Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PIN FIX

Facility

$460.00

Service Code	HCPCS C1713
Hospital Charge Code	270665075
Hospital Revenue Code	278
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$111.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$92.00
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

PIN FIXATION ANKLE 4X150X40MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270695539
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 FIXATION ANKLE 4X150X40MM

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	270695539
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 FIXATION CERV BLUNT

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270692985
Hospital Revenue Code	278
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

PIN FIXATION CERV BLUNT

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270692985
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

PIN FIXATION SHARP

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270692984
Hospital Revenue Code	278
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

PIN FIXATION SHARP

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	270692984
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

PIN FIXATION SPRING LOADED

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696272
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

PIN FIXATION SPRING LOADED

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270696272
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

PIN FIXATION TEMP 1.4MM SM

Facility

$370.00

Hospital Charge Code	270662461
Hospital Revenue Code	272
Min. Negotiated Rate	$8.92
Max. Negotiated Rate	$185.00
Rate for Payer: Aetna Commercial	$140.60
Rate for Payer: Aetna Medicare Advantage	$111.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.35
Rate for Payer: Cigna Commercial	$185.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.00
Rate for Payer: Oxford Commercial	$74.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.50
Rate for Payer: UnitedHealthcare Commercial	$74.00
Rate for Payer: UnitedHealthcare Community & State	$8.92
Rate for Payer: Wellpoint Medicaid Managed Care	$9.80

PIN FIXATION TEMP 1.4MM SM

Facility

$370.00

Hospital Charge Code	270662461
Hospital Revenue Code	272
Min. Negotiated Rate	$55.50
Max. Negotiated Rate	$55.50
Rate for Payer: Qualcare PPO/HMO/WC	$55.50

PIN FIX PROTECTIVE CAP 6MM

Facility

$329.65

Service Code	HCPCS C1713
Hospital Charge Code	270694576
Hospital Revenue Code	278
Min. Negotiated Rate	$49.45
Max. Negotiated Rate	$79.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$72.52
Rate for Payer: Qualcare PPO/HMO/WC	$49.45

PIN FIX PROTECTIVE CAP 6MM

Facility

$329.65

Service Code	HCPCS C1713
Hospital Charge Code	270694576
Hospital Revenue Code	278
Min. Negotiated Rate	$7.94
Max. Negotiated Rate	$164.82
Rate for Payer: Aetna Commercial	$125.27
Rate for Payer: Aetna Medicare Advantage	$98.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$84.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$84.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$84.06
Rate for Payer: Cigna Commercial	$164.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$72.52
Rate for Payer: Qualcare PPO/HMO/WC	$49.45
Rate for Payer: UnitedHealthcare Community & State	$7.94
Rate for Payer: Wellpoint Medicaid Managed Care	$8.74

PIN FIX SMOOTH MINI 1.1X10MM

Facility

$375.00

Hospital Charge Code	270697021
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

PIN FIX SMOOTH MINI 1.1X10MM

Facility

$375.00

Hospital Charge Code	270697021
Hospital Revenue Code	272
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

PIN GBA GUIDE 2.4 AR133003-24

Facility

$268.85

Hospital Charge Code	270616690
Hospital Revenue Code	278
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$134.43
Rate for Payer: Aetna Commercial	$102.16
Rate for Payer: Aetna Medicare Advantage	$80.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.56
Rate for Payer: Cigna Commercial	$134.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.15
Rate for Payer: Qualcare PPO/HMO/WC	$40.33
Rate for Payer: UnitedHealthcare Community & State	$6.48
Rate for Payer: Wellpoint Medicaid Managed Care	$7.12

PIN GBA GUIDE 2.4 AR133003-24

Facility

$268.85

Hospital Charge Code	270616690
Hospital Revenue Code	278
Min. Negotiated Rate	$40.33
Max. Negotiated Rate	$65.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$59.15
Rate for Payer: Qualcare PPO/HMO/WC	$40.33

PIN GBA GUIDE 3.0 AR133003-30

Facility

$231.25

Hospital Charge Code	270616689
Hospital Revenue Code	278
Min. Negotiated Rate	$5.57
Max. Negotiated Rate	$115.62
Rate for Payer: Aetna Commercial	$87.88
Rate for Payer: Aetna Medicare Advantage	$69.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.97
Rate for Payer: Cigna Commercial	$115.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$50.88
Rate for Payer: Qualcare PPO/HMO/WC	$34.69
Rate for Payer: UnitedHealthcare Community & State	$5.57
Rate for Payer: Wellpoint Medicaid Managed Care	$6.13

PIN GBA GUIDE 3.0 AR133003-30

Facility

$231.25

Hospital Charge Code	270616689
Hospital Revenue Code	278
Min. Negotiated Rate	$34.69
Max. Negotiated Rate	$55.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$50.88
Rate for Payer: Qualcare PPO/HMO/WC	$34.69

PIN GBA GUIDE NIT 1.1 AR-1249

Facility

$184.85

Hospital Charge Code	270614983
Hospital Revenue Code	278
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$92.42
Rate for Payer: Aetna Commercial	$70.24
Rate for Payer: Aetna Medicare Advantage	$55.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.14
Rate for Payer: Cigna Commercial	$92.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$40.67
Rate for Payer: Qualcare PPO/HMO/WC	$27.73
Rate for Payer: UnitedHealthcare Community & State	$4.45
Rate for Payer: Wellpoint Medicaid Managed Care	$4.90

PIN GBA GUIDE NIT 1.1 AR-1249

Facility

$184.85

Hospital Charge Code	270614983
Hospital Revenue Code	278
Min. Negotiated Rate	$27.73
Max. Negotiated Rate	$44.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$40.67
Rate for Payer: Qualcare PPO/HMO/WC	$27.73

PIN GREEN

Facility

$364.75

Hospital Charge Code	270630423
Hospital Revenue Code	279
Min. Negotiated Rate	$8.79
Max. Negotiated Rate	$182.38
Rate for Payer: Aetna Commercial	$138.60
Rate for Payer: Aetna Medicare Advantage	$109.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.01
Rate for Payer: Cigna Commercial	$182.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.42
Rate for Payer: Oxford Commercial	$72.95
Rate for Payer: Qualcare PPO/HMO/WC	$54.71
Rate for Payer: UnitedHealthcare Commercial	$72.95
Rate for Payer: UnitedHealthcare Community & State	$8.79
Rate for Payer: Wellpoint Medicaid Managed Care	$9.67

PIN GREEN

Facility

$364.75

Hospital Charge Code	270630423
Hospital Revenue Code	279
Min. Negotiated Rate	$54.71
Max. Negotiated Rate	$54.71
Rate for Payer: Qualcare PPO/HMO/WC	$54.71

PIN GUIDE CSI SZ 9

Facility

$255.00

Hospital Charge Code	270678242
Hospital Revenue Code	278
Min. Negotiated Rate	$38.25
Max. Negotiated Rate	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$38.25

PIN GUIDE CSI SZ 9

Facility

$255.00

Hospital Charge Code	270678242
Hospital Revenue Code	278
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$127.50
Rate for Payer: Aetna Commercial	$96.90
Rate for Payer: Aetna Medicare Advantage	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.03
Rate for Payer: Cigna Commercial	$127.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$56.10
Rate for Payer: Qualcare PPO/HMO/WC	$38.25
Rate for Payer: UnitedHealthcare Community & State	$6.15
Rate for Payer: Wellpoint Medicaid Managed Care	$6.76

Know your out-of-pocket cost for care.

All Charges