Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRILL BIT 3 FLUTED 2.7x125mm

Facility

$719.30

Hospital Charge Code	270681007
Hospital Revenue Code	272
Min. Negotiated Rate	$107.89
Max. Negotiated Rate	$107.89
Rate for Payer: Qualcare PPO/HMO/WC	$107.89

DRILL BIT 3-FLUTED 2.7x125MM

Facility

$1,253.95

Hospital Charge Code	270681008
Hospital Revenue Code	272
Min. Negotiated Rate	$188.09
Max. Negotiated Rate	$188.09
Rate for Payer: Qualcare PPO/HMO/WC	$188.09

DRILL BIT 3-FLUTED 2.7x125MM

Facility

$1,253.95

Hospital Charge Code	270681008
Hospital Revenue Code	272
Min. Negotiated Rate	$30.22
Max. Negotiated Rate	$626.98
Rate for Payer: Aetna Commercial	$476.50
Rate for Payer: Aetna Medicare Advantage	$376.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$319.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$319.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$319.76
Rate for Payer: Cigna Commercial	$626.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$376.19
Rate for Payer: Oxford Commercial	$250.79
Rate for Payer: Qualcare PPO/HMO/WC	$188.09
Rate for Payer: UnitedHealthcare Commercial	$250.79
Rate for Payer: UnitedHealthcare Community & State	$30.22
Rate for Payer: Wellpoint Medicaid Managed Care	$33.23

DRILL BIT 3-FLUTED 2.7x125MM

Facility

$506.05

Hospital Charge Code	270603600
Hospital Revenue Code	272
Min. Negotiated Rate	$12.20
Max. Negotiated Rate	$253.03
Rate for Payer: Aetna Commercial	$192.30
Rate for Payer: Aetna Medicare Advantage	$151.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$129.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$129.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$129.04
Rate for Payer: Cigna Commercial	$253.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.81
Rate for Payer: Oxford Commercial	$101.21
Rate for Payer: Qualcare PPO/HMO/WC	$75.91
Rate for Payer: UnitedHealthcare Commercial	$101.21
Rate for Payer: UnitedHealthcare Community & State	$12.20
Rate for Payer: Wellpoint Medicaid Managed Care	$13.41

DRILL BIT 3-FLUTED 2.7x125MM

Facility

$506.05

Hospital Charge Code	270603600
Hospital Revenue Code	272
Min. Negotiated Rate	$75.91
Max. Negotiated Rate	$75.91
Rate for Payer: Qualcare PPO/HMO/WC	$75.91

DRILL BIT 3-FLUTED 4.2x145mm

Facility

$719.95

Hospital Charge Code	270645688
Hospital Revenue Code	272
Min. Negotiated Rate	$107.99
Max. Negotiated Rate	$107.99
Rate for Payer: Qualcare PPO/HMO/WC	$107.99

DRILL BIT 3-FLUTED 4.2x145mm

Facility

$719.95

Hospital Charge Code	270645688
Hospital Revenue Code	272
Min. Negotiated Rate	$17.35
Max. Negotiated Rate	$359.98
Rate for Payer: Aetna Commercial	$273.58
Rate for Payer: Aetna Medicare Advantage	$215.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$183.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$183.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$183.59
Rate for Payer: Cigna Commercial	$359.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.99
Rate for Payer: Oxford Commercial	$143.99
Rate for Payer: Qualcare PPO/HMO/WC	$107.99
Rate for Payer: UnitedHealthcare Commercial	$143.99
Rate for Payer: UnitedHealthcare Community & State	$17.35
Rate for Payer: Wellpoint Medicaid Managed Care	$19.08

DRILL BIT 3-FLUTED 4.2x330MM

Facility

$1,253.95

Hospital Charge Code	270675116
Hospital Revenue Code	272
Min. Negotiated Rate	$30.22
Max. Negotiated Rate	$626.98
Rate for Payer: Aetna Commercial	$476.50
Rate for Payer: Aetna Medicare Advantage	$376.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$319.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$319.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$319.76
Rate for Payer: Cigna Commercial	$626.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$376.19
Rate for Payer: Oxford Commercial	$250.79
Rate for Payer: Qualcare PPO/HMO/WC	$188.09
Rate for Payer: UnitedHealthcare Commercial	$250.79
Rate for Payer: UnitedHealthcare Community & State	$30.22
Rate for Payer: Wellpoint Medicaid Managed Care	$33.23

DRILL BIT 3-FLUTED 4.2x330MM

Facility

$1,253.95

Hospital Charge Code	270675116
Hospital Revenue Code	272
Min. Negotiated Rate	$188.09
Max. Negotiated Rate	$188.09
Rate for Payer: Qualcare PPO/HMO/WC	$188.09

DRILL BIT 3MM CANN. PROXIMA

Facility

$750.00

Hospital Charge Code	270666769
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

DRILL BIT 3MM CANN. PROXIMA

Facility

$750.00

Hospital Charge Code	270666769
Hospital Revenue Code	272
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

