Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW ZIM CORT 4.5 44 231945

Facility

$63.75

Hospital Charge Code	270605551
Hospital Revenue Code	278
Min. Negotiated Rate	$9.56
Max. Negotiated Rate	$15.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.03
Rate for Payer: Qualcare PPO/HMO/WC	$9.56

SCREW ZIM CORT 4.5 44 231945

Facility

$63.75

Hospital Charge Code	270605551
Hospital Revenue Code	278
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$31.88
Rate for Payer: Aetna Commercial	$24.23
Rate for Payer: Aetna Medicare Advantage	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.26
Rate for Payer: Cigna Commercial	$31.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.03
Rate for Payer: Qualcare PPO/HMO/WC	$9.56
Rate for Payer: UnitedHealthcare Community & State	$1.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1.69

SCREW ZIM CORT 4.5 46 230647

Facility

$38.45

Service Code	HCPCS C1713
Hospital Charge Code	270610340
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 46 230647

Facility

$38.45

Service Code	HCPCS C1713
Hospital Charge Code	270610340
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 46 231946

Facility

$52.00

Hospital Charge Code	270601799
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 46 231946

Facility

$52.00

Hospital Charge Code	270601799
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 48 230649

Facility

$33.65

Hospital Charge Code	270610342
Hospital Revenue Code	278
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$8.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.05

SCREW ZIM CORT 4.5 48 230649

Facility

$33.65

Hospital Charge Code	270610342
Hospital Revenue Code	278
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$16.82
Rate for Payer: Aetna Commercial	$12.79
Rate for Payer: Aetna Medicare Advantage	$10.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.58
Rate for Payer: Cigna Commercial	$16.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.05
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.89

SCREW ZIM CORT 4.5 48 231949

Facility

$65.65

Hospital Charge Code	270605552
Hospital Revenue Code	278
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$15.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.44
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

SCREW ZIM CORT 4.5 48 231949

Facility

$65.65

Hospital Charge Code	270605552
Hospital Revenue Code	278
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$32.83
Rate for Payer: Aetna Commercial	$24.95
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.44
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.74

SCREW ZIM CORT 4.5 50 230651

Facility

$40.00

Service Code	HCPCS C1713
Hospital Charge Code	270610343
Hospital Revenue Code	278
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

SCREW ZIM CORT 4.5 50 230651

Facility

$40.00

Service Code	HCPCS C1713
Hospital Charge Code	270610343
Hospital Revenue Code	278
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$9.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.68
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

SCREW ZIM CORT 4.5 50 231951

Facility

$65.65

Hospital Charge Code	270613660
Hospital Revenue Code	278
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$32.83
Rate for Payer: Aetna Commercial	$24.95
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.44
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.74

SCREW ZIM CORT 4.5 50 231951

Facility

$65.65

Hospital Charge Code	270613660
Hospital Revenue Code	278
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$15.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$14.44
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

SCREW ZIM CORT 4.5 52 230653

Facility

$33.65

Hospital Charge Code	270610344
Hospital Revenue Code	278
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$8.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.05

SCREW ZIM CORT 4.5 52 230653

Facility

$33.65

Hospital Charge Code	270610344
Hospital Revenue Code	278
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$16.82
Rate for Payer: Aetna Commercial	$12.79
Rate for Payer: Aetna Medicare Advantage	$10.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.58
Rate for Payer: Cigna Commercial	$16.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.05
Rate for Payer: UnitedHealthcare Community & State	$0.81
Rate for Payer: Wellpoint Medicaid Managed Care	$0.89

SCREW ZIM CORT 4.5 52 231953

Facility

$63.25

Hospital Charge Code	270613661
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 CORT 4.5 52 231953

Facility

$63.25

Hospital Charge Code	270613661
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 CORT 4.5 54 231955

Facility

$63.25

Hospital Charge Code	270613662
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 CORT 4.5 54 231955

Facility

$63.25

Hospital Charge Code	270613662
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 CORT 4.5 55 22455545

Facility

$664.85

Hospital Charge Code	270610834
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 55 22455545

Facility

$664.85

Hospital Charge Code	270610834
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 56 230657

Facility

$50.45

Hospital Charge Code	270601999
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 56 230657

Facility

$50.45

Hospital Charge Code	270601999
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 CORT 4.5 58 2306-159

Facility

$36.00

Hospital Charge Code	270610346
Hospital Revenue Code	278
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$18.00
Rate for Payer: Aetna Commercial	$13.68
Rate for Payer: Aetna Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.18
Rate for Payer: Cigna Commercial	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.71
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$7.92
Rate for Payer: Qualcare PPO/HMO/WC	$5.40
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

Know your out-of-pocket cost for care.

All Charges