Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PIN HALF 5x170x30 FF1017030

Facility

$545.65

Hospital Charge Code	270612448
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 5x180MM 40MM THD

Facility

$600.00

Hospital Charge Code	270671028
Hospital Revenue Code	272
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00

PIN HALF 5x180MM 40MM THD

Facility

$600.00

Hospital Charge Code	270671028
Hospital Revenue Code	272
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) PPO	$153.00
Rate for Payer: Cigna Commercial	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.00
Rate for Payer: Oxford Commercial	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.00
Rate for Payer: UnitedHealthcare Commercial	$120.00
Rate for Payer: UnitedHealthcare Community & State	$14.46
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

PIN HMD GAMMA 4.0 38015-8920

Facility

$307.25

Hospital Charge Code	270613085
Hospital Revenue Code	278
Min. Negotiated Rate	$46.09
Max. Negotiated Rate	$74.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.59
Rate for Payer: Qualcare PPO/HMO/WC	$46.09

PIN HMD GAMMA 4.0 38015-8920

Facility

$307.25

Hospital Charge Code	270613085
Hospital Revenue Code	278
Min. Negotiated Rate	$7.40
Max. Negotiated Rate	$153.62
Rate for Payer: Aetna Commercial	$116.75
Rate for Payer: Aetna Medicare Advantage	$92.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.35
Rate for Payer: Cigna Commercial	$153.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.59
Rate for Payer: Qualcare PPO/HMO/WC	$46.09
Rate for Payer: UnitedHealthcare Community & State	$7.40
Rate for Payer: Wellpoint Medicaid Managed Care	$8.14

PIN HMD MOD 4 150 5023-5-150

Facility

$430.45

Hospital Charge Code	270621587
Hospital Revenue Code	278
Min. Negotiated Rate	$64.57
Max. Negotiated Rate	$104.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$94.70
Rate for Payer: Qualcare PPO/HMO/WC	$64.57

PIN HMD MOD 4 150 5023-5-150

Facility

$430.45

Hospital Charge Code	270621587
Hospital Revenue Code	278
Min. Negotiated Rate	$10.37
Max. Negotiated Rate	$215.22
Rate for Payer: Aetna Commercial	$163.57
Rate for Payer: Aetna Medicare Advantage	$129.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$86.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.76
Rate for Payer: Cigna Commercial	$215.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$94.70
Rate for Payer: Qualcare PPO/HMO/WC	$64.57
Rate for Payer: UnitedHealthcare Community & State	$10.37
Rate for Payer: Wellpoint Medicaid Managed Care	$11.41

PIN HMD MOD 5 150 5018-6-150

Facility

$522.45

Hospital Charge Code	270621588
Hospital Revenue Code	278
Min. Negotiated Rate	$78.37
Max. Negotiated Rate	$126.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.94
Rate for Payer: Qualcare PPO/HMO/WC	$78.37

PIN HMD MOD 5 150 5018-6-150

Facility

$522.45

Hospital Charge Code	270621588
Hospital Revenue Code	278
Min. Negotiated Rate	$12.59
Max. Negotiated Rate	$261.23
Rate for Payer: Aetna Commercial	$198.53
Rate for Payer: Aetna Medicare Advantage	$156.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.22
Rate for Payer: Cigna Commercial	$261.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$114.94
Rate for Payer: Qualcare PPO/HMO/WC	$78.37
Rate for Payer: UnitedHealthcare Community & State	$12.59
Rate for Payer: Wellpoint Medicaid Managed Care	$13.84

PIN HMD TARGET 4.0 3815-8-920

Facility

$307.25

Hospital Charge Code	270613086
Hospital Revenue Code	278
Min. Negotiated Rate	$7.40
Max. Negotiated Rate	$153.62
Rate for Payer: Aetna Commercial	$116.75
Rate for Payer: Aetna Medicare Advantage	$92.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.35
Rate for Payer: Cigna Commercial	$153.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.59
Rate for Payer: Qualcare PPO/HMO/WC	$46.09
Rate for Payer: UnitedHealthcare Community & State	$7.40
Rate for Payer: Wellpoint Medicaid Managed Care	$8.14

PIN HMD TARGET 4.0 3815-8-920

Facility

$307.25

Hospital Charge Code	270613086
Hospital Revenue Code	278
Min. Negotiated Rate	$46.09
Max. Negotiated Rate	$74.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.59
Rate for Payer: Qualcare PPO/HMO/WC	$46.09

PIN HOLDER ADAPT 90o FA10054.2

Facility

$1,711.25

Hospital Charge Code	270632398
Hospital Revenue Code	272
Min. Negotiated Rate	$256.69
Max. Negotiated Rate	$256.69
Rate for Payer: Qualcare PPO/HMO/WC	$256.69

