Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PIN CERV RETAIN CASPAR 14MM

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270697849
Hospital Revenue Code	278
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$62.50
Rate for Payer: Aetna Commercial	$47.50
Rate for Payer: Aetna Medicare Advantage	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.88
Rate for Payer: Cigna Commercial	$62.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$3.31

PIN CERV RETAIN CASPAR 14MM

Facility

$125.00

Service Code	HCPCS C1713
Hospital Charge Code	270697849
Hospital Revenue Code	278
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$30.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.75

PIN CUTTER DIAMON

Facility

$610.00

Hospital Charge Code	270667640
Hospital Revenue Code	278
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$231.80
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: Wellpoint Medicaid Managed Care	$16.16

PIN CUTTER DIAMON

Facility

$610.00

Hospital Charge Code	270667640
Hospital Revenue Code	278
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$147.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

PIN DISTRACTION SCREW 12MM

Facility

$128.24

Hospital Charge Code	270688300
Hospital Revenue Code	272
Min. Negotiated Rate	$19.24
Max. Negotiated Rate	$19.24
Rate for Payer: Qualcare PPO/HMO/WC	$19.24

PIN DISTRACTION SCREW 12MM

Facility

$128.24

Hospital Charge Code	270688300
Hospital Revenue Code	272
Min. Negotiated Rate	$3.09
Max. Negotiated Rate	$64.12
Rate for Payer: Aetna Commercial	$48.73
Rate for Payer: Aetna Medicare Advantage	$38.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.70
Rate for Payer: Cigna Commercial	$64.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.47
Rate for Payer: Oxford Commercial	$25.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.24
Rate for Payer: UnitedHealthcare Commercial	$25.65
Rate for Payer: UnitedHealthcare Community & State	$3.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3.40

PIN DISTRACTOR 14 MM

Facility

$2,500.00

Hospital Charge Code	270692225
Hospital Revenue Code	272
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$500.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

PIN DISTRACTOR 14 MM

Facility

$2,500.00

Hospital Charge Code	270692225
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

PIN DISTRACTOR CERVICAL 12MM

Facility

$930.00

Service Code	HCPCS C1713
Hospital Charge Code	270697852
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

PIN DISTRACTOR CERVICAL 12MM

Facility

$930.00

Service Code	HCPCS C1713
Hospital Charge Code	270697852
Hospital Revenue Code	278
Min. Negotiated Rate	$22.41
Max. Negotiated Rate	$465.00
Rate for Payer: Aetna Commercial	$353.40
Rate for Payer: Aetna Medicare Advantage	$279.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.15
Rate for Payer: Cigna Commercial	$465.00
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
Rate for Payer: UnitedHealthcare Community & State	$22.41
Rate for Payer: Wellpoint Medicaid Managed Care	$24.64

PINDOLOL 5 MG TAB

Facility

$9.65

Hospital Charge Code	60628865
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.83
Rate for Payer: Aetna Commercial	$3.67
Rate for Payer: Aetna Medicare Advantage	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.46
Rate for Payer: Cigna Commercial	$4.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.90
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$1.45
Rate for Payer: UnitedHealthcare Commercial	$1.93
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

PINDOLOL 5 MG TAB

Facility

$9.65

Hospital Charge Code	60628865
Hospital Revenue Code	250
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1.45
Rate for Payer: Qualcare PPO/HMO/WC	$1.45

PIN DPY HALF 5 160MM FF1016020

Facility

$614.45

Hospital Charge Code	270612447
Hospital Revenue Code	278
Min. Negotiated Rate	$92.17
Max. Negotiated Rate	$148.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.18
Rate for Payer: Qualcare PPO/HMO/WC	$92.17

