Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

COMPNT ZIM FEM RT SZ F 5970162

Facility

$8,215.25

Hospital Charge Code	270607687
Hospital Revenue Code	278
Min. Negotiated Rate	$1,232.29
Max. Negotiated Rate	$1,988.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,643.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,988.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,807.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,232.29

COMPNT ZIM FEM RT SZ F 5970162

Facility

$8,215.25

Hospital Charge Code	270607687
Hospital Revenue Code	278
Min. Negotiated Rate	$197.99
Max. Negotiated Rate	$4,107.62
Rate for Payer: Aetna Commercial	$3,121.80
Rate for Payer: Aetna Medicare Advantage	$2,464.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,094.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,094.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,643.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,094.89
Rate for Payer: Cigna Commercial	$4,107.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,988.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,807.36
Rate for Payer: Qualcare PPO/HMO/WC	$1,232.29
Rate for Payer: UnitedHealthcare Community & State	$197.99
Rate for Payer: Wellpoint Medicaid Managed Care	$217.70

COMPNT ZIM FEM RT SZ F 5972162

Facility

$15,497.50

Hospital Charge Code	270607283
Hospital Revenue Code	278
Min. Negotiated Rate	$373.49
Max. Negotiated Rate	$7,748.75
Rate for Payer: Aetna Commercial	$5,889.05
Rate for Payer: Aetna Medicare Advantage	$4,649.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,951.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,951.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,099.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,951.86
Rate for Payer: Cigna Commercial	$7,748.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,750.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,409.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,324.62
Rate for Payer: UnitedHealthcare Community & State	$373.49
Rate for Payer: Wellpoint Medicaid Managed Care	$410.68

COMPNT ZIM FEM RT SZ F 5972162

Facility

$15,497.50

Hospital Charge Code	270607283
Hospital Revenue Code	278
Min. Negotiated Rate	$2,324.62
Max. Negotiated Rate	$3,750.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,099.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,750.39
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,409.45
Rate for Payer: Qualcare PPO/HMO/WC	$2,324.62

COMPNT ZIM FEM RT SZ G 5972172

Facility

$14,213.75

Hospital Charge Code	270606475
Hospital Revenue Code	278
Min. Negotiated Rate	$2,132.06
Max. Negotiated Rate	$3,439.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,842.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,439.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,127.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,132.06

COMPNT ZIM FEM RT SZ G 5972172

Facility

$14,213.75

Hospital Charge Code	270606475
Hospital Revenue Code	278
Min. Negotiated Rate	$342.55
Max. Negotiated Rate	$7,106.88
Rate for Payer: Aetna Commercial	$5,401.23
Rate for Payer: Aetna Medicare Advantage	$4,264.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,624.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,624.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,842.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,624.51
Rate for Payer: Cigna Commercial	$7,106.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,439.73
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,127.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,132.06
Rate for Payer: UnitedHealthcare Community & State	$342.55
Rate for Payer: Wellpoint Medicaid Managed Care	$376.66

COMPNT ZIM FEM SZ 5982132

Facility

$12,905.00

Hospital Charge Code	270611705
Hospital Revenue Code	278
Min. Negotiated Rate	$311.01
Max. Negotiated Rate	$6,452.50
Rate for Payer: Aetna Commercial	$4,903.90
Rate for Payer: Aetna Medicare Advantage	$3,871.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,290.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,290.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,581.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,290.78
Rate for Payer: Cigna Commercial	$6,452.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,123.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,839.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,935.75
Rate for Payer: UnitedHealthcare Community & State	$311.01
Rate for Payer: Wellpoint Medicaid Managed Care	$341.98

COMPNT ZIM FEM SZ 5982132

Facility

$12,905.00

Hospital Charge Code	270611705
Hospital Revenue Code	278
Min. Negotiated Rate	$1,935.75
Max. Negotiated Rate	$3,123.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,581.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,123.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,839.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,935.75

COMPNT ZIM TIB SZ 2 59802702

Facility

$4,919.25

Hospital Charge Code	270616331
Hospital Revenue Code	278
Min. Negotiated Rate	$737.89
Max. Negotiated Rate	$1,190.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$983.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,190.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,082.23
Rate for Payer: Qualcare PPO/HMO/WC	$737.89

