Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

WIRE WC GUIDE .038 145 638413

Facility

$105.65

Hospital Charge Code	270608176
Hospital Revenue Code	278
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$52.83
Rate for Payer: Aetna Commercial	$40.15
Rate for Payer: Aetna Medicare Advantage	$31.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.94
Rate for Payer: Cigna Commercial	$52.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$23.24
Rate for Payer: Qualcare PPO/HMO/WC	$15.85
Rate for Payer: UnitedHealthcare Community & State	$2.55
Rate for Payer: Wellpoint Medicaid Managed Care	$2.80

WIRE WC GUIDE PAPILL PTG-30-6

Facility

$1,175.25

Hospital Charge Code	270600978
Hospital Revenue Code	278
Min. Negotiated Rate	$176.29
Max. Negotiated Rate	$284.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$258.56
Rate for Payer: Qualcare PPO/HMO/WC	$176.29

WIRE WC GUIDE PAPILL PTG-30-6

Facility

$1,175.25

Hospital Charge Code	270600978
Hospital Revenue Code	278
Min. Negotiated Rate	$28.32
Max. Negotiated Rate	$587.62
Rate for Payer: Aetna Commercial	$446.60
Rate for Payer: Aetna Medicare Advantage	$352.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$235.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.69
Rate for Payer: Cigna Commercial	$587.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$284.41
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$258.56
Rate for Payer: Qualcare PPO/HMO/WC	$176.29
Rate for Payer: UnitedHealthcare Community & State	$28.32
Rate for Payer: Wellpoint Medicaid Managed Care	$31.14

WIRE WC GUIDE TFL THSF-21-400

Facility

$440.85

Hospital Charge Code	270600983
Hospital Revenue Code	278
Min. Negotiated Rate	$66.13
Max. Negotiated Rate	$106.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.99
Rate for Payer: Qualcare PPO/HMO/WC	$66.13

WIRE WC GUIDE TFL THSF-21-400

Facility

$440.85

Hospital Charge Code	270600983
Hospital Revenue Code	278
Min. Negotiated Rate	$10.62
Max. Negotiated Rate	$220.43
Rate for Payer: Aetna Commercial	$167.52
Rate for Payer: Aetna Medicare Advantage	$132.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.42
Rate for Payer: Cigna Commercial	$220.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.99
Rate for Payer: Qualcare PPO/HMO/WC	$66.13
Rate for Payer: UnitedHealthcare Community & State	$10.62
Rate for Payer: Wellpoint Medicaid Managed Care	$11.68

WIRE WC GUIDE THSF-35-400

Facility

$440.85

Hospital Charge Code	270600971
Hospital Revenue Code	278
Min. Negotiated Rate	$66.13
Max. Negotiated Rate	$106.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.99
Rate for Payer: Qualcare PPO/HMO/WC	$66.13

WIRE WC GUIDE THSF-35-400

Facility

$440.85

Hospital Charge Code	270600971
Hospital Revenue Code	278
Min. Negotiated Rate	$10.62
Max. Negotiated Rate	$220.43
Rate for Payer: Aetna Commercial	$167.52
Rate for Payer: Aetna Medicare Advantage	$132.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.42
Rate for Payer: Cigna Commercial	$220.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.69
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$96.99
Rate for Payer: Qualcare PPO/HMO/WC	$66.13
Rate for Payer: UnitedHealthcare Community & State	$10.62
Rate for Payer: Wellpoint Medicaid Managed Care	$11.68

WIRE ZIM GUIDE BULL 3.0 900038

Facility

$1,164.85

Hospital Charge Code	270610837
Hospital Revenue Code	278
Min. Negotiated Rate	$28.07
Max. Negotiated Rate	$582.42
Rate for Payer: Aetna Commercial	$442.64
Rate for Payer: Aetna Medicare Advantage	$349.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$297.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$297.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$232.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$297.04
Rate for Payer: Cigna Commercial	$582.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$256.27
Rate for Payer: Qualcare PPO/HMO/WC	$174.73
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: Wellpoint Medicaid Managed Care	$30.87

