Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PIN ALIGNMENT 4301-02-03

Facility

$735.00

Hospital Charge Code	270637581
Hospital Revenue Code	272
Min. Negotiated Rate	$110.25
Max. Negotiated Rate	$110.25
Rate for Payer: Qualcare PPO/HMO/WC	$110.25

PIN ALIGNMENT 4301-02-03

Facility

$735.00

Hospital Charge Code	270637581
Hospital Revenue Code	272
Min. Negotiated Rate	$17.71
Max. Negotiated Rate	$367.50
Rate for Payer: Aetna Commercial	$279.30
Rate for Payer: Aetna Medicare Advantage	$220.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$187.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$187.43
Rate for Payer: Cigna Commercial	$367.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.50
Rate for Payer: Oxford Commercial	$147.00
Rate for Payer: Qualcare PPO/HMO/WC	$110.25
Rate for Payer: UnitedHealthcare Commercial	$147.00
Rate for Payer: UnitedHealthcare Community & State	$17.71
Rate for Payer: Wellpoint Medicaid Managed Care	$19.48

PIN ANKLE 4x150MM

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270677300
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

PIN ANKLE 4x150MM

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270677300
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

PIN ANKLE 5x200MM

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270677298
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$157.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

PIN ANKLE 5x200MM

Facility

$650.00

Service Code	HCPCS C1713
Hospital Charge Code	270677298
Hospital Revenue Code	278
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

PIN ANKLE FIXAT TM 5X200X80MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270695545
Hospital Revenue Code	278
Min. Negotiated Rate	$14.46
Max. Negotiated Rate	$300.00
Rate for Payer: Aetna Commercial	$228.00
Rate for Payer: Aetna Medicare Advantage	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

PIN ANKLE FIXAT TM 5X200X80MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270695545
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$145.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$120.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$132.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

PIN APEX 5X150

Facility

$1,075.00

Hospital Charge Code	270664938
Hospital Revenue Code	270
Min. Negotiated Rate	$25.91
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.50
Rate for Payer: Oxford Commercial	$215.00
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Commercial	$215.00
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$28.49

PIN APEX 5X150

Facility

$1,075.00

Hospital Charge Code	270664938
Hospital Revenue Code	270
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$161.25
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

PIN APEX BLUE 5MM

Facility

$355.00

Service Code	HCPCS C1713
Hospital Charge Code	270669478
Hospital Revenue Code	278
Min. Negotiated Rate	$8.56
Max. Negotiated Rate	$177.50
Rate for Payer: Aetna Commercial	$134.90
Rate for Payer: Aetna Medicare Advantage	$106.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.53
Rate for Payer: Cigna Commercial	$177.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$78.10
Rate for Payer: Qualcare PPO/HMO/WC	$53.25
Rate for Payer: UnitedHealthcare Community & State	$8.56
Rate for Payer: Wellpoint Medicaid Managed Care	$9.41

PIN APEX BLUE 5MM

Facility

$355.00

Service Code	HCPCS C1713
Hospital Charge Code	270669478
Hospital Revenue Code	278
Min. Negotiated Rate	$53.25
Max. Negotiated Rate	$85.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$78.10
Rate for Payer: Qualcare PPO/HMO/WC	$53.25

PIN APEX HALF S/D 4x120 30MM

Facility

$653.40

Service Code	HCPCS C1713
Hospital Charge Code	270647959
Hospital Revenue Code	278
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$326.70
Rate for Payer: Aetna Commercial	$248.29
Rate for Payer: Aetna Medicare Advantage	$196.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.62
Rate for Payer: Cigna Commercial	$326.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.75
Rate for Payer: Qualcare PPO/HMO/WC	$98.01
Rate for Payer: UnitedHealthcare Community & State	$15.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.32

PIN APEX HALF S/D 4x120 30MM

Facility

$653.40

Service Code	HCPCS C1713
Hospital Charge Code	270647959
Hospital Revenue Code	278
Min. Negotiated Rate	$98.01
Max. Negotiated Rate	$158.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.75
Rate for Payer: Qualcare PPO/HMO/WC	$98.01

PIN APEX HALF S/D 5x120 35MM

Facility

$811.80

Hospital Charge Code	270674577
Hospital Revenue Code	278
Min. Negotiated Rate	$121.77
Max. Negotiated Rate	$196.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$178.60
Rate for Payer: Qualcare PPO/HMO/WC	$121.77

