Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PIN VA LCKG BUTTRESS 1.8x24MM

Facility

$577.85

Hospital Charge Code	270677802
Hospital Revenue Code	278
Min. Negotiated Rate	$86.68
Max. Negotiated Rate	$139.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.13
Rate for Payer: Qualcare PPO/HMO/WC	$86.68

PIN VA LCKG BUTTRESS 1.8x24MM

Facility

$577.85

Hospital Charge Code	270677802
Hospital Revenue Code	278
Min. Negotiated Rate	$13.93
Max. Negotiated Rate	$288.93
Rate for Payer: Aetna Commercial	$219.58
Rate for Payer: Aetna Medicare Advantage	$173.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.35
Rate for Payer: Cigna Commercial	$288.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.13
Rate for Payer: Qualcare PPO/HMO/WC	$86.68
Rate for Payer: UnitedHealthcare Community & State	$13.93
Rate for Payer: Wellpoint Medicaid Managed Care	$15.31

PIN VA LCKG BUTTRESS 1.8x26MM

Facility

$577.85

Hospital Charge Code	270677803
Hospital Revenue Code	278
Min. Negotiated Rate	$86.68
Max. Negotiated Rate	$139.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.13
Rate for Payer: Qualcare PPO/HMO/WC	$86.68

PIN VA LCKG BUTTRESS 1.8x26MM

Facility

$577.85

Hospital Charge Code	270677803
Hospital Revenue Code	278
Min. Negotiated Rate	$13.93
Max. Negotiated Rate	$288.93
Rate for Payer: Aetna Commercial	$219.58
Rate for Payer: Aetna Medicare Advantage	$173.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.35
Rate for Payer: Cigna Commercial	$288.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.13
Rate for Payer: Qualcare PPO/HMO/WC	$86.68
Rate for Payer: UnitedHealthcare Community & State	$13.93
Rate for Payer: Wellpoint Medicaid Managed Care	$15.31

PIN VA LCKG BUTTRESS 1.8x28mm

Facility

$577.85

Service Code	HCPCS C1713
Hospital Charge Code	270680388
Hospital Revenue Code	278
Min. Negotiated Rate	$86.68
Max. Negotiated Rate	$139.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.13
Rate for Payer: Qualcare PPO/HMO/WC	$86.68

PIN VA LCKG BUTTRESS 1.8x28mm

Facility

$577.85

Service Code	HCPCS C1713
Hospital Charge Code	270680388
Hospital Revenue Code	278
Min. Negotiated Rate	$13.93
Max. Negotiated Rate	$288.93
Rate for Payer: Aetna Commercial	$219.58
Rate for Payer: Aetna Medicare Advantage	$173.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.35
Rate for Payer: Cigna Commercial	$288.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.13
Rate for Payer: Qualcare PPO/HMO/WC	$86.68
Rate for Payer: UnitedHealthcare Community & State	$13.93
Rate for Payer: Wellpoint Medicaid Managed Care	$15.31

PIN VA LCKG BUTTRESS 1.8x30MM

Facility

$577.85

Hospital Charge Code	270676422
Hospital Revenue Code	278
Min. Negotiated Rate	$13.93
Max. Negotiated Rate	$288.93
Rate for Payer: Aetna Commercial	$219.58
Rate for Payer: Aetna Medicare Advantage	$173.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.35
Rate for Payer: Cigna Commercial	$288.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.13
Rate for Payer: Qualcare PPO/HMO/WC	$86.68
Rate for Payer: UnitedHealthcare Community & State	$13.93
Rate for Payer: Wellpoint Medicaid Managed Care	$15.31

PIN VA LCKG BUTTRESS 1.8x30MM

Facility

$577.85

Hospital Charge Code	270676422
Hospital Revenue Code	278
Min. Negotiated Rate	$86.68
Max. Negotiated Rate	$139.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.13
Rate for Payer: Qualcare PPO/HMO/WC	$86.68

PIN VA LCKG BUTTRESS 1.8x8MM

Facility

$577.85

Hospital Charge Code	270676421
Hospital Revenue Code	278
Min. Negotiated Rate	$13.93
Max. Negotiated Rate	$288.93
Rate for Payer: Aetna Commercial	$219.58
Rate for Payer: Aetna Medicare Advantage	$173.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.35
Rate for Payer: Cigna Commercial	$288.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.13
Rate for Payer: Qualcare PPO/HMO/WC	$86.68
Rate for Payer: UnitedHealthcare Community & State	$13.93
Rate for Payer: Wellpoint Medicaid Managed Care	$15.31

PIN VA LCKG BUTTRESS 1.8x8MM

Facility

$577.85

Hospital Charge Code	270676421
Hospital Revenue Code	278
Min. Negotiated Rate	$86.68
Max. Negotiated Rate	$139.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$127.13
Rate for Payer: Qualcare PPO/HMO/WC	$86.68

PIN VERSITOMIC STERILE

Facility

$278.40

Hospital Charge Code	270676802
Hospital Revenue Code	272
Min. Negotiated Rate	$6.71
Max. Negotiated Rate	$139.20
Rate for Payer: Aetna Commercial	$105.79
Rate for Payer: Aetna Medicare Advantage	$83.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.99
Rate for Payer: Cigna Commercial	$139.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.52
Rate for Payer: Oxford Commercial	$55.68
Rate for Payer: Qualcare PPO/HMO/WC	$41.76
Rate for Payer: UnitedHealthcare Commercial	$55.68
Rate for Payer: UnitedHealthcare Community & State	$6.71
Rate for Payer: Wellpoint Medicaid Managed Care	$7.38

