Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE VICRYL 1 XLH

Facility

$18.03

Hospital Charge Code	270671479
Hospital Revenue Code	272
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.02
Rate for Payer: Aetna Commercial	$6.85
Rate for Payer: Aetna Medicare Advantage	$5.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.60
Rate for Payer: Cigna Commercial	$9.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.41
Rate for Payer: Oxford Commercial	$3.61
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.61
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

SUTURE VICRYL 1 XLH

Facility

$18.03

Hospital Charge Code	270671479
Hospital Revenue Code	272
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

SUTURE VICRYL 2-0 CT

Facility

$9.36

Hospital Charge Code	270667074
Hospital Revenue Code	272
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.40

SUTURE VICRYL 2-0 CT

Facility

$9.36

Hospital Charge Code	270667074
Hospital Revenue Code	272
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.68
Rate for Payer: Aetna Commercial	$3.56
Rate for Payer: Aetna Medicare Advantage	$2.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.39
Rate for Payer: Cigna Commercial	$4.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.81
Rate for Payer: Oxford Commercial	$1.87
Rate for Payer: Qualcare PPO/HMO/WC	$1.40
Rate for Payer: UnitedHealthcare Commercial	$1.87
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

SUTURE VICRYL 2-0 CT-1

Facility

$56.77

Hospital Charge Code	270672601
Hospital Revenue Code	272
Min. Negotiated Rate	$8.52
Max. Negotiated Rate	$8.52
Rate for Payer: Qualcare PPO/HMO/WC	$8.52

SUTURE VICRYL 2-0 CT-1

Facility

$13.30

Hospital Charge Code	270655941
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$6.65
Rate for Payer: Aetna Commercial	$5.05
Rate for Payer: Aetna Medicare Advantage	$3.99
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	$6.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.99
Rate for Payer: Oxford Commercial	$2.66
Rate for Payer: Qualcare PPO/HMO/WC	$2.00
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 2-0 CT-1

Facility

$13.30

Hospital Charge Code	270655941
Hospital Revenue Code	272
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.00

SUTURE VICRYL 2-0 CT-1

Facility

$7.38

Hospital Charge Code	270671460
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.69
Rate for Payer: Aetna Commercial	$2.80
Rate for Payer: Aetna Medicare Advantage	$2.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.88
Rate for Payer: Cigna Commercial	$3.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.21
Rate for Payer: Oxford Commercial	$1.48
Rate for Payer: Qualcare PPO/HMO/WC	$1.11
Rate for Payer: UnitedHealthcare Commercial	$1.48
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

SUTURE VICRYL 2-0 CT-1

Facility

$9.02

Hospital Charge Code	270672386
Hospital Revenue Code	272
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.51
Rate for Payer: Aetna Commercial	$3.43
Rate for Payer: Aetna Medicare Advantage	$2.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.30
Rate for Payer: Cigna Commercial	$4.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.71
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

SUTURE VICRYL 2-0 CT-1

Facility

$9.02

Hospital Charge Code	270672386
Hospital Revenue Code	272
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

SUTURE VICRYL 2-0 CT-1

Facility

$6.91

Hospital Charge Code	270671452
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.46
Rate for Payer: Aetna Commercial	$2.63
Rate for Payer: Aetna Medicare Advantage	$2.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.76
Rate for Payer: Cigna Commercial	$3.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.07
Rate for Payer: Oxford Commercial	$1.38
Rate for Payer: Qualcare PPO/HMO/WC	$1.04
Rate for Payer: UnitedHealthcare Commercial	$1.38
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

SUTURE VICRYL 2-0 CT-1

Facility

$7.38

Hospital Charge Code	270671460
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$1.11
Rate for Payer: Qualcare PPO/HMO/WC	$1.11

SUTURE VICRYL 2-0 CT-1

Facility

$56.77

Hospital Charge Code	270672601
Hospital Revenue Code	272
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$28.39
Rate for Payer: Aetna Commercial	$21.57
Rate for Payer: Aetna Medicare Advantage	$17.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.48
Rate for Payer: Cigna Commercial	$28.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.03
Rate for Payer: Oxford Commercial	$11.35
Rate for Payer: Qualcare PPO/HMO/WC	$8.52
Rate for Payer: UnitedHealthcare Commercial	$11.35
Rate for Payer: UnitedHealthcare Community & State	$1.37
Rate for Payer: Wellpoint Medicaid Managed Care	$1.50

