Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW BMT LAG VHS 85 200185

Facility

$1,404.00

Hospital Charge Code	270612301
Hospital Revenue Code	278
Min. Negotiated Rate	$33.84
Max. Negotiated Rate	$702.00
Rate for Payer: Aetna Commercial	$533.52
Rate for Payer: Aetna Medicare Advantage	$421.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.02
Rate for Payer: Cigna Commercial	$702.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$308.88
Rate for Payer: Qualcare PPO/HMO/WC	$210.60
Rate for Payer: UnitedHealthcare Community & State	$33.84
Rate for Payer: Wellpoint Medicaid Managed Care	$37.21

SCREW BMT LAG VHS 85 200185

Facility

$1,404.00

Hospital Charge Code	270612301
Hospital Revenue Code	278
Min. Negotiated Rate	$210.60
Max. Negotiated Rate	$339.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$308.88
Rate for Payer: Qualcare PPO/HMO/WC	$210.60

SCREW BMT LAG VHS 90 200190

Facility

$1,404.00

Hospital Charge Code	270612876
Hospital Revenue Code	278
Min. Negotiated Rate	$210.60
Max. Negotiated Rate	$339.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$308.88
Rate for Payer: Qualcare PPO/HMO/WC	$210.60

SCREW BMT LAG VHS 90 200190

Facility

$1,404.00

Hospital Charge Code	270612876
Hospital Revenue Code	278
Min. Negotiated Rate	$33.84
Max. Negotiated Rate	$702.00
Rate for Payer: Aetna Commercial	$533.52
Rate for Payer: Aetna Medicare Advantage	$421.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.02
Rate for Payer: Cigna Commercial	$702.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$308.88
Rate for Payer: Qualcare PPO/HMO/WC	$210.60
Rate for Payer: UnitedHealthcare Community & State	$33.84
Rate for Payer: Wellpoint Medicaid Managed Care	$37.21

SCREW BMT LAG VHS 95 200195

Facility

$1,404.00

Hospital Charge Code	270613966
Hospital Revenue Code	278
Min. Negotiated Rate	$210.60
Max. Negotiated Rate	$339.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$308.88
Rate for Payer: Qualcare PPO/HMO/WC	$210.60

SCREW BMT LAG VHS 95 200195

Facility

$1,404.00

Hospital Charge Code	270613966
Hospital Revenue Code	278
Min. Negotiated Rate	$33.84
Max. Negotiated Rate	$702.00
Rate for Payer: Aetna Commercial	$533.52
Rate for Payer: Aetna Medicare Advantage	$421.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$358.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$280.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$358.02
Rate for Payer: Cigna Commercial	$702.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$339.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$308.88
Rate for Payer: Qualcare PPO/HMO/WC	$210.60
Rate for Payer: UnitedHealthcare Community & State	$33.84
Rate for Payer: Wellpoint Medicaid Managed Care	$37.21

SCREW BMT PT 4 34 345834

Facility

$629.65

Hospital Charge Code	270619787
Hospital Revenue Code	278
Min. Negotiated Rate	$15.17
Max. Negotiated Rate	$314.82
Rate for Payer: Aetna Commercial	$239.27
Rate for Payer: Aetna Medicare Advantage	$188.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.56
Rate for Payer: Cigna Commercial	$314.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$138.52
Rate for Payer: Qualcare PPO/HMO/WC	$94.45
Rate for Payer: UnitedHealthcare Community & State	$15.17
Rate for Payer: Wellpoint Medicaid Managed Care	$16.69

SCREW BMT PT 4 34 345834

Facility

$629.65

Hospital Charge Code	270619787
Hospital Revenue Code	278
Min. Negotiated Rate	$94.45
Max. Negotiated Rate	$152.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$138.52
Rate for Payer: Qualcare PPO/HMO/WC	$94.45

