Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRILL BIT 2.0MM/MINI QC/52MM

Facility

$350.00

Hospital Charge Code	270674782
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 2.0MM/MINI QC/52MM

Facility

$350.00

Hospital Charge Code	270674782
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 2.0MM/MINI QC/67MM

Facility

$350.00

Hospital Charge Code	270674783
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 2.0MM/MINI QC/67MM

Facility

$350.00

Hospital Charge Code	270674783
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 2.0mm NCS-DR22

Facility

$425.00

Hospital Charge Code	270645464
Hospital Revenue Code	272
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.50
Rate for Payer: Oxford Commercial	$85.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$85.00
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

DRILL BIT 2.0mm NCS-DR22

Facility

$425.00

Hospital Charge Code	270645464
Hospital Revenue Code	272
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

DRILL BIT 2.0MM QC 140MM

Facility

$789.60

Hospital Charge Code	270691895
Hospital Revenue Code	272
Min. Negotiated Rate	$118.44
Max. Negotiated Rate	$118.44
Rate for Payer: Qualcare PPO/HMO/WC	$118.44

DRILL BIT 2.0MM QC 140MM

Facility

$789.60

Hospital Charge Code	270691895
Hospital Revenue Code	272
Min. Negotiated Rate	$19.03
Max. Negotiated Rate	$394.80
Rate for Payer: Aetna Commercial	$300.05
Rate for Payer: Aetna Medicare Advantage	$236.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.35
Rate for Payer: Cigna Commercial	$394.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.88
Rate for Payer: Oxford Commercial	$157.92
Rate for Payer: Qualcare PPO/HMO/WC	$118.44
Rate for Payer: UnitedHealthcare Commercial	$157.92
Rate for Payer: UnitedHealthcare Community & State	$19.03
Rate for Payer: Wellpoint Medicaid Managed Care	$20.92

DRILL BIT 2.0MM QC 140MM 60MM

Facility

$924.00

Hospital Charge Code	270687282
Hospital Revenue Code	272
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$138.60
Rate for Payer: Qualcare PPO/HMO/WC	$138.60

DRILL BIT 2.0MM QC 140MM 60MM

Facility

$924.00

Hospital Charge Code	270687282
Hospital Revenue Code	272
Min. Negotiated Rate	$22.27
Max. Negotiated Rate	$462.00
Rate for Payer: Aetna Commercial	$351.12
Rate for Payer: Aetna Medicare Advantage	$277.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.62
Rate for Payer: Cigna Commercial	$462.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$277.20
Rate for Payer: Oxford Commercial	$184.80
Rate for Payer: Qualcare PPO/HMO/WC	$138.60
Rate for Payer: UnitedHealthcare Commercial	$184.80
Rate for Payer: UnitedHealthcare Community & State	$22.27
Rate for Payer: Wellpoint Medicaid Managed Care	$24.49

DRILLBIT 2.0 QC CANN 145MM

Facility

$1,817.75

Service Code	HCPCS A4649
Hospital Charge Code	270698219
Hospital Revenue Code	272
Min. Negotiated Rate	$272.66
Max. Negotiated Rate	$272.66
Rate for Payer: Qualcare PPO/HMO/WC	$272.66

DRILLBIT 2.0 QC CANN 145MM

Facility

$1,817.75

Service Code	HCPCS A4649
Hospital Charge Code	270698219
Hospital Revenue Code	272
Min. Negotiated Rate	$43.81
Max. Negotiated Rate	$908.88
Rate for Payer: Aetna Commercial	$690.75
Rate for Payer: Aetna Medicare Advantage	$545.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$463.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$463.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$463.53
Rate for Payer: Cigna Commercial	$908.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$545.33
Rate for Payer: Oxford Commercial	$363.55
Rate for Payer: Qualcare PPO/HMO/WC	$272.66
Rate for Payer: UnitedHealthcare Commercial	$363.55
Rate for Payer: UnitedHealthcare Community & State	$43.81
Rate for Payer: Wellpoint Medicaid Managed Care	$48.17

DRILL BIT 2.1 ASNIC MICRO

Facility

$626.30

Hospital Charge Code	270704926
Hospital Revenue Code	279
Min. Negotiated Rate	$93.94
Max. Negotiated Rate	$93.94
Rate for Payer: Qualcare PPO/HMO/WC	$93.94

DRILL BIT 2.1 ASNIC MICRO

Facility

$626.30

Hospital Charge Code	270704926
Hospital Revenue Code	279
Min. Negotiated Rate	$15.09
Max. Negotiated Rate	$313.15
Rate for Payer: Aetna Commercial	$237.99
Rate for Payer: Aetna Medicare Advantage	$187.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.71
Rate for Payer: Cigna Commercial	$313.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.89
Rate for Payer: Oxford Commercial	$125.26
Rate for Payer: Qualcare PPO/HMO/WC	$93.94
Rate for Payer: UnitedHealthcare Commercial	$125.26
Rate for Payer: UnitedHealthcare Community & State	$15.09
Rate for Payer: Wellpoint Medicaid Managed Care	$16.60

