Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW ZIM CANC 4.0 18 234019

Facility

$44.85

Hospital Charge Code	270607160
Hospital Revenue Code	278
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.43
Rate for Payer: Aetna Commercial	$17.04
Rate for Payer: Aetna Medicare Advantage	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.44
Rate for Payer: Cigna Commercial	$22.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.87
Rate for Payer: Qualcare PPO/HMO/WC	$6.73
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

SCREW ZIM CANC 4.0 18 234019

Facility

$44.85

Hospital Charge Code	270607160
Hospital Revenue Code	278
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$10.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9.87
Rate for Payer: Qualcare PPO/HMO/WC	$6.73

SCREW ZIM CANC 4.0 20 234021

Facility

$52.85

Hospital Charge Code	270607161
Hospital Revenue Code	278
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$12.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.63
Rate for Payer: Qualcare PPO/HMO/WC	$7.93

SCREW ZIM CANC 4.0 20 234021

Facility

$52.85

Hospital Charge Code	270607161
Hospital Revenue Code	278
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$26.43
Rate for Payer: Aetna Commercial	$20.08
Rate for Payer: Aetna Medicare Advantage	$15.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.48
Rate for Payer: Cigna Commercial	$26.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.63
Rate for Payer: Qualcare PPO/HMO/WC	$7.93
Rate for Payer: UnitedHealthcare Community & State	$1.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

SCREW ZIM CANC 4.0 22 234023

Facility

$57.65

Hospital Charge Code	270608340
Hospital Revenue Code	278
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$13.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.68
Rate for Payer: Qualcare PPO/HMO/WC	$8.65

SCREW ZIM CANC 4.0 22 234023

Facility

$57.65

Hospital Charge Code	270608340
Hospital Revenue Code	278
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$28.82
Rate for Payer: Aetna Commercial	$21.91
Rate for Payer: Aetna Medicare Advantage	$17.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.70
Rate for Payer: Cigna Commercial	$28.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.68
Rate for Payer: Qualcare PPO/HMO/WC	$8.65
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.53

SCREW ZIM CANC 4.0 24 234525

Facility

$57.65

Hospital Charge Code	270607162
Hospital Revenue Code	278
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$28.82
Rate for Payer: Aetna Commercial	$21.91
Rate for Payer: Aetna Medicare Advantage	$17.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.70
Rate for Payer: Cigna Commercial	$28.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.68
Rate for Payer: Qualcare PPO/HMO/WC	$8.65
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.53

SCREW ZIM CANC 4.0 24 234525

Facility

$57.65

Hospital Charge Code	270607162
Hospital Revenue Code	278
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$13.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.68
Rate for Payer: Qualcare PPO/HMO/WC	$8.65

SCREW ZIM CANC 4.0 26 234027

Facility

$57.65

Hospital Charge Code	270607931
Hospital Revenue Code	278
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$28.82
Rate for Payer: Aetna Commercial	$21.91
Rate for Payer: Aetna Medicare Advantage	$17.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.70
Rate for Payer: Cigna Commercial	$28.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.68
Rate for Payer: Qualcare PPO/HMO/WC	$8.65
Rate for Payer: UnitedHealthcare Community & State	$1.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1.53

SCREW ZIM CANC 4.0 26 234027

Facility

$57.65

Hospital Charge Code	270607931
Hospital Revenue Code	278
Min. Negotiated Rate	$8.65
Max. Negotiated Rate	$13.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12.68
Rate for Payer: Qualcare PPO/HMO/WC	$8.65

SCREW ZIM CANC 4.0 28 232229

Facility

$63.25

Hospital Charge Code	270610239
Hospital Revenue Code	278
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$31.62
Rate for Payer: Aetna Commercial	$24.04
Rate for Payer: Aetna Medicare Advantage	$18.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.13
Rate for Payer: Cigna Commercial	$31.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.91
Rate for Payer: Qualcare PPO/HMO/WC	$9.49
Rate for Payer: UnitedHealthcare Community & State	$1.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1.68

SCREW ZIM CANC 4.0 28 232229

Facility

$63.25

Hospital Charge Code	270610239
Hospital Revenue Code	278
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$15.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13.91
Rate for Payer: Qualcare PPO/HMO/WC	$9.49

SCREW ZIM CANC 4.0 45 234046

Facility

$69.65

Hospital Charge Code	270610186
Hospital Revenue Code	278
Min. Negotiated Rate	$10.45
Max. Negotiated Rate	$16.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.32
Rate for Payer: Qualcare PPO/HMO/WC	$10.45

