Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE VICRYL 5-0 P-3

Facility

$20.30

Hospital Charge Code	270671473
Hospital Revenue Code	272
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$10.15
Rate for Payer: Aetna Commercial	$7.71
Rate for Payer: Aetna Medicare Advantage	$6.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.18
Rate for Payer: Cigna Commercial	$10.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.09
Rate for Payer: Oxford Commercial	$4.06
Rate for Payer: Qualcare PPO/HMO/WC	$3.04
Rate for Payer: UnitedHealthcare Commercial	$4.06
Rate for Payer: UnitedHealthcare Community & State	$0.49
Rate for Payer: Wellpoint Medicaid Managed Care	$0.54

SUTURE VICRYL 5-0 P-3

Facility

$18.40

Hospital Charge Code	270671474
Hospital Revenue Code	272
Min. Negotiated Rate	$2.76
Max. Negotiated Rate	$2.76
Rate for Payer: Qualcare PPO/HMO/WC	$2.76

SUTURE VICRYL 5-0 PC-5

Facility

$20.30

Hospital Charge Code	270671483
Hospital Revenue Code	272
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$3.04
Rate for Payer: Qualcare PPO/HMO/WC	$3.04

SUTURE VICRYL 5-0 PC-5

Facility

$20.30

Hospital Charge Code	270671483
Hospital Revenue Code	272
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$10.15
Rate for Payer: Aetna Commercial	$7.71
Rate for Payer: Aetna Medicare Advantage	$6.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.18
Rate for Payer: Cigna Commercial	$10.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.09
Rate for Payer: Oxford Commercial	$4.06
Rate for Payer: Qualcare PPO/HMO/WC	$3.04
Rate for Payer: UnitedHealthcare Commercial	$4.06
Rate for Payer: UnitedHealthcare Community & State	$0.49
Rate for Payer: Wellpoint Medicaid Managed Care	$0.54

SUTURE VICRYL 5-0 RB-1

Facility

$12.80

Hospital Charge Code	270671458
Hospital Revenue Code	272
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.40
Rate for Payer: Aetna Commercial	$4.86
Rate for Payer: Aetna Medicare Advantage	$3.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.26
Rate for Payer: Cigna Commercial	$6.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.84
Rate for Payer: Oxford Commercial	$2.56
Rate for Payer: Qualcare PPO/HMO/WC	$1.92
Rate for Payer: UnitedHealthcare Commercial	$2.56
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

SUTURE VICRYL 5-0 RB-1

Facility

$12.80

Hospital Charge Code	270671458
Hospital Revenue Code	272
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.92

SUTURE VICRYL 5-0 S-14

Facility

$59.15

Hospital Charge Code	270657444
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 5-0 S-14

Facility

$59.15

Hospital Charge Code	270657444
Hospital Revenue Code	272
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$29.57
Rate for Payer: Aetna Commercial	$22.48
Rate for Payer: Aetna Medicare Advantage	$17.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.08
Rate for Payer: Cigna Commercial	$29.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.75
Rate for Payer: Oxford Commercial	$11.83
Rate for Payer: Qualcare PPO/HMO/WC	$8.87
Rate for Payer: UnitedHealthcare Commercial	$11.83
Rate for Payer: UnitedHealthcare Community & State	$1.43
Rate for Payer: Wellpoint Medicaid Managed Care	$1.57

SUTURE VICRYL 5-0 S-14

Facility

$57.10

Hospital Charge Code	270655816
Hospital Revenue Code	272
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$28.55
Rate for Payer: Aetna Commercial	$21.70
Rate for Payer: Aetna Medicare Advantage	$17.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.56
Rate for Payer: Cigna Commercial	$28.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.13
Rate for Payer: Oxford Commercial	$11.42
Rate for Payer: Qualcare PPO/HMO/WC	$8.56
Rate for Payer: UnitedHealthcare Commercial	$11.42
Rate for Payer: UnitedHealthcare Community & State	$1.38
Rate for Payer: Wellpoint Medicaid Managed Care	$1.51

