Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE VICRYL 3-0 TIES

Facility

$40.28

Hospital Charge Code	270672607
Hospital Revenue Code	272
Min. Negotiated Rate	$6.04
Max. Negotiated Rate	$6.04
Rate for Payer: Qualcare PPO/HMO/WC	$6.04

SUTURE VICRYL 3-0 TIES

Facility

$40.28

Hospital Charge Code	270672607
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$20.14
Rate for Payer: Aetna Commercial	$15.31
Rate for Payer: Aetna Medicare Advantage	$12.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.27
Rate for Payer: Cigna Commercial	$20.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.08
Rate for Payer: Oxford Commercial	$8.06
Rate for Payer: Qualcare PPO/HMO/WC	$6.04
Rate for Payer: UnitedHealthcare Commercial	$8.06
Rate for Payer: UnitedHealthcare Community & State	$0.97
Rate for Payer: Wellpoint Medicaid Managed Care	$1.07

SUTURE VICRYL 3-0 TIES

Facility

$38.02

Hospital Charge Code	270671444
Hospital Revenue Code	272
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$19.01
Rate for Payer: Aetna Commercial	$14.45
Rate for Payer: Aetna Medicare Advantage	$11.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.70
Rate for Payer: Cigna Commercial	$19.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.41
Rate for Payer: Oxford Commercial	$7.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$7.60
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

SUTURE VICRYL 3-0 TIES

Facility

$9.25

Hospital Charge Code	270677257
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 3-0 TIES

Facility

$9.25

Hospital Charge Code	270677257
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 3-0 TIES

Facility

$38.02

Hospital Charge Code	270671444
Hospital Revenue Code	272
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

SUTURE VICRYL 3-0 TIES UNDYED

Facility

$9.73

Hospital Charge Code	270671455
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 3-0 TIES UNDYED

Facility

$9.73

Hospital Charge Code	270671455
Hospital Revenue Code	272
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.87
Rate for Payer: Aetna Commercial	$3.70
Rate for Payer: Aetna Medicare Advantage	$2.92
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	$4.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.46
Rate for Payer: UnitedHealthcare Commercial	$1.95
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

SUTURE VICRYL 3-0 V-20

Facility

$8.05

Hospital Charge Code	270655691
Hospital Revenue Code	272
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$1.21

SUTURE VICRYL 3-0 V-20

Facility

$8.05

Hospital Charge Code	270655691
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$4.03
Rate for Payer: Aetna Commercial	$3.06
Rate for Payer: Aetna Medicare Advantage	$2.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.05
Rate for Payer: Cigna Commercial	$4.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.42
Rate for Payer: Oxford Commercial	$1.61
Rate for Payer: Qualcare PPO/HMO/WC	$1.21
Rate for Payer: UnitedHealthcare Commercial	$1.61
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

SUTURE VICRYL 4-0 FS-2

Facility

$10.93

Hospital Charge Code	270671466
Hospital Revenue Code	272
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

SUTURE VICRYL 4-0 FS-2

Facility

$10.93

Hospital Charge Code	270671466
Hospital Revenue Code	272
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$5.46
Rate for Payer: Aetna Commercial	$4.15
Rate for Payer: Aetna Medicare Advantage	$3.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.79
Rate for Payer: Cigna Commercial	$5.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.28
Rate for Payer: Oxford Commercial	$2.19
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Commercial	$2.19
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

SUTURE VICRYL 4-0 P-3

Facility

$28.42

Hospital Charge Code	270671476
Hospital Revenue Code	272
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$14.21
Rate for Payer: Aetna Commercial	$10.80
Rate for Payer: Aetna Medicare Advantage	$8.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.25
Rate for Payer: Cigna Commercial	$14.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.53
Rate for Payer: Oxford Commercial	$5.68
Rate for Payer: Qualcare PPO/HMO/WC	$4.26
Rate for Payer: UnitedHealthcare Commercial	$5.68
Rate for Payer: UnitedHealthcare Community & State	$0.68
Rate for Payer: Wellpoint Medicaid Managed Care	$0.75

SUTURE VICRYL 4-0 P-3

Facility

$18.19

Hospital Charge Code	270671475
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 4-0 P-3

Facility

$28.42

Hospital Charge Code	270671476
Hospital Revenue Code	272
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$4.26
Rate for Payer: Qualcare PPO/HMO/WC	$4.26

SUTURE VICRYL 4-0 P-3

Facility

$18.19

Hospital Charge Code	270671475
Hospital Revenue Code	272
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$9.10
Rate for Payer: Aetna Commercial	$6.91
Rate for Payer: Aetna Medicare Advantage	$5.46
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	$9.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.46
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 4-0 P-5

Facility

$20.00

Hospital Charge Code	270674241
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 4-0 P-5

Facility

$20.00

Hospital Charge Code	270674241
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 4-0 PC-1

Facility

$20.00

Hospital Charge Code	270661073
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 4-0 PC-1

Facility

$20.00

Hospital Charge Code	270661073
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 4-0 PC-5

Facility

$20.00

Hospital Charge Code	270675773
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 4-0 PC-5

Facility

$20.00

Hospital Charge Code	270675773
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 4-0 PS-1

Facility

$29.92

Hospital Charge Code	270671488
Hospital Revenue Code	272
Min. Negotiated Rate	$4.49
Max. Negotiated Rate	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$4.49

SUTURE VICRYL 4-0 PS-1

Facility

$29.92

Hospital Charge Code	270671488
Hospital Revenue Code	272
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$14.96
Rate for Payer: Aetna Commercial	$11.37
Rate for Payer: Aetna Medicare Advantage	$8.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.63
Rate for Payer: Cigna Commercial	$14.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.98
Rate for Payer: Oxford Commercial	$5.98
Rate for Payer: Qualcare PPO/HMO/WC	$4.49
Rate for Payer: UnitedHealthcare Commercial	$5.98
Rate for Payer: UnitedHealthcare Community & State	$0.72
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

SUTURE VICRYL 4-0 PS-2

Facility

$19.96

Hospital Charge Code	270672392
Hospital Revenue Code	272
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$9.98
Rate for Payer: Aetna Commercial	$7.58
Rate for Payer: Aetna Medicare Advantage	$5.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.09
Rate for Payer: Cigna Commercial	$9.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.99
Rate for Payer: Oxford Commercial	$3.99
Rate for Payer: Qualcare PPO/HMO/WC	$2.99
Rate for Payer: UnitedHealthcare Commercial	$3.99
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

Know your out-of-pocket cost for care.

All Charges