Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW ZIM CANN 32 7 85 114685

Facility

$751.95

Hospital Charge Code	270606470
Hospital Revenue Code	278
Min. Negotiated Rate	$112.79
Max. Negotiated Rate	$181.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.43
Rate for Payer: Qualcare PPO/HMO/WC	$112.79

SCREW ZIM CANN 32 7 90 114690

Facility

$813.65

Hospital Charge Code	270606851
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 ZIM CANN 32 7 90 114690

Facility

$813.65

Hospital Charge Code	270606851
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 ZIM CANN 32 7 95 114695

Facility

$751.95

Hospital Charge Code	270606471
Hospital Revenue Code	278
Min. Negotiated Rate	$18.12
Max. Negotiated Rate	$375.98
Rate for Payer: Aetna Commercial	$285.74
Rate for Payer: Aetna Medicare Advantage	$225.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.75
Rate for Payer: Cigna Commercial	$375.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.43
Rate for Payer: Qualcare PPO/HMO/WC	$112.79
Rate for Payer: UnitedHealthcare Community & State	$18.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.93

SCREW ZIM CANN 32 7 95 114695

Facility

$751.95

Hospital Charge Code	270606471
Hospital Revenue Code	278
Min. Negotiated Rate	$112.79
Max. Negotiated Rate	$181.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$150.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$181.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$165.43
Rate for Payer: Qualcare PPO/HMO/WC	$112.79

SCREW ZIM CANN 4 28 11424028

Facility

$568.15

Hospital Charge Code	270614918
Hospital Revenue Code	278
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$284.07
Rate for Payer: Aetna Commercial	$215.90
Rate for Payer: Aetna Medicare Advantage	$170.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.88
Rate for Payer: Cigna Commercial	$284.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$124.99
Rate for Payer: Qualcare PPO/HMO/WC	$85.22
Rate for Payer: UnitedHealthcare Community & State	$13.69
Rate for Payer: Wellpoint Medicaid Managed Care	$15.06

SCREW ZIM CANN 4 28 11424028

Facility

$568.15

Hospital Charge Code	270614918
Hospital Revenue Code	278
Min. Negotiated Rate	$85.22
Max. Negotiated Rate	$137.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.49
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$124.99
Rate for Payer: Qualcare PPO/HMO/WC	$85.22

SCREW ZIM CANN 4 34 11424134

Facility

$542.00

Hospital Charge Code	270627006
Hospital Revenue Code	278
Min. Negotiated Rate	$81.30
Max. Negotiated Rate	$131.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.24
Rate for Payer: Qualcare PPO/HMO/WC	$81.30

SCREW ZIM CANN 4 34 11424134

Facility

$542.00

Hospital Charge Code	270627006
Hospital Revenue Code	278
Min. Negotiated Rate	$13.06
Max. Negotiated Rate	$271.00
Rate for Payer: Aetna Commercial	$205.96
Rate for Payer: Aetna Medicare Advantage	$162.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.21
Rate for Payer: Cigna Commercial	$271.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.24
Rate for Payer: Qualcare PPO/HMO/WC	$81.30
Rate for Payer: UnitedHealthcare Community & State	$13.06
Rate for Payer: Wellpoint Medicaid Managed Care	$14.36

SCREW ZIM CANN 4 36 11424136

Facility

$503.25

Hospital Charge Code	270623647
Hospital Revenue Code	278
Min. Negotiated Rate	$12.13
Max. Negotiated Rate	$251.62
Rate for Payer: Aetna Commercial	$191.24
Rate for Payer: Aetna Medicare Advantage	$150.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.33
Rate for Payer: Cigna Commercial	$251.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.72
Rate for Payer: Qualcare PPO/HMO/WC	$75.49
Rate for Payer: UnitedHealthcare Community & State	$12.13
Rate for Payer: Wellpoint Medicaid Managed Care	$13.34

SCREW ZIM CANN 4 36 11424136

Facility

$503.25

Hospital Charge Code	270623647
Hospital Revenue Code	278
Min. Negotiated Rate	$75.49
Max. Negotiated Rate	$121.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.72
Rate for Payer: Qualcare PPO/HMO/WC	$75.49

SCREW ZIM CANN 4 40 11424040

Facility

$536.85

Hospital Charge Code	270619890
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 ZIM CANN 4 40 11424040

Facility

$536.85

Hospital Charge Code	270619890
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 ZIM CANN 4 40 11424140

Facility

$547.25

Hospital Charge Code	270620613
Hospital Revenue Code	278
Min. Negotiated Rate	$82.09
Max. Negotiated Rate	$132.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$120.39
Rate for Payer: Qualcare PPO/HMO/WC	$82.09

SCREW ZIM CANN 4 40 11424140

Facility

$547.25

Hospital Charge Code	270620613
Hospital Revenue Code	278
Min. Negotiated Rate	$13.19
Max. Negotiated Rate	$273.62
Rate for Payer: Aetna Commercial	$207.96
Rate for Payer: Aetna Medicare Advantage	$164.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.55
Rate for Payer: Cigna Commercial	$273.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$120.39
Rate for Payer: Qualcare PPO/HMO/WC	$82.09
Rate for Payer: UnitedHealthcare Community & State	$13.19
Rate for Payer: Wellpoint Medicaid Managed Care	$14.50

