Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PLATE ZIM 1/3 TUB 7H 236107

Facility

$150.45

Hospital Charge Code	270607163
Hospital Revenue Code	278
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$75.22
Rate for Payer: Aetna Commercial	$57.17
Rate for Payer: Aetna Medicare Advantage	$45.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.36
Rate for Payer: Cigna Commercial	$75.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$33.10
Rate for Payer: Qualcare PPO/HMO/WC	$22.57
Rate for Payer: UnitedHealthcare Community & State	$3.63
Rate for Payer: Wellpoint Medicaid Managed Care	$3.99

PLATE ZIM CB 246 8H 2232-03-02

Facility

$3,725.65

Hospital Charge Code	270617129
Hospital Revenue Code	278
Min. Negotiated Rate	$558.85
Max. Negotiated Rate	$901.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$745.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$901.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$819.64
Rate for Payer: Qualcare PPO/HMO/WC	$558.85

PLATE ZIM CB 246 8H 2232-03-02

Facility

$3,725.65

Hospital Charge Code	270617129
Hospital Revenue Code	278
Min. Negotiated Rate	$89.79
Max. Negotiated Rate	$1,862.83
Rate for Payer: Aetna Commercial	$1,415.75
Rate for Payer: Aetna Medicare Advantage	$1,117.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$950.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$950.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$745.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$950.04
Rate for Payer: Cigna Commercial	$1,862.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$901.61
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$819.64
Rate for Payer: Qualcare PPO/HMO/WC	$558.85
Rate for Payer: UnitedHealthcare Community & State	$89.79
Rate for Payer: Wellpoint Medicaid Managed Care	$98.73

PLATE ZIM FRL 10 135 118113510

Facility

$2,368.85

Hospital Charge Code	270617282
Hospital Revenue Code	278
Min. Negotiated Rate	$355.33
Max. Negotiated Rate	$573.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$473.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$521.15
Rate for Payer: Qualcare PPO/HMO/WC	$355.33

PLATE ZIM FRL 10 135 118113510

Facility

$2,368.85

Hospital Charge Code	270617282
Hospital Revenue Code	278
Min. Negotiated Rate	$57.09
Max. Negotiated Rate	$1,184.42
Rate for Payer: Aetna Commercial	$900.16
Rate for Payer: Aetna Medicare Advantage	$710.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$604.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$604.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$473.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$604.06
Rate for Payer: Cigna Commercial	$1,184.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$573.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$521.15
Rate for Payer: Qualcare PPO/HMO/WC	$355.33
Rate for Payer: UnitedHealthcare Community & State	$57.09
Rate for Payer: Wellpoint Medicaid Managed Care	$62.77

PLATE ZIM FRL 4H 130 118113004

Facility

$1,609.65

Hospital Charge Code	270607312
Hospital Revenue Code	278
Min. Negotiated Rate	$241.45
Max. Negotiated Rate	$389.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$321.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$354.12
Rate for Payer: Qualcare PPO/HMO/WC	$241.45

PLATE ZIM FRL 4H 130 118113004

Facility

$1,609.65

Hospital Charge Code	270607312
Hospital Revenue Code	278
Min. Negotiated Rate	$38.79
Max. Negotiated Rate	$804.83
Rate for Payer: Aetna Commercial	$611.67
Rate for Payer: Aetna Medicare Advantage	$482.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$410.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$410.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$321.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$410.46
Rate for Payer: Cigna Commercial	$804.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$389.54
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$354.12
Rate for Payer: Qualcare PPO/HMO/WC	$241.45
Rate for Payer: UnitedHealthcare Community & State	$38.79
Rate for Payer: Wellpoint Medicaid Managed Care	$42.66

PLATE ZIM FRL 4H 135 118113504

Facility

$1,585.05

Service Code	HCPCS C1713
Hospital Charge Code	270601785
Hospital Revenue Code	278
Min. Negotiated Rate	$38.20
Max. Negotiated Rate	$792.52
Rate for Payer: Aetna Commercial	$602.32
Rate for Payer: Aetna Medicare Advantage	$475.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$404.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$404.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$317.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$404.19
Rate for Payer: Cigna Commercial	$792.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$348.71
Rate for Payer: Qualcare PPO/HMO/WC	$237.76
Rate for Payer: UnitedHealthcare Community & State	$38.20
Rate for Payer: Wellpoint Medicaid Managed Care	$42.00

