Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW ZIM CORT 4.5 36 231936

Facility

$67.25

Hospital Charge Code	270601796
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$16.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.79
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW ZIM CORT 4.5 36 231938

Facility

$67.25

Hospital Charge Code	270605548
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$16.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.79
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW ZIM CORT 4.5 36 231938

Facility

$67.25

Hospital Charge Code	270605548
Hospital Revenue Code	278
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$33.62
Rate for Payer: Aetna Commercial	$25.55
Rate for Payer: Aetna Medicare Advantage	$20.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$33.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.79
Rate for Payer: Qualcare PPO/HMO/WC	$10.09
Rate for Payer: UnitedHealthcare Community & State	$1.62
Rate for Payer: Wellpoint Medicaid Managed Care	$1.78

SCREW ZIM CORT 4.5 36 23472336

Facility

$133.65

Hospital Charge Code	270611497
Hospital Revenue Code	278
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$32.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$20.05

SCREW ZIM CORT 4.5 36 23472336

Facility

$133.65

Hospital Charge Code	270611497
Hospital Revenue Code	278
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$66.83
Rate for Payer: Aetna Commercial	$50.79
Rate for Payer: Aetna Medicare Advantage	$40.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.08
Rate for Payer: Cigna Commercial	$66.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$20.05
Rate for Payer: UnitedHealthcare Community & State	$3.22
Rate for Payer: Wellpoint Medicaid Managed Care	$3.54

SCREW ZIM CORT 4.5 36 48453601

Facility

$66.80

Hospital Charge Code	270605547
Hospital Revenue Code	278
Min. Negotiated Rate	$10.02
Max. Negotiated Rate	$16.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.70
Rate for Payer: Qualcare PPO/HMO/WC	$10.02

SCREW ZIM CORT 4.5 36 48453601

Facility

$66.80

Hospital Charge Code	270605547
Hospital Revenue Code	278
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$33.40
Rate for Payer: Aetna Commercial	$25.38
Rate for Payer: Aetna Medicare Advantage	$20.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.03
Rate for Payer: Cigna Commercial	$33.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.70
Rate for Payer: Qualcare PPO/HMO/WC	$10.02
Rate for Payer: UnitedHealthcare Community & State	$1.61
Rate for Payer: Wellpoint Medicaid Managed Care	$1.77

SCREW ZIM CORT 4.5 38 230639

Facility

$52.00

Hospital Charge Code	270601798
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 38 230639

Facility

$52.00

Hospital Charge Code	270601798
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 38 23472338

Facility

$133.65

Hospital Charge Code	270611494
Hospital Revenue Code	278
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$32.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$20.05

SCREW ZIM CORT 4.5 38 23472338

Facility

$133.65

Hospital Charge Code	270611494
Hospital Revenue Code	278
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$66.83
Rate for Payer: Aetna Commercial	$50.79
Rate for Payer: Aetna Medicare Advantage	$40.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.08
Rate for Payer: Cigna Commercial	$66.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$20.05
Rate for Payer: UnitedHealthcare Community & State	$3.22
Rate for Payer: Wellpoint Medicaid Managed Care	$3.54

SCREW ZIM CORT 4.5 40 230641

Facility

$52.00

Hospital Charge Code	270606816
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 40 230641

Facility

$52.00

Hospital Charge Code	270606816
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 40 231940

Facility

$67.25

Hospital Charge Code	270606051
Hospital Revenue Code	278
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$33.62
Rate for Payer: Aetna Commercial	$25.55
Rate for Payer: Aetna Medicare Advantage	$20.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$33.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.79
Rate for Payer: Qualcare PPO/HMO/WC	$10.09
Rate for Payer: UnitedHealthcare Community & State	$1.62
Rate for Payer: Wellpoint Medicaid Managed Care	$1.78

SCREW ZIM CORT 4.5 40 231940

Facility

$67.25

Hospital Charge Code	270606051
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$16.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.79
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

