Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE VICRYL 3-0 KS

Facility

$9.84

Hospital Charge Code	270671482
Hospital Revenue Code	272
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$4.92
Rate for Payer: Aetna Commercial	$3.74
Rate for Payer: Aetna Medicare Advantage	$2.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.51
Rate for Payer: Cigna Commercial	$4.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.95
Rate for Payer: Oxford Commercial	$1.97
Rate for Payer: Qualcare PPO/HMO/WC	$1.48
Rate for Payer: UnitedHealthcare Commercial	$1.97
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

SUTURE VICRYL 3-0 PC-5

Facility

$20.00

Hospital Charge Code	270674240
Hospital Revenue Code	272
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

SUTURE VICRYL 3-0 PC-5

Facility

$20.00

Hospital Charge Code	270674240
Hospital Revenue Code	272
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$7.60
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.00
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$4.00
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

SUTURE VICRYL 3-0 PS1 18 IN UN

Facility

$18.85

Hospital Charge Code	270681808
Hospital Revenue Code	272
Min. Negotiated Rate	$2.83
Max. Negotiated Rate	$2.83
Rate for Payer: Qualcare PPO/HMO/WC	$2.83

SUTURE VICRYL 3-0 PS1 18 IN UN

Facility

$18.85

Hospital Charge Code	270681808
Hospital Revenue Code	272
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$9.43
Rate for Payer: Aetna Commercial	$7.16
Rate for Payer: Aetna Medicare Advantage	$5.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.81
Rate for Payer: Cigna Commercial	$9.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.66
Rate for Payer: Oxford Commercial	$3.77
Rate for Payer: Qualcare PPO/HMO/WC	$2.83
Rate for Payer: UnitedHealthcare Commercial	$3.77
Rate for Payer: UnitedHealthcare Community & State	$0.45
Rate for Payer: Wellpoint Medicaid Managed Care	$0.50

SUTURE VICRYL 3-0 PS-2

Facility

$19.23

Hospital Charge Code	270672390
Hospital Revenue Code	272
Min. Negotiated Rate	$2.88
Max. Negotiated Rate	$2.88
Rate for Payer: Qualcare PPO/HMO/WC	$2.88

SUTURE VICRYL 3-0 PS-2

Facility

$19.23

Hospital Charge Code	270672390
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$9.62
Rate for Payer: Aetna Commercial	$7.31
Rate for Payer: Aetna Medicare Advantage	$5.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.90
Rate for Payer: Cigna Commercial	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.77
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.88
Rate for Payer: UnitedHealthcare Commercial	$3.85
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.51

SUTURE VICRYL 3-0 PS-2

Facility

$28.32

Hospital Charge Code	270671468
Hospital Revenue Code	272
Min. Negotiated Rate	$4.25
Max. Negotiated Rate	$4.25
Rate for Payer: Qualcare PPO/HMO/WC	$4.25

SUTURE VICRYL 3-0 PS-2

Facility

$18.18

Hospital Charge Code	270671478
Hospital Revenue Code	272
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$9.09
Rate for Payer: Aetna Commercial	$6.91
Rate for Payer: Aetna Medicare Advantage	$5.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.64
Rate for Payer: Cigna Commercial	$9.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.45
Rate for Payer: Oxford Commercial	$3.64
Rate for Payer: Qualcare PPO/HMO/WC	$2.73
Rate for Payer: UnitedHealthcare Commercial	$3.64
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

SUTURE VICRYL 3-0 PS-2

Facility

$28.32

Hospital Charge Code	270671468
Hospital Revenue Code	272
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$14.16
Rate for Payer: Aetna Commercial	$10.76
Rate for Payer: Aetna Medicare Advantage	$8.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.22
Rate for Payer: Cigna Commercial	$14.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.50
Rate for Payer: Oxford Commercial	$5.66
Rate for Payer: Qualcare PPO/HMO/WC	$4.25
Rate for Payer: UnitedHealthcare Commercial	$5.66
Rate for Payer: UnitedHealthcare Community & State	$0.68
Rate for Payer: Wellpoint Medicaid Managed Care	$0.75

SUTURE VICRYL 3-0 PS-2

Facility

$18.18

Hospital Charge Code	270671478
Hospital Revenue Code	272
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.73

SUTURE VICRYL 3-0 PS2 18 IN UN

Facility

$18.14

Hospital Charge Code	270681807
Hospital Revenue Code	272
Min. Negotiated Rate	$2.72
Max. Negotiated Rate	$2.72
Rate for Payer: Qualcare PPO/HMO/WC	$2.72

