Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRILL BIT AEQUALIS REV 3X220MM

Facility

$717.50

Service Code	HCPCS A4649
Hospital Charge Code	270657901
Hospital Revenue Code	272
Min. Negotiated Rate	$17.29
Max. Negotiated Rate	$358.75
Rate for Payer: Aetna Commercial	$272.65
Rate for Payer: Aetna Medicare Advantage	$215.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.96
Rate for Payer: Cigna Commercial	$358.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$215.25
Rate for Payer: Oxford Commercial	$143.50
Rate for Payer: Qualcare PPO/HMO/WC	$107.62
Rate for Payer: UnitedHealthcare Commercial	$143.50
Rate for Payer: UnitedHealthcare Community & State	$17.29
Rate for Payer: Wellpoint Medicaid Managed Care	$19.01

DRILL BIT AEQUALIS REV 3X220MM

Facility

$717.50

Service Code	HCPCS A4649
Hospital Charge Code	270657901
Hospital Revenue Code	272
Min. Negotiated Rate	$107.62
Max. Negotiated Rate	$107.62
Rate for Payer: Qualcare PPO/HMO/WC	$107.62

DRILL BIT AMBASSADOR 24X10MM

Facility

$375.00

Hospital Charge Code	270705838
Hospital Revenue Code	279
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

DRILL BIT AMBASSADOR 24X10MM

Facility

$375.00

Hospital Charge Code	270705838
Hospital Revenue Code	279
Min. Negotiated Rate	$9.04
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$112.50
Rate for Payer: Oxford Commercial	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Commercial	$75.00
Rate for Payer: UnitedHealthcare Community & State	$9.04
Rate for Payer: Wellpoint Medicaid Managed Care	$9.94

DRILL BIT AO 1.7MM

Facility

$800.00

Hospital Charge Code	270693606
Hospital Revenue Code	272
Min. Negotiated Rate	$19.28
Max. Negotiated Rate	$400.00
Rate for Payer: Aetna Commercial	$304.00
Rate for Payer: Aetna Medicare Advantage	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$204.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$204.00
Rate for Payer: Cigna Commercial	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.00
Rate for Payer: Oxford Commercial	$160.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00
Rate for Payer: UnitedHealthcare Commercial	$160.00
Rate for Payer: UnitedHealthcare Community & State	$19.28
Rate for Payer: Wellpoint Medicaid Managed Care	$21.20

DRILL BIT AO 1.7MM

Facility

$800.00

Hospital Charge Code	270693606
Hospital Revenue Code	272
Min. Negotiated Rate	$120.00
Max. Negotiated Rate	$120.00
Rate for Payer: Qualcare PPO/HMO/WC	$120.00

DRILL BIT AO 2.0X110MM

Facility

$852.50

Hospital Charge Code	270700280
Hospital Revenue Code	272
Min. Negotiated Rate	$20.55
Max. Negotiated Rate	$426.25
Rate for Payer: Aetna Commercial	$323.95
Rate for Payer: Aetna Medicare Advantage	$255.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.39
Rate for Payer: Cigna Commercial	$426.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.75
Rate for Payer: Oxford Commercial	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.88
Rate for Payer: UnitedHealthcare Commercial	$170.50
Rate for Payer: UnitedHealthcare Community & State	$20.55
Rate for Payer: Wellpoint Medicaid Managed Care	$22.59

DRILL BIT AO 2.0X110MM

Facility

$852.50

Hospital Charge Code	270700280
Hospital Revenue Code	272
Min. Negotiated Rate	$127.88
Max. Negotiated Rate	$127.88
Rate for Payer: Qualcare PPO/HMO/WC	$127.88

DRILL BIT AO 2.1X120MM

Facility

$852.50

Hospital Charge Code	270700591
Hospital Revenue Code	272
Min. Negotiated Rate	$127.88
Max. Negotiated Rate	$127.88
Rate for Payer: Qualcare PPO/HMO/WC	$127.88

