Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRILL BIT QC 2.4X100MM

Facility

$1,245.00

Service Code	HCPCS A4649
Hospital Charge Code	270660914
Hospital Revenue Code	272
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$622.50
Rate for Payer: Aetna Commercial	$473.10
Rate for Payer: Aetna Medicare Advantage	$373.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.48
Rate for Payer: Cigna Commercial	$622.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.50
Rate for Payer: Oxford Commercial	$249.00
Rate for Payer: Qualcare PPO/HMO/WC	$186.75
Rate for Payer: UnitedHealthcare Commercial	$249.00
Rate for Payer: UnitedHealthcare Community & State	$30.00
Rate for Payer: Wellpoint Medicaid Managed Care	$32.99

DRILL BIT QC 2.4X100MM

Facility

$1,245.00

Service Code	HCPCS A4649
Hospital Charge Code	270660914
Hospital Revenue Code	272
Min. Negotiated Rate	$186.75
Max. Negotiated Rate	$186.75
Rate for Payer: Qualcare PPO/HMO/WC	$186.75

DRILL BIT Q-C 2.5mm 480611025

Facility

$261.80

Hospital Charge Code	270632093
Hospital Revenue Code	272
Min. Negotiated Rate	$6.31
Max. Negotiated Rate	$130.90
Rate for Payer: Aetna Commercial	$99.48
Rate for Payer: Aetna Medicare Advantage	$78.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.76
Rate for Payer: Cigna Commercial	$130.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.54
Rate for Payer: Oxford Commercial	$52.36
Rate for Payer: Qualcare PPO/HMO/WC	$39.27
Rate for Payer: UnitedHealthcare Commercial	$52.36
Rate for Payer: UnitedHealthcare Community & State	$6.31
Rate for Payer: Wellpoint Medicaid Managed Care	$6.94

DRILL BIT Q-C 2.5mm 480611025

Facility

$261.80

Hospital Charge Code	270632093
Hospital Revenue Code	272
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$39.27
Rate for Payer: Qualcare PPO/HMO/WC	$39.27

DRILL BIT Q-C 2.5MM DIA 110

Facility

$378.33

Hospital Charge Code	270661151
Hospital Revenue Code	272
Min. Negotiated Rate	$9.12
Max. Negotiated Rate	$189.16
Rate for Payer: Aetna Commercial	$143.77
Rate for Payer: Aetna Medicare Advantage	$113.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.47
Rate for Payer: Cigna Commercial	$189.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.50
Rate for Payer: Oxford Commercial	$75.67
Rate for Payer: Qualcare PPO/HMO/WC	$56.75
Rate for Payer: UnitedHealthcare Commercial	$75.67
Rate for Payer: UnitedHealthcare Community & State	$9.12
Rate for Payer: Wellpoint Medicaid Managed Care	$10.03

DRILL BIT Q-C 2.5MM DIA 110

Facility

$378.33

Hospital Charge Code	270661151
Hospital Revenue Code	272
Min. Negotiated Rate	$56.75
Max. Negotiated Rate	$56.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.75

DRILL BIT Q-C 2.7MMX100MM

Facility

$455.00

Hospital Charge Code	270697189
Hospital Revenue Code	272
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$68.25
Rate for Payer: Qualcare PPO/HMO/WC	$68.25

DRILL BIT Q-C 2.7MMX100MM

Facility

$455.00

Hospital Charge Code	270697189
Hospital Revenue Code	272
Min. Negotiated Rate	$10.97
Max. Negotiated Rate	$227.50
Rate for Payer: Aetna Commercial	$172.90
Rate for Payer: Aetna Medicare Advantage	$136.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$116.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$116.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$116.03
Rate for Payer: Cigna Commercial	$227.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$136.50
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$68.25
Rate for Payer: UnitedHealthcare Commercial	$91.00
Rate for Payer: UnitedHealthcare Community & State	$10.97
Rate for Payer: Wellpoint Medicaid Managed Care	$12.06

DRILL BIT QC 2.7x100MM

Facility

$316.65

Hospital Charge Code	270604122
Hospital Revenue Code	272
Min. Negotiated Rate	$47.50
Max. Negotiated Rate	$47.50
Rate for Payer: Qualcare PPO/HMO/WC	$47.50