SCREW ZIM CANC 4.0 45 234046

Facility

$69.65

Hospital Charge Code	270610186
Hospital Revenue Code	278
Min. Negotiated Rate	$1.68
Max. Negotiated Rate	$34.83
Rate for Payer: Aetna Commercial	$26.47
Rate for Payer: Aetna Medicare Advantage	$20.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.76
Rate for Payer: Cigna Commercial	$34.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.86
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15.32
Rate for Payer: Qualcare PPO/HMO/WC	$10.45
Rate for Payer: UnitedHealthcare Community & State	$1.68
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

SCREW ZIM CANC 4.0 50 232251

Facility

$50.45

Hospital Charge Code	270610244
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

SCREW ZIM CANC 4.0 50 232251

Facility

$50.45

Hospital Charge Code	270610244
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

SCREW ZIM CANC 6.5 16 45

Facility

$80.00

Service Code	HCPCS C1713
Hospital Charge Code	270610370
Hospital Revenue Code	278
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$19.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$17.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.00

SCREW ZIM CANC 6.5 16 45

Facility

$80.00

Service Code	HCPCS C1713
Hospital Charge Code	270610370
Hospital Revenue Code	278
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$40.00
Rate for Payer: Aetna Commercial	$30.40
Rate for Payer: Aetna Medicare Advantage	$24.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.40
Rate for Payer: Cigna Commercial	$40.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$17.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.93
Rate for Payer: Wellpoint Medicaid Managed Care	$2.12

SCREW ZIM CANC 6.5 25 233225

Facility

$663.25

Hospital Charge Code	270611160
Hospital Revenue Code	278
Min. Negotiated Rate	$15.98
Max. Negotiated Rate	$331.62
Rate for Payer: Aetna Commercial	$252.03
Rate for Payer: Aetna Medicare Advantage	$198.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.13
Rate for Payer: Cigna Commercial	$331.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.91
Rate for Payer: Qualcare PPO/HMO/WC	$99.49
Rate for Payer: UnitedHealthcare Community & State	$15.98
Rate for Payer: Wellpoint Medicaid Managed Care	$17.58

SCREW ZIM CANC 6.5 25 233225

Facility

$663.25

Hospital Charge Code	270611160
Hospital Revenue Code	278
Min. Negotiated Rate	$99.49
Max. Negotiated Rate	$160.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.91
Rate for Payer: Qualcare PPO/HMO/WC	$99.49

SCREW ZIM CANC 6.5 30 233231

Facility

$84.85

Hospital Charge Code	270610367
Hospital Revenue Code	278
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$42.42
Rate for Payer: Aetna Commercial	$32.24
Rate for Payer: Aetna Medicare Advantage	$25.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.64
Rate for Payer: Cigna Commercial	$42.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.67
Rate for Payer: Qualcare PPO/HMO/WC	$12.73
Rate for Payer: UnitedHealthcare Community & State	$2.04
Rate for Payer: Wellpoint Medicaid Managed Care	$2.25

SCREW ZIM CANC 6.5 30 233231

Facility

$84.85

Hospital Charge Code	270610367
Hospital Revenue Code	278
Min. Negotiated Rate	$12.73
Max. Negotiated Rate	$20.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$18.67
Rate for Payer: Qualcare PPO/HMO/WC	$12.73

SCREW ZIM CANC 6.5 35 233335

Facility

$111.25

Hospital Charge Code	270606817
Hospital Revenue Code	278
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$55.62
Rate for Payer: Aetna Commercial	$42.27
Rate for Payer: Aetna Medicare Advantage	$33.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.37
Rate for Payer: Cigna Commercial	$55.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$24.48
Rate for Payer: Qualcare PPO/HMO/WC	$16.69
Rate for Payer: UnitedHealthcare Community & State	$2.68
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

SCREW ZIM CANC 6.5 35 233335

Facility

$111.25

Hospital Charge Code	270606817
Hospital Revenue Code	278
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$26.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.92
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$24.48
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

SCREW ZIM CANC 6.5 35 233336

Facility

$103.25

Hospital Charge Code	270605562
Hospital Revenue Code	278
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$51.62
Rate for Payer: Aetna Commercial	$39.23
Rate for Payer: Aetna Medicare Advantage	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.33
Rate for Payer: Cigna Commercial	$51.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$22.71
Rate for Payer: Qualcare PPO/HMO/WC	$15.49
Rate for Payer: UnitedHealthcare Community & State	$2.49
Rate for Payer: Wellpoint Medicaid Managed Care	$2.74

Know your out-of-pocket cost for care.

All Charges