SUTURE VICRYL 2-0 CT-1

Facility

$6.91

Hospital Charge Code	270671452
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$1.04
Rate for Payer: Qualcare PPO/HMO/WC	$1.04

SUTURE VICRYL 2-0 CT-2

Facility

$8.95

Hospital Charge Code	270672605
Hospital Revenue Code	272
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$1.34
Rate for Payer: Qualcare PPO/HMO/WC	$1.34

SUTURE VICRYL 2-0 CT-2

Facility

$8.95

Hospital Charge Code	270672605
Hospital Revenue Code	272
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.47
Rate for Payer: Aetna Commercial	$3.40
Rate for Payer: Aetna Medicare Advantage	$2.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.28
Rate for Payer: Cigna Commercial	$4.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.69
Rate for Payer: Oxford Commercial	$1.79
Rate for Payer: Qualcare PPO/HMO/WC	$1.34
Rate for Payer: UnitedHealthcare Commercial	$1.79
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

SUTURE VICRYL 2-0 CT-2

Facility

$7.38

Hospital Charge Code	270674279
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.69
Rate for Payer: Aetna Commercial	$2.80
Rate for Payer: Aetna Medicare Advantage	$2.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.88
Rate for Payer: Cigna Commercial	$3.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.21
Rate for Payer: Oxford Commercial	$1.48
Rate for Payer: Qualcare PPO/HMO/WC	$1.11
Rate for Payer: UnitedHealthcare Commercial	$1.48
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

SUTURE VICRYL 2-0 CT-2

Facility

$7.38

Hospital Charge Code	270674279
Hospital Revenue Code	272
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$1.11
Rate for Payer: Qualcare PPO/HMO/WC	$1.11

SUTURE VICRYL 2-0 CTD NO NDL

Facility

$51.52

Hospital Charge Code	270677690
Hospital Revenue Code	272
Min. Negotiated Rate	$7.73
Max. Negotiated Rate	$7.73
Rate for Payer: Qualcare PPO/HMO/WC	$7.73

SUTURE VICRYL 2-0 CTD NO NDL

Facility

$51.52

Hospital Charge Code	270677690
Hospital Revenue Code	272
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$25.76
Rate for Payer: Aetna Commercial	$19.58
Rate for Payer: Aetna Medicare Advantage	$15.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.14
Rate for Payer: Cigna Commercial	$25.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.46
Rate for Payer: Oxford Commercial	$10.30
Rate for Payer: Qualcare PPO/HMO/WC	$7.73
Rate for Payer: UnitedHealthcare Commercial	$10.30
Rate for Payer: UnitedHealthcare Community & State	$1.24
Rate for Payer: Wellpoint Medicaid Managed Care	$1.37

SUTURE VICRYL 2-0 FS-1

Facility

$9.91

Hospital Charge Code	270671472
Hospital Revenue Code	272
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$4.96
Rate for Payer: Aetna Commercial	$3.77
Rate for Payer: Aetna Medicare Advantage	$2.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.53
Rate for Payer: Cigna Commercial	$4.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.97
Rate for Payer: Oxford Commercial	$1.98
Rate for Payer: Qualcare PPO/HMO/WC	$1.49
Rate for Payer: UnitedHealthcare Commercial	$1.98
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

SUTURE VICRYL 2-0 FS-1

Facility

$9.91

Hospital Charge Code	270671472
Hospital Revenue Code	272
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$1.49
Rate for Payer: Qualcare PPO/HMO/WC	$1.49

SUTURE VICRYL 2-0 GS-24

Facility

$8.67

Hospital Charge Code	270671490
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.33
Rate for Payer: Aetna Commercial	$3.29
Rate for Payer: Aetna Medicare Advantage	$2.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.21
Rate for Payer: Cigna Commercial	$4.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.60
Rate for Payer: Oxford Commercial	$1.73
Rate for Payer: Qualcare PPO/HMO/WC	$1.30
Rate for Payer: UnitedHealthcare Commercial	$1.73
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

SUTURE VICRYL 2-0 GS-24

Facility

$8.67

Hospital Charge Code	270671490
Hospital Revenue Code	272
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$1.30
Rate for Payer: Qualcare PPO/HMO/WC	$1.30

SUTURE VICRYL 2-0 MO-4

Facility

$10.51

Hospital Charge Code	270671469
Hospital Revenue Code	272
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$1.58
Rate for Payer: Qualcare PPO/HMO/WC	$1.58

Know your out-of-pocket cost for care.

All Charges