Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PIN RUSH MED SM A-M****

Facility

$105.00

Hospital Charge Code	1602127
Hospital Revenue Code	274
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$25.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$15.75

PIN RUSH MED SM A-M****

Facility

$105.00

Hospital Charge Code	1602127
Hospital Revenue Code	274
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$52.50
Rate for Payer: Aetna Commercial	$39.90
Rate for Payer: Aetna Medicare Advantage	$31.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.77
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Community & State	$2.53
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

PIN RUSH MED SM N-T****

Facility

$107.00

Hospital Charge Code	1602135
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 RUSH MED SM N-T****

Facility

$107.00

Hospital Charge Code	1602135
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 RUSH MED SM U-Y****

Facility

$88.00

Hospital Charge Code	1602143
Hospital Revenue Code	274
Min. Negotiated Rate	$13.20
Max. Negotiated Rate	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19.36
Rate for Payer: Qualcare PPO/HMO/WC	$13.20

PIN RUSH MED SM U-Y****

Facility

$88.00

Hospital Charge Code	1602143
Hospital Revenue Code	274
Min. Negotiated Rate	$2.12
Max. Negotiated Rate	$44.00
Rate for Payer: Aetna Commercial	$33.44
Rate for Payer: Aetna Medicare Advantage	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.44
Rate for Payer: Cigna Commercial	$44.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$19.36
Rate for Payer: Qualcare PPO/HMO/WC	$13.20
Rate for Payer: UnitedHealthcare Community & State	$2.12
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

PIN RUSH MEDULLARY 1/8 8030108

Facility

$281.65

Hospital Charge Code	270635390
Hospital Revenue Code	278
Min. Negotiated Rate	$6.79
Max. Negotiated Rate	$140.82
Rate for Payer: Aetna Commercial	$107.03
Rate for Payer: Aetna Medicare Advantage	$84.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.82
Rate for Payer: Cigna Commercial	$140.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.96
Rate for Payer: Qualcare PPO/HMO/WC	$42.25
Rate for Payer: UnitedHealthcare Community & State	$6.79
Rate for Payer: Wellpoint Medicaid Managed Care	$7.46

PIN RUSH MEDULLARY 1/8 8030108

Facility

$281.65

Hospital Charge Code	270635390
Hospital Revenue Code	278
Min. Negotiated Rate	$42.25
Max. Negotiated Rate	$68.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.96
Rate for Payer: Qualcare PPO/HMO/WC	$42.25

PIN RUSH MEDULLARY 3.2x254MM

Facility

$281.65

Hospital Charge Code	270614876
Hospital Revenue Code	278
Min. Negotiated Rate	$6.79
Max. Negotiated Rate	$140.82
Rate for Payer: Aetna Commercial	$107.03
Rate for Payer: Aetna Medicare Advantage	$84.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.82
Rate for Payer: Cigna Commercial	$140.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.96
Rate for Payer: Qualcare PPO/HMO/WC	$42.25
Rate for Payer: UnitedHealthcare Community & State	$6.79
Rate for Payer: Wellpoint Medicaid Managed Care	$7.46

PIN RUSH MEDULLARY 3.2x254MM

Facility

$281.65

Hospital Charge Code	270614876
Hospital Revenue Code	278
Min. Negotiated Rate	$42.25
Max. Negotiated Rate	$68.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$61.96
Rate for Payer: Qualcare PPO/HMO/WC	$42.25

PIN RUSH MED XLG A***

Facility

$192.00

Hospital Charge Code	1602093
Hospital Revenue Code	274
Min. Negotiated Rate	$4.63
Max. Negotiated Rate	$96.00
Rate for Payer: Aetna Commercial	$72.96
Rate for Payer: Aetna Medicare Advantage	$57.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.96
Rate for Payer: Cigna Commercial	$96.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.24
Rate for Payer: Qualcare PPO/HMO/WC	$28.80
Rate for Payer: UnitedHealthcare Community & State	$4.63
Rate for Payer: Wellpoint Medicaid Managed Care	$5.09

PIN RUSH MED XLG A***

Facility

$192.00

Hospital Charge Code	1602093
Hospital Revenue Code	274
Min. Negotiated Rate	$28.80
Max. Negotiated Rate	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$42.24
Rate for Payer: Qualcare PPO/HMO/WC	$28.80

PINS 3.2 X 110 MM

Facility

$676.00

Service Code	HCPCS C1713
Hospital Charge Code	270691008
Hospital Revenue Code	278
Min. Negotiated Rate	$16.29
Max. Negotiated Rate	$338.00
Rate for Payer: Aetna Commercial	$256.88
Rate for Payer: Aetna Medicare Advantage	$202.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.38
Rate for Payer: Cigna Commercial	$338.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.72
Rate for Payer: Qualcare PPO/HMO/WC	$101.40
Rate for Payer: UnitedHealthcare Community & State	$16.29
Rate for Payer: Wellpoint Medicaid Managed Care	$17.91