PLATE ZIM FRL 4H 135 118113504

Facility

$1,585.05

Service Code	HCPCS C1713
Hospital Charge Code	270601785
Hospital Revenue Code	278
Min. Negotiated Rate	$237.76
Max. Negotiated Rate	$383.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$317.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$348.71
Rate for Payer: Qualcare PPO/HMO/WC	$237.76

PLATE ZIM FRL 4H 140 118114004

Facility

$1,473.90

Service Code	HCPCS C1713
Hospital Charge Code	270601395
Hospital Revenue Code	278
Min. Negotiated Rate	$35.52
Max. Negotiated Rate	$736.95
Rate for Payer: Aetna Commercial	$560.08
Rate for Payer: Aetna Medicare Advantage	$442.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$375.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$375.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$375.84
Rate for Payer: Cigna Commercial	$736.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.26
Rate for Payer: Qualcare PPO/HMO/WC	$221.09
Rate for Payer: UnitedHealthcare Community & State	$35.52
Rate for Payer: Wellpoint Medicaid Managed Care	$39.06

PLATE ZIM FRL 4H 140 118114004

Facility

$1,473.90

Service Code	HCPCS C1713
Hospital Charge Code	270601395
Hospital Revenue Code	278
Min. Negotiated Rate	$221.09
Max. Negotiated Rate	$356.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$294.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$356.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$324.26
Rate for Payer: Qualcare PPO/HMO/WC	$221.09

PLATE ZIM FRL 4H 145 118114504

Facility

$1,747.25

Hospital Charge Code	270601396
Hospital Revenue Code	278
Min. Negotiated Rate	$262.09
Max. Negotiated Rate	$422.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$349.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$422.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$384.39
Rate for Payer: Qualcare PPO/HMO/WC	$262.09

PLATE ZIM FRL 4H 145 118114504

Facility

$1,747.25

Hospital Charge Code	270601396
Hospital Revenue Code	278
Min. Negotiated Rate	$42.11
Max. Negotiated Rate	$873.62
Rate for Payer: Aetna Commercial	$663.96
Rate for Payer: Aetna Medicare Advantage	$524.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$445.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$445.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$349.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$445.55
Rate for Payer: Cigna Commercial	$873.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$422.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$384.39
Rate for Payer: Qualcare PPO/HMO/WC	$262.09
Rate for Payer: UnitedHealthcare Community & State	$42.11
Rate for Payer: Wellpoint Medicaid Managed Care	$46.30

PLATE ZIM FRL 4H 150 118115004

Facility

$1,940.00

Hospital Charge Code	270601398
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

PLATE ZIM FRL 4H 150 118115004

Facility

$1,940.00

Hospital Charge Code	270601398
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

PLATE ZIM FRL 5H 135 118113595

Facility

$1,381.50

Hospital Charge Code	270614852
Hospital Revenue Code	278
Min. Negotiated Rate	$33.29
Max. Negotiated Rate	$690.75
Rate for Payer: Aetna Commercial	$524.97
Rate for Payer: Aetna Medicare Advantage	$414.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$352.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$352.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$352.28
Rate for Payer: Cigna Commercial	$690.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$303.93
Rate for Payer: Qualcare PPO/HMO/WC	$207.22
Rate for Payer: UnitedHealthcare Community & State	$33.29
Rate for Payer: Wellpoint Medicaid Managed Care	$36.61

PLATE ZIM FRL 5H 135 118113595

Facility

$1,381.50

Hospital Charge Code	270614852
Hospital Revenue Code	278
Min. Negotiated Rate	$207.22
Max. Negotiated Rate	$334.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$276.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$303.93
Rate for Payer: Qualcare PPO/HMO/WC	$207.22