DRILL BIT 2.2MM

Facility

$635.00

Hospital Charge Code	270672338
Hospital Revenue Code	272
Min. Negotiated Rate	$15.30
Max. Negotiated Rate	$317.50
Rate for Payer: Aetna Commercial	$241.30
Rate for Payer: Aetna Medicare Advantage	$190.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$161.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$161.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$161.93
Rate for Payer: Cigna Commercial	$317.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$190.50
Rate for Payer: Oxford Commercial	$127.00
Rate for Payer: Qualcare PPO/HMO/WC	$95.25
Rate for Payer: UnitedHealthcare Commercial	$127.00
Rate for Payer: UnitedHealthcare Community & State	$15.30
Rate for Payer: Wellpoint Medicaid Managed Care	$16.83

DRILL BIT 2.2MM

Facility

$840.00

Hospital Charge Code	270663855
Hospital Revenue Code	270
Min. Negotiated Rate	$20.24
Max. Negotiated Rate	$420.00
Rate for Payer: Aetna Commercial	$319.20
Rate for Payer: Aetna Medicare Advantage	$252.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$214.20
Rate for Payer: Cigna Commercial	$420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.00
Rate for Payer: Oxford Commercial	$168.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.00
Rate for Payer: UnitedHealthcare Commercial	$168.00
Rate for Payer: UnitedHealthcare Community & State	$20.24
Rate for Payer: Wellpoint Medicaid Managed Care	$22.26

DRILL BIT 2.2MM

Facility

$635.00

Hospital Charge Code	270672338
Hospital Revenue Code	272
Min. Negotiated Rate	$95.25
Max. Negotiated Rate	$95.25
Rate for Payer: Qualcare PPO/HMO/WC	$95.25

DRILL BIT 2.2MM

Facility

$840.00

Hospital Charge Code	270663855
Hospital Revenue Code	270
Min. Negotiated Rate	$126.00
Max. Negotiated Rate	$126.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.00

DRILL BIT 2.2MM 8MM STP

Facility

$1,300.00

Hospital Charge Code	270684919
Hospital Revenue Code	272
Min. Negotiated Rate	$31.33
Max. Negotiated Rate	$650.00
Rate for Payer: Aetna Commercial	$494.00
Rate for Payer: Aetna Medicare Advantage	$390.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$331.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$331.50
Rate for Payer: Cigna Commercial	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.00
Rate for Payer: Oxford Commercial	$260.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00
Rate for Payer: UnitedHealthcare Commercial	$260.00
Rate for Payer: UnitedHealthcare Community & State	$31.33
Rate for Payer: Wellpoint Medicaid Managed Care	$34.45

DRILL BIT 2.2MM 8MM STP

Facility

$1,300.00

Hospital Charge Code	270684919
Hospital Revenue Code	272
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$195.00
Rate for Payer: Qualcare PPO/HMO/WC	$195.00

DRILL BIT 2.2MM NS

Facility

$390.00

Hospital Charge Code	270681161
Hospital Revenue Code	272
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$78.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$78.00
Rate for Payer: UnitedHealthcare Community & State	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

DRILL BIT 2.2MM NS

Facility

$390.00

Hospital Charge Code	270681161
Hospital Revenue Code	272
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

DRILL BIT 2.2MMX60MM MICA CANN

Facility

$2,240.50

Hospital Charge Code	270703024
Hospital Revenue Code	272
Min. Negotiated Rate	$336.07
Max. Negotiated Rate	$336.07
Rate for Payer: Qualcare PPO/HMO/WC	$336.07

DRILL BIT 2.2MMX60MM MICA CANN

Facility

$2,240.50

Hospital Charge Code	270703024
Hospital Revenue Code	272
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$1,120.25
Rate for Payer: Aetna Commercial	$851.39
Rate for Payer: Aetna Medicare Advantage	$672.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$571.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$571.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$571.33
Rate for Payer: Cigna Commercial	$1,120.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$672.15
Rate for Payer: Oxford Commercial	$448.10
Rate for Payer: Qualcare PPO/HMO/WC	$336.07
Rate for Payer: UnitedHealthcare Commercial	$448.10
Rate for Payer: UnitedHealthcare Community & State	$54.00
Rate for Payer: Wellpoint Medicaid Managed Care	$59.37

DRILL BIT 2.35X33.5MM

Facility

$1,535.00

Hospital Charge Code	270693164
Hospital Revenue Code	272
Min. Negotiated Rate	$230.25
Max. Negotiated Rate	$230.25
Rate for Payer: Qualcare PPO/HMO/WC	$230.25

Know your out-of-pocket cost for care.

All Charges