DRILL BIT QC 2.7x100MM

Facility

$316.65

Hospital Charge Code	270604122
Hospital Revenue Code	272
Min. Negotiated Rate	$7.63
Max. Negotiated Rate	$158.32
Rate for Payer: Aetna Commercial	$120.33
Rate for Payer: Aetna Medicare Advantage	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.75
Rate for Payer: Cigna Commercial	$158.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.00
Rate for Payer: Oxford Commercial	$63.33
Rate for Payer: Qualcare PPO/HMO/WC	$47.50
Rate for Payer: UnitedHealthcare Commercial	$63.33
Rate for Payer: UnitedHealthcare Community & State	$7.63
Rate for Payer: Wellpoint Medicaid Managed Care	$8.39

DRILL BIT QC 2.7x125MM

Facility

$346.10

Hospital Charge Code	270604123
Hospital Revenue Code	272
Min. Negotiated Rate	$8.34
Max. Negotiated Rate	$173.05
Rate for Payer: Aetna Commercial	$131.52
Rate for Payer: Aetna Medicare Advantage	$103.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.26
Rate for Payer: Cigna Commercial	$173.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$103.83
Rate for Payer: Oxford Commercial	$69.22
Rate for Payer: Qualcare PPO/HMO/WC	$51.91
Rate for Payer: UnitedHealthcare Commercial	$69.22
Rate for Payer: UnitedHealthcare Community & State	$8.34
Rate for Payer: Wellpoint Medicaid Managed Care	$9.17

DRILL BIT QC 2.7x125MM

Facility

$346.10

Hospital Charge Code	270604123
Hospital Revenue Code	272
Min. Negotiated Rate	$51.91
Max. Negotiated Rate	$51.91
Rate for Payer: Qualcare PPO/HMO/WC	$51.91

DRILL BIT QC 2.8x165MM

Facility

$394.65

Hospital Charge Code	270660400
Hospital Revenue Code	272
Min. Negotiated Rate	$59.20
Max. Negotiated Rate	$59.20
Rate for Payer: Qualcare PPO/HMO/WC	$59.20

DRILL BIT QC 2.8x165MM

Facility

$394.65

Hospital Charge Code	270633523
Hospital Revenue Code	272
Min. Negotiated Rate	$9.51
Max. Negotiated Rate	$197.32
Rate for Payer: Aetna Commercial	$149.97
Rate for Payer: Aetna Medicare Advantage	$118.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.64
Rate for Payer: Cigna Commercial	$197.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.39
Rate for Payer: Oxford Commercial	$78.93
Rate for Payer: Qualcare PPO/HMO/WC	$59.20
Rate for Payer: UnitedHealthcare Commercial	$78.93
Rate for Payer: UnitedHealthcare Community & State	$9.51
Rate for Payer: Wellpoint Medicaid Managed Care	$10.46

DRILL BIT QC 2.8x165MM

Facility

$394.65

Hospital Charge Code	270660400
Hospital Revenue Code	272
Min. Negotiated Rate	$9.51
Max. Negotiated Rate	$197.32
Rate for Payer: Aetna Commercial	$149.97
Rate for Payer: Aetna Medicare Advantage	$118.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.64
Rate for Payer: Cigna Commercial	$197.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.39
Rate for Payer: Oxford Commercial	$78.93
Rate for Payer: Qualcare PPO/HMO/WC	$59.20
Rate for Payer: UnitedHealthcare Commercial	$78.93
Rate for Payer: UnitedHealthcare Community & State	$9.51
Rate for Payer: Wellpoint Medicaid Managed Care	$10.46

DRILL BIT QC 2.8x165MM

Facility

$394.65

Hospital Charge Code	270633523
Hospital Revenue Code	272
Min. Negotiated Rate	$59.20
Max. Negotiated Rate	$59.20
Rate for Payer: Qualcare PPO/HMO/WC	$59.20

DRILL BIT QC 2.9x150MM

Facility

$372.00

Hospital Charge Code	270675549
Hospital Revenue Code	278
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$90.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$81.84
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