SCREW ZIM CANN 4 42 11424142

Facility

$542.00

Hospital Charge Code	270623786
Hospital Revenue Code	278
Min. Negotiated Rate	$81.30
Max. Negotiated Rate	$131.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.24
Rate for Payer: Qualcare PPO/HMO/WC	$81.30

SCREW ZIM CANN 4 42 11424142

Facility

$542.00

Hospital Charge Code	270623786
Hospital Revenue Code	278
Min. Negotiated Rate	$13.06
Max. Negotiated Rate	$271.00
Rate for Payer: Aetna Commercial	$205.96
Rate for Payer: Aetna Medicare Advantage	$162.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.21
Rate for Payer: Cigna Commercial	$271.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.24
Rate for Payer: Qualcare PPO/HMO/WC	$81.30
Rate for Payer: UnitedHealthcare Community & State	$13.06
Rate for Payer: Wellpoint Medicaid Managed Care	$14.36

SCREW ZIM CANN 4 44 11424044

Facility

$542.00

Hospital Charge Code	270622643
Hospital Revenue Code	278
Min. Negotiated Rate	$13.06
Max. Negotiated Rate	$271.00
Rate for Payer: Aetna Commercial	$205.96
Rate for Payer: Aetna Medicare Advantage	$162.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.21
Rate for Payer: Cigna Commercial	$271.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.24
Rate for Payer: Qualcare PPO/HMO/WC	$81.30
Rate for Payer: UnitedHealthcare Community & State	$13.06
Rate for Payer: Wellpoint Medicaid Managed Care	$14.36

SCREW ZIM CANN 4 44 11424044

Facility

$542.00

Hospital Charge Code	270622643
Hospital Revenue Code	278
Min. Negotiated Rate	$81.30
Max. Negotiated Rate	$131.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.24
Rate for Payer: Qualcare PPO/HMO/WC	$81.30

SCREW ZIM CANN 4 44 11424144

Facility

$547.25

Hospital Charge Code	270620033
Hospital Revenue Code	278
Min. Negotiated Rate	$13.19
Max. Negotiated Rate	$273.62
Rate for Payer: Aetna Commercial	$207.96
Rate for Payer: Aetna Medicare Advantage	$164.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.55
Rate for Payer: Cigna Commercial	$273.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$120.39
Rate for Payer: Qualcare PPO/HMO/WC	$82.09
Rate for Payer: UnitedHealthcare Community & State	$13.19
Rate for Payer: Wellpoint Medicaid Managed Care	$14.50

SCREW ZIM CANN 4 44 11424144

Facility

$547.25

Hospital Charge Code	270620033
Hospital Revenue Code	278
Min. Negotiated Rate	$82.09
Max. Negotiated Rate	$132.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$120.39
Rate for Payer: Qualcare PPO/HMO/WC	$82.09

SCREW ZIM CANN 4 46 11424146

Facility

$548.00

Hospital Charge Code	270613713
Hospital Revenue Code	278
Min. Negotiated Rate	$13.21
Max. Negotiated Rate	$274.00
Rate for Payer: Aetna Commercial	$208.24
Rate for Payer: Aetna Medicare Advantage	$164.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.74
Rate for Payer: Cigna Commercial	$274.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$120.56
Rate for Payer: Qualcare PPO/HMO/WC	$82.20
Rate for Payer: UnitedHealthcare Community & State	$13.21
Rate for Payer: Wellpoint Medicaid Managed Care	$14.52

SCREW ZIM CANN 4 46 11424146

Facility

$548.00

Hospital Charge Code	270613713
Hospital Revenue Code	278
Min. Negotiated Rate	$82.20
Max. Negotiated Rate	$132.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$120.56
Rate for Payer: Qualcare PPO/HMO/WC	$82.20

SCREW ZIM CANN 4 46 11425144

Facility

$548.00

Hospital Charge Code	270613714
Hospital Revenue Code	278
Min. Negotiated Rate	$82.20
Max. Negotiated Rate	$132.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$120.56
Rate for Payer: Qualcare PPO/HMO/WC	$82.20

SCREW ZIM CANN 4 46 11425144

Facility

$548.00

Hospital Charge Code	270613714
Hospital Revenue Code	278
Min. Negotiated Rate	$13.21
Max. Negotiated Rate	$274.00
Rate for Payer: Aetna Commercial	$208.24
Rate for Payer: Aetna Medicare Advantage	$164.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.74
Rate for Payer: Cigna Commercial	$274.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$120.56
Rate for Payer: Qualcare PPO/HMO/WC	$82.20
Rate for Payer: UnitedHealthcare Community & State	$13.21
Rate for Payer: Wellpoint Medicaid Managed Care	$14.52

Know your out-of-pocket cost for care.

All Charges