Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PIN GUIDE DHS 338.00

Facility

$211.25

Hospital Charge Code	270603802
Hospital Revenue Code	278
Min. Negotiated Rate	$31.69
Max. Negotiated Rate	$51.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$46.48
Rate for Payer: Qualcare PPO/HMO/WC	$31.69

PIN GUIDE DHS 338.00

Facility

$211.25

Hospital Charge Code	270603802
Hospital Revenue Code	278
Min. Negotiated Rate	$5.09
Max. Negotiated Rate	$105.62
Rate for Payer: Aetna Commercial	$80.28
Rate for Payer: Aetna Medicare Advantage	$63.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.87
Rate for Payer: Cigna Commercial	$105.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$46.48
Rate for Payer: Qualcare PPO/HMO/WC	$31.69
Rate for Payer: UnitedHealthcare Community & State	$5.09
Rate for Payer: Wellpoint Medicaid Managed Care	$5.60

PIN GUIDE DISPOSABLE 2MM

Facility

$2,580.00

Service Code	HCPCS C1769
Hospital Charge Code	270696337
Hospital Revenue Code	272
Min. Negotiated Rate	$62.18
Max. Negotiated Rate	$1,290.00
Rate for Payer: Aetna Commercial	$980.40
Rate for Payer: Aetna Medicare Advantage	$774.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$657.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$657.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$657.90
Rate for Payer: Cigna Commercial	$1,290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$774.00
Rate for Payer: Oxford Commercial	$516.00
Rate for Payer: Qualcare PPO/HMO/WC	$387.00
Rate for Payer: UnitedHealthcare Commercial	$516.00
Rate for Payer: UnitedHealthcare Community & State	$62.18
Rate for Payer: Wellpoint Medicaid Managed Care	$68.37

PIN GUIDE DISPOSABLE 2MM

Facility

$2,580.00

Service Code	HCPCS C1769
Hospital Charge Code	270696337
Hospital Revenue Code	272
Min. Negotiated Rate	$387.00
Max. Negotiated Rate	$387.00
Rate for Payer: Qualcare PPO/HMO/WC	$387.00

PIN GUIDE FLAREHAWK 27MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692661
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 GUIDE FLAREHAWK 27MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	270692661
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 GUIDE OPD DVL 100MM G68345

Facility

$24.85

Hospital Charge Code	270606255
Hospital Revenue Code	278
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$9.44
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5.47
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

PIN GUIDE OPD DVL 100MM G68345

Facility

$24.85

Hospital Charge Code	270606255
Hospital Revenue Code	278
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5.47
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

PIN GUIDE - RICHARDS *****

Facility

$80.00

Hospital Charge Code	1605666
Hospital Revenue Code	274
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$30.40
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$17.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

PIN GUIDE - RICHARDS *****

Facility

$80.00

Hospital Charge Code	1605666
Hospital Revenue Code	274
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$19.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$17.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

PIN GUIDE THREAD 3.2mmx444mm

Facility

$895.00

Hospital Charge Code	270650499
Hospital Revenue Code	271
Min. Negotiated Rate	$21.57
Max. Negotiated Rate	$447.50
Rate for Payer: Aetna Commercial	$340.10
Rate for Payer: Aetna Medicare Advantage	$268.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$228.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$228.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$228.22
Rate for Payer: Cigna Commercial	$447.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.50
Rate for Payer: Oxford Commercial	$179.00
Rate for Payer: Qualcare PPO/HMO/WC	$134.25
Rate for Payer: UnitedHealthcare Commercial	$179.00
Rate for Payer: UnitedHealthcare Community & State	$21.57
Rate for Payer: Wellpoint Medicaid Managed Care	$23.72

PIN GUIDE THREAD 3.2mmx444mm

Facility

$895.00

Hospital Charge Code	270650499
Hospital Revenue Code	271
Min. Negotiated Rate	$134.25
Max. Negotiated Rate	$134.25
Rate for Payer: Qualcare PPO/HMO/WC	$134.25

PIN HALF 3MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270685124
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

PIN HALF 3MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	270685124
Hospital Revenue Code	278
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) NJ Health	$125.00
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	$151.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$137.50
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

PIN HALF 3MM X 100MM X 25MM

Facility

$653.25

Hospital Charge Code	270668711
Hospital Revenue Code	278
Min. Negotiated Rate	$97.99
Max. Negotiated Rate	$158.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.72
Rate for Payer: Qualcare PPO/HMO/WC	$97.99

