Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PIN ZIM RUSH XLG B 8010103

Facility

$400.00

Hospital Charge Code	270615028
Hospital Revenue Code	278
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.60

PIN ZIM RUSH XLG B 8010103

Facility

$400.00

Hospital Charge Code	270615028
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$88.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

PIN ZIM STEIN 3RD 1/8 2620404

Facility

$85.65

Hospital Charge Code	270601754
Hospital Revenue Code	278
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$20.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.85

PIN ZIM STEIN 3RD 1/8 2620404

Facility

$85.65

Hospital Charge Code	270601754
Hospital Revenue Code	278
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$42.83
Rate for Payer: Aetna Commercial	$32.55
Rate for Payer: Aetna Medicare Advantage	$25.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.84
Rate for Payer: Cigna Commercial	$42.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.85
Rate for Payer: UnitedHealthcare Community & State	$2.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.27

PIN ZIM STEIN 3RD 9/64 2620304

Facility

$85.65

Hospital Charge Code	270601755
Hospital Revenue Code	278
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$20.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.85

PIN ZIM STEIN 3RD 9/64 2620304

Facility

$85.65

Hospital Charge Code	270601755
Hospital Revenue Code	278
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$42.83
Rate for Payer: Aetna Commercial	$32.55
Rate for Payer: Aetna Medicare Advantage	$25.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.84
Rate for Payer: Cigna Commercial	$42.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.85
Rate for Payer: UnitedHealthcare Community & State	$2.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.27

PIN ZIM STEINMAN 3.2 187-04-59

Facility

$40.85

Hospital Charge Code	270620529
Hospital Revenue Code	278
Min. Negotiated Rate	$6.13
Max. Negotiated Rate	$9.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.99
Rate for Payer: Qualcare PPO/HMO/WC	$6.13

PIN ZIM STEINMAN 3.2 187-04-59

Facility

$40.85

Hospital Charge Code	270620529
Hospital Revenue Code	278
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$20.43
Rate for Payer: Aetna Commercial	$15.52
Rate for Payer: Aetna Medicare Advantage	$12.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.42
Rate for Payer: Cigna Commercial	$20.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.99
Rate for Payer: Qualcare PPO/HMO/WC	$6.13
Rate for Payer: UnitedHealthcare Community & State	$0.98
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

PIN ZIM STEINMAN 6 187-02-69

Facility

$39.25

Hospital Charge Code	270608044
Hospital Revenue Code	278
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.62
Rate for Payer: Aetna Commercial	$14.91
Rate for Payer: Aetna Medicare Advantage	$11.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.01
Rate for Payer: Cigna Commercial	$19.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.63
Rate for Payer: Qualcare PPO/HMO/WC	$5.89
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.04

PIN ZIM STEINMAN 6 187-02-69

Facility

$39.25

Hospital Charge Code	270608044
Hospital Revenue Code	278
Min. Negotiated Rate	$5.89
Max. Negotiated Rate	$9.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.63
Rate for Payer: Qualcare PPO/HMO/WC	$5.89

PIN ZIM STEINMAN SM 1/8

Facility

$50.45

Hospital Charge Code	270601760
Hospital Revenue Code	278
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$25.23
Rate for Payer: Aetna Commercial	$19.17
Rate for Payer: Aetna Medicare Advantage	$15.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.86
Rate for Payer: Cigna Commercial	$25.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.10
Rate for Payer: Qualcare PPO/HMO/WC	$7.57
Rate for Payer: UnitedHealthcare Community & State	$1.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1.34

PIN ZIM STEINMAN SM 1/8

Facility

$50.45

Hospital Charge Code	270601760
Hospital Revenue Code	278
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$12.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.10
Rate for Payer: Qualcare PPO/HMO/WC	$7.57

PIN ZIM STEINMAN SM 187-06-69

Facility

$65.65

Service Code	HCPCS C1713
Hospital Charge Code	270601759
Hospital Revenue Code	278
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$32.83
Rate for Payer: Aetna Commercial	$24.95
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.44
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.74

