Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE VICRYL 0 MO-5 18

Facility

$77.30

Hospital Charge Code	270677185
Hospital Revenue Code	272
Min. Negotiated Rate	$11.60
Max. Negotiated Rate	$11.60
Rate for Payer: Qualcare PPO/HMO/WC	$11.60

SUTURE VICRYL 0 MO-5 18

Facility

$77.30

Hospital Charge Code	270677185
Hospital Revenue Code	272
Min. Negotiated Rate	$1.86
Max. Negotiated Rate	$38.65
Rate for Payer: Aetna Commercial	$29.37
Rate for Payer: Aetna Medicare Advantage	$23.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.71
Rate for Payer: Cigna Commercial	$38.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.19
Rate for Payer: Oxford Commercial	$15.46
Rate for Payer: Qualcare PPO/HMO/WC	$11.60
Rate for Payer: UnitedHealthcare Commercial	$15.46
Rate for Payer: UnitedHealthcare Community & State	$1.86
Rate for Payer: Wellpoint Medicaid Managed Care	$2.05

SUTURE VICRYL 0 MO-5 27

Facility

$82.78

Hospital Charge Code	270677186
Hospital Revenue Code	272
Min. Negotiated Rate	$12.42
Max. Negotiated Rate	$12.42
Rate for Payer: Qualcare PPO/HMO/WC	$12.42

SUTURE VICRYL 0 MO-5 27

Facility

$82.78

Hospital Charge Code	270677186
Hospital Revenue Code	272
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$41.39
Rate for Payer: Aetna Commercial	$31.46
Rate for Payer: Aetna Medicare Advantage	$24.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.11
Rate for Payer: Cigna Commercial	$41.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.83
Rate for Payer: Oxford Commercial	$16.56
Rate for Payer: Qualcare PPO/HMO/WC	$12.42
Rate for Payer: UnitedHealthcare Commercial	$16.56
Rate for Payer: UnitedHealthcare Community & State	$1.99
Rate for Payer: Wellpoint Medicaid Managed Care	$2.19

SUTURE VICRYL 0 OS-6

Facility

$13.28

Hospital Charge Code	270672602
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$6.64
Rate for Payer: Aetna Commercial	$5.05
Rate for Payer: Aetna Medicare Advantage	$3.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.39
Rate for Payer: Cigna Commercial	$6.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.98
Rate for Payer: Oxford Commercial	$2.66
Rate for Payer: Qualcare PPO/HMO/WC	$1.99
Rate for Payer: UnitedHealthcare Commercial	$2.66
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.35

SUTURE VICRYL 0 OS-6

Facility

$13.28

Hospital Charge Code	270672602
Hospital Revenue Code	272
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$1.99
Rate for Payer: Qualcare PPO/HMO/WC	$1.99

SUTURE VICRYL 0 REEL TIES

Facility

$9.71

Hospital Charge Code	270671450
Hospital Revenue Code	272
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$1.46
Rate for Payer: Qualcare PPO/HMO/WC	$1.46

SUTURE VICRYL 0 REEL TIES

Facility

$9.71

Hospital Charge Code	270671450
Hospital Revenue Code	272
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.86
Rate for Payer: Aetna Commercial	$3.69
Rate for Payer: Aetna Medicare Advantage	$2.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.48
Rate for Payer: Cigna Commercial	$4.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.91
Rate for Payer: Oxford Commercial	$1.94
Rate for Payer: Qualcare PPO/HMO/WC	$1.46
Rate for Payer: UnitedHealthcare Commercial	$1.94
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

SUTURE VICRYL 0 TIES

Facility

$22.68

Hospital Charge Code	270671446
Hospital Revenue Code	272
Min. Negotiated Rate	$3.40
Max. Negotiated Rate	$3.40
Rate for Payer: Qualcare PPO/HMO/WC	$3.40

SUTURE VICRYL 0 TIES

Facility

$22.68

Hospital Charge Code	270671446
Hospital Revenue Code	272
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$11.34
Rate for Payer: Aetna Commercial	$8.62
Rate for Payer: Aetna Medicare Advantage	$6.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.78
Rate for Payer: Cigna Commercial	$11.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.80
Rate for Payer: Oxford Commercial	$4.54
Rate for Payer: Qualcare PPO/HMO/WC	$3.40
Rate for Payer: UnitedHealthcare Commercial	$4.54
Rate for Payer: UnitedHealthcare Community & State	$0.55
Rate for Payer: Wellpoint Medicaid Managed Care	$0.60

