Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE VICRYL 0 CT-1 27

Facility

$58.67

Hospital Charge Code	270672608
Hospital Revenue Code	272
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$29.34
Rate for Payer: Aetna Commercial	$22.29
Rate for Payer: Aetna Medicare Advantage	$17.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.96
Rate for Payer: Cigna Commercial	$29.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.60
Rate for Payer: Oxford Commercial	$11.73
Rate for Payer: Qualcare PPO/HMO/WC	$8.80
Rate for Payer: UnitedHealthcare Commercial	$11.73
Rate for Payer: UnitedHealthcare Community & State	$1.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1.55

SUTURE VICRYL 0 CT-1 36

Facility

$8.87

Hospital Charge Code	270672382
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	$0.24

SUTURE VICRYL 0 CT-1 36

Facility

$8.87

Hospital Charge Code	270672382
Hospital Revenue Code	272
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$1.33
Rate for Payer: Qualcare PPO/HMO/WC	$1.33

SUTURE VICRYL 0 CT-1/GS-21

Facility

$55.37

Hospital Charge Code	270652225
Hospital Revenue Code	272
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$27.68
Rate for Payer: Aetna Commercial	$21.04
Rate for Payer: Aetna Medicare Advantage	$16.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.12
Rate for Payer: Cigna Commercial	$27.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.61
Rate for Payer: Oxford Commercial	$11.07
Rate for Payer: Qualcare PPO/HMO/WC	$8.31
Rate for Payer: UnitedHealthcare Commercial	$11.07
Rate for Payer: UnitedHealthcare Community & State	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$1.47

SUTURE VICRYL 0 CT-1/GS-21

Facility

$55.37

Hospital Charge Code	270652225
Hospital Revenue Code	272
Min. Negotiated Rate	$8.31
Max. Negotiated Rate	$8.31
Rate for Payer: Qualcare PPO/HMO/WC	$8.31

SUTURE VICRYL 0 CT1 JJ42G

Facility

$54.33

Hospital Charge Code	270678108
Hospital Revenue Code	272
Min. Negotiated Rate	$8.15
Max. Negotiated Rate	$8.15
Rate for Payer: Qualcare PPO/HMO/WC	$8.15

SUTURE VICRYL 0 CT1 JJ42G

Facility

$54.33

Hospital Charge Code	270678108
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$27.16
Rate for Payer: Aetna Commercial	$20.65
Rate for Payer: Aetna Medicare Advantage	$16.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.85
Rate for Payer: Cigna Commercial	$27.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.30
Rate for Payer: Oxford Commercial	$10.87
Rate for Payer: Qualcare PPO/HMO/WC	$8.15
Rate for Payer: UnitedHealthcare Commercial	$10.87
Rate for Payer: UnitedHealthcare Community & State	$1.31
Rate for Payer: Wellpoint Medicaid Managed Care	$1.44

SUTURE VICRYL 0 CT-2

Facility

$8.25

Hospital Charge Code	270655689
Hospital Revenue Code	272
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$1.24
Rate for Payer: Qualcare PPO/HMO/WC	$1.24

SUTURE VICRYL 0 CT-2

Facility

$8.25

Hospital Charge Code	270655689
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$4.12
Rate for Payer: Aetna Commercial	$3.13
Rate for Payer: Aetna Medicare Advantage	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.10
Rate for Payer: Cigna Commercial	$4.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.48
Rate for Payer: Oxford Commercial	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.24
Rate for Payer: UnitedHealthcare Commercial	$1.65
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.22

SUTURE VICRYL 0 CT-2

Facility

$8.75

Hospital Charge Code	270672383
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.38
Rate for Payer: Aetna Commercial	$3.33
Rate for Payer: Aetna Medicare Advantage	$2.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.23
Rate for Payer: Cigna Commercial	$4.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.62
Rate for Payer: Oxford Commercial	$1.75
Rate for Payer: Qualcare PPO/HMO/WC	$1.31
Rate for Payer: UnitedHealthcare Commercial	$1.75
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

SUTURE VICRYL 0 CT-2

Facility

$8.75

Hospital Charge Code	270672383
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$1.31

SUTURE VICRYL 0 CT 36 IN VIOLE

Facility

$8.75

Hospital Charge Code	270681806
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$1.31
Rate for Payer: Qualcare PPO/HMO/WC	$1.31

SUTURE VICRYL 0 CT 36 IN VIOLE

Facility

$8.75

Hospital Charge Code	270681806
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.38
Rate for Payer: Aetna Commercial	$3.33
Rate for Payer: Aetna Medicare Advantage	$2.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.23
Rate for Payer: Cigna Commercial	$4.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.62
Rate for Payer: Oxford Commercial	$1.75
Rate for Payer: Qualcare PPO/HMO/WC	$1.31
Rate for Payer: UnitedHealthcare Commercial	$1.75
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

SUTURE VICRYL 0 D-SPECIAL KIT

Facility

$117.93

Hospital Charge Code	270677066
Hospital Revenue Code	272
Min. Negotiated Rate	$17.69
Max. Negotiated Rate	$17.69
Rate for Payer: Qualcare PPO/HMO/WC	$17.69

