Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURE V-LOC 180 2-0 GS-21

Facility

$110.00

Hospital Charge Code	270665291
Hospital Revenue Code	272
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.00
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$22.00
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

SUTURE VLOC 180 2/0 GS-21

Facility

$267.86

Hospital Charge Code	270683239
Hospital Revenue Code	272
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$133.93
Rate for Payer: Aetna Commercial	$101.79
Rate for Payer: Aetna Medicare Advantage	$80.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$133.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.36
Rate for Payer: Oxford Commercial	$53.57
Rate for Payer: Qualcare PPO/HMO/WC	$40.18
Rate for Payer: UnitedHealthcare Commercial	$53.57
Rate for Payer: UnitedHealthcare Community & State	$6.46
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

SUTURE VLOC 180 2/0 GS-21

Facility

$267.86

Hospital Charge Code	270683239
Hospital Revenue Code	272
Min. Negotiated Rate	$40.18
Max. Negotiated Rate	$40.18
Rate for Payer: Qualcare PPO/HMO/WC	$40.18

SUTURE V-LOC 180 ABS

Facility

$220.80

Hospital Charge Code	270667871
Hospital Revenue Code	272
Min. Negotiated Rate	$5.32
Max. Negotiated Rate	$110.40
Rate for Payer: Aetna Commercial	$83.90
Rate for Payer: Aetna Medicare Advantage	$66.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.30
Rate for Payer: Cigna Commercial	$110.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.24
Rate for Payer: Oxford Commercial	$44.16
Rate for Payer: Qualcare PPO/HMO/WC	$33.12
Rate for Payer: UnitedHealthcare Commercial	$44.16
Rate for Payer: UnitedHealthcare Community & State	$5.32
Rate for Payer: Wellpoint Medicaid Managed Care	$5.85

SUTURE V-LOC 180 ABS

Facility

$220.80

Hospital Charge Code	270667871
Hospital Revenue Code	272
Min. Negotiated Rate	$33.12
Max. Negotiated Rate	$33.12
Rate for Payer: Qualcare PPO/HMO/WC	$33.12

SUTURE VLOC 180 GR9 GS 21

Facility

$110.00

Hospital Charge Code	270660299
Hospital Revenue Code	272
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$16.50

SUTURE VLOC 180 GR9 GS 21

Facility

$110.00

Hospital Charge Code	270660299
Hospital Revenue Code	272
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$55.00
Rate for Payer: Aetna Commercial	$41.80
Rate for Payer: Aetna Medicare Advantage	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.05
Rate for Payer: Cigna Commercial	$55.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.00
Rate for Payer: Oxford Commercial	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.50
Rate for Payer: UnitedHealthcare Commercial	$22.00
Rate for Payer: UnitedHealthcare Community & State	$2.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

SUTURE V-LOC 2-0 30 CM 180 GS

Facility

$249.71

Hospital Charge Code	270665843
Hospital Revenue Code	272
Min. Negotiated Rate	$6.02
Max. Negotiated Rate	$124.86
Rate for Payer: Aetna Commercial	$94.89
Rate for Payer: Aetna Medicare Advantage	$74.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.68
Rate for Payer: Cigna Commercial	$124.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.91
Rate for Payer: Oxford Commercial	$49.94
Rate for Payer: Qualcare PPO/HMO/WC	$37.46
Rate for Payer: UnitedHealthcare Commercial	$49.94
Rate for Payer: UnitedHealthcare Community & State	$6.02
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

SUTURE V-LOC 2-0 30 CM 180 GS

Facility

$249.71

Hospital Charge Code	270665843
Hospital Revenue Code	272
Min. Negotiated Rate	$37.46
Max. Negotiated Rate	$37.46
Rate for Payer: Qualcare PPO/HMO/WC	$37.46

SUTURE V-LOC 2-0 GS-21

Facility

$215.42

Hospital Charge Code	270666903
Hospital Revenue Code	272
Min. Negotiated Rate	$32.31
Max. Negotiated Rate	$32.31
Rate for Payer: Qualcare PPO/HMO/WC	$32.31

