Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

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

DRILL BIT BUD 11MM

Facility

$1,650.00

Hospital Charge Code	270671063
Hospital Revenue Code	272
Min. Negotiated Rate	$39.77
Max. Negotiated Rate	$825.00
Rate for Payer: Aetna Commercial	$627.00
Rate for Payer: Aetna Medicare Advantage	$495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$420.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$420.75
Rate for Payer: Cigna Commercial	$825.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$495.00
Rate for Payer: Oxford Commercial	$330.00
Rate for Payer: Qualcare PPO/HMO/WC	$247.50
Rate for Payer: UnitedHealthcare Commercial	$330.00
Rate for Payer: UnitedHealthcare Community & State	$39.77
Rate for Payer: Wellpoint Medicaid Managed Care	$43.73

DRILL BIT BUD 11MM

Facility

$1,650.00

Hospital Charge Code	270671063
Hospital Revenue Code	272
Min. Negotiated Rate	$247.50
Max. Negotiated Rate	$247.50
Rate for Payer: Qualcare PPO/HMO/WC	$247.50

DRILL BIT BUSHING 4.3MM

Facility

$1,675.00

Hospital Charge Code	270700120
Hospital Revenue Code	272
Min. Negotiated Rate	$251.25
Max. Negotiated Rate	$251.25
Rate for Payer: Qualcare PPO/HMO/WC	$251.25

DRILL BIT BUSHING 4.3MM

Facility

$1,675.00

Hospital Charge Code	270700120
Hospital Revenue Code	272
Min. Negotiated Rate	$40.37
Max. Negotiated Rate	$837.50
Rate for Payer: Aetna Commercial	$636.50
Rate for Payer: Aetna Medicare Advantage	$502.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$427.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$427.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$427.12
Rate for Payer: Cigna Commercial	$837.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$502.50
Rate for Payer: Oxford Commercial	$335.00
Rate for Payer: Qualcare PPO/HMO/WC	$251.25
Rate for Payer: UnitedHealthcare Commercial	$335.00
Rate for Payer: UnitedHealthcare Community & State	$40.37
Rate for Payer: Wellpoint Medicaid Managed Care	$44.39

DRILL BIT CALI 4.2 EXTRA LONG

Facility

$1,175.00

Hospital Charge Code	270692384
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 CALI 4.2 EXTRA LONG

Facility

$1,175.00

Hospital Charge Code	270692384
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 CALIB 2.0X110MM

Facility

$646.25

Hospital Charge Code	270691082
Hospital Revenue Code	272
Min. Negotiated Rate	$96.94
Max. Negotiated Rate	$96.94
Rate for Payer: Qualcare PPO/HMO/WC	$96.94

DRILL BIT CALIB 2.0X110MM

Facility

$646.25

Hospital Charge Code	270691082
Hospital Revenue Code	272
Min. Negotiated Rate	$15.57
Max. Negotiated Rate	$323.12
Rate for Payer: Aetna Commercial	$245.57
Rate for Payer: Aetna Medicare Advantage	$193.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$164.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$164.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$164.79
Rate for Payer: Cigna Commercial	$323.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$193.88
Rate for Payer: Oxford Commercial	$129.25
Rate for Payer: Qualcare PPO/HMO/WC	$96.94
Rate for Payer: UnitedHealthcare Commercial	$129.25
Rate for Payer: UnitedHealthcare Community & State	$15.57
Rate for Payer: Wellpoint Medicaid Managed Care	$17.13

DRILL BIT CALIB 4.2MM XL

Facility

$3,625.00

Service Code	HCPCS A4649
Hospital Charge Code	270697681
Hospital Revenue Code	272
Min. Negotiated Rate	$87.36
Max. Negotiated Rate	$1,812.50
Rate for Payer: Aetna Commercial	$1,377.50
Rate for Payer: Aetna Medicare Advantage	$1,087.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$924.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$924.38
Rate for Payer: Cigna Commercial	$1,812.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,087.50
Rate for Payer: Oxford Commercial	$725.00
Rate for Payer: Qualcare PPO/HMO/WC	$543.75
Rate for Payer: UnitedHealthcare Commercial	$725.00
Rate for Payer: UnitedHealthcare Community & State	$87.36
Rate for Payer: Wellpoint Medicaid Managed Care	$96.06

DRILL BIT CALIB 4.2MM XL

Facility

$3,625.00

Service Code	HCPCS A4649
Hospital Charge Code	270697681
Hospital Revenue Code	272
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$543.75
Rate for Payer: Qualcare PPO/HMO/WC	$543.75

DRILL BIT CALIBERAT 3.2m 27565

Facility

$1,040.00

Hospital Charge Code	270640160
Hospital Revenue Code	272
Min. Negotiated Rate	$25.06
Max. Negotiated Rate	$520.00
Rate for Payer: Aetna Commercial	$395.20
Rate for Payer: Aetna Medicare Advantage	$312.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$265.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$265.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$265.20
Rate for Payer: Cigna Commercial	$520.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.00
Rate for Payer: Oxford Commercial	$208.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.00
Rate for Payer: UnitedHealthcare Commercial	$208.00
Rate for Payer: UnitedHealthcare Community & State	$25.06
Rate for Payer: Wellpoint Medicaid Managed Care	$27.56

DRILL BIT CALIBERAT 3.2m 27565

Facility

$1,040.00

Hospital Charge Code	270640160
Hospital Revenue Code	272
Min. Negotiated Rate	$156.00
Max. Negotiated Rate	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.00

