Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW ZIM CANN 4 48 11424048

Facility

$476.00

Hospital Charge Code	270627777
Hospital Revenue Code	278
Min. Negotiated Rate	$11.47
Max. Negotiated Rate	$238.00
Rate for Payer: Aetna Commercial	$180.88
Rate for Payer: Aetna Medicare Advantage	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.38
Rate for Payer: Cigna Commercial	$238.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.72
Rate for Payer: Qualcare PPO/HMO/WC	$71.40
Rate for Payer: UnitedHealthcare Community & State	$11.47
Rate for Payer: Wellpoint Medicaid Managed Care	$12.61

SCREW ZIM CANN 4 48 11424048

Facility

$476.00

Hospital Charge Code	270627777
Hospital Revenue Code	278
Min. Negotiated Rate	$71.40
Max. Negotiated Rate	$115.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.72
Rate for Payer: Qualcare PPO/HMO/WC	$71.40

SCREW ZIM CANN 4 48 11425148

Facility

$544.85

Hospital Charge Code	270621544
Hospital Revenue Code	278
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$272.43
Rate for Payer: Aetna Commercial	$207.04
Rate for Payer: Aetna Medicare Advantage	$163.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.94
Rate for Payer: Cigna Commercial	$272.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.87
Rate for Payer: Qualcare PPO/HMO/WC	$81.73
Rate for Payer: UnitedHealthcare Community & State	$13.13
Rate for Payer: Wellpoint Medicaid Managed Care	$14.44

SCREW ZIM CANN 4 48 11425148

Facility

$544.85

Hospital Charge Code	270621544
Hospital Revenue Code	278
Min. Negotiated Rate	$81.73
Max. Negotiated Rate	$131.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.87
Rate for Payer: Qualcare PPO/HMO/WC	$81.73

SCREW ZIM CANN 4 55 11424155

Facility

$544.85

Hospital Charge Code	270616872
Hospital Revenue Code	278
Min. Negotiated Rate	$81.73
Max. Negotiated Rate	$131.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.87
Rate for Payer: Qualcare PPO/HMO/WC	$81.73

SCREW ZIM CANN 4 55 11424155

Facility

$544.85

Hospital Charge Code	270616872
Hospital Revenue Code	278
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$272.43
Rate for Payer: Aetna Commercial	$207.04
Rate for Payer: Aetna Medicare Advantage	$163.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.94
Rate for Payer: Cigna Commercial	$272.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.87
Rate for Payer: Qualcare PPO/HMO/WC	$81.73
Rate for Payer: UnitedHealthcare Community & State	$13.13
Rate for Payer: Wellpoint Medicaid Managed Care	$14.44

SCREW ZIM CANN 4 65 11424165

Facility

$544.85

Hospital Charge Code	270614919
Hospital Revenue Code	278
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$272.43
Rate for Payer: Aetna Commercial	$207.04
Rate for Payer: Aetna Medicare Advantage	$163.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.94
Rate for Payer: Cigna Commercial	$272.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.87
Rate for Payer: Qualcare PPO/HMO/WC	$81.73
Rate for Payer: UnitedHealthcare Community & State	$13.13
Rate for Payer: Wellpoint Medicaid Managed Care	$14.44

SCREW ZIM CANN 4 65 11424165

Facility

$544.85

Hospital Charge Code	270614919
Hospital Revenue Code	278
Min. Negotiated Rate	$81.73
Max. Negotiated Rate	$131.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.87
Rate for Payer: Qualcare PPO/HMO/WC	$81.73

SCREW ZIM CANN 4 65 11424165

Facility

$213.00

Hospital Charge Code	270617919
Hospital Revenue Code	278
Min. Negotiated Rate	$5.13
Max. Negotiated Rate	$106.50
Rate for Payer: Aetna Commercial	$80.94
Rate for Payer: Aetna Medicare Advantage	$63.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.31
Rate for Payer: Cigna Commercial	$106.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$46.86
Rate for Payer: Qualcare PPO/HMO/WC	$31.95
Rate for Payer: UnitedHealthcare Community & State	$5.13
Rate for Payer: Wellpoint Medicaid Managed Care	$5.64

SCREW ZIM CANN 4 65 11424165

Facility

$213.00

Hospital Charge Code	270617919
Hospital Revenue Code	278
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$51.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$46.86
Rate for Payer: Qualcare PPO/HMO/WC	$31.95

SCREW ZIM CANN 4 70 11424170

Facility

$542.00

Hospital Charge Code	270614921
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 70 11424170

Facility

$542.00

Hospital Charge Code	270614921
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 5 36 11425136

Facility

$568.60

Hospital Charge Code	270624547
Hospital Revenue Code	278
Min. Negotiated Rate	$85.29
Max. Negotiated Rate	$137.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.09
Rate for Payer: Qualcare PPO/HMO/WC	$85.29