DRILL BIT QC 2.9x150MM

Facility

$372.00

Hospital Charge Code	270675549
Hospital Revenue Code	278
Min. Negotiated Rate	$8.97
Max. Negotiated Rate	$186.00
Rate for Payer: Aetna Commercial	$141.36
Rate for Payer: Aetna Medicare Advantage	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$74.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.86
Rate for Payer: Cigna Commercial	$186.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$81.84
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Community & State	$8.97
Rate for Payer: Wellpoint Medicaid Managed Care	$9.86

DRILL BIT QC 3.2x145MM

Facility

$311.90

Hospital Charge Code	270606029
Hospital Revenue Code	272
Min. Negotiated Rate	$46.78
Max. Negotiated Rate	$46.78
Rate for Payer: Qualcare PPO/HMO/WC	$46.78

DRILL BIT QC 3.2x145MM

Facility

$311.90

Hospital Charge Code	270606029
Hospital Revenue Code	272
Min. Negotiated Rate	$7.52
Max. Negotiated Rate	$155.95
Rate for Payer: Aetna Commercial	$118.52
Rate for Payer: Aetna Medicare Advantage	$93.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.53
Rate for Payer: Cigna Commercial	$155.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$93.57
Rate for Payer: Oxford Commercial	$62.38
Rate for Payer: Qualcare PPO/HMO/WC	$46.78
Rate for Payer: UnitedHealthcare Commercial	$62.38
Rate for Payer: UnitedHealthcare Community & State	$7.52
Rate for Payer: Wellpoint Medicaid Managed Care	$8.27

DRILL BIT QC 3.2x145MM STER

Facility

$525.15

Hospital Charge Code	270681479
Hospital Revenue Code	272
Min. Negotiated Rate	$78.77
Max. Negotiated Rate	$78.77
Rate for Payer: Qualcare PPO/HMO/WC	$78.77

DRILL BIT QC 3.2x145MM STER

Facility

$525.15

Hospital Charge Code	270681479
Hospital Revenue Code	272
Min. Negotiated Rate	$12.66
Max. Negotiated Rate	$262.57
Rate for Payer: Aetna Commercial	$199.56
Rate for Payer: Aetna Medicare Advantage	$157.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$133.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$133.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$133.91
Rate for Payer: Cigna Commercial	$262.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.54
Rate for Payer: Oxford Commercial	$105.03
Rate for Payer: Qualcare PPO/HMO/WC	$78.77
Rate for Payer: UnitedHealthcare Commercial	$105.03
Rate for Payer: UnitedHealthcare Community & State	$12.66
Rate for Payer: Wellpoint Medicaid Managed Care	$13.92

DRILL BIT Q-C 3.5M DIA 110M

Facility

$378.33

Hospital Charge Code	270661148
Hospital Revenue Code	272
Min. Negotiated Rate	$9.12
Max. Negotiated Rate	$189.16
Rate for Payer: Aetna Commercial	$143.77
Rate for Payer: Aetna Medicare Advantage	$113.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.47
Rate for Payer: Cigna Commercial	$189.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.50
Rate for Payer: Oxford Commercial	$75.67
Rate for Payer: Qualcare PPO/HMO/WC	$56.75
Rate for Payer: UnitedHealthcare Commercial	$75.67
Rate for Payer: UnitedHealthcare Community & State	$9.12
Rate for Payer: Wellpoint Medicaid Managed Care	$10.03

DRILL BIT Q-C 3.5M DIA 110M

Facility

$378.33

Hospital Charge Code	270661148
Hospital Revenue Code	272
Min. Negotiated Rate	$56.75
Max. Negotiated Rate	$56.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.75

DRILL BIT QC 3.5x110 480611035

Facility

$249.75

Hospital Charge Code	270632094
Hospital Revenue Code	272
Min. Negotiated Rate	$6.02
Max. Negotiated Rate	$124.88
Rate for Payer: Aetna Commercial	$94.91
Rate for Payer: Aetna Medicare Advantage	$74.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.69
Rate for Payer: Cigna Commercial	$124.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.92
Rate for Payer: Oxford Commercial	$49.95
Rate for Payer: Qualcare PPO/HMO/WC	$37.46
Rate for Payer: UnitedHealthcare Commercial	$49.95
Rate for Payer: UnitedHealthcare Community & State	$6.02
Rate for Payer: Wellpoint Medicaid Managed Care	$6.62

Know your out-of-pocket cost for care.

All Charges