DRILL BIT AO 2.1X120MM

Facility

$852.50

Hospital Charge Code	270700591
Hospital Revenue Code	272
Min. Negotiated Rate	$20.55
Max. Negotiated Rate	$426.25
Rate for Payer: Aetna Commercial	$323.95
Rate for Payer: Aetna Medicare Advantage	$255.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$217.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$217.39
Rate for Payer: Cigna Commercial	$426.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$255.75
Rate for Payer: Oxford Commercial	$170.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.88
Rate for Payer: UnitedHealthcare Commercial	$170.50
Rate for Payer: UnitedHealthcare Community & State	$20.55
Rate for Payer: Wellpoint Medicaid Managed Care	$22.59

DRILL BIT AO 4 2x130 18064280S

Facility

$935.00

Hospital Charge Code	270638649
Hospital Revenue Code	272
Min. Negotiated Rate	$22.53
Max. Negotiated Rate	$467.50
Rate for Payer: Aetna Commercial	$355.30
Rate for Payer: Aetna Medicare Advantage	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$238.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$238.43
Rate for Payer: Cigna Commercial	$467.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$280.50
Rate for Payer: Oxford Commercial	$187.00
Rate for Payer: Qualcare PPO/HMO/WC	$140.25
Rate for Payer: UnitedHealthcare Commercial	$187.00
Rate for Payer: UnitedHealthcare Community & State	$22.53
Rate for Payer: Wellpoint Medicaid Managed Care	$24.78

DRILL BIT AO 4 2x130 18064280S

Facility

$935.00

Hospital Charge Code	270638649
Hospital Revenue Code	272
Min. Negotiated Rate	$140.25
Max. Negotiated Rate	$140.25
Rate for Payer: Qualcare PPO/HMO/WC	$140.25

DRILL BIT AO CANN 1.7X32MM

Facility

$1,550.35

Service Code	HCPCS A4649
Hospital Charge Code	270699830
Hospital Revenue Code	272
Min. Negotiated Rate	$232.55
Max. Negotiated Rate	$232.55
Rate for Payer: Qualcare PPO/HMO/WC	$232.55

DRILL BIT AO CANN 1.7X32MM

Facility

$1,550.35

Service Code	HCPCS A4649
Hospital Charge Code	270699830
Hospital Revenue Code	272
Min. Negotiated Rate	$37.36
Max. Negotiated Rate	$775.17
Rate for Payer: Aetna Commercial	$589.13
Rate for Payer: Aetna Medicare Advantage	$465.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$395.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$395.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$395.34
Rate for Payer: Cigna Commercial	$775.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$465.11
Rate for Payer: Oxford Commercial	$310.07
Rate for Payer: Qualcare PPO/HMO/WC	$232.55
Rate for Payer: UnitedHealthcare Commercial	$310.07
Rate for Payer: UnitedHealthcare Community & State	$37.36
Rate for Payer: Wellpoint Medicaid Managed Care	$41.08

DRILL BIT AO DIA 2.6X135MM

Facility

$1,160.70

Hospital Charge Code	270692183
Hospital Revenue Code	272
Min. Negotiated Rate	$174.10
Max. Negotiated Rate	$174.10
Rate for Payer: Qualcare PPO/HMO/WC	$174.10

DRILL BIT AO DIA 2.6X135MM

Facility

$1,160.70

Hospital Charge Code	270692183
Hospital Revenue Code	272
Min. Negotiated Rate	$27.97
Max. Negotiated Rate	$580.35
Rate for Payer: Aetna Commercial	$441.07
Rate for Payer: Aetna Medicare Advantage	$348.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$295.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$295.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$295.98
Rate for Payer: Cigna Commercial	$580.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$348.21
Rate for Payer: Oxford Commercial	$232.14
Rate for Payer: Qualcare PPO/HMO/WC	$174.10
Rate for Payer: UnitedHealthcare Commercial	$232.14
Rate for Payer: UnitedHealthcare Community & State	$27.97
Rate for Payer: Wellpoint Medicaid Managed Care	$30.76

DRILL BIT AO SCALED 2.0X105MM

Facility

$1,232.20

Service Code	HCPCS A4649
Hospital Charge Code	270699831
Hospital Revenue Code	272
Min. Negotiated Rate	$184.83
Max. Negotiated Rate	$184.83
Rate for Payer: Qualcare PPO/HMO/WC	$184.83

