commercial	$3.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.34
Rate for Payer: Oxford Commercial	$1.56
Rate for Payer: Qualcare PPO/HMO/WC	$1.17
Rate for Payer: UnitedHealthcare Commercial	$1.56
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SUTURE VICRYL 0 CT-1

Facility

$8.40

Hospital Charge Code	270677189
Hospital Revenue Code	272
Min. Negotiated Rate	$1.26
Max. Negotiated Rate	$1.26
Rate for Payer: Qualcare PPO/HMO/WC	$1.26

SUTURE VICRYL 0 CT-1

Facility

$8.40

Hospital Charge Code	270677189
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$4.20
Rate for Payer: Aetna Commercial	$3.19
Rate for Payer: Aetna Medicare Advantage	$2.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.14
Rate for Payer: Cigna Commercial	$4.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.52
Rate for Payer: Oxford Commercial	$1.68
Rate for Payer: Qualcare PPO/HMO/WC	$1.26
Rate for Payer: UnitedHealthcare Commercial	$1.68
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

SUTURE VICRYL 0 CT-1 27

Facility

$58.67

Hospital Charge Code	270672608
Hospital Revenue Code	272
Min. Negotiated Rate	$8.80
Max. Negotiated Rate	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$8.80

Know your out-of-pocket cost for care.

All Charges