SCREW ZIM CANN 5 36 11425136

Facility

$568.60

Hospital Charge Code	270624547
Hospital Revenue Code	278
Min. Negotiated Rate	$13.70
Max. Negotiated Rate	$284.30
Rate for Payer: Aetna Commercial	$216.07
Rate for Payer: Aetna Medicare Advantage	$170.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.99
Rate for Payer: Cigna Commercial	$284.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.09
Rate for Payer: Qualcare PPO/HMO/WC	$85.29
Rate for Payer: UnitedHealthcare Community & State	$13.70
Rate for Payer: Wellpoint Medicaid Managed Care	$15.07

SCREW ZIM CANN 5 50 11425150

Facility

$568.60

Hospital Charge Code	270624548
Hospital Revenue Code	278
Min. Negotiated Rate	$85.29
Max. Negotiated Rate	$137.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.09
Rate for Payer: Qualcare PPO/HMO/WC	$85.29

SCREW ZIM CANN 5 50 11425150

Facility

$568.60

Hospital Charge Code	270624548
Hospital Revenue Code	278
Min. Negotiated Rate	$13.70
Max. Negotiated Rate	$284.30
Rate for Payer: Aetna Commercial	$216.07
Rate for Payer: Aetna Medicare Advantage	$170.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$144.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$144.99
Rate for Payer: Cigna Commercial	$284.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$125.09
Rate for Payer: Qualcare PPO/HMO/WC	$85.29
Rate for Payer: UnitedHealthcare Community & State	$13.70
Rate for Payer: Wellpoint Medicaid Managed Care	$15.07

SCREW ZIM CANN 5 55 11425155

Facility

$500.00

Hospital Charge Code	270624549
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

SCREW ZIM CANN 5 55 11425155

Facility

$500.00

Hospital Charge Code	270624549
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

SCREW ZIM CANN 5 60 11425160

Facility

$544.85

Hospital Charge Code	270613715
Hospital Revenue Code	278
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$272.43
Rate for Payer: Aetna Commercial	$207.04
Rate for Payer: Aetna Medicare Advantage	$163.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.94
Rate for Payer: Cigna Commercial	$272.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.87
Rate for Payer: Qualcare PPO/HMO/WC	$81.73
Rate for Payer: UnitedHealthcare Community & State	$13.13
Rate for Payer: Wellpoint Medicaid Managed Care	$14.44

SCREW ZIM CANN 5 60 11425160

Facility

$544.85

Hospital Charge Code	270613715
Hospital Revenue Code	278
Min. Negotiated Rate	$81.73
Max. Negotiated Rate	$131.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$119.87
Rate for Payer: Qualcare PPO/HMO/WC	$81.73

SCREW ZIM CANN 5 65 11425165

Facility

$529.65

Hospital Charge Code	270623439
Hospital Revenue Code	278
Min. Negotiated Rate	$12.76
Max. Negotiated Rate	$264.82
Rate for Payer: Aetna Commercial	$201.27
Rate for Payer: Aetna Medicare Advantage	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.06
Rate for Payer: Cigna Commercial	$264.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.52
Rate for Payer: Qualcare PPO/HMO/WC	$79.45
Rate for Payer: UnitedHealthcare Community & State	$12.76
Rate for Payer: Wellpoint Medicaid Managed Care	$14.04

SCREW ZIM CANN 5 65 11425165

Facility

$529.65

Hospital Charge Code	270623439
Hospital Revenue Code	278
Min. Negotiated Rate	$79.45
Max. Negotiated Rate	$128.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.52
Rate for Payer: Qualcare PPO/HMO/WC	$79.45

SCREW ZIM CANN 5 70 11425170

Facility

$529.65

Hospital Charge Code	270623440
Hospital Revenue Code	278
Min. Negotiated Rate	$12.76
Max. Negotiated Rate	$264.82
Rate for Payer: Aetna Commercial	$201.27
Rate for Payer: Aetna Medicare Advantage	$158.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.06
Rate for Payer: Cigna Commercial	$264.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.52
Rate for Payer: Qualcare PPO/HMO/WC	$79.45
Rate for Payer: UnitedHealthcare Community & State	$12.76
Rate for Payer: Wellpoint Medicaid Managed Care	$14.04

SCREW ZIM CANN 5 70 11425170

Facility

$529.65

Hospital Charge Code	270623440
Hospital Revenue Code	278
Min. Negotiated Rate	$79.45
Max. Negotiated Rate	$128.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$105.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.18
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.52
Rate for Payer: Qualcare PPO/HMO/WC	$79.45

SCREW ZIM CANN7Dx80m16m1146-80

Facility

$751.95

Hospital Charge Code	270605977
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

Know your out-of-pocket cost for care.

All Charges