Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW ZIM CORT 3.7 25 22532537

Facility

$490.45

Hospital Charge Code	270625008
Hospital Revenue Code	278
Min. Negotiated Rate	$73.57
Max. Negotiated Rate	$118.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$107.90
Rate for Payer: Qualcare PPO/HMO/WC	$73.57

SCREW ZIM CORT 4.2 25 22532542

Facility

$530.45

Hospital Charge Code	270618074
Hospital Revenue Code	278
Min. Negotiated Rate	$79.57
Max. Negotiated Rate	$128.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.70
Rate for Payer: Qualcare PPO/HMO/WC	$79.57

SCREW ZIM CORT 4.2 25 22532542

Facility

$530.45

Hospital Charge Code	270618074
Hospital Revenue Code	278
Min. Negotiated Rate	$12.78
Max. Negotiated Rate	$265.23
Rate for Payer: Aetna Commercial	$201.57
Rate for Payer: Aetna Medicare Advantage	$159.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.26
Rate for Payer: Cigna Commercial	$265.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.70
Rate for Payer: Qualcare PPO/HMO/WC	$79.57
Rate for Payer: UnitedHealthcare Community & State	$12.78
Rate for Payer: Wellpoint Medicaid Managed Care	$14.06

SCREW ZIM CORT 4.2 30 22533042

Facility

$611.10

Hospital Charge Code	270619337
Hospital Revenue Code	278
Min. Negotiated Rate	$91.67
Max. Negotiated Rate	$147.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.44
Rate for Payer: Qualcare PPO/HMO/WC	$91.67

SCREW ZIM CORT 4.2 30 22533042

Facility

$611.10

Hospital Charge Code	270619337
Hospital Revenue Code	278
Min. Negotiated Rate	$14.73
Max. Negotiated Rate	$305.55
Rate for Payer: Aetna Commercial	$232.22
Rate for Payer: Aetna Medicare Advantage	$183.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.83
Rate for Payer: Cigna Commercial	$305.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.44
Rate for Payer: Qualcare PPO/HMO/WC	$91.67
Rate for Payer: UnitedHealthcare Community & State	$14.73
Rate for Payer: Wellpoint Medicaid Managed Care	$16.19

SCREW ZIM CORT 4.2 35 22533542

Facility

$490.45

Hospital Charge Code	270624302
Hospital Revenue Code	278
Min. Negotiated Rate	$73.57
Max. Negotiated Rate	$118.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$107.90
Rate for Payer: Qualcare PPO/HMO/WC	$73.57

SCREW ZIM CORT 4.2 35 22533542

Facility

$490.45

Hospital Charge Code	270624302
Hospital Revenue Code	278
Min. Negotiated Rate	$11.82
Max. Negotiated Rate	$245.22
Rate for Payer: Aetna Commercial	$186.37
Rate for Payer: Aetna Medicare Advantage	$147.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$98.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.06
Rate for Payer: Cigna Commercial	$245.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$107.90
Rate for Payer: Qualcare PPO/HMO/WC	$73.57
Rate for Payer: UnitedHealthcare Community & State	$11.82
Rate for Payer: Wellpoint Medicaid Managed Care	$13.00

SCREW ZIM CORT 4.2 40 22534042

Facility

$611.10

Hospital Charge Code	270624282
Hospital Revenue Code	278
Min. Negotiated Rate	$91.67
Max. Negotiated Rate	$147.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.44
Rate for Payer: Qualcare PPO/HMO/WC	$91.67

SCREW ZIM CORT 4.2 40 22534042

Facility

$611.10

Hospital Charge Code	270624282
Hospital Revenue Code	278
Min. Negotiated Rate	$14.73
Max. Negotiated Rate	$305.55
Rate for Payer: Aetna Commercial	$232.22
Rate for Payer: Aetna Medicare Advantage	$183.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.83
Rate for Payer: Cigna Commercial	$305.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.44
Rate for Payer: Qualcare PPO/HMO/WC	$91.67
Rate for Payer: UnitedHealthcare Community & State	$14.73
Rate for Payer: Wellpoint Medicaid Managed Care	$16.19

SCREW ZIM CORT 4.2 45 22534542

Facility

$611.10

Hospital Charge Code	270619867
Hospital Revenue Code	278
Min. Negotiated Rate	$14.73
Max. Negotiated Rate	$305.55
Rate for Payer: Aetna Commercial	$232.22
Rate for Payer: Aetna Medicare Advantage	$183.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.83
Rate for Payer: Cigna Commercial	$305.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.44
Rate for Payer: Qualcare PPO/HMO/WC	$91.67
Rate for Payer: UnitedHealthcare Community & State	$14.73
Rate for Payer: Wellpoint Medicaid Managed Care	$16.19