SUTURE VICRYL 5-0 S-14

Facility

$57.10

Hospital Charge Code	270674249
Hospital Revenue Code	272
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$28.55
Rate for Payer: Aetna Commercial	$21.70
Rate for Payer: Aetna Medicare Advantage	$17.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.56
Rate for Payer: Cigna Commercial	$28.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.13
Rate for Payer: Oxford Commercial	$11.42
Rate for Payer: Qualcare PPO/HMO/WC	$8.56
Rate for Payer: UnitedHealthcare Commercial	$11.42
Rate for Payer: UnitedHealthcare Community & State	$1.38
Rate for Payer: Wellpoint Medicaid Managed Care	$1.51

SUTURE VICRYL 5-0 S-14

Facility

$57.10

Hospital Charge Code	270655816
Hospital Revenue Code	272
Min. Negotiated Rate	$8.56
Max. Negotiated Rate	$8.56
Rate for Payer: Qualcare PPO/HMO/WC	$8.56

SUTURE VICRYL 5-0 S-14

Facility

$57.10

Hospital Charge Code	270674249
Hospital Revenue Code	272
Min. Negotiated Rate	$8.56
Max. Negotiated Rate	$8.56
Rate for Payer: Qualcare PPO/HMO/WC	$8.56

SUTURE VICRYL 5/0 S14

Facility

$1,627.40

Hospital Charge Code	270660055
Hospital Revenue Code	272
Min. Negotiated Rate	$244.11
Max. Negotiated Rate	$244.11
Rate for Payer: Qualcare PPO/HMO/WC	$244.11

SUTURE VICRYL 5/0 S14

Facility

$1,627.40

Hospital Charge Code	270660055
Hospital Revenue Code	272
Min. Negotiated Rate	$39.22
Max. Negotiated Rate	$813.70
Rate for Payer: Aetna Commercial	$618.41
Rate for Payer: Aetna Medicare Advantage	$488.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$414.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$414.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$414.99
Rate for Payer: Cigna Commercial	$813.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$488.22
Rate for Payer: Oxford Commercial	$325.48
Rate for Payer: Qualcare PPO/HMO/WC	$244.11
Rate for Payer: UnitedHealthcare Commercial	$325.48
Rate for Payer: UnitedHealthcare Community & State	$39.22
Rate for Payer: Wellpoint Medicaid Managed Care	$43.13

SUTURE VICRYL 6-0 P-1

Facility

$30.35

Hospital Charge Code	270669631
Hospital Revenue Code	272
Min. Negotiated Rate	$4.55
Max. Negotiated Rate	$4.55
Rate for Payer: Qualcare PPO/HMO/WC	$4.55

SUTURE VICRYL 6-0 P-1

Facility

$30.35

Hospital Charge Code	270669631
Hospital Revenue Code	272
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$15.18
Rate for Payer: Aetna Commercial	$11.53
Rate for Payer: Aetna Medicare Advantage	$9.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.74
Rate for Payer: Cigna Commercial	$15.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.11
Rate for Payer: Oxford Commercial	$6.07
Rate for Payer: Qualcare PPO/HMO/WC	$4.55
Rate for Payer: UnitedHealthcare Commercial	$6.07
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

SUTURE VICRYL 6-0 S-14

Facility

$57.10

Hospital Charge Code	270655814
Hospital Revenue Code	272
Min. Negotiated Rate	$8.56
Max. Negotiated Rate	$8.56
Rate for Payer: Qualcare PPO/HMO/WC	$8.56

SUTURE VICRYL 6-0 S-14

Facility

$58.84

Hospital Charge Code	270661872
Hospital Revenue Code	272
Min. Negotiated Rate	$8.83
Max. Negotiated Rate	$8.83
Rate for Payer: Qualcare PPO/HMO/WC	$8.83