PIN HOLDER ADAPT 90o FA10054.2

Facility

$1,711.25

Hospital Charge Code	270632398
Hospital Revenue Code	272
Min. Negotiated Rate	$41.24
Max. Negotiated Rate	$855.62
Rate for Payer: Aetna Commercial	$650.27
Rate for Payer: Aetna Medicare Advantage	$513.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$436.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$436.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$436.37
Rate for Payer: Cigna Commercial	$855.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$513.38
Rate for Payer: Oxford Commercial	$342.25
Rate for Payer: Qualcare PPO/HMO/WC	$256.69
Rate for Payer: UnitedHealthcare Commercial	$342.25
Rate for Payer: UnitedHealthcare Community & State	$41.24
Rate for Payer: Wellpoint Medicaid Managed Care	$45.35

PIN INTRAFLEX 4.0MM *****

Facility

$181.00

Hospital Charge Code	1602085
Hospital Revenue Code	274
Min. Negotiated Rate	$4.36
Max. Negotiated Rate	$90.50
Rate for Payer: Aetna Commercial	$68.78
Rate for Payer: Aetna Medicare Advantage	$54.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.16
Rate for Payer: Cigna Commercial	$90.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.82
Rate for Payer: Qualcare PPO/HMO/WC	$27.15
Rate for Payer: UnitedHealthcare Community & State	$4.36
Rate for Payer: Wellpoint Medicaid Managed Care	$4.80

PIN INTRAFLEX 4.0MM *****

Facility

$181.00

Hospital Charge Code	1602085
Hospital Revenue Code	274
Min. Negotiated Rate	$27.15
Max. Negotiated Rate	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.82
Rate for Payer: Qualcare PPO/HMO/WC	$27.15

PIN INTRAFLEX 4.5MM *****

Facility

$181.00

Hospital Charge Code	1602077
Hospital Revenue Code	274
Min. Negotiated Rate	$4.36
Max. Negotiated Rate	$90.50
Rate for Payer: Aetna Commercial	$68.78
Rate for Payer: Aetna Medicare Advantage	$54.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.16
Rate for Payer: Cigna Commercial	$90.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.82
Rate for Payer: Qualcare PPO/HMO/WC	$27.15
Rate for Payer: UnitedHealthcare Community & State	$4.36
Rate for Payer: Wellpoint Medicaid Managed Care	$4.80

PIN INTRAFLEX 4.5MM *****

Facility

$181.00

Hospital Charge Code	1602077
Hospital Revenue Code	274
Min. Negotiated Rate	$27.15
Max. Negotiated Rate	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$39.82
Rate for Payer: Qualcare PPO/HMO/WC	$27.15

PIN KNOWLES 2 1/2 INCH****

Facility

$107.00

Hospital Charge Code	1601699
Hospital Revenue Code	274
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$25.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$23.54
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

PIN KNOWLES 2 1/2 INCH****

Facility

$107.00

Hospital Charge Code	1601699
Hospital Revenue Code	274
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$53.50
Rate for Payer: Aetna Commercial	$40.66
Rate for Payer: Aetna Medicare Advantage	$32.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.29
Rate for Payer: Cigna Commercial	$53.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$23.54
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Community & State	$2.58
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

PIN KNOWLES 4 1/4 INCH****

Facility

$124.00

Hospital Charge Code	1601707
Hospital Revenue Code	274
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$30.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.28
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

PIN KNOWLES 4 1/4 INCH****

Facility

$124.00

Hospital Charge Code	1601707
Hospital Revenue Code	274
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$62.00
Rate for Payer: Aetna Commercial	$47.12
Rate for Payer: Aetna Medicare Advantage	$37.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.62
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$27.28
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Community & State	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

PIN KNOWLES 5 1/2

Facility

$328.85

Hospital Charge Code	270601384
Hospital Revenue Code	278
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$164.43
Rate for Payer: Aetna Commercial	$124.96
Rate for Payer: Aetna Medicare Advantage	$98.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.86
Rate for Payer: Cigna Commercial	$164.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$72.35
Rate for Payer: Qualcare PPO/HMO/WC	$49.33
Rate for Payer: UnitedHealthcare Community & State	$7.93
Rate for Payer: Wellpoint Medicaid Managed Care	$8.71

PIN KNOWLES 5 1/2

Facility

$328.85

Hospital Charge Code	270601384
Hospital Revenue Code	278
Min. Negotiated Rate	$49.33
Max. Negotiated Rate	$79.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$72.35
Rate for Payer: Qualcare PPO/HMO/WC	$49.33

PIN KNOWLES 5 1/4 INCH****

Facility

$140.00

Hospital Charge Code	1601715
Hospital Revenue Code	278
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$33.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.80
Rate for Payer: Qualcare PPO/HMO/WC	$21.00

PIN KNOWLES 5 1/4 INCH****

Facility

$140.00

Hospital Charge Code	1601715
Hospital Revenue Code	278
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$70.00
Rate for Payer: Aetna Commercial	$53.20
Rate for Payer: Aetna Medicare Advantage	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.70
Rate for Payer: Cigna Commercial	$70.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$30.80
Rate for Payer: Qualcare PPO/HMO/WC	$21.00
Rate for Payer: UnitedHealthcare Community & State	$3.37
Rate for Payer: Wellpoint Medicaid Managed Care	$3.71

Know your out-of-pocket cost for care.

All Charges