SCREW ZIM CORT 4.2 45 22534542

Facility

$611.10

Hospital Charge Code	270619867
Hospital Revenue Code	278
Min. Negotiated Rate	$91.67
Max. Negotiated Rate	$147.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$122.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$134.44
Rate for Payer: Qualcare PPO/HMO/WC	$91.67

SCREW ZIM CORT 4.2 50 22535042

Facility

$530.45

Hospital Charge Code	270618075
Hospital Revenue Code	278
Min. Negotiated Rate	$79.57
Max. Negotiated Rate	$128.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.70
Rate for Payer: Qualcare PPO/HMO/WC	$79.57

SCREW ZIM CORT 4.2 50 22535042

Facility

$530.45

Hospital Charge Code	270618075
Hospital Revenue Code	278
Min. Negotiated Rate	$12.78
Max. Negotiated Rate	$265.23
Rate for Payer: Aetna Commercial	$201.57
Rate for Payer: Aetna Medicare Advantage	$159.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.26
Rate for Payer: Cigna Commercial	$265.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.70
Rate for Payer: Qualcare PPO/HMO/WC	$79.57
Rate for Payer: UnitedHealthcare Community & State	$12.78
Rate for Payer: Wellpoint Medicaid Managed Care	$14.06

SCREW ZIM CORT 4.2 55 22535542

Facility

$530.45

Hospital Charge Code	270619335
Hospital Revenue Code	278
Min. Negotiated Rate	$12.78
Max. Negotiated Rate	$265.23
Rate for Payer: Aetna Commercial	$201.57
Rate for Payer: Aetna Medicare Advantage	$159.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.26
Rate for Payer: Cigna Commercial	$265.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.70
Rate for Payer: Qualcare PPO/HMO/WC	$79.57
Rate for Payer: UnitedHealthcare Community & State	$12.78
Rate for Payer: Wellpoint Medicaid Managed Care	$14.06

SCREW ZIM CORT 4.2 55 22535542

Facility

$530.45

Hospital Charge Code	270619335
Hospital Revenue Code	278
Min. Negotiated Rate	$79.57
Max. Negotiated Rate	$128.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$116.70
Rate for Payer: Qualcare PPO/HMO/WC	$79.57

SCREW ZIM CORT 4.5 14 230614

Facility

$47.25

Hospital Charge Code	270601794
Hospital Revenue Code	278
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$23.62
Rate for Payer: Aetna Commercial	$17.95
Rate for Payer: Aetna Medicare Advantage	$14.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.05
Rate for Payer: Cigna Commercial	$23.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.39
Rate for Payer: Qualcare PPO/HMO/WC	$7.09
Rate for Payer: UnitedHealthcare Community & State	$1.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

SCREW ZIM CORT 4.5 14 230614

Facility

$47.25

Hospital Charge Code	270601794
Hospital Revenue Code	278
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$11.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$10.39
Rate for Payer: Qualcare PPO/HMO/WC	$7.09

SCREW ZIM CORT 4.5 20 22452045

Facility

$664.85

Hospital Charge Code	270610833
Hospital Revenue Code	278
Min. Negotiated Rate	$16.02
Max. Negotiated Rate	$332.43
Rate for Payer: Aetna Commercial	$252.64
Rate for Payer: Aetna Medicare Advantage	$199.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.54
Rate for Payer: Cigna Commercial	$332.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.27
Rate for Payer: Qualcare PPO/HMO/WC	$99.73
Rate for Payer: UnitedHealthcare Community & State	$16.02
Rate for Payer: Wellpoint Medicaid Managed Care	$17.62

SCREW ZIM CORT 4.5 20 22452045

Facility

$664.85

Hospital Charge Code	270610833
Hospital Revenue Code	278
Min. Negotiated Rate	$99.73
Max. Negotiated Rate	$160.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$146.27
Rate for Payer: Qualcare PPO/HMO/WC	$99.73

SCREW ZIM CORT 4.5 230643

Facility

$52.00

Service Code	HCPCS C1713
Hospital Charge Code	270607256
Hospital Revenue Code	278
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$12.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.44
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

SCREW ZIM CORT 4.5 230643

Facility

$52.00

Service Code	HCPCS C1713
Hospital Charge Code	270607256
Hospital Revenue Code	278
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.58
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.44
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

SCREW ZIM CORT 4.5 24 230624

Facility

$69.65

Hospital Charge Code	270606814
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 CORT 4.5 24 230624

Facility

$69.65

Hospital Charge Code	270606814
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 CORT 4.5 24 230625

Facility

$50.45

Hospital Charge Code	270605560
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 CORT 4.5 24 230625

Facility

$50.45

Hospital Charge Code	270605560
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

Know your out-of-pocket cost for care.

All Charges