Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRILL BIT 1.1MM

Facility

$107.80

Hospital Charge Code	270664050
Hospital Revenue Code	270
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$16.17
Rate for Payer: Qualcare PPO/HMO/WC	$16.17

DRILL BIT 1.1MM/MINI QC/28MM

Facility

$350.00

Hospital Charge Code	270674777
Hospital Revenue Code	272
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.00
Rate for Payer: Oxford Commercial	$70.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Commercial	$70.00
Rate for Payer: UnitedHealthcare Community & State	$8.44
Rate for Payer: Wellpoint Medicaid Managed Care	$9.28

DRILL BIT 1.1MM/MINI QC/28MM

Facility

$350.00

Hospital Charge Code	270674777
Hospital Revenue Code	272
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

DRILL BIT 1.1MM/MINI QC/45MM

Facility

$350.00

Hospital Charge Code	270674778
Hospital Revenue Code	272
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.00
Rate for Payer: Oxford Commercial	$70.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Commercial	$70.00
Rate for Payer: UnitedHealthcare Community & State	$8.44
Rate for Payer: Wellpoint Medicaid Managed Care	$9.28

DRILL BIT 1.1MM/MINI QC/45MM

Facility

$350.00

Hospital Charge Code	270674778
Hospital Revenue Code	272
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

DRILL BIT 12.0MM 03.010.036

Facility

$2,508.75

Hospital Charge Code	270647426
Hospital Revenue Code	270
Min. Negotiated Rate	$60.46
Max. Negotiated Rate	$1,254.38
Rate for Payer: Aetna Commercial	$953.33
Rate for Payer: Aetna Medicare Advantage	$752.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$639.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$639.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$639.73
Rate for Payer: Cigna Commercial	$1,254.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$752.62
Rate for Payer: Oxford Commercial	$501.75
Rate for Payer: Qualcare PPO/HMO/WC	$376.31
Rate for Payer: UnitedHealthcare Commercial	$501.75
Rate for Payer: UnitedHealthcare Community & State	$60.46
Rate for Payer: Wellpoint Medicaid Managed Care	$66.48

DRILL BIT 12.0MM 03.010.036

Facility

$2,508.75

Hospital Charge Code	270647426
Hospital Revenue Code	270
Min. Negotiated Rate	$376.31
Max. Negotiated Rate	$376.31
Rate for Payer: Qualcare PPO/HMO/WC	$376.31

DRILL BIT 12 MM

Facility

$1,250.00

Hospital Charge Code	270691931
Hospital Revenue Code	272
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$250.00
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

DRILL BIT 12 MM

Facility

$1,250.00

Hospital Charge Code	270691931
Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

DRILL BIT 12MM

Facility

$1,737.50

Hospital Charge Code	270693818
Hospital Revenue Code	272
Min. Negotiated Rate	$260.62
Max. Negotiated Rate	$260.62
Rate for Payer: Qualcare PPO/HMO/WC	$260.62

DRILL BIT 12MM

Facility

$1,500.00

Hospital Charge Code	270667753
Hospital Revenue Code	272
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

DRILL BIT 12MM

Facility

$1,175.00

Hospital Charge Code	270687814
Hospital Revenue Code	272
Min. Negotiated Rate	$28.32
Max. Negotiated Rate	$587.50
Rate for Payer: Aetna Commercial	$446.50
Rate for Payer: Aetna Medicare Advantage	$352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$299.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$299.62
Rate for Payer: Cigna Commercial	$587.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.50
Rate for Payer: Oxford Commercial	$235.00
Rate for Payer: Qualcare PPO/HMO/WC	$176.25
Rate for Payer: UnitedHealthcare Commercial	$235.00
Rate for Payer: UnitedHealthcare Community & State	$28.32
Rate for Payer: Wellpoint Medicaid Managed Care	$31.14

DRILL BIT 12MM

Facility

$1,500.00

Hospital Charge Code	270667753
Hospital Revenue Code	272
Min. Negotiated Rate	$36.15
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$450.00
Rate for Payer: Oxford Commercial	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Commercial	$300.00
Rate for Payer: UnitedHealthcare Community & State	$36.15
Rate for Payer: Wellpoint Medicaid Managed Care	$39.75

DRILL BIT 12MM

Facility

$1,175.00

Hospital Charge Code	270687814
Hospital Revenue Code	272
Min. Negotiated Rate	$176.25
Max. Negotiated Rate	$176.25
Rate for Payer: Qualcare PPO/HMO/WC	$176.25

