Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SUTURTAK PEEK CURVED 2.0MM

Facility

$1,375.00

Hospital Charge Code	270677689
Hospital Revenue Code	272
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$206.25
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

SUTUTE SIK 6-0 TG 140-8

Facility

$56.90

Hospital Charge Code	270665523
Hospital Revenue Code	270
Min. Negotiated Rate	$8.54
Max. Negotiated Rate	$8.54
Rate for Payer: Qualcare PPO/HMO/WC	$8.54

SUTUTE SIK 6-0 TG 140-8

Facility

$56.90

Hospital Charge Code	270665523
Hospital Revenue Code	270
Min. Negotiated Rate	$1.37
Max. Negotiated Rate	$28.45
Rate for Payer: Aetna Commercial	$21.62
Rate for Payer: Aetna Medicare Advantage	$17.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.51
Rate for Payer: Cigna Commercial	$28.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.07
Rate for Payer: Oxford Commercial	$11.38
Rate for Payer: Qualcare PPO/HMO/WC	$8.54
Rate for Payer: UnitedHealthcare Commercial	$11.38
Rate for Payer: UnitedHealthcare Community & State	$1.37
Rate for Payer: Wellpoint Medicaid Managed Care	$1.51

SUT VICRYL RAPIDE2-0 CT-1/CP-1

Facility

$28.88

Hospital Charge Code	270667334
Hospital Revenue Code	272
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$14.44
Rate for Payer: Aetna Commercial	$10.97
Rate for Payer: Aetna Medicare Advantage	$8.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.36
Rate for Payer: Cigna Commercial	$14.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.66
Rate for Payer: Oxford Commercial	$5.78
Rate for Payer: Qualcare PPO/HMO/WC	$4.33
Rate for Payer: UnitedHealthcare Commercial	$5.78
Rate for Payer: UnitedHealthcare Community & State	$0.70
Rate for Payer: Wellpoint Medicaid Managed Care	$0.77

SUT VICRYL RAPIDE2-0 CT-1/CP-1

Facility

$28.88

Hospital Charge Code	270667334
Hospital Revenue Code	272
Min. Negotiated Rate	$4.33
Max. Negotiated Rate	$4.33
Rate for Payer: Qualcare PPO/HMO/WC	$4.33

SV16 2.5X 16MM CANN SCREW

Facility

$1,918.80

Service Code	HCPCS C1713
Hospital Charge Code	270667213
Hospital Revenue Code	278
Min. Negotiated Rate	$46.24
Max. Negotiated Rate	$959.40
Rate for Payer: Aetna Commercial	$729.14
Rate for Payer: Aetna Medicare Advantage	$575.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$489.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$489.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$489.29
Rate for Payer: Cigna Commercial	$959.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$422.14
Rate for Payer: Qualcare PPO/HMO/WC	$287.82
Rate for Payer: UnitedHealthcare Community & State	$46.24
Rate for Payer: Wellpoint Medicaid Managed Care	$50.85

SV16 2.5X 16MM CANN SCREW

Facility

$1,918.80

Service Code	HCPCS C1713
Hospital Charge Code	270667213
Hospital Revenue Code	278
Min. Negotiated Rate	$287.82
Max. Negotiated Rate	$464.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$422.14
Rate for Payer: Qualcare PPO/HMO/WC	$287.82

SV20 2.5X20MM CANN SCREW

Facility

$1,918.80

Service Code	HCPCS C1713
Hospital Charge Code	270678804
Hospital Revenue Code	278
Min. Negotiated Rate	$46.24
Max. Negotiated Rate	$959.40
Rate for Payer: Aetna Commercial	$729.14
Rate for Payer: Aetna Medicare Advantage	$575.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$489.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$489.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$489.29
Rate for Payer: Cigna Commercial	$959.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$422.14
Rate for Payer: Qualcare PPO/HMO/WC	$287.82
Rate for Payer: UnitedHealthcare Community & State	$46.24
Rate for Payer: Wellpoint Medicaid Managed Care	$50.85