DRILL BIT AO SCALED 2.0X105MM

Facility

$1,232.20

Service Code	HCPCS A4649
Hospital Charge Code	270699831
Hospital Revenue Code	272
Min. Negotiated Rate	$29.70
Max. Negotiated Rate	$616.10
Rate for Payer: Aetna Commercial	$468.24
Rate for Payer: Aetna Medicare Advantage	$369.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$314.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$314.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$314.21
Rate for Payer: Cigna Commercial	$616.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.66
Rate for Payer: Oxford Commercial	$246.44
Rate for Payer: Qualcare PPO/HMO/WC	$184.83
Rate for Payer: UnitedHealthcare Commercial	$246.44
Rate for Payer: UnitedHealthcare Community & State	$29.70
Rate for Payer: Wellpoint Medicaid Managed Care	$32.65

DRILL BIT AO SCALED 2.0X135MM

Facility

$1,232.20

Hospital Charge Code	270703690
Hospital Revenue Code	272
Min. Negotiated Rate	$184.83
Max. Negotiated Rate	$184.83
Rate for Payer: Qualcare PPO/HMO/WC	$184.83

DRILL BIT AO SCALED 2.0X135MM

Facility

$1,232.20

Hospital Charge Code	270703690
Hospital Revenue Code	272
Min. Negotiated Rate	$29.70
Max. Negotiated Rate	$616.10
Rate for Payer: Aetna Commercial	$468.24
Rate for Payer: Aetna Medicare Advantage	$369.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$314.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$314.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$314.21
Rate for Payer: Cigna Commercial	$616.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$369.66
Rate for Payer: Oxford Commercial	$246.44
Rate for Payer: Qualcare PPO/HMO/WC	$184.83
Rate for Payer: UnitedHealthcare Commercial	$246.44
Rate for Payer: UnitedHealthcare Community & State	$29.70
Rate for Payer: Wellpoint Medicaid Managed Care	$32.65

DRILL BIT AO SCALED 2X135MM

Facility

$1,795.00

Hospital Charge Code	270699702
Hospital Revenue Code	272
Min. Negotiated Rate	$43.26
Max. Negotiated Rate	$897.50
Rate for Payer: Aetna Commercial	$682.10
Rate for Payer: Aetna Medicare Advantage	$538.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$457.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$457.73
Rate for Payer: Cigna Commercial	$897.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.50
Rate for Payer: Oxford Commercial	$359.00
Rate for Payer: Qualcare PPO/HMO/WC	$269.25
Rate for Payer: UnitedHealthcare Commercial	$359.00
Rate for Payer: UnitedHealthcare Community & State	$43.26
Rate for Payer: Wellpoint Medicaid Managed Care	$47.57

DRILL BIT AO SCALED 2X135MM

Facility

$1,795.00

Hospital Charge Code	270699702
Hospital Revenue Code	272
Min. Negotiated Rate	$269.25
Max. Negotiated Rate	$269.25
Rate for Payer: Qualcare PPO/HMO/WC	$269.25

DRILL BIT AO STERILE 4.2x340m

Facility

$985.50

Hospital Charge Code	270645792
Hospital Revenue Code	272
Min. Negotiated Rate	$23.75
Max. Negotiated Rate	$492.75
Rate for Payer: Aetna Commercial	$374.49
Rate for Payer: Aetna Medicare Advantage	$295.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$251.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$251.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$251.30
Rate for Payer: Cigna Commercial	$492.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$295.65
Rate for Payer: Oxford Commercial	$197.10
Rate for Payer: Qualcare PPO/HMO/WC	$147.82
Rate for Payer: UnitedHealthcare Commercial	$197.10
Rate for Payer: UnitedHealthcare Community & State	$23.75
Rate for Payer: Wellpoint Medicaid Managed Care	$26.12

DRILL BIT AO STERILE 4.2x340m

Facility

$985.50

Hospital Charge Code	270645792
Hospital Revenue Code	272
Min. Negotiated Rate	$147.82
Max. Negotiated Rate	$147.82
Rate for Payer: Qualcare PPO/HMO/WC	$147.82

DRILL BIT ASNIS 2.1MM

Facility

$2,135.85

Hospital Charge Code	270704925
Hospital Revenue Code	279
Min. Negotiated Rate	$320.38
Max. Negotiated Rate	$320.38
Rate for Payer: Qualcare PPO/HMO/WC	$320.38

Know your out-of-pocket cost for care.

All Charges