SCREW BMT PT 4 36 345836

Facility

$629.65

Hospital Charge Code	270617178
Hospital Revenue Code	278
Min. Negotiated Rate	$15.17
Max. Negotiated Rate	$314.82
Rate for Payer: Aetna Commercial	$239.27
Rate for Payer: Aetna Medicare Advantage	$188.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.56
Rate for Payer: Cigna Commercial	$314.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$138.52
Rate for Payer: Qualcare PPO/HMO/WC	$94.45
Rate for Payer: UnitedHealthcare Community & State	$15.17
Rate for Payer: Wellpoint Medicaid Managed Care	$16.69

SCREW BMT PT 4 36 345836

Facility

$629.65

Hospital Charge Code	270617178
Hospital Revenue Code	278
Min. Negotiated Rate	$94.45
Max. Negotiated Rate	$152.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$138.52
Rate for Payer: Qualcare PPO/HMO/WC	$94.45

SCREW BMT PT 4 40 345840

Facility

$629.65

Hospital Charge Code	270619026
Hospital Revenue Code	278
Min. Negotiated Rate	$15.17
Max. Negotiated Rate	$314.82
Rate for Payer: Aetna Commercial	$239.27
Rate for Payer: Aetna Medicare Advantage	$188.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.56
Rate for Payer: Cigna Commercial	$314.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$138.52
Rate for Payer: Qualcare PPO/HMO/WC	$94.45
Rate for Payer: UnitedHealthcare Community & State	$15.17
Rate for Payer: Wellpoint Medicaid Managed Care	$16.69

SCREW BMT PT 4 40 345840

Facility

$629.65

Hospital Charge Code	270619026
Hospital Revenue Code	278
Min. Negotiated Rate	$94.45
Max. Negotiated Rate	$152.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$138.52
Rate for Payer: Qualcare PPO/HMO/WC	$94.45

SCREW BMT PT 4 48 345848

Facility

$495.25

Hospital Charge Code	270625379
Hospital Revenue Code	278
Min. Negotiated Rate	$74.29
Max. Negotiated Rate	$119.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.95
Rate for Payer: Qualcare PPO/HMO/WC	$74.29

SCREW BMT PT 4 48 345848

Facility

$495.25

Hospital Charge Code	270625379
Hospital Revenue Code	278
Min. Negotiated Rate	$11.94
Max. Negotiated Rate	$247.62
Rate for Payer: Aetna Commercial	$188.19
Rate for Payer: Aetna Medicare Advantage	$148.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.29
Rate for Payer: Cigna Commercial	$247.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$108.95
Rate for Payer: Qualcare PPO/HMO/WC	$74.29
Rate for Payer: UnitedHealthcare Community & State	$11.94
Rate for Payer: Wellpoint Medicaid Managed Care	$13.12

SCREW BMT PT 4 52 345852

Facility

$629.65

Hospital Charge Code	270619020
Hospital Revenue Code	278
Min. Negotiated Rate	$94.45
Max. Negotiated Rate	$152.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$138.52
Rate for Payer: Qualcare PPO/HMO/WC	$94.45

SCREW BMT PT 4 52 345852

Facility

$629.65

Hospital Charge Code	270619020
Hospital Revenue Code	278
Min. Negotiated Rate	$15.17
Max. Negotiated Rate	$314.82
Rate for Payer: Aetna Commercial	$239.27
Rate for Payer: Aetna Medicare Advantage	$188.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.56
Rate for Payer: Cigna Commercial	$314.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$152.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$138.52
Rate for Payer: Qualcare PPO/HMO/WC	$94.45
Rate for Payer: UnitedHealthcare Community & State	$15.17
Rate for Payer: Wellpoint Medicaid Managed Care	$16.69

SCREW BMT TRNV 4.0 22 345266

Facility

$536.85

Hospital Charge Code	270609862
Hospital Revenue Code	278
Min. Negotiated Rate	$80.53
Max. Negotiated Rate	$129.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.11
Rate for Payer: Qualcare PPO/HMO/WC	$80.53

