Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DRILL BIT S 2.0MM

Facility

$381.50

Hospital Charge Code	270674527
Hospital Revenue Code	272
Min. Negotiated Rate	$9.19
Max. Negotiated Rate	$190.75
Rate for Payer: Aetna Commercial	$144.97
Rate for Payer: Aetna Medicare Advantage	$114.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.28
Rate for Payer: Cigna Commercial	$190.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.45
Rate for Payer: Oxford Commercial	$76.30
Rate for Payer: Qualcare PPO/HMO/WC	$57.23
Rate for Payer: UnitedHealthcare Commercial	$76.30
Rate for Payer: UnitedHealthcare Community & State	$9.19
Rate for Payer: Wellpoint Medicaid Managed Care	$10.11

DRILL BIT S 2.5MM

Facility

$381.50

Hospital Charge Code	270674529
Hospital Revenue Code	272
Min. Negotiated Rate	$9.19
Max. Negotiated Rate	$190.75
Rate for Payer: Aetna Commercial	$144.97
Rate for Payer: Aetna Medicare Advantage	$114.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.28
Rate for Payer: Cigna Commercial	$190.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.45
Rate for Payer: Oxford Commercial	$76.30
Rate for Payer: Qualcare PPO/HMO/WC	$57.23
Rate for Payer: UnitedHealthcare Commercial	$76.30
Rate for Payer: UnitedHealthcare Community & State	$9.19
Rate for Payer: Wellpoint Medicaid Managed Care	$10.11

DRILL BIT S 2.5MM

Facility

$381.50

Hospital Charge Code	270674529
Hospital Revenue Code	272
Min. Negotiated Rate	$57.23
Max. Negotiated Rate	$57.23
Rate for Payer: Qualcare PPO/HMO/WC	$57.23

DRILL BIT S9 CARBIDE 6MM

Facility

$1,250.00

Hospital Charge Code	270696262
Hospital Revenue Code	272
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$250.00
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

DRILL BIT S9 CARBIDE 6MM

Facility

$1,250.00

Hospital Charge Code	270696262
Hospital Revenue Code	272
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

DRILL BIT SALVATION 4.5/3.2MM

Facility

$1,720.00

Service Code	HCPCS A4649
Hospital Charge Code	270698684
Hospital Revenue Code	272
Min. Negotiated Rate	$41.45
Max. Negotiated Rate	$860.00
Rate for Payer: Aetna Commercial	$653.60
Rate for Payer: Aetna Medicare Advantage	$516.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$438.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$438.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$438.60
Rate for Payer: Cigna Commercial	$860.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$516.00
Rate for Payer: Oxford Commercial	$344.00
Rate for Payer: Qualcare PPO/HMO/WC	$258.00
Rate for Payer: UnitedHealthcare Commercial	$344.00
Rate for Payer: UnitedHealthcare Community & State	$41.45
Rate for Payer: Wellpoint Medicaid Managed Care	$45.58

DRILL BIT SALVATION 4.5/3.2MM

Facility

$1,720.00

Service Code	HCPCS A4649
Hospital Charge Code	270698684
Hospital Revenue Code	272
Min. Negotiated Rate	$258.00
Max. Negotiated Rate	$258.00
Rate for Payer: Qualcare PPO/HMO/WC	$258.00

DRILL BIT SALVATION 5.0 CANNUL

Facility

$1,370.00

Service Code	HCPCS A4649
Hospital Charge Code	270698685
Hospital Revenue Code	272
Min. Negotiated Rate	$33.02
Max. Negotiated Rate	$685.00
Rate for Payer: Aetna Commercial	$520.60
Rate for Payer: Aetna Medicare Advantage	$411.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.35
Rate for Payer: Cigna Commercial	$685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.00
Rate for Payer: Oxford Commercial	$274.00
Rate for Payer: Qualcare PPO/HMO/WC	$205.50
Rate for Payer: UnitedHealthcare Commercial	$274.00
Rate for Payer: UnitedHealthcare Community & State	$33.02
Rate for Payer: Wellpoint Medicaid Managed Care	$36.30

DRILL BIT SALVATION 5.0 CANNUL

Facility

$1,370.00

Service Code	HCPCS A4649
Hospital Charge Code	270698685
Hospital Revenue Code	272
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$205.50
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

DRILL BIT SHORELINE 14MM

Facility

$625.00

Hospital Charge Code	270694464
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 SHORELINE 14MM

Facility

$625.00

Hospital Charge Code	270694464
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 SHORT

Facility

$725.00

Hospital Charge Code	270672051
Hospital Revenue Code	272
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.50
Rate for Payer: Oxford Commercial	$145.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Commercial	$145.00
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

DRILL BIT SHORT

Facility

$725.00

Hospital Charge Code	270672051
Hospital Revenue Code	272
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$108.75
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