PIN VERSITOMIC STERILE

Facility

$278.40

Hospital Charge Code	270676802
Hospital Revenue Code	272
Min. Negotiated Rate	$41.76
Max. Negotiated Rate	$41.76
Rate for Payer: Qualcare PPO/HMO/WC	$41.76

PINWORM EXAM

Facility

$45.00

Service Code	HCPCS 87172
Hospital Charge Code	3006832
Hospital Revenue Code	309
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$11.61
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.41
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: Cigna Medicare Advantage	$4.27
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Medicare Advantage	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

PINWORM EXAM

Facility

$45.00

Service Code	HCPCS 87172
Hospital Charge Code	3006832
Hospital Revenue Code	309
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

PINWORM EXAM(EG,CELLPH TAPE PR

Facility

$30.00

Service Code	HCPCS 87172
Hospital Charge Code	38475078
Hospital Revenue Code	309
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$11.61
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.41
Rate for Payer: Cigna Commercial	$15.00
Rate for Payer: Cigna Medicare Advantage	$4.27
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Medicare Advantage	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

PINWORM EXAM(EG,CELLPH TAPE PR

Facility

$30.00

Service Code	HCPCS 87172
Hospital Charge Code	38475078
Hospital Revenue Code	309
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

PIN ZIM CABLE 4 45 2232-50-20

Facility

$1,940.00

Hospital Charge Code	270622494
Hospital Revenue Code	278
Min. Negotiated Rate	$46.75
Max. Negotiated Rate	$970.00
Rate for Payer: Aetna Commercial	$737.20
Rate for Payer: Aetna Medicare Advantage	$582.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$494.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$494.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$388.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$494.70
Rate for Payer: Cigna Commercial	$970.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$469.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$426.80
Rate for Payer: Qualcare PPO/HMO/WC	$291.00
Rate for Payer: UnitedHealthcare Community & State	$46.75
Rate for Payer: Wellpoint Medicaid Managed Care	$51.41

PIN ZIM CABLE 4 45 2232-50-20

Facility

$1,940.00

Hospital Charge Code	270622494
Hospital Revenue Code	278
Min. Negotiated Rate	$291.00
Max. Negotiated Rate	$469.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$388.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$469.48
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$426.80
Rate for Payer: Qualcare PPO/HMO/WC	$291.00

PIN ZIM CABLE 4 65 2232-50-21

Facility

$2,905.65

Hospital Charge Code	270618955
Hospital Revenue Code	278
Min. Negotiated Rate	$70.03
Max. Negotiated Rate	$1,452.83
Rate for Payer: Aetna Commercial	$1,104.15
Rate for Payer: Aetna Medicare Advantage	$871.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$740.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$740.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$581.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$740.94
Rate for Payer: Cigna Commercial	$1,452.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$703.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$639.24
Rate for Payer: Qualcare PPO/HMO/WC	$435.85
Rate for Payer: UnitedHealthcare Community & State	$70.03
Rate for Payer: Wellpoint Medicaid Managed Care	$77.00

PIN ZIM CABLE 4 65 2232-50-21

Facility

$2,905.65

Hospital Charge Code	270618955
Hospital Revenue Code	278
Min. Negotiated Rate	$435.85
Max. Negotiated Rate	$703.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$581.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$703.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$639.24
Rate for Payer: Qualcare PPO/HMO/WC	$435.85

PIN ZIM FRLOK GUIDE 1181-110

Facility

$274.45

Hospital Charge Code	270601392
Hospital Revenue Code	278
Min. Negotiated Rate	$41.17
Max. Negotiated Rate	$66.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.38
Rate for Payer: Qualcare PPO/HMO/WC	$41.17

PIN ZIM FRLOK GUIDE 1181-110

Facility

$274.45

Hospital Charge Code	270601392
Hospital Revenue Code	278
Min. Negotiated Rate	$6.61
Max. Negotiated Rate	$137.22
Rate for Payer: Aetna Commercial	$104.29
Rate for Payer: Aetna Medicare Advantage	$82.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$69.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$69.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$69.98
Rate for Payer: Cigna Commercial	$137.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$60.38
Rate for Payer: Qualcare PPO/HMO/WC	$41.17
Rate for Payer: UnitedHealthcare Community & State	$6.61
Rate for Payer: Wellpoint Medicaid Managed Care	$7.27

PIN ZIM FRLOK THRD 1/8 1181-20

Facility

$134.00

Hospital Charge Code	270601382
Hospital Revenue Code	278
Min. Negotiated Rate	$20.10
Max. Negotiated Rate	$32.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.48
Rate for Payer: Qualcare PPO/HMO/WC	$20.10

PIN ZIM FRLOK THRD 1/8 1181-20

Facility

$134.00

Hospital Charge Code	270601382
Hospital Revenue Code	278
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$67.00
Rate for Payer: Aetna Commercial	$50.92
Rate for Payer: Aetna Medicare Advantage	$40.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.17
Rate for Payer: Cigna Commercial	$67.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.48
Rate for Payer: Qualcare PPO/HMO/WC	$20.10
Rate for Payer: UnitedHealthcare Community & State	$3.23
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

PIN ZIM GUIDE 3.2 30.5 2246-23

Facility

$134.00

Hospital Charge Code	270620531
Hospital Revenue Code	278
Min. Negotiated Rate	$20.10
Max. Negotiated Rate	$32.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.48
Rate for Payer: Qualcare PPO/HMO/WC	$20.10

Know your out-of-pocket cost for care.

All Charges