SCREW BMT TRNV 4.0 22 345266

Facility

$536.85

Hospital Charge Code	270609862
Hospital Revenue Code	278
Min. Negotiated Rate	$12.94
Max. Negotiated Rate	$268.43
Rate for Payer: Aetna Commercial	$204.00
Rate for Payer: Aetna Medicare Advantage	$161.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.90
Rate for Payer: Cigna Commercial	$268.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.11
Rate for Payer: Qualcare PPO/HMO/WC	$80.53
Rate for Payer: UnitedHealthcare Community & State	$12.94
Rate for Payer: Wellpoint Medicaid Managed Care	$14.23

SCREW BMT TRNV 4.0 26 345270

Facility

$536.85

Hospital Charge Code	270609863
Hospital Revenue Code	278
Min. Negotiated Rate	$12.94
Max. Negotiated Rate	$268.43
Rate for Payer: Aetna Commercial	$204.00
Rate for Payer: Aetna Medicare Advantage	$161.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.90
Rate for Payer: Cigna Commercial	$268.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.11
Rate for Payer: Qualcare PPO/HMO/WC	$80.53
Rate for Payer: UnitedHealthcare Community & State	$12.94
Rate for Payer: Wellpoint Medicaid Managed Care	$14.23

SCREW BMT TRNV 4.0 26 345270

Facility

$536.85

Hospital Charge Code	270609863
Hospital Revenue Code	278
Min. Negotiated Rate	$80.53
Max. Negotiated Rate	$129.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$107.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$118.11
Rate for Payer: Qualcare PPO/HMO/WC	$80.53

SCREW BMT TRNV 5.0 30 345434

Facility

$931.25

Hospital Charge Code	270607863
Hospital Revenue Code	278
Min. Negotiated Rate	$22.44
Max. Negotiated Rate	$465.62
Rate for Payer: Aetna Commercial	$353.88
Rate for Payer: Aetna Medicare Advantage	$279.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.47
Rate for Payer: Cigna Commercial	$465.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.88
Rate for Payer: Qualcare PPO/HMO/WC	$139.69
Rate for Payer: UnitedHealthcare Community & State	$22.44
Rate for Payer: Wellpoint Medicaid Managed Care	$24.68

SCREW BMT TRNV 5.0 30 345434

Facility

$931.25

Hospital Charge Code	270607863
Hospital Revenue Code	278
Min. Negotiated Rate	$139.69
Max. Negotiated Rate	$225.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$186.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$204.88
Rate for Payer: Qualcare PPO/HMO/WC	$139.69

SCREW BMT TRNV 5.0 35 345424

Facility

$813.65

Hospital Charge Code	270606457
Hospital Revenue Code	278
Min. Negotiated Rate	$19.61
Max. Negotiated Rate	$406.82
Rate for Payer: Aetna Commercial	$309.19
Rate for Payer: Aetna Medicare Advantage	$244.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$207.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$207.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$207.48
Rate for Payer: Cigna Commercial	$406.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$179.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.05
Rate for Payer: UnitedHealthcare Community & State	$19.61
Rate for Payer: Wellpoint Medicaid Managed Care	$21.56

SCREW BMT TRNV 5.0 35 345424

Facility

$813.65

Hospital Charge Code	270606457
Hospital Revenue Code	278
Min. Negotiated Rate	$122.05
Max. Negotiated Rate	$196.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$162.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$179.00
Rate for Payer: Qualcare PPO/HMO/WC	$122.05

SCREW BMT TRNV 5.0 40 156940

Facility

$1,056.50

Hospital Charge Code	270628484
Hospital Revenue Code	278
Min. Negotiated Rate	$25.46
Max. Negotiated Rate	$528.25
Rate for Payer: Aetna Commercial	$401.47
Rate for Payer: Aetna Medicare Advantage	$316.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$269.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$269.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$269.41
Rate for Payer: Cigna Commercial	$528.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$232.43
Rate for Payer: Qualcare PPO/HMO/WC	$158.47
Rate for Payer: UnitedHealthcare Community & State	$25.46
Rate for Payer: Wellpoint Medicaid Managed Care	$28.00

Know your out-of-pocket cost for care.

All Charges