DRILL BIT SHORT 2.8MM

Facility

$415.00

Hospital Charge Code	270668130
Hospital Revenue Code	272
Min. Negotiated Rate	$10.00
Max. Negotiated Rate	$207.50
Rate for Payer: Aetna Commercial	$157.70
Rate for Payer: Aetna Medicare Advantage	$124.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.83
Rate for Payer: Cigna Commercial	$207.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.50
Rate for Payer: Oxford Commercial	$83.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.25
Rate for Payer: UnitedHealthcare Commercial	$83.00
Rate for Payer: UnitedHealthcare Community & State	$10.00
Rate for Payer: Wellpoint Medicaid Managed Care	$11.00

DRILL BIT SHORT 2.8MM

Facility

$415.00

Hospital Charge Code	270668130
Hospital Revenue Code	272
Min. Negotiated Rate	$62.25
Max. Negotiated Rate	$62.25
Rate for Payer: Qualcare PPO/HMO/WC	$62.25

DRILL BIT SOLID

Facility

$790.00

Hospital Charge Code	270686748
Hospital Revenue Code	272
Min. Negotiated Rate	$118.50
Max. Negotiated Rate	$118.50
Rate for Payer: Qualcare PPO/HMO/WC	$118.50

DRILL BIT SOLID

Facility

$790.00

Hospital Charge Code	270686748
Hospital Revenue Code	272
Min. Negotiated Rate	$19.04
Max. Negotiated Rate	$395.00
Rate for Payer: Aetna Commercial	$300.20
Rate for Payer: Aetna Medicare Advantage	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.45
Rate for Payer: Cigna Commercial	$395.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.00
Rate for Payer: Oxford Commercial	$158.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.50
Rate for Payer: UnitedHealthcare Commercial	$158.00
Rate for Payer: UnitedHealthcare Community & State	$19.04
Rate for Payer: Wellpoint Medicaid Managed Care	$20.93

DRILL BIT SOLID SIDE CUTTING 2

Facility

$550.00

Hospital Charge Code	270665012
Hospital Revenue Code	270
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

DRILL BIT SOLID SIDE CUTTING 2

Facility

$550.00

Hospital Charge Code	270665012
Hospital Revenue Code	270
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$275.00
Rate for Payer: Aetna Commercial	$209.00
Rate for Payer: Aetna Medicare Advantage	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.25
Rate for Payer: Cigna Commercial	$275.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.00
Rate for Payer: Oxford Commercial	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$110.00
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

DRILL BIT STD 2MM

Facility

$1,370.00

Hospital Charge Code	270674061
Hospital Revenue Code	272
Min. Negotiated Rate	$33.02
Max. Negotiated Rate	$685.00
Rate for Payer: Aetna Commercial	$520.60
Rate for Payer: Aetna Medicare Advantage	$411.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.35
Rate for Payer: Cigna Commercial	$685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.00
Rate for Payer: Oxford Commercial	$274.00
Rate for Payer: Qualcare PPO/HMO/WC	$205.50
Rate for Payer: UnitedHealthcare Commercial	$274.00
Rate for Payer: UnitedHealthcare Community & State	$33.02
Rate for Payer: Wellpoint Medicaid Managed Care	$36.30

DRILL BIT STD 2MM

Facility

$1,370.00

Hospital Charge Code	270674061
Hospital Revenue Code	272
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$205.50
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

DRILL BIT STD 3MM

Facility

$1,370.00

Hospital Charge Code	270674058
Hospital Revenue Code	272
Min. Negotiated Rate	$205.50
Max. Negotiated Rate	$205.50
Rate for Payer: Qualcare PPO/HMO/WC	$205.50

DRILL BIT STD 3MM

Facility

$1,370.00

Hospital Charge Code	270674058
Hospital Revenue Code	272
Min. Negotiated Rate	$33.02
Max. Negotiated Rate	$685.00
Rate for Payer: Aetna Commercial	$520.60
Rate for Payer: Aetna Medicare Advantage	$411.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$349.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$349.35
Rate for Payer: Cigna Commercial	$685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$411.00
Rate for Payer: Oxford Commercial	$274.00
Rate for Payer: Qualcare PPO/HMO/WC	$205.50
Rate for Payer: UnitedHealthcare Commercial	$274.00
Rate for Payer: UnitedHealthcare Community & State	$33.02
Rate for Payer: Wellpoint Medicaid Managed Care	$36.30

DRILL BIT STEP 2.5 MM

Facility

$1,475.00

Hospital Charge Code	270683543
Hospital Revenue Code	272
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.50
Rate for Payer: Oxford Commercial	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$295.00
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

DRILL BIT STEP 2.5 MM

Facility

$1,475.00

Hospital Charge Code	270683543
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

Know your out-of-pocket cost for care.

All Charges