PINS 3.2 X 110 MM

Facility

$676.00

Service Code	HCPCS C1713
Hospital Charge Code	270691008
Hospital Revenue Code	278
Min. Negotiated Rate	$101.40
Max. Negotiated Rate	$163.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.72
Rate for Payer: Qualcare PPO/HMO/WC	$101.40

PINS 5.0MM FIXATION CAPS

Facility

$176.65

Service Code	HCPCS C1713
Hospital Charge Code	270638105
Hospital Revenue Code	278
Min. Negotiated Rate	$26.50
Max. Negotiated Rate	$42.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.86
Rate for Payer: Qualcare PPO/HMO/WC	$26.50

PINS 5.0MM FIXATION CAPS

Facility

$176.65

Service Code	HCPCS C1713
Hospital Charge Code	270638105
Hospital Revenue Code	278
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$88.33
Rate for Payer: Aetna Commercial	$67.13
Rate for Payer: Aetna Medicare Advantage	$52.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.05
Rate for Payer: Cigna Commercial	$88.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$38.86
Rate for Payer: Qualcare PPO/HMO/WC	$26.50
Rate for Payer: UnitedHealthcare Community & State	$4.26
Rate for Payer: Wellpoint Medicaid Managed Care	$4.68

PIN SACHANZ 4.0MM AO CONNECT

Facility

$536.25

Service Code	HCPCS C1713
Hospital Charge Code	270701296
Hospital Revenue Code	278
Min. Negotiated Rate	$80.44
Max. Negotiated Rate	$129.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.97
Rate for Payer: Qualcare PPO/HMO/WC	$80.44

PIN SACHANZ 4.0MM AO CONNECT

Facility

$536.25

Service Code	HCPCS C1713
Hospital Charge Code	270701296
Hospital Revenue Code	278
Min. Negotiated Rate	$12.92
Max. Negotiated Rate	$268.12
Rate for Payer: Aetna Commercial	$203.78
Rate for Payer: Aetna Medicare Advantage	$160.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.74
Rate for Payer: Cigna Commercial	$268.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.97
Rate for Payer: Qualcare PPO/HMO/WC	$80.44
Rate for Payer: UnitedHealthcare Community & State	$12.92
Rate for Payer: Wellpoint Medicaid Managed Care	$14.21

PIN SACHANZ 6.0MM AO CONNECT

Facility

$536.25

Hospital Charge Code	270701709
Hospital Revenue Code	278
Min. Negotiated Rate	$80.44
Max. Negotiated Rate	$129.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.97
Rate for Payer: Qualcare PPO/HMO/WC	$80.44

PIN SACHANZ 6.0MM AO CONNECT

Facility

$536.25

Hospital Charge Code	270701709
Hospital Revenue Code	278
Min. Negotiated Rate	$12.92
Max. Negotiated Rate	$268.12
Rate for Payer: Aetna Commercial	$203.78
Rate for Payer: Aetna Medicare Advantage	$160.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.74
Rate for Payer: Cigna Commercial	$268.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$117.97
Rate for Payer: Qualcare PPO/HMO/WC	$80.44
Rate for Payer: UnitedHealthcare Community & State	$12.92
Rate for Payer: Wellpoint Medicaid Managed Care	$14.21

PIN SAFETY #3 STERILE

Facility

$4.85

Hospital Charge Code	270609405
Hospital Revenue Code	272
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.42
Rate for Payer: Aetna Commercial	$1.84
Rate for Payer: Aetna Medicare Advantage	$1.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.24
Rate for Payer: Cigna Commercial	$2.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.73
Rate for Payer: UnitedHealthcare Commercial	$0.97
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

PIN SAFETY #3 STERILE

Facility

$4.85

Hospital Charge Code	270609405
Hospital Revenue Code	272
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$0.73
Rate for Payer: Qualcare PPO/HMO/WC	$0.73

PIN SAFETY STERILE 2 PK

Facility

$3.70

Hospital Charge Code	270649680
Hospital Revenue Code	270
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.85
Rate for Payer: Aetna Commercial	$1.41
Rate for Payer: Aetna Medicare Advantage	$1.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.94
Rate for Payer: Cigna Commercial	$1.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.11
Rate for Payer: Oxford Commercial	$0.74
Rate for Payer: Qualcare PPO/HMO/WC	$0.56
Rate for Payer: UnitedHealthcare Commercial	$0.74
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

PIN SAFETY STERILE 2 PK

Facility

$3.70

Hospital Charge Code	270649680
Hospital Revenue Code	270
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$0.56
Rate for Payer: Qualcare PPO/HMO/WC	$0.56

PIN SAFETY STERILE #3

Facility

$3.86

Hospital Charge Code	270649478
Hospital Revenue Code	272
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.47
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.16
Rate for Payer: Oxford Commercial	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$0.77
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

Know your out-of-pocket cost for care.

All Charges