SCREW ZIM CORT 4.5 40 23472340

Facility

$133.65

Hospital Charge Code	270611491
Hospital Revenue Code	278
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$66.83
Rate for Payer: Aetna Commercial	$50.79
Rate for Payer: Aetna Medicare Advantage	$40.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.08
Rate for Payer: Cigna Commercial	$66.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$20.05
Rate for Payer: UnitedHealthcare Community & State	$3.22
Rate for Payer: Wellpoint Medicaid Managed Care	$3.54

SCREW ZIM CORT 4.5 40 23472340

Facility

$133.65

Hospital Charge Code	270611491
Hospital Revenue Code	278
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$32.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$20.05

SCREW ZIM CORT 4.5 42 231942

Facility

$405.65

Hospital Charge Code	270608075
Hospital Revenue Code	274
Min. Negotiated Rate	$60.85
Max. Negotiated Rate	$98.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$89.24
Rate for Payer: Qualcare PPO/HMO/WC	$60.85

SCREW ZIM CORT 4.5 42 231942

Facility

$405.65

Hospital Charge Code	270608075
Hospital Revenue Code	274
Min. Negotiated Rate	$9.78
Max. Negotiated Rate	$202.82
Rate for Payer: Aetna Commercial	$154.15
Rate for Payer: Aetna Medicare Advantage	$121.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.44
Rate for Payer: Cigna Commercial	$202.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.17
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$89.24
Rate for Payer: Qualcare PPO/HMO/WC	$60.85
Rate for Payer: UnitedHealthcare Community & State	$9.78
Rate for Payer: Wellpoint Medicaid Managed Care	$10.75

SCREW ZIM CORT 4.5 42 23472342

Facility

$133.65

Hospital Charge Code	270611490
Hospital Revenue Code	278
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$66.83
Rate for Payer: Aetna Commercial	$50.79
Rate for Payer: Aetna Medicare Advantage	$40.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.08
Rate for Payer: Cigna Commercial	$66.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$20.05
Rate for Payer: UnitedHealthcare Community & State	$3.22
Rate for Payer: Wellpoint Medicaid Managed Care	$3.54

SCREW ZIM CORT 4.5 42 23472342

Facility

$133.65

Hospital Charge Code	270611490
Hospital Revenue Code	278
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$32.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.34
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$20.05

SCREW ZIM CORT 4.5 44 230645

Facility

$38.45

Hospital Charge Code	270610337
Hospital Revenue Code	278
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$19.23
Rate for Payer: Aetna Commercial	$14.61
Rate for Payer: Aetna Medicare Advantage	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.80
Rate for Payer: Cigna Commercial	$19.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.46
Rate for Payer: Qualcare PPO/HMO/WC	$5.77
Rate for Payer: UnitedHealthcare Community & State	$0.93
Rate for Payer: Wellpoint Medicaid Managed Care	$1.02

SCREW ZIM CORT 4.5 44 230645

Facility

$38.45

Hospital Charge Code	270610337
Hospital Revenue Code	278
Min. Negotiated Rate	$5.77
Max. Negotiated Rate	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.46
Rate for Payer: Qualcare PPO/HMO/WC	$5.77

SCREW ZIM CORT 4.5 44 231944

Facility

$67.25

Hospital Charge Code	270606951
Hospital Revenue Code	278
Min. Negotiated Rate	$1.62
Max. Negotiated Rate	$33.62
Rate for Payer: Aetna Commercial	$25.55
Rate for Payer: Aetna Medicare Advantage	$20.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$33.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.79
Rate for Payer: Qualcare PPO/HMO/WC	$10.09
Rate for Payer: UnitedHealthcare Community & State	$1.62
Rate for Payer: Wellpoint Medicaid Managed Care	$1.78

SCREW ZIM CORT 4.5 44 231944

Facility

$67.25

Hospital Charge Code	270606951
Hospital Revenue Code	278
Min. Negotiated Rate	$10.09
Max. Negotiated Rate	$16.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.27
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.79
Rate for Payer: Qualcare PPO/HMO/WC	$10.09

Know your out-of-pocket cost for care.

All Charges