Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE VICRYL 1 CT-1

Facility

$59.10

Hospital Charge Code	270672381
Hospital Revenue Code	272
Min. Negotiated Rate	$8.87
Max. Negotiated Rate	$8.87
Rate for Payer: Qualcare PPO/HMO/WC	$8.87

SUTURE VICRYL 1 CT-1

Facility

$7.20

Hospital Charge Code	270671454
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

$7.20

Hospital Charge Code	270671454
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.60
Rate for Payer: Aetna Commercial	$2.74
Rate for Payer: Aetna Medicare Advantage	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.84
Rate for Payer: Cigna Commercial	$3.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.16
Rate for Payer: Oxford Commercial	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.08
Rate for Payer: UnitedHealthcare Commercial	$1.44
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE VICRYL 1 CT-1

Facility

$9.23

Hospital Charge Code	270672380
Hospital Revenue Code	272
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.62
Rate for Payer: Aetna Commercial	$3.51
Rate for Payer: Aetna Medicare Advantage	$2.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.35
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	$1.38
Rate for Payer: UnitedHealthcare Commercial	$1.85
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

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

$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

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 1CT-1 8X18 UNDYE

Facility

$53.45

Hospital Charge Code	270694728
Hospital Revenue Code	272
Min. Negotiated Rate	$8.02
Max. Negotiated Rate	$8.02
Rate for Payer: Qualcare PPO/HMO/WC	$8.02

SUTURE VICRYL 1CT-1 8X18 UNDYE

Facility

$53.45

Hospital Charge Code	270694728
Hospital Revenue Code	272
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$26.73
Rate for Payer: Aetna Commercial	$20.31
Rate for Payer: Aetna Medicare Advantage	$16.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.63
Rate for Payer: Cigna Commercial	$26.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.04
Rate for Payer: Oxford Commercial	$10.69
Rate for Payer: Qualcare PPO/HMO/WC	$8.02
Rate for Payer: UnitedHealthcare Commercial	$10.69
Rate for Payer: UnitedHealthcare Community & State	$1.29
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

SUTURE VICRYL 1CT1 CR 8X18

Facility

$77.30

Hospital Charge Code	270698430
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 1CT1 CR 8X18

Facility

$77.30

Hospital Charge Code	270698430
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 1 CT-1/GS-21

Facility

$54.17

Hospital Charge Code	270655802
Hospital Revenue Code	272
Min. Negotiated Rate	$1.31
Max. Negotiated Rate	$27.09
Rate for Payer: Aetna Commercial	$20.58
Rate for Payer: Aetna Medicare Advantage	$16.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.81
Rate for Payer: Cigna Commercial	$27.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.25
Rate for Payer: Oxford Commercial	$10.83
Rate for Payer: Qualcare PPO/HMO/WC	$8.13
Rate for Payer: UnitedHealthcare Commercial	$10.83
Rate for Payer: UnitedHealthcare Community & State	$1.31
Rate for Payer: Wellpoint Medicaid Managed Care	$1.44

SUTURE VICRYL 1 CT-1/GS-21

Facility

$54.17

Hospital Charge Code	270655802
Hospital Revenue Code	272
Min. Negotiated Rate	$8.13
Max. Negotiated Rate	$8.13
Rate for Payer: Qualcare PPO/HMO/WC	$8.13

SUTURE VICRYL 1 GS-24

Facility

$7.65

Hospital Charge Code	270655701
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 1 GS-24

Facility

$7.20

Hospital Charge Code	270675772
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.60
Rate for Payer: Aetna Commercial	$2.74
Rate for Payer: Aetna Medicare Advantage	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.84
Rate for Payer: Cigna Commercial	$3.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.16
Rate for Payer: Oxford Commercial	$1.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.08
Rate for Payer: UnitedHealthcare Commercial	$1.44
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

SUTURE VICRYL 1 GS-24

Facility

$7.20

Hospital Charge Code	270675772
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 GS-24

Facility

$7.65

Hospital Charge Code	270655701
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 1 MO-4

Facility

$11.02

Hospital Charge Code	270671471
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$5.51
Rate for Payer: Aetna Commercial	$4.19
Rate for Payer: Aetna Medicare Advantage	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.81
Rate for Payer: Cigna Commercial	$5.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.31
Rate for Payer: Oxford Commercial	$2.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.65
Rate for Payer: UnitedHealthcare Commercial	$2.20
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

SUTURE VICRYL 1 MO-4

Facility

$11.02

Hospital Charge Code	270671471
Hospital Revenue Code	272
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$1.65
Rate for Payer: Qualcare PPO/HMO/WC	$1.65

SUTURE VICRYL 1 MO-5 27INCH

Facility

$82.70

Hospital Charge Code	270677187
Hospital Revenue Code	272
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$41.35
Rate for Payer: Aetna Commercial	$31.43
Rate for Payer: Aetna Medicare Advantage	$24.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.09
Rate for Payer: Cigna Commercial	$41.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.81
Rate for Payer: Oxford Commercial	$16.54
Rate for Payer: Qualcare PPO/HMO/WC	$12.40
Rate for Payer: UnitedHealthcare Commercial	$16.54
Rate for Payer: UnitedHealthcare Community & State	$1.99
Rate for Payer: Wellpoint Medicaid Managed Care	$2.19

SUTURE VICRYL 1 MO-5 27INCH

Facility

$82.70

Hospital Charge Code	270677187
Hospital Revenue Code	272
Min. Negotiated Rate	$12.40
Max. Negotiated Rate	$12.40
Rate for Payer: Qualcare PPO/HMO/WC	$12.40

SUTURE VICRYL 1 OS-6

Facility

$13.40

Hospital Charge Code	270672374
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$6.70
Rate for Payer: Aetna Commercial	$5.09
Rate for Payer: Aetna Medicare Advantage	$4.02
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	$6.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.02
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 1 OS-6

Facility

$13.40

Hospital Charge Code	270672374
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 1 REEL

Facility

$10.40

Hospital Charge Code	270672864
Hospital Revenue Code	272
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$1.56
Rate for Payer: Qualcare PPO/HMO/WC	$1.56

SUTURE VICRYL 1 REEL

Facility

$10.40

Hospital Charge Code	270672864
Hospital Revenue Code	272
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$5.20
Rate for Payer: Aetna Commercial	$3.95
Rate for Payer: Aetna Medicare Advantage	$3.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.65
Rate for Payer: Cigna Commercial	$5.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.12
Rate for Payer: Oxford Commercial	$2.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.56
Rate for Payer: UnitedHealthcare Commercial	$2.08
Rate for Payer: UnitedHealthcare Community & State	$0.25
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

Know your out-of-pocket cost for care.

All Charges