WIRE ZIM GUIDE BULL 3.0 900038

Facility

$1,164.85

Hospital Charge Code	270610837
Hospital Revenue Code	278
Min. Negotiated Rate	$174.73
Max. Negotiated Rate	$281.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$232.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$281.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$256.27
Rate for Payer: Qualcare PPO/HMO/WC	$174.73

WIRE ZIM GUIDE IM 2.4 2255-25

Facility

$307.25

Hospital Charge Code	270618070
Hospital Revenue Code	278
Min. Negotiated Rate	$46.09
Max. Negotiated Rate	$74.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.59
Rate for Payer: Qualcare PPO/HMO/WC	$46.09

WIRE ZIM GUIDE IM 2.4 2255-25

Facility

$307.25

Hospital Charge Code	270618070
Hospital Revenue Code	278
Min. Negotiated Rate	$7.40
Max. Negotiated Rate	$153.62
Rate for Payer: Aetna Commercial	$116.75
Rate for Payer: Aetna Medicare Advantage	$92.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.35
Rate for Payer: Cigna Commercial	$153.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$67.59
Rate for Payer: Qualcare PPO/HMO/WC	$46.09
Rate for Payer: UnitedHealthcare Community & State	$7.40
Rate for Payer: Wellpoint Medicaid Managed Care	$8.14

WIRE ZIM GUIDE IM 2.4 2255-26

Facility

$346.45

Hospital Charge Code	270618071
Hospital Revenue Code	278
Min. Negotiated Rate	$51.97
Max. Negotiated Rate	$83.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$76.22
Rate for Payer: Qualcare PPO/HMO/WC	$51.97

WIRE ZIM GUIDE IM 2.4 2255-26

Facility

$346.45

Hospital Charge Code	270618071
Hospital Revenue Code	278
Min. Negotiated Rate	$8.35
Max. Negotiated Rate	$173.22
Rate for Payer: Aetna Commercial	$131.65
Rate for Payer: Aetna Medicare Advantage	$103.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$69.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.34
Rate for Payer: Cigna Commercial	$173.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$76.22
Rate for Payer: Qualcare PPO/HMO/WC	$51.97
Rate for Payer: UnitedHealthcare Community & State	$8.35
Rate for Payer: Wellpoint Medicaid Managed Care	$9.18

WIRE ZIM GUIDE ZMS 47223733

Facility

$710.45

Hospital Charge Code	270610836
Hospital Revenue Code	278
Min. Negotiated Rate	$106.57
Max. Negotiated Rate	$171.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$156.30
Rate for Payer: Qualcare PPO/HMO/WC	$106.57

WIRE ZIM GUIDE ZMS 47223733

Facility

$710.45

Hospital Charge Code	270610836
Hospital Revenue Code	278
Min. Negotiated Rate	$17.12
Max. Negotiated Rate	$355.23
Rate for Payer: Aetna Commercial	$269.97
Rate for Payer: Aetna Medicare Advantage	$213.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.16
Rate for Payer: Cigna Commercial	$355.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.93
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$156.30
Rate for Payer: Qualcare PPO/HMO/WC	$106.57
Rate for Payer: UnitedHealthcare Community & State	$17.12
Rate for Payer: Wellpoint Medicaid Managed Care	$18.83

WIRE ZIM GUIDE ZMS BT 47223738

Facility

$447.25

Hospital Charge Code	270620525
Hospital Revenue Code	278
Min. Negotiated Rate	$10.78
Max. Negotiated Rate	$223.62
Rate for Payer: Aetna Commercial	$169.96
Rate for Payer: Aetna Medicare Advantage	$134.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.05
Rate for Payer: Cigna Commercial	$223.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$98.39
Rate for Payer: Qualcare PPO/HMO/WC	$67.09
Rate for Payer: UnitedHealthcare Community & State	$10.78
Rate for Payer: Wellpoint Medicaid Managed Care	$11.85