SUTURE VICRYL 3-0 PS2 18 IN UN

Facility

$18.14

Hospital Charge Code	270681807
Hospital Revenue Code	272
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$9.07
Rate for Payer: Aetna Commercial	$6.89
Rate for Payer: Aetna Medicare Advantage	$5.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.63
Rate for Payer: Cigna Commercial	$9.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.44
Rate for Payer: Oxford Commercial	$3.63
Rate for Payer: Qualcare PPO/HMO/WC	$2.72
Rate for Payer: UnitedHealthcare Commercial	$3.63
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

SUTURE VICRYL 3-0 RB-1

Facility

$26.95

Hospital Charge Code	270672860
Hospital Revenue Code	272
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$4.04
Rate for Payer: Qualcare PPO/HMO/WC	$4.04

SUTURE VICRYL 3-0 RB-1

Facility

$26.95

Hospital Charge Code	270672860
Hospital Revenue Code	272
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$13.47
Rate for Payer: Aetna Commercial	$10.24
Rate for Payer: Aetna Medicare Advantage	$8.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.87
Rate for Payer: Cigna Commercial	$13.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.09
Rate for Payer: Oxford Commercial	$5.39
Rate for Payer: Qualcare PPO/HMO/WC	$4.04
Rate for Payer: UnitedHealthcare Commercial	$5.39
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

SUTURE VICRYL 3-0 REEL TIES

Facility

$9.81

Hospital Charge Code	270671448
Hospital Revenue Code	272
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$4.91
Rate for Payer: Aetna Commercial	$3.73
Rate for Payer: Aetna Medicare Advantage	$2.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.50
Rate for Payer: Cigna Commercial	$4.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.94
Rate for Payer: Oxford Commercial	$1.96
Rate for Payer: Qualcare PPO/HMO/WC	$1.47
Rate for Payer: UnitedHealthcare Commercial	$1.96
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

SUTURE VICRYL 3-0 REEL TIES

Facility

$9.81

Hospital Charge Code	270671448
Hospital Revenue Code	272
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$1.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.47

SUTURE VICRYL 3-0 SH

Facility

$57.60

Hospital Charge Code	270672752
Hospital Revenue Code	272
Min. Negotiated Rate	$8.64
Max. Negotiated Rate	$8.64
Rate for Payer: Qualcare PPO/HMO/WC	$8.64

SUTURE VICRYL 3-0 SH

Facility

$8.57

Hospital Charge Code	270669198
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.29
Rate for Payer: Aetna Commercial	$3.26
Rate for Payer: Aetna Medicare Advantage	$2.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.19
Rate for Payer: Cigna Commercial	$4.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.57
Rate for Payer: Oxford Commercial	$1.71
Rate for Payer: Qualcare PPO/HMO/WC	$1.29
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 3-0 SH

Facility

$8.57

Hospital Charge Code	270669198
Hospital Revenue Code	272
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$1.29

SUTURE VICRYL 3-0 SH

Facility

$8.57

Hospital Charge Code	270672228
Hospital Revenue Code	272
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$1.29

SUTURE VICRYL 3-0 SH

Facility

$8.57

Hospital Charge Code	270672228
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.29
Rate for Payer: Aetna Commercial	$3.26
Rate for Payer: Aetna Medicare Advantage	$2.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.19
Rate for Payer: Cigna Commercial	$4.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.57
Rate for Payer: Oxford Commercial	$1.71
Rate for Payer: Qualcare PPO/HMO/WC	$1.29
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 3-0 SH

Facility

$57.60

Hospital Charge Code	270672752
Hospital Revenue Code	272
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$28.80
Rate for Payer: Aetna Commercial	$21.89
Rate for Payer: Aetna Medicare Advantage	$17.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.69
Rate for Payer: Cigna Commercial	$28.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.28
Rate for Payer: Oxford Commercial	$11.52
Rate for Payer: Qualcare PPO/HMO/WC	$8.64
Rate for Payer: UnitedHealthcare Commercial	$11.52
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.53

SUTURE VICRYL 3-0 SH V-20

Facility

$52.94

Hospital Charge Code	270671485
Hospital Revenue Code	272
Min. Negotiated Rate	$7.94
Max. Negotiated Rate	$7.94
Rate for Payer: Qualcare PPO/HMO/WC	$7.94

SUTURE VICRYL 3-0 SH V-20

Facility

$52.94

Hospital Charge Code	270671485
Hospital Revenue Code	272
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$26.47
Rate for Payer: Aetna Commercial	$20.12
Rate for Payer: Aetna Medicare Advantage	$15.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.50
Rate for Payer: Cigna Commercial	$26.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.88
Rate for Payer: Oxford Commercial	$10.59
Rate for Payer: Qualcare PPO/HMO/WC	$7.94
Rate for Payer: UnitedHealthcare Commercial	$10.59
Rate for Payer: UnitedHealthcare Community & State	$1.28
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

Know your out-of-pocket cost for care.

All Charges