SUTURE VICRYL 6-0 S-14

Facility

$57.10

Hospital Charge Code	270655814
Hospital Revenue Code	272
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$28.55
Rate for Payer: Aetna Commercial	$21.70
Rate for Payer: Aetna Medicare Advantage	$17.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.56
Rate for Payer: Cigna Commercial	$28.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.13
Rate for Payer: Oxford Commercial	$11.42
Rate for Payer: Qualcare PPO/HMO/WC	$8.56
Rate for Payer: UnitedHealthcare Commercial	$11.42
Rate for Payer: UnitedHealthcare Community & State	$1.38
Rate for Payer: Wellpoint Medicaid Managed Care	$1.51

SUTURE VICRYL 6-0 S-14

Facility

$58.84

Hospital Charge Code	270661872
Hospital Revenue Code	272
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$29.42
Rate for Payer: Aetna Commercial	$22.36
Rate for Payer: Aetna Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.00
Rate for Payer: Cigna Commercial	$29.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.65
Rate for Payer: Oxford Commercial	$11.77
Rate for Payer: Qualcare PPO/HMO/WC	$8.83
Rate for Payer: UnitedHealthcare Commercial	$11.77
Rate for Payer: UnitedHealthcare Community & State	$1.42
Rate for Payer: Wellpoint Medicaid Managed Care	$1.56

SUTURE VICRYL 7-0 TG160-8

Facility

$62.19

Hospital Charge Code	270688008
Hospital Revenue Code	272
Min. Negotiated Rate	$9.33
Max. Negotiated Rate	$9.33
Rate for Payer: Qualcare PPO/HMO/WC	$9.33

SUTURE VICRYL 7-0 TG160-8

Facility

$62.19

Hospital Charge Code	270688008
Hospital Revenue Code	272
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$31.09
Rate for Payer: Aetna Commercial	$23.63
Rate for Payer: Aetna Medicare Advantage	$18.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.86
Rate for Payer: Cigna Commercial	$31.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.66
Rate for Payer: Oxford Commercial	$12.44
Rate for Payer: Qualcare PPO/HMO/WC	$9.33
Rate for Payer: UnitedHealthcare Commercial	$12.44
Rate for Payer: UnitedHealthcare Community & State	$1.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1.65

SUTURE VICRYL 8-0 TG140-8 12

Facility

$107.95

Hospital Charge Code	270652987
Hospital Revenue Code	272
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$53.98
Rate for Payer: Aetna Commercial	$41.02
Rate for Payer: Aetna Medicare Advantage	$32.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.53
Rate for Payer: Cigna Commercial	$53.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.38
Rate for Payer: Oxford Commercial	$21.59
Rate for Payer: Qualcare PPO/HMO/WC	$16.19
Rate for Payer: UnitedHealthcare Commercial	$21.59
Rate for Payer: UnitedHealthcare Community & State	$2.60
Rate for Payer: Wellpoint Medicaid Managed Care	$2.86

SUTURE VICRYL 8-0 TG140-8 12

Facility

$107.95

Hospital Charge Code	270652987
Hospital Revenue Code	272
Min. Negotiated Rate	$16.19
Max. Negotiated Rate	$16.19
Rate for Payer: Qualcare PPO/HMO/WC	$16.19

SUTURE VICRYL 8-0 TG140-8 8

Facility

$17.93

Hospital Charge Code	270655747
Hospital Revenue Code	272
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$8.96
Rate for Payer: Aetna Commercial	$6.81
Rate for Payer: Aetna Medicare Advantage	$5.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.57
Rate for Payer: Cigna Commercial	$8.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.38
Rate for Payer: Oxford Commercial	$3.59
Rate for Payer: Qualcare PPO/HMO/WC	$2.69
Rate for Payer: UnitedHealthcare Commercial	$3.59
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

Know your out-of-pocket cost for care.

All Charges