DRILL BIT 3X220MM

Facility

$1,075.00

Hospital Charge Code	270669432
Hospital Revenue Code	272
Min. Negotiated Rate	$25.91
Max. Negotiated Rate	$537.50
Rate for Payer: Aetna Commercial	$408.50
Rate for Payer: Aetna Medicare Advantage	$322.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$274.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$274.12
Rate for Payer: Cigna Commercial	$537.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$322.50
Rate for Payer: Oxford Commercial	$215.00
Rate for Payer: Qualcare PPO/HMO/WC	$161.25
Rate for Payer: UnitedHealthcare Commercial	$215.00
Rate for Payer: UnitedHealthcare Community & State	$25.91
Rate for Payer: Wellpoint Medicaid Managed Care	$28.49

DRILL BIT 3X220MM

Facility

$1,075.00

Hospital Charge Code	270669432
Hospital Revenue Code	272
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$161.25
Rate for Payer: Qualcare PPO/HMO/WC	$161.25

DRILL BIT 4.0

Facility

$625.00

Hospital Charge Code	270676696
Hospital Revenue Code	272
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

DRILL BIT 4.0

Facility

$1,100.00

Hospital Charge Code	270660404
Hospital Revenue Code	270
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

DRILL BIT 4.0

Facility

$1,100.00

Hospital Charge Code	270660404
Hospital Revenue Code	270
Min. Negotiated Rate	$26.51
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$418.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$330.00
Rate for Payer: Oxford Commercial	$220.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Commercial	$220.00
Rate for Payer: UnitedHealthcare Community & State	$26.51
Rate for Payer: Wellpoint Medicaid Managed Care	$29.15

DRILL BIT 4.0

Facility

$625.00

Hospital Charge Code	270676696
Hospital Revenue Code	272
Min. Negotiated Rate	$15.06
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$187.50
Rate for Payer: Oxford Commercial	$125.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Commercial	$125.00
Rate for Payer: UnitedHealthcare Community & State	$15.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.56

DRILL BIT 4.0MM 3 FLUTE 315.40

Facility

$419.25

Hospital Charge Code	270627568
Hospital Revenue Code	272
Min. Negotiated Rate	$10.10
Max. Negotiated Rate	$209.62
Rate for Payer: Aetna Commercial	$159.31
Rate for Payer: Aetna Medicare Advantage	$125.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.91
Rate for Payer: Cigna Commercial	$209.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.78
Rate for Payer: Oxford Commercial	$83.85
Rate for Payer: Qualcare PPO/HMO/WC	$62.89
Rate for Payer: UnitedHealthcare Commercial	$83.85
Rate for Payer: UnitedHealthcare Community & State	$10.10
Rate for Payer: Wellpoint Medicaid Managed Care	$11.11

DRILL BIT 4.0MM 3 FLUTE 315.40

Facility

$419.25

Hospital Charge Code	270627568
Hospital Revenue Code	272
Min. Negotiated Rate	$62.89
Max. Negotiated Rate	$62.89
Rate for Payer: Qualcare PPO/HMO/WC	$62.89

DRILL BIT 4.0MM 466121

Facility

$480.00

Hospital Charge Code	270640896
Hospital Revenue Code	272
Min. Negotiated Rate	$11.57
Max. Negotiated Rate	$240.00
Rate for Payer: Aetna Commercial	$182.40
Rate for Payer: Aetna Medicare Advantage	$144.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.40
Rate for Payer: Cigna Commercial	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.00
Rate for Payer: Oxford Commercial	$96.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.00
Rate for Payer: UnitedHealthcare Commercial	$96.00
Rate for Payer: UnitedHealthcare Community & State	$11.57
Rate for Payer: Wellpoint Medicaid Managed Care	$12.72

DRILL BIT 4.0MM 466121

Facility

$480.00

Hospital Charge Code	270640896
Hospital Revenue Code	272
Min. Negotiated Rate	$72.00
Max. Negotiated Rate	$72.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.00

DRILL BIT 4.0MM CANN

Facility

$875.00

Hospital Charge Code	270688367
Hospital Revenue Code	272
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Qualcare PPO/HMO/WC	$131.25

DRILL BIT 4.0MM CANN

Facility

$875.00

Hospital Charge Code	270688367
Hospital Revenue Code	272
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$437.50
Rate for Payer: Aetna Commercial	$332.50
Rate for Payer: Aetna Medicare Advantage	$262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.12
Rate for Payer: Cigna Commercial	$437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.50
Rate for Payer: Oxford Commercial	$175.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.25
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$23.19

DRILL BIT 4.2. THREE FLT DRL B

Facility

$1,066.90

Hospital Charge Code	270688102
Hospital Revenue Code	272
Min. Negotiated Rate	$25.71
Max. Negotiated Rate	$533.45
Rate for Payer: Aetna Commercial	$405.42
Rate for Payer: Aetna Medicare Advantage	$320.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$272.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$272.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$272.06
Rate for Payer: Cigna Commercial	$533.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$320.07
Rate for Payer: Oxford Commercial	$213.38
Rate for Payer: Qualcare PPO/HMO/WC	$160.03
Rate for Payer: UnitedHealthcare Commercial	$213.38
Rate for Payer: UnitedHealthcare Community & State	$25.71
Rate for Payer: Wellpoint Medicaid Managed Care	$28.27

DRILL BIT 4.2. THREE FLT DRL B

Facility

$1,066.90

Hospital Charge Code	270688102
Hospital Revenue Code	272
Min. Negotiated Rate	$160.03
Max. Negotiated Rate	$160.03
Rate for Payer: Qualcare PPO/HMO/WC	$160.03

Know your out-of-pocket cost for care.

All Charges