SUTURE VICRYL 0 D-SPECIAL KIT

Facility

$117.93

Hospital Charge Code	270677066
Hospital Revenue Code	272
Min. Negotiated Rate	$2.84
Max. Negotiated Rate	$58.97
Rate for Payer: Aetna Commercial	$44.81
Rate for Payer: Aetna Medicare Advantage	$35.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.07
Rate for Payer: Cigna Commercial	$58.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.38
Rate for Payer: Oxford Commercial	$23.59
Rate for Payer: Qualcare PPO/HMO/WC	$17.69
Rate for Payer: UnitedHealthcare Commercial	$23.59
Rate for Payer: UnitedHealthcare Community & State	$2.84
Rate for Payer: Wellpoint Medicaid Managed Care	$3.13

SUTURE VICRYL 0 ENDOLOOP

Facility

$175.46

Hospital Charge Code	270628304
Hospital Revenue Code	272
Min. Negotiated Rate	$4.23
Max. Negotiated Rate	$87.73
Rate for Payer: Aetna Commercial	$66.67
Rate for Payer: Aetna Medicare Advantage	$52.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.74
Rate for Payer: Cigna Commercial	$87.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.64
Rate for Payer: Oxford Commercial	$35.09
Rate for Payer: Qualcare PPO/HMO/WC	$26.32
Rate for Payer: UnitedHealthcare Commercial	$35.09
Rate for Payer: UnitedHealthcare Community & State	$4.23
Rate for Payer: Wellpoint Medicaid Managed Care	$4.65

SUTURE VICRYL 0 ENDOLOOP

Facility

$175.46

Hospital Charge Code	270628304
Hospital Revenue Code	272
Min. Negotiated Rate	$26.32
Max. Negotiated Rate	$26.32
Rate for Payer: Qualcare PPO/HMO/WC	$26.32

SUTURE VICRYL 0 GR-6

Facility

$8.55

Hospital Charge Code	270671480
Hospital Revenue Code	272
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$1.28
Rate for Payer: Qualcare PPO/HMO/WC	$1.28

SUTURE VICRYL 0 GR-6

Facility

$8.55

Hospital Charge Code	270671480
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.28
Rate for Payer: Aetna Commercial	$3.25
Rate for Payer: Aetna Medicare Advantage	$2.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.18
Rate for Payer: Cigna Commercial	$4.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.56
Rate for Payer: Oxford Commercial	$1.71
Rate for Payer: Qualcare PPO/HMO/WC	$1.28
Rate for Payer: UnitedHealthcare Commercial	$1.71
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

SUTURE VICRYL 0 GS-24

Facility

$13.42

Hospital Charge Code	270655745
Hospital Revenue Code	272
Min. Negotiated Rate	$2.01
Max. Negotiated Rate	$2.01
Rate for Payer: Qualcare PPO/HMO/WC	$2.01

SUTURE VICRYL 0 GS-24

Facility

$13.42

Hospital Charge Code	270655745
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$6.71
Rate for Payer: Aetna Commercial	$5.10
Rate for Payer: Aetna Medicare Advantage	$4.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.42
Rate for Payer: Cigna Commercial	$6.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.03
Rate for Payer: Oxford Commercial	$2.68
Rate for Payer: Qualcare PPO/HMO/WC	$2.01
Rate for Payer: UnitedHealthcare Commercial	$2.68
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

SUTURE VICRYL 0 GS-24

Facility

$7.65

Hospital Charge Code	270671491
Hospital Revenue Code	272
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$1.15
Rate for Payer: Qualcare PPO/HMO/WC	$1.15

SUTURE VICRYL 0 GS-24

Facility

$7.65

Hospital Charge Code	270671491
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.83
Rate for Payer: Aetna Commercial	$2.91
Rate for Payer: Aetna Medicare Advantage	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.95
Rate for Payer: Cigna Commercial	$3.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.29
Rate for Payer: Oxford Commercial	$1.53
Rate for Payer: Qualcare PPO/HMO/WC	$1.15
Rate for Payer: UnitedHealthcare Commercial	$1.53
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

SUTURE VICRYL 0 MO-4

Facility

$17.15

Hospital Charge Code	270671470
Hospital Revenue Code	272
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.57
Rate for Payer: Aetna Commercial	$6.52
Rate for Payer: Aetna Medicare Advantage	$5.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.37
Rate for Payer: Cigna Commercial	$8.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.14
Rate for Payer: Oxford Commercial	$3.43
Rate for Payer: Qualcare PPO/HMO/WC	$2.57
Rate for Payer: UnitedHealthcare Commercial	$3.43
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

SUTURE VICRYL 0 MO-4

Facility

$17.15

Hospital Charge Code	270671470
Hospital Revenue Code	272
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$2.57
Rate for Payer: Qualcare PPO/HMO/WC	$2.57

Know your out-of-pocket cost for care.

All Charges