COMPNT ZIM TIB SZ 2 59802702

Facility

$4,919.25

Hospital Charge Code	270616331
Hospital Revenue Code	278
Min. Negotiated Rate	$118.55
Max. Negotiated Rate	$2,459.62
Rate for Payer: Aetna Commercial	$1,869.32
Rate for Payer: Aetna Medicare Advantage	$1,475.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,254.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,254.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$983.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,254.41
Rate for Payer: Cigna Commercial	$2,459.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,190.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,082.23
Rate for Payer: Qualcare PPO/HMO/WC	$737.89
Rate for Payer: UnitedHealthcare Community & State	$118.55
Rate for Payer: Wellpoint Medicaid Managed Care	$130.36

COMPNT ZIM TIB SZ 5 598805

Facility

$5,529.65

Service Code	HCPCS C1776
Hospital Charge Code	270625220
Hospital Revenue Code	278
Min. Negotiated Rate	$133.26
Max. Negotiated Rate	$2,764.82
Rate for Payer: Aetna Commercial	$2,101.27
Rate for Payer: Aetna Medicare Advantage	$1,658.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,410.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,410.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,105.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,410.06
Rate for Payer: Cigna Commercial	$2,764.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,338.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,216.52
Rate for Payer: Qualcare PPO/HMO/WC	$829.45
Rate for Payer: UnitedHealthcare Community & State	$133.26
Rate for Payer: Wellpoint Medicaid Managed Care	$146.54

COMPNT ZIM TIB SZ 5 598805

Facility

$5,529.65

Service Code	HCPCS C1776
Hospital Charge Code	270625220
Hospital Revenue Code	278
Min. Negotiated Rate	$829.45
Max. Negotiated Rate	$1,338.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,105.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,338.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,216.52
Rate for Payer: Qualcare PPO/HMO/WC	$829.45

COMPNT ZIM TIB SZ 6 59804702

Facility

$8,337.95

Hospital Charge Code	270607284
Hospital Revenue Code	278
Min. Negotiated Rate	$1,250.69
Max. Negotiated Rate	$2,017.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,667.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,017.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,834.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,250.69

COMPNT ZIM TIB SZ 6 59804702

Facility

$8,337.95

Hospital Charge Code	270607284
Hospital Revenue Code	278
Min. Negotiated Rate	$200.94
Max. Negotiated Rate	$4,168.98
Rate for Payer: Aetna Commercial	$3,168.42
Rate for Payer: Aetna Medicare Advantage	$2,501.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,126.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,126.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,667.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,126.18
Rate for Payer: Cigna Commercial	$4,168.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,017.78
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,834.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,250.69
Rate for Payer: UnitedHealthcare Community & State	$200.94
Rate for Payer: Wellpoint Medicaid Managed Care	$220.96

COMPONENT FEMORAL CEMN SZ22 RT

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677984
Hospital Revenue Code	278
Min. Negotiated Rate	$192.80
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$192.80
Rate for Payer: Wellpoint Medicaid Managed Care	$212.00

COMPONENT FEMORAL CEMN SZ22 RT

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677984
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

COMPONENT FEMORAL CEMTD SZ1+

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270680559
Hospital Revenue Code	278
Min. Negotiated Rate	$192.80
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$192.80
Rate for Payer: Wellpoint Medicaid Managed Care	$212.00

COMPONENT FEMORAL CEMTD SZ1+

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270680559
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

COMPONENT FEMORAL CEMTD SZ 3 L

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270684046
Hospital Revenue Code	278
Min. Negotiated Rate	$192.80
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$192.80
Rate for Payer: Wellpoint Medicaid Managed Care	$212.00

COMPONENT FEMORAL CEMTD SZ 3 L

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270684046
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

COMPONENT FEMORAL CEMTD SZ3+ R

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677872
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

COMPONENT FEMORAL CEMTD SZ3+ R

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677872
Hospital Revenue Code	278
Min. Negotiated Rate	$192.80
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$192.80
Rate for Payer: Wellpoint Medicaid Managed Care	$212.00

COMPONENT FEMORAL CEMTD SZ3 RT

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677545
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

COMPONENT FEMORAL CEMTD SZ3 RT

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677545
Hospital Revenue Code	278
Min. Negotiated Rate	$192.80
Max. Negotiated Rate	$4,000.00
Rate for Payer: Aetna Commercial	$3,040.00
Rate for Payer: Aetna Medicare Advantage	$2,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,040.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,040.00
Rate for Payer: Cigna Commercial	$4,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00
Rate for Payer: UnitedHealthcare Community & State	$192.80
Rate for Payer: Wellpoint Medicaid Managed Care	$212.00

COMPONENT FEMORAL CEMTD SZ4+ R

Facility

$8,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270677557
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.00
Max. Negotiated Rate	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,936.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,760.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,200.00

Know your out-of-pocket cost for care.

All Charges