DRILL BIT 12MM

Facility

$1,737.50

Hospital Charge Code	270693818
Hospital Revenue Code	272
Min. Negotiated Rate	$41.87
Max. Negotiated Rate	$868.75
Rate for Payer: Aetna Commercial	$660.25
Rate for Payer: Aetna Medicare Advantage	$521.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$443.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$443.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$443.06
Rate for Payer: Cigna Commercial	$868.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$521.25
Rate for Payer: Oxford Commercial	$347.50
Rate for Payer: Qualcare PPO/HMO/WC	$260.62
Rate for Payer: UnitedHealthcare Commercial	$347.50
Rate for Payer: UnitedHealthcare Community & State	$41.87
Rate for Payer: Wellpoint Medicaid Managed Care	$46.04

DRILL BIT 1.30

Facility

$2,798.10

Hospital Charge Code	270693268
Hospital Revenue Code	272
Min. Negotiated Rate	$419.71
Max. Negotiated Rate	$419.71
Rate for Payer: Qualcare PPO/HMO/WC	$419.71

DRILL BIT 1.30

Facility

$2,798.10

Hospital Charge Code	270693268
Hospital Revenue Code	272
Min. Negotiated Rate	$67.43
Max. Negotiated Rate	$1,399.05
Rate for Payer: Aetna Commercial	$1,063.28
Rate for Payer: Aetna Medicare Advantage	$839.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$713.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$713.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$713.52
Rate for Payer: Cigna Commercial	$1,399.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$839.43
Rate for Payer: Oxford Commercial	$559.62
Rate for Payer: Qualcare PPO/HMO/WC	$419.71
Rate for Payer: UnitedHealthcare Commercial	$559.62
Rate for Payer: UnitedHealthcare Community & State	$67.43
Rate for Payer: Wellpoint Medicaid Managed Care	$74.15

DRILL BIT 1.3B MM

Facility

$366.00

Hospital Charge Code	270681690
Hospital Revenue Code	272
Min. Negotiated Rate	$54.90
Max. Negotiated Rate	$54.90
Rate for Payer: Qualcare PPO/HMO/WC	$54.90

DRILL BIT 1.3B MM

Facility

$366.00

Hospital Charge Code	270681690
Hospital Revenue Code	272
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$183.00
Rate for Payer: Aetna Commercial	$139.08
Rate for Payer: Aetna Medicare Advantage	$109.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.33
Rate for Payer: Cigna Commercial	$183.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.80
Rate for Payer: Oxford Commercial	$73.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.90
Rate for Payer: UnitedHealthcare Commercial	$73.20
Rate for Payer: UnitedHealthcare Community & State	$8.82
Rate for Payer: Wellpoint Medicaid Managed Care	$9.70

DRILL BIT 14MM

Facility

$1,375.00

Hospital Charge Code	270692537
Hospital Revenue Code	272
Min. Negotiated Rate	$33.14
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$522.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$412.50
Rate for Payer: Oxford Commercial	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Commercial	$275.00
Rate for Payer: UnitedHealthcare Community & State	$33.14
Rate for Payer: Wellpoint Medicaid Managed Care	$36.44

DRILL BIT 14MM

Facility

$1,375.00

Hospital Charge Code	270692537
Hospital Revenue Code	272
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$206.25
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

DRILL BIT 1.5 MM

Facility

$366.00

Hospital Charge Code	270686488
Hospital Revenue Code	272
Min. Negotiated Rate	$54.90
Max. Negotiated Rate	$54.90
Rate for Payer: Qualcare PPO/HMO/WC	$54.90

DRILL BIT 1.5 MM

Facility

$366.00

Hospital Charge Code	270686488
Hospital Revenue Code	272
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$183.00
Rate for Payer: Aetna Commercial	$139.08
Rate for Payer: Aetna Medicare Advantage	$109.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$93.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$93.33
Rate for Payer: Cigna Commercial	$183.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$109.80
Rate for Payer: Oxford Commercial	$73.20
Rate for Payer: Qualcare PPO/HMO/WC	$54.90
Rate for Payer: UnitedHealthcare Commercial	$73.20
Rate for Payer: UnitedHealthcare Community & State	$8.82
Rate for Payer: Wellpoint Medicaid Managed Care	$9.70

DRILL BIT 1.5MM/MINI QC/28MM

Facility

$350.00

Hospital Charge Code	270674779
Hospital Revenue Code	272
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Qualcare PPO/HMO/WC	$52.50

DRILL BIT 1.5MM/MINI QC/28MM

Facility

$350.00

Hospital Charge Code	270674779
Hospital Revenue Code	272
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$133.00
Rate for Payer: Aetna Medicare Advantage	$105.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.25
Rate for Payer: Cigna Commercial	$175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.00
Rate for Payer: Oxford Commercial	$70.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.50
Rate for Payer: UnitedHealthcare Commercial	$70.00
Rate for Payer: UnitedHealthcare Community & State	$8.44
Rate for Payer: Wellpoint Medicaid Managed Care	$9.28

Know your out-of-pocket cost for care.

All Charges