PIN APEX HALF S/D 5x120 35MM

Facility

$811.80

Hospital Charge Code	270674577
Hospital Revenue Code	278
Min. Negotiated Rate	$19.56
Max. Negotiated Rate	$405.90
Rate for Payer: Aetna Commercial	$308.48
Rate for Payer: Aetna Medicare Advantage	$243.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.01
Rate for Payer: Cigna Commercial	$405.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$178.60
Rate for Payer: Qualcare PPO/HMO/WC	$121.77
Rate for Payer: UnitedHealthcare Community & State	$19.56
Rate for Payer: Wellpoint Medicaid Managed Care	$21.51

PIN APEX HALF S/D 5x150 40MM

Facility

$811.80

Service Code	HCPCS C1713
Hospital Charge Code	270647997
Hospital Revenue Code	278
Min. Negotiated Rate	$19.56
Max. Negotiated Rate	$405.90
Rate for Payer: Aetna Commercial	$308.48
Rate for Payer: Aetna Medicare Advantage	$243.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.01
Rate for Payer: Cigna Commercial	$405.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$178.60
Rate for Payer: Qualcare PPO/HMO/WC	$121.77
Rate for Payer: UnitedHealthcare Community & State	$19.56
Rate for Payer: Wellpoint Medicaid Managed Care	$21.51

PIN APEX HALF S/D 5x150 40MM

Facility

$811.80

Service Code	HCPCS C1713
Hospital Charge Code	270647997
Hospital Revenue Code	278
Min. Negotiated Rate	$121.77
Max. Negotiated Rate	$196.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$178.60
Rate for Payer: Qualcare PPO/HMO/WC	$121.77

PIN APEX S/D 3 X 110 25 THR

Facility

$320.10

Hospital Charge Code	270702951
Hospital Revenue Code	278
Min. Negotiated Rate	$48.02
Max. Negotiated Rate	$77.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.42
Rate for Payer: Qualcare PPO/HMO/WC	$48.02

PIN APEX S/D 3 X 110 25 THR

Facility

$320.10

Hospital Charge Code	270702951
Hospital Revenue Code	278
Min. Negotiated Rate	$7.71
Max. Negotiated Rate	$160.05
Rate for Payer: Aetna Commercial	$121.64
Rate for Payer: Aetna Medicare Advantage	$96.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$64.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.63
Rate for Payer: Cigna Commercial	$160.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$70.42
Rate for Payer: Qualcare PPO/HMO/WC	$48.02
Rate for Payer: UnitedHealthcare Community & State	$7.71
Rate for Payer: Wellpoint Medicaid Managed Care	$8.48

PIN APEX SELF TAPPING 4X120MM

Facility

$885.00

Hospital Charge Code	270669062
Hospital Revenue Code	278
Min. Negotiated Rate	$132.75
Max. Negotiated Rate	$214.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$194.70
Rate for Payer: Qualcare PPO/HMO/WC	$132.75

PIN APEX SELF TAPPING 4X120MM

Facility

$885.00

Hospital Charge Code	270669062
Hospital Revenue Code	278
Min. Negotiated Rate	$21.33
Max. Negotiated Rate	$442.50
Rate for Payer: Aetna Commercial	$336.30
Rate for Payer: Aetna Medicare Advantage	$265.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.68
Rate for Payer: Cigna Commercial	$442.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$194.70
Rate for Payer: Qualcare PPO/HMO/WC	$132.75
Rate for Payer: UnitedHealthcare Community & State	$21.33
Rate for Payer: Wellpoint Medicaid Managed Care	$23.45

PIN APEX SLF DRL 3x80 50382080

Facility

$112.50

Hospital Charge Code	270647958
Hospital Revenue Code	278
Min. Negotiated Rate	$2.71
Max. Negotiated Rate	$56.25
Rate for Payer: Aetna Commercial	$42.75
Rate for Payer: Aetna Medicare Advantage	$33.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.69
Rate for Payer: Cigna Commercial	$56.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$24.75
Rate for Payer: Qualcare PPO/HMO/WC	$16.88
Rate for Payer: UnitedHealthcare Community & State	$2.71
Rate for Payer: Wellpoint Medicaid Managed Care	$2.98

PIN APEX SLF DRL 3x80 50382080

Facility

$112.50

Hospital Charge Code	270647958
Hospital Revenue Code	278
Min. Negotiated Rate	$16.88
Max. Negotiated Rate	$27.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$24.75
Rate for Payer: Qualcare PPO/HMO/WC	$16.88

PIN APEX STERILE 5MMx200MM

Facility

$930.00

Service Code	HCPCS C1713
Hospital Charge Code	270650708
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$225.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.60
Rate for Payer: Qualcare PPO/HMO/WC	$139.50

Know your out-of-pocket cost for care.

All Charges