PIN DPY HALF 5 160MM FF1016020

Facility

$614.45

Hospital Charge Code	270612447
Hospital Revenue Code	278
Min. Negotiated Rate	$14.81
Max. Negotiated Rate	$307.23
Rate for Payer: Aetna Commercial	$233.49
Rate for Payer: Aetna Medicare Advantage	$184.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.68
Rate for Payer: Cigna Commercial	$307.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.18
Rate for Payer: Qualcare PPO/HMO/WC	$92.17
Rate for Payer: UnitedHealthcare Community & State	$14.81
Rate for Payer: Wellpoint Medicaid Managed Care	$16.28

PIN DPY HALF 5 165MM FF1016525

Facility

$614.45

Hospital Charge Code	270612489
Hospital Revenue Code	278
Min. Negotiated Rate	$92.17
Max. Negotiated Rate	$148.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.18
Rate for Payer: Qualcare PPO/HMO/WC	$92.17

PIN DPY HALF 5 165MM FF1016525

Facility

$614.45

Hospital Charge Code	270612489
Hospital Revenue Code	278
Min. Negotiated Rate	$14.81
Max. Negotiated Rate	$307.23
Rate for Payer: Aetna Commercial	$233.49
Rate for Payer: Aetna Medicare Advantage	$184.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.68
Rate for Payer: Cigna Commercial	$307.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$135.18
Rate for Payer: Qualcare PPO/HMO/WC	$92.17
Rate for Payer: UnitedHealthcare Community & State	$14.81
Rate for Payer: Wellpoint Medicaid Managed Care	$16.28

PIN DPY HALF 5 175MM FF1017535

Facility

$529.65

Hospital Charge Code	270612633
Hospital Revenue Code	278
Min. Negotiated Rate	$12.76
Max. Negotiated Rate	$264.82
Rate for Payer: Aetna Commercial	$201.27
Rate for Payer: Aetna Medicare Advantage	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.06
Rate for Payer: Cigna Commercial	$264.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.52
Rate for Payer: Qualcare PPO/HMO/WC	$79.45
Rate for Payer: UnitedHealthcare Community & State	$12.76
Rate for Payer: Wellpoint Medicaid Managed Care	$14.04

PIN DPY HALF 5 175MM FF1017535

Facility

$529.65

Hospital Charge Code	270612633
Hospital Revenue Code	278
Min. Negotiated Rate	$79.45
Max. Negotiated Rate	$128.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.52
Rate for Payer: Qualcare PPO/HMO/WC	$79.45

PIN DRIVER DIAMOND 8GX15CM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692233
Hospital Revenue Code	278
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

PIN DRIVER DIAMOND 8GX15CM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	270692233
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$181.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

PIN DRL ,ACL T-ROPE CLSD. 4MM

Facility

$625.00

Hospital Charge Code	270681330
Hospital Revenue Code	272
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

PIN DRL ,ACL T-ROPE CLSD. 4MM

Facility

$625.00

Hospital Charge Code	270681330
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

PIN FINGER DISLOCATION

Facility

$10,580.92

Service Code	HCPCS 26776
Hospital Charge Code	16000858
Hospital Revenue Code	360
Min. Negotiated Rate	$1,587.14
Max. Negotiated Rate	$1,587.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,587.14

PIN FINGER DISLOCATION

Facility

$10,580.92

Service Code	HCPCS 26776
Hospital Charge Code	16000858
Hospital Revenue Code	360
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,174.28
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,587.14
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$255.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$280.39

PIN FIX

Facility

$460.00

Service Code	HCPCS C1713
Hospital Charge Code	270665075
Hospital Revenue Code	278
Min. Negotiated Rate	$11.09
Max. Negotiated Rate	$230.00
Rate for Payer: Aetna Commercial	$174.80
Rate for Payer: Aetna Medicare Advantage	$138.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.30
Rate for Payer: Cigna Commercial	$230.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$101.20
Rate for Payer: Qualcare PPO/HMO/WC	$69.00
Rate for Payer: UnitedHealthcare Community & State	$11.09
Rate for Payer: Wellpoint Medicaid Managed Care	$12.19

Know your out-of-pocket cost for care.

All Charges