PLATE ZIM FRL 6H

Facility

$1,747.25

Hospital Charge Code	270606037
Hospital Revenue Code	278
Min. Negotiated Rate	$42.11
Max. Negotiated Rate	$873.62
Rate for Payer: Aetna Commercial	$663.96
Rate for Payer: Aetna Medicare Advantage	$524.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$445.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$445.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$349.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$445.55
Rate for Payer: Cigna Commercial	$873.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$422.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$384.39
Rate for Payer: Qualcare PPO/HMO/WC	$262.09
Rate for Payer: UnitedHealthcare Community & State	$42.11
Rate for Payer: Wellpoint Medicaid Managed Care	$46.30

PLATE ZIM FRL 6H

Facility

$1,747.25

Hospital Charge Code	270606037
Hospital Revenue Code	278
Min. Negotiated Rate	$262.09
Max. Negotiated Rate	$422.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$349.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$422.83
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$384.39
Rate for Payer: Qualcare PPO/HMO/WC	$262.09

PLATE ZIM FRL 6H 130

Facility

$1,941.65

Hospital Charge Code	270601393
Hospital Revenue Code	278
Min. Negotiated Rate	$291.25
Max. Negotiated Rate	$469.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$388.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$469.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$427.16
Rate for Payer: Qualcare PPO/HMO/WC	$291.25

PLATE ZIM FRL 6H 130

Facility

$1,941.65

Hospital Charge Code	270601393
Hospital Revenue Code	278
Min. Negotiated Rate	$46.79
Max. Negotiated Rate	$970.83
Rate for Payer: Aetna Commercial	$737.83
Rate for Payer: Aetna Medicare Advantage	$582.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$495.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$495.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$388.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$495.12
Rate for Payer: Cigna Commercial	$970.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$469.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$427.16
Rate for Payer: Qualcare PPO/HMO/WC	$291.25
Rate for Payer: UnitedHealthcare Community & State	$46.79
Rate for Payer: Wellpoint Medicaid Managed Care	$51.45

PLATE ZIM FRL 6H 135

Facility

$1,904.00

Hospital Charge Code	270601394
Hospital Revenue Code	278
Min. Negotiated Rate	$45.89
Max. Negotiated Rate	$952.00
Rate for Payer: Aetna Commercial	$723.52
Rate for Payer: Aetna Medicare Advantage	$571.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$485.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$485.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$380.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$485.52
Rate for Payer: Cigna Commercial	$952.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$460.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$418.88
Rate for Payer: Qualcare PPO/HMO/WC	$285.60
Rate for Payer: UnitedHealthcare Community & State	$45.89
Rate for Payer: Wellpoint Medicaid Managed Care	$50.46

PLATE ZIM FRL 6H 135

Facility

$1,904.00

Hospital Charge Code	270601394
Hospital Revenue Code	278
Min. Negotiated Rate	$285.60
Max. Negotiated Rate	$460.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$380.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$460.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$418.88
Rate for Payer: Qualcare PPO/HMO/WC	$285.60

PLATE ZIM FRL 6H 135 11811350

Facility

$2,586.45

Hospital Charge Code	270601786
Hospital Revenue Code	278
Min. Negotiated Rate	$62.33
Max. Negotiated Rate	$1,293.22
Rate for Payer: Aetna Commercial	$982.85
Rate for Payer: Aetna Medicare Advantage	$775.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$659.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$659.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$517.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$659.54
Rate for Payer: Cigna Commercial	$1,293.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$625.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$569.02
Rate for Payer: Qualcare PPO/HMO/WC	$387.97
Rate for Payer: UnitedHealthcare Community & State	$62.33
Rate for Payer: Wellpoint Medicaid Managed Care	$68.54

PLATE ZIM FRL 6H 135 11811350

Facility

$2,586.45

Hospital Charge Code	270601786
Hospital Revenue Code	278
Min. Negotiated Rate	$387.97
Max. Negotiated Rate	$625.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$517.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$625.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$569.02
Rate for Payer: Qualcare PPO/HMO/WC	$387.97

Know your out-of-pocket cost for care.

All Charges