DRILL BIT CALIBERAT 4.5m 27555

Facility

$1,040.00

Hospital Charge Code	270640161
Hospital Revenue Code	272
Min. Negotiated Rate	$156.00
Max. Negotiated Rate	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.00

DRILL BIT CALIBERAT 4.5m 27555

Facility

$1,040.00

Hospital Charge Code	270640161
Hospital Revenue Code	272
Min. Negotiated Rate	$25.06
Max. Negotiated Rate	$520.00
Rate for Payer: Aetna Commercial	$395.20
Rate for Payer: Aetna Medicare Advantage	$312.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$265.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$265.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$265.20
Rate for Payer: Cigna Commercial	$520.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$312.00
Rate for Payer: Oxford Commercial	$208.00
Rate for Payer: Qualcare PPO/HMO/WC	$156.00
Rate for Payer: UnitedHealthcare Commercial	$208.00
Rate for Payer: UnitedHealthcare Community & State	$25.06
Rate for Payer: Wellpoint Medicaid Managed Care	$27.56

DRILL BIT CALIBRATED 2.5MM

Facility

$501.00

Hospital Charge Code	270671106
Hospital Revenue Code	272
Min. Negotiated Rate	$75.15
Max. Negotiated Rate	$75.15
Rate for Payer: Qualcare PPO/HMO/WC	$75.15

DRILL BIT CALIBRATED 2.5MM

Facility

$501.00

Hospital Charge Code	270671106
Hospital Revenue Code	272
Min. Negotiated Rate	$12.07
Max. Negotiated Rate	$250.50
Rate for Payer: Aetna Commercial	$190.38
Rate for Payer: Aetna Medicare Advantage	$150.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.75
Rate for Payer: Cigna Commercial	$250.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.30
Rate for Payer: Oxford Commercial	$100.20
Rate for Payer: Qualcare PPO/HMO/WC	$75.15
Rate for Payer: UnitedHealthcare Commercial	$100.20
Rate for Payer: UnitedHealthcare Community & State	$12.07
Rate for Payer: Wellpoint Medicaid Managed Care	$13.28

DRILL BIT CALIBRATED 2.9MM

Facility

$935.00

Hospital Charge Code	270661695
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 CALIBRATED 2.9MM

Facility

$935.00

Hospital Charge Code	270661695
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 CALIBRTD 4.8mm 27550

Facility

$1,380.00

Hospital Charge Code	270648677
Hospital Revenue Code	272
Min. Negotiated Rate	$33.26
Max. Negotiated Rate	$690.00
Rate for Payer: Aetna Commercial	$524.40
Rate for Payer: Aetna Medicare Advantage	$414.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$351.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$351.90
Rate for Payer: Cigna Commercial	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$414.00
Rate for Payer: Oxford Commercial	$276.00
Rate for Payer: Qualcare PPO/HMO/WC	$207.00
Rate for Payer: UnitedHealthcare Commercial	$276.00
Rate for Payer: UnitedHealthcare Community & State	$33.26
Rate for Payer: Wellpoint Medicaid Managed Care	$36.57

DRILL BIT CALIBRTD 4.8mm 27550

Facility

$1,380.00

Hospital Charge Code	270648677
Hospital Revenue Code	272
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$207.00
Rate for Payer: Qualcare PPO/HMO/WC	$207.00

DRILL BIT CAN AO/QC 3.0MM

Facility

$1,125.00

Hospital Charge Code	270697017
Hospital Revenue Code	272
Min. Negotiated Rate	$27.11
Max. Negotiated Rate	$562.50
Rate for Payer: Aetna Commercial	$427.50
Rate for Payer: Aetna Medicare Advantage	$337.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$286.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$286.88
Rate for Payer: Cigna Commercial	$562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$337.50
Rate for Payer: Oxford Commercial	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.75
Rate for Payer: UnitedHealthcare Commercial	$225.00
Rate for Payer: UnitedHealthcare Community & State	$27.11
Rate for Payer: Wellpoint Medicaid Managed Care	$29.81

DRILL BIT CAN AO/QC 3.0MM

Facility

$1,125.00

Hospital Charge Code	270697017
Hospital Revenue Code	272
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Qualcare PPO/HMO/WC	$168.75

DRILL BIT CANN 11.0mm X 280mm

Facility

$2,095.00

Hospital Charge Code	270633852
Hospital Revenue Code	272
Min. Negotiated Rate	$50.49
Max. Negotiated Rate	$1,047.50
Rate for Payer: Aetna Commercial	$796.10
Rate for Payer: Aetna Medicare Advantage	$628.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$534.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$534.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$534.23
Rate for Payer: Cigna Commercial	$1,047.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.50
Rate for Payer: Oxford Commercial	$419.00
Rate for Payer: Qualcare PPO/HMO/WC	$314.25
Rate for Payer: UnitedHealthcare Commercial	$419.00
Rate for Payer: UnitedHealthcare Community & State	$50.49
Rate for Payer: Wellpoint Medicaid Managed Care	$55.52

DRILL BIT CANN 11.0mm X 280mm

Facility

$2,095.00

Hospital Charge Code	270633852
Hospital Revenue Code	272
Min. Negotiated Rate	$314.25
Max. Negotiated Rate	$314.25
Rate for Payer: Qualcare PPO/HMO/WC	$314.25

Know your out-of-pocket cost for care.

All Charges