SV20 2.5X20MM CANN SCREW

Facility

$1,918.80

Service Code	HCPCS C1713
Hospital Charge Code	270678804
Hospital Revenue Code	278
Min. Negotiated Rate	$287.82
Max. Negotiated Rate	$464.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$383.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$422.14
Rate for Payer: Qualcare PPO/HMO/WC	$287.82

SVG INJ

Facility

$414.45

Service Code	HCPCS 93563
Hospital Charge Code	74110004
Hospital Revenue Code	481
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

SVG INJ

Facility

$414.45

Service Code	HCPCS 93563
Hospital Charge Code	5100037
Hospital Revenue Code	481
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$157.49
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.68
Rate for Payer: Cigna Commercial	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$9.99
Rate for Payer: Wellpoint Medicaid Managed Care	$10.98

SVG INJ

Facility

$414.45

Service Code	HCPCS 93563
Hospital Charge Code	5100037
Hospital Revenue Code	481
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

SVG INJ

Facility

$414.45

Service Code	HCPCS 93563
Hospital Charge Code	74110004
Hospital Revenue Code	481
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$157.49
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.68
Rate for Payer: Cigna Commercial	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$9.99
Rate for Payer: Wellpoint Medicaid Managed Care	$10.98

SWAB GYN 8 INCH

Facility

$260.85

Hospital Charge Code	270654564
Hospital Revenue Code	270
Min. Negotiated Rate	$39.13
Max. Negotiated Rate	$39.13
Rate for Payer: Qualcare PPO/HMO/WC	$39.13

SWAB GYN 8 INCH

Facility

$260.85

Hospital Charge Code	270654564
Hospital Revenue Code	270
Min. Negotiated Rate	$6.29
Max. Negotiated Rate	$130.43
Rate for Payer: Aetna Commercial	$99.12
Rate for Payer: Aetna Medicare Advantage	$78.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.52
Rate for Payer: Cigna Commercial	$130.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.25
Rate for Payer: Oxford Commercial	$52.17
Rate for Payer: Qualcare PPO/HMO/WC	$39.13
Rate for Payer: UnitedHealthcare Commercial	$52.17
Rate for Payer: UnitedHealthcare Community & State	$6.29
Rate for Payer: Wellpoint Medicaid Managed Care	$6.91

SWAB LEMON GLYCERINE

Facility

$2.45

Hospital Charge Code	270302080
Hospital Revenue Code	270
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

SWAB LEMON GLYCERINE

Facility

$2.45

Hospital Charge Code	270302080
Hospital Revenue Code	270
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$0.93
Rate for Payer: Aetna Medicare Advantage	$0.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.62
Rate for Payer: Cigna Commercial	$1.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.74
Rate for Payer: Oxford Commercial	$0.49
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$0.49
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

SWABSTICK BETADINE SINGLE

Facility

$2.45

Hospital Charge Code	270302090
Hospital Revenue Code	270
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

SWABSTICK BETADINE SINGLE

Facility

$2.45

Hospital Charge Code	270302090
Hospital Revenue Code	270
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$0.93
Rate for Payer: Aetna Medicare Advantage	$0.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.62
Rate for Payer: Cigna Commercial	$1.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.74
Rate for Payer: Oxford Commercial	$0.49
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$0.49
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

SWALLOW CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8996GN
Hospital Charge Code	74204033
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SWALLOW CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8996GN
Hospital Charge Code	74204033
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SWALLOW CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8996GN
Hospital Charge Code	9109148
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

SWALLOW CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8996GN
Hospital Charge Code	9109148
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SWALLOW CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8996GN
Hospital Charge Code	84201156
Hospital Revenue Code	440
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$0.00
Rate for Payer: Aetna Medicare Advantage	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.00
Rate for Payer: Cigna Commercial	$0.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

SWALLOW CURRENT STATUS

Facility

$0.01

Service Code	HCPCS G8996GN
Hospital Charge Code	84201156
Hospital Revenue Code	440
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

Know your out-of-pocket cost for care.

All Charges