SUTURE V-LOC 2-0 GS-21

Facility

$215.42

Hospital Charge Code	270666903
Hospital Revenue Code	272
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$107.71
Rate for Payer: Aetna Commercial	$81.86
Rate for Payer: Aetna Medicare Advantage	$64.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.93
Rate for Payer: Cigna Commercial	$107.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.63
Rate for Payer: Oxford Commercial	$43.08
Rate for Payer: Qualcare PPO/HMO/WC	$32.31
Rate for Payer: UnitedHealthcare Commercial	$43.08
Rate for Payer: UnitedHealthcare Community & State	$5.19
Rate for Payer: Wellpoint Medicaid Managed Care	$5.71

SUTURE V-LOC 2-0 GS-22

Facility

$237.63

Hospital Charge Code	270677026
Hospital Revenue Code	272
Min. Negotiated Rate	$35.64
Max. Negotiated Rate	$35.64
Rate for Payer: Qualcare PPO/HMO/WC	$35.64

SUTURE V-LOC 2-0 GS-22

Facility

$237.63

Hospital Charge Code	270677026
Hospital Revenue Code	272
Min. Negotiated Rate	$5.73
Max. Negotiated Rate	$118.81
Rate for Payer: Aetna Commercial	$90.30
Rate for Payer: Aetna Medicare Advantage	$71.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.60
Rate for Payer: Cigna Commercial	$118.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.29
Rate for Payer: Oxford Commercial	$47.53
Rate for Payer: Qualcare PPO/HMO/WC	$35.64
Rate for Payer: UnitedHealthcare Commercial	$47.53
Rate for Payer: UnitedHealthcare Community & State	$5.73
Rate for Payer: Wellpoint Medicaid Managed Care	$6.30

SUTURE VLOC 2-0 GS-22

Facility

$259.95

Hospital Charge Code	270677025
Hospital Revenue Code	272
Min. Negotiated Rate	$6.26
Max. Negotiated Rate	$129.97
Rate for Payer: Aetna Commercial	$98.78
Rate for Payer: Aetna Medicare Advantage	$77.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.29
Rate for Payer: Cigna Commercial	$129.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.98
Rate for Payer: Oxford Commercial	$51.99
Rate for Payer: Qualcare PPO/HMO/WC	$38.99
Rate for Payer: UnitedHealthcare Commercial	$51.99
Rate for Payer: UnitedHealthcare Community & State	$6.26
Rate for Payer: Wellpoint Medicaid Managed Care	$6.89

SUTURE VLOC 2-0 GS-22

Facility

$259.95

Hospital Charge Code	270677025
Hospital Revenue Code	272
Min. Negotiated Rate	$38.99
Max. Negotiated Rate	$38.99
Rate for Payer: Qualcare PPO/HMO/WC	$38.99

SUTURE V-LOC 3-0 P-12

Facility

$231.67

Service Code	HCPCS A4649
Hospital Charge Code	270697937
Hospital Revenue Code	272
Min. Negotiated Rate	$34.75
Max. Negotiated Rate	$34.75
Rate for Payer: Qualcare PPO/HMO/WC	$34.75

SUTURE V-LOC 3-0 P-12

Facility

$231.67

Service Code	HCPCS A4649
Hospital Charge Code	270697937
Hospital Revenue Code	272
Min. Negotiated Rate	$5.58
Max. Negotiated Rate	$115.83
Rate for Payer: Aetna Commercial	$88.03
Rate for Payer: Aetna Medicare Advantage	$69.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.08
Rate for Payer: Cigna Commercial	$115.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.50
Rate for Payer: Oxford Commercial	$46.33
Rate for Payer: Qualcare PPO/HMO/WC	$34.75
Rate for Payer: UnitedHealthcare Commercial	$46.33
Rate for Payer: UnitedHealthcare Community & State	$5.58
Rate for Payer: Wellpoint Medicaid Managed Care	$6.14