SUTURE VICRYL 0 TIES 18

Facility

$24.03

Hospital Charge Code	270672606
Hospital Revenue Code	272
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$12.02
Rate for Payer: Aetna Commercial	$9.13
Rate for Payer: Aetna Medicare Advantage	$7.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.13
Rate for Payer: Cigna Commercial	$12.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.21
Rate for Payer: Oxford Commercial	$4.81
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$4.81
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

SUTURE VICRYL 0 TIES 18

Facility

$24.03

Hospital Charge Code	270672606
Hospital Revenue Code	272
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

SUTURE VICRYL 0 TIES 54

Facility

$9.25

Hospital Charge Code	270672385
Hospital Revenue Code	272
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$1.39
Rate for Payer: Qualcare PPO/HMO/WC	$1.39

SUTURE VICRYL 0 TIES 54

Facility

$9.25

Hospital Charge Code	270672385
Hospital Revenue Code	272
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.62
Rate for Payer: Aetna Commercial	$3.52
Rate for Payer: Aetna Medicare Advantage	$2.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.36
Rate for Payer: Cigna Commercial	$4.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.77
Rate for Payer: Oxford Commercial	$1.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.39
Rate for Payer: UnitedHealthcare Commercial	$1.85
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

SUTURE VICRYL 0 TIES UNDYED

Facility

$14.98

Hospital Charge Code	270671457
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.49
Rate for Payer: Aetna Commercial	$5.69
Rate for Payer: Aetna Medicare Advantage	$4.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.82
Rate for Payer: Cigna Commercial	$7.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.49
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$3.00
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

SUTURE VICRYL 0 TIES UNDYED

Facility

$14.98

Hospital Charge Code	270671457
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

SUTURE VICRYL 0 UND TIES

Facility

$57.01

Hospital Charge Code	270671487
Hospital Revenue Code	272
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$28.50
Rate for Payer: Aetna Commercial	$21.66
Rate for Payer: Aetna Medicare Advantage	$17.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.54
Rate for Payer: Cigna Commercial	$28.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.10
Rate for Payer: Oxford Commercial	$11.40
Rate for Payer: Qualcare PPO/HMO/WC	$8.55
Rate for Payer: UnitedHealthcare Commercial	$11.40
Rate for Payer: UnitedHealthcare Community & State	$1.37
Rate for Payer: Wellpoint Medicaid Managed Care	$1.51

SUTURE VICRYL 0 UND TIES

Facility

$57.01

Hospital Charge Code	270671487
Hospital Revenue Code	272
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$8.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.55

SUTURE VICRYL 0 UR-5

Facility

$15.58

Hospital Charge Code	270671463
Hospital Revenue Code	272
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$2.34
Rate for Payer: Qualcare PPO/HMO/WC	$2.34

SUTURE VICRYL 0 UR-5

Facility

$15.58

Hospital Charge Code	270671463
Hospital Revenue Code	272
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$7.79
Rate for Payer: Aetna Commercial	$5.92
Rate for Payer: Aetna Medicare Advantage	$4.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.97
Rate for Payer: Cigna Commercial	$7.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.67
Rate for Payer: Oxford Commercial	$3.12
Rate for Payer: Qualcare PPO/HMO/WC	$2.34
Rate for Payer: UnitedHealthcare Commercial	$3.12
Rate for Payer: UnitedHealthcare Community & State	$0.38
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

SUTURE VICRYL 0 V-20

Facility

$7.17

Hospital Charge Code	270673242
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.58
Rate for Payer: Aetna Commercial	$2.72
Rate for Payer: Aetna Medicare Advantage	$2.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.83
Rate for Payer: Cigna Commercial	$3.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.15
Rate for Payer: Oxford Commercial	$1.43
Rate for Payer: Qualcare PPO/HMO/WC	$1.08
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 VICRYL 0 V-20

Facility

$7.17

Hospital Charge Code	270673242
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$1.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.08

SUTURE VICRYL 1 CT-1

Facility

$7.57

Hospital Charge Code	270671461
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$1.14
Rate for Payer: Qualcare PPO/HMO/WC	$1.14

SUTURE VICRYL 1 CT-1

Facility

$9.23

Hospital Charge Code	270672380
Hospital Revenue Code	272
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$1.38
Rate for Payer: Qualcare PPO/HMO/WC	$1.38

SUTURE VICRYL 1 CT-1

Facility

$7.57

Hospital Charge Code	270671461
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.79
Rate for Payer: Aetna Commercial	$2.88
Rate for Payer: Aetna Medicare Advantage	$2.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.93
Rate for Payer: Cigna Commercial	$3.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.27
Rate for Payer: Oxford Commercial	$1.51
Rate for Payer: Qualcare PPO/HMO/WC	$1.14
Rate for Payer: UnitedHealthcare Commercial	$1.51
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

Know your out-of-pocket cost for care.

All Charges