WIRE ZIM GUIDE ZMS BT 47223738

Facility

$447.25

Hospital Charge Code	270620525
Hospital Revenue Code	278
Min. Negotiated Rate	$67.09
Max. Negotiated Rate	$108.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$89.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.23
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$98.39
Rate for Payer: Qualcare PPO/HMO/WC	$67.09

WIRE ZIM GUIDE ZMS SM 47223737

Facility

$555.60

Hospital Charge Code	270620524
Hospital Revenue Code	278
Min. Negotiated Rate	$83.34
Max. Negotiated Rate	$134.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$122.23
Rate for Payer: Qualcare PPO/HMO/WC	$83.34

WIRE ZIM GUIDE ZMS SM 47223737

Facility

$555.60

Hospital Charge Code	270620524
Hospital Revenue Code	278
Min. Negotiated Rate	$13.39
Max. Negotiated Rate	$277.80
Rate for Payer: Aetna Commercial	$211.13
Rate for Payer: Aetna Medicare Advantage	$166.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$141.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$141.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$111.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$141.68
Rate for Payer: Cigna Commercial	$277.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$122.23
Rate for Payer: Qualcare PPO/HMO/WC	$83.34
Rate for Payer: UnitedHealthcare Community & State	$13.39
Rate for Payer: Wellpoint Medicaid Managed Care	$14.72

WIRE ZIM K .032 186-01-69

Facility

$36.51

Service Code	HCPCS C1769
Hospital Charge Code	270601978
Hospital Revenue Code	278
Min. Negotiated Rate	$5.48
Max. Negotiated Rate	$8.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.03
Rate for Payer: Qualcare PPO/HMO/WC	$5.48

WIRE ZIM K .032 186-01-69

Facility

$36.51

Service Code	HCPCS C1769
Hospital Charge Code	270601978
Hospital Revenue Code	278
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$18.25
Rate for Payer: Aetna Commercial	$13.87
Rate for Payer: Aetna Medicare Advantage	$10.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.31
Rate for Payer: Cigna Commercial	$18.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.03
Rate for Payer: Qualcare PPO/HMO/WC	$5.48
Rate for Payer: UnitedHealthcare Community & State	$0.88
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

WIRE ZIM K .045 186-02-69

Facility

$36.81

Service Code	HCPCS C1769
Hospital Charge Code	270601917
Hospital Revenue Code	278
Min. Negotiated Rate	$5.52
Max. Negotiated Rate	$8.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.10
Rate for Payer: Qualcare PPO/HMO/WC	$5.52

WIRE ZIM K .045 186-02-69

Facility

$36.81

Service Code	HCPCS C1769
Hospital Charge Code	270601917
Hospital Revenue Code	278
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$18.41
Rate for Payer: Aetna Commercial	$13.99
Rate for Payer: Aetna Medicare Advantage	$11.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.39
Rate for Payer: Cigna Commercial	$18.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.91
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.10
Rate for Payer: Qualcare PPO/HMO/WC	$5.52
Rate for Payer: UnitedHealthcare Community & State	$0.89
Rate for Payer: Wellpoint Medicaid Managed Care	$0.98

WIRE ZIM K .062 186-03-69

Facility

$39.56

Service Code	HCPCS C1769
Hospital Charge Code	270609825
Hospital Revenue Code	278
Min. Negotiated Rate	$5.93
Max. Negotiated Rate	$9.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.93

WIRE ZIM K .062 186-03-69

Facility

$39.56

Service Code	HCPCS C1769
Hospital Charge Code	270609825
Hospital Revenue Code	278
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$19.78
Rate for Payer: Aetna Commercial	$15.03
Rate for Payer: Aetna Medicare Advantage	$11.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.09
Rate for Payer: Cigna Commercial	$19.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.57
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.93
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$1.05

Know your out-of-pocket cost for care.

All Charges