SUTURE VLOC 3-0 V-20

Facility

$263.14

Hospital Charge Code	270665246
Hospital Revenue Code	272
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$131.57
Rate for Payer: Aetna Commercial	$99.99
Rate for Payer: Aetna Medicare Advantage	$78.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.10
Rate for Payer: Cigna Commercial	$131.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.94
Rate for Payer: Oxford Commercial	$52.63
Rate for Payer: Qualcare PPO/HMO/WC	$39.47
Rate for Payer: UnitedHealthcare Commercial	$52.63
Rate for Payer: UnitedHealthcare Community & State	$6.34
Rate for Payer: Wellpoint Medicaid Managed Care	$6.97

SUTURE VLOC 3-0 V-20

Facility

$263.14

Hospital Charge Code	270665246
Hospital Revenue Code	272
Min. Negotiated Rate	$39.47
Max. Negotiated Rate	$39.47
Rate for Payer: Qualcare PPO/HMO/WC	$39.47

SUTURE V-LOC 90 2-0 GS-21

Facility

$193.92

Hospital Charge Code	270671573
Hospital Revenue Code	272
Min. Negotiated Rate	$4.67
Max. Negotiated Rate	$96.96
Rate for Payer: Aetna Commercial	$73.69
Rate for Payer: Aetna Medicare Advantage	$58.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.45
Rate for Payer: Cigna Commercial	$96.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.18
Rate for Payer: Oxford Commercial	$38.78
Rate for Payer: Qualcare PPO/HMO/WC	$29.09
Rate for Payer: UnitedHealthcare Commercial	$38.78
Rate for Payer: UnitedHealthcare Community & State	$4.67
Rate for Payer: Wellpoint Medicaid Managed Care	$5.14

SUTURE V-LOC 90 2-0 GS-21

Facility

$193.92

Hospital Charge Code	270671573
Hospital Revenue Code	272
Min. Negotiated Rate	$29.09
Max. Negotiated Rate	$29.09
Rate for Payer: Qualcare PPO/HMO/WC	$29.09

SUTURE V-LOC 90 ABS CLOS DEV

Facility

$183.72

Hospital Charge Code	270648847
Hospital Revenue Code	272
Min. Negotiated Rate	$27.56
Max. Negotiated Rate	$27.56
Rate for Payer: Qualcare PPO/HMO/WC	$27.56

SUTURE V-LOC 90 ABS CLOS DEV

Facility

$183.72

Hospital Charge Code	270648847
Hospital Revenue Code	272
Min. Negotiated Rate	$4.43
Max. Negotiated Rate	$91.86
Rate for Payer: Aetna Commercial	$69.81
Rate for Payer: Aetna Medicare Advantage	$55.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.85
Rate for Payer: Cigna Commercial	$91.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.12
Rate for Payer: Oxford Commercial	$36.74
Rate for Payer: Qualcare PPO/HMO/WC	$27.56
Rate for Payer: UnitedHealthcare Commercial	$36.74
Rate for Payer: UnitedHealthcare Community & State	$4.43
Rate for Payer: Wellpoint Medicaid Managed Care	$4.87

SUTURE VLOC BLU GS-21 0

Facility

$435.72

Hospital Charge Code	270692408
Hospital Revenue Code	272
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$217.86
Rate for Payer: Aetna Commercial	$165.57
Rate for Payer: Aetna Medicare Advantage	$130.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.11
Rate for Payer: Cigna Commercial	$217.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.72
Rate for Payer: Oxford Commercial	$87.14
Rate for Payer: Qualcare PPO/HMO/WC	$65.36
Rate for Payer: UnitedHealthcare Commercial	$87.14
Rate for Payer: UnitedHealthcare Community & State	$10.50
Rate for Payer: Wellpoint Medicaid Managed Care	$11.55

SUTURE VLOC BLU GS-21 0

Facility

$435.72

Hospital Charge Code	270692408
Hospital Revenue Code	272
Min. Negotiated Rate	$65.36
Max. Negotiated Rate	$65.36
Rate for Payer: Qualcare PPO/HMO/WC	$65.36

Know your out-of-pocket cost for care.

All Charges