PIN ZIM STEINMAN SM 187-06-69

Facility

$65.65

Service Code	HCPCS C1713
Hospital Charge Code	270601759
Hospital Revenue Code	278
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$15.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.44
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

PIN ZIM STEINMAN SM 3/16

Facility

$44.00

Hospital Charge Code	270601761
Hospital Revenue Code	278
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.68
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Community & State	$1.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

PIN ZIM STEINMAN SM 3/16

Facility

$44.00

Hospital Charge Code	270601761
Hospital Revenue Code	278
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$10.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.68
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

PIN ZIM STEINMAN SM 5/64

Facility

$37.65

Hospital Charge Code	270606038
Hospital Revenue Code	278
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.82
Rate for Payer: Aetna Commercial	$14.31
Rate for Payer: Aetna Medicare Advantage	$11.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.60
Rate for Payer: Cigna Commercial	$18.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.28
Rate for Payer: Qualcare PPO/HMO/WC	$5.65
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

PIN ZIM STEINMAN SM 5/64

Facility

$37.65

Hospital Charge Code	270606038
Hospital Revenue Code	278
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$9.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.11
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.28
Rate for Payer: Qualcare PPO/HMO/WC	$5.65

PIN ZIM STEINMAN SM 9/64

Facility

$50.45

Hospital Charge Code	270601758
Hospital Revenue Code	278
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$25.23
Rate for Payer: Aetna Commercial	$19.17
Rate for Payer: Aetna Medicare Advantage	$15.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.86
Rate for Payer: Cigna Commercial	$25.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.10
Rate for Payer: Qualcare PPO/HMO/WC	$7.57
Rate for Payer: UnitedHealthcare Community & State	$1.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1.34

PIN ZIM STEINMAN SM 9/64

Facility

$50.45

Hospital Charge Code	270601758
Hospital Revenue Code	278
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$12.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.10
Rate for Payer: Qualcare PPO/HMO/WC	$7.57

PIN ZIM STEINMAN THRD 3/16

Facility

$85.65

Hospital Charge Code	270601757
Hospital Revenue Code	278
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$42.83
Rate for Payer: Aetna Commercial	$32.55
Rate for Payer: Aetna Medicare Advantage	$25.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.84
Rate for Payer: Cigna Commercial	$42.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.85
Rate for Payer: UnitedHealthcare Community & State	$2.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.27

PIN ZIM STEINMAN THRD 3/16

Facility

$85.65

Hospital Charge Code	270601757
Hospital Revenue Code	278
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$20.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.84
Rate for Payer: Qualcare PPO/HMO/WC	$12.85

PIN ZIM STEINMAN THRD 5/32

Facility

$61.59

Hospital Charge Code	270601756
Hospital Revenue Code	278
Min. Negotiated Rate	$9.24
Max. Negotiated Rate	$14.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.55
Rate for Payer: Qualcare PPO/HMO/WC	$9.24

PIN ZIM STEINMAN THRD 5/32

Facility

$61.59

Hospital Charge Code	270601756
Hospital Revenue Code	278
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$30.80
Rate for Payer: Aetna Commercial	$23.40
Rate for Payer: Aetna Medicare Advantage	$18.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.71
Rate for Payer: Cigna Commercial	$30.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.55
Rate for Payer: Qualcare PPO/HMO/WC	$9.24
Rate for Payer: UnitedHealthcare Community & State	$1.48
Rate for Payer: Wellpoint Medicaid Managed Care	$1.63

PIOGLITAZONE 15 MG TAB

Facility

$83.68

Service Code	NDC 64764015104
Hospital Charge Code	60629054
Hospital Revenue Code	250
Min. Negotiated Rate	$12.55
Max. Negotiated Rate	$12.55
Rate for Payer: Qualcare PPO/HMO/WC	$12.55

Know your out-of-pocket cost for care.

All Charges