PIN HALF 3MM X 100MM X 25MM

Facility

$653.25

Hospital Charge Code	270668711
Hospital Revenue Code	278
Min. Negotiated Rate	$15.74
Max. Negotiated Rate	$326.62
Rate for Payer: Aetna Commercial	$248.24
Rate for Payer: Aetna Medicare Advantage	$195.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.58
Rate for Payer: Cigna Commercial	$326.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.72
Rate for Payer: Qualcare PPO/HMO/WC	$97.99
Rate for Payer: UnitedHealthcare Community & State	$15.74
Rate for Payer: Wellpoint Medicaid Managed Care	$17.31

PIN HALF 4MM X 100MM X 35MM

Facility

$653.25

Hospital Charge Code	270668712
Hospital Revenue Code	278
Min. Negotiated Rate	$15.74
Max. Negotiated Rate	$326.62
Rate for Payer: Aetna Commercial	$248.24
Rate for Payer: Aetna Medicare Advantage	$195.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.58
Rate for Payer: Cigna Commercial	$326.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.72
Rate for Payer: Qualcare PPO/HMO/WC	$97.99
Rate for Payer: UnitedHealthcare Community & State	$15.74
Rate for Payer: Wellpoint Medicaid Managed Care	$17.31

PIN HALF 4MM X 100MM X 35MM

Facility

$653.25

Hospital Charge Code	270668712
Hospital Revenue Code	278
Min. Negotiated Rate	$97.99
Max. Negotiated Rate	$158.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$130.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$158.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$143.72
Rate for Payer: Qualcare PPO/HMO/WC	$97.99

PIN HALF 5MM X 160MM X35MM

Facility

$960.00

Hospital Charge Code	270668713
Hospital Revenue Code	278
Min. Negotiated Rate	$23.14
Max. Negotiated Rate	$480.00
Rate for Payer: Aetna Commercial	$364.80
Rate for Payer: Aetna Medicare Advantage	$288.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$244.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$244.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$244.80
Rate for Payer: Cigna Commercial	$480.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.20
Rate for Payer: Qualcare PPO/HMO/WC	$144.00
Rate for Payer: UnitedHealthcare Community & State	$23.14
Rate for Payer: Wellpoint Medicaid Managed Care	$25.44

PIN HALF 5MM X 160MM X35MM

Facility

$960.00

Hospital Charge Code	270668713
Hospital Revenue Code	278
Min. Negotiated Rate	$144.00
Max. Negotiated Rate	$232.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$192.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$211.20
Rate for Payer: Qualcare PPO/HMO/WC	$144.00

PIN HALF 5MM X 160MM X 55MM

Facility

$720.25

Hospital Charge Code	270668714
Hospital Revenue Code	278
Min. Negotiated Rate	$108.04
Max. Negotiated Rate	$174.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.46
Rate for Payer: Qualcare PPO/HMO/WC	$108.04

PIN HALF 5MM X 160MM X 55MM

Facility

$720.25

Hospital Charge Code	270668714
Hospital Revenue Code	278
Min. Negotiated Rate	$17.36
Max. Negotiated Rate	$360.12
Rate for Payer: Aetna Commercial	$273.69
Rate for Payer: Aetna Medicare Advantage	$216.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$144.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.66
Rate for Payer: Cigna Commercial	$360.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$158.46
Rate for Payer: Qualcare PPO/HMO/WC	$108.04
Rate for Payer: UnitedHealthcare Community & State	$17.36
Rate for Payer: Wellpoint Medicaid Managed Care	$19.09

PIN HALF 5x155x20THD FF1015515

Facility

$545.65

Hospital Charge Code	270632628
Hospital Revenue Code	278
Min. Negotiated Rate	$13.15
Max. Negotiated Rate	$272.82
Rate for Payer: Aetna Commercial	$207.35
Rate for Payer: Aetna Medicare Advantage	$163.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.14
Rate for Payer: Cigna Commercial	$272.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$120.04
Rate for Payer: Qualcare PPO/HMO/WC	$81.85
Rate for Payer: UnitedHealthcare Community & State	$13.15
Rate for Payer: Wellpoint Medicaid Managed Care	$14.46

PIN HALF 5x155x20THD FF1015515

Facility

$545.65

Hospital Charge Code	270632628
Hospital Revenue Code	278
Min. Negotiated Rate	$81.85
Max. Negotiated Rate	$132.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$120.04
Rate for Payer: Qualcare PPO/HMO/WC	$81.85

PIN HALF 5x170x30 FF1017030

Facility

$545.65

Hospital Charge Code	270612448
Hospital Revenue Code	278
Min. Negotiated Rate	$81.85
Max. Negotiated Rate	$132.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.05
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$120.04
Rate for Payer: Qualcare PPO/HMO/WC